Digital Commons Network^™

Impact Of Prolonged Isolation On Adolescents With Drug-Susceptible Tuberculosis In Lima, Peru: A Qualitative Study, Victoria Elena Rapoport, Elmer Altamirano, Liz Senador, Milagros Wong, Catherine B. Beckhorn, Julia Coit, Stephanie D. Roche, Leonid Lecca, Jerome T. Galea, Silvia S. Chiang

Social Work Faculty Publications

Objectives Patients with tuberculosis (TB) generally are instructed to isolate at the beginning of treatment in order to prevent disease transmission. The duration of isolation varies and may be prolonged (ie, lasting 1 month or more). Few studies have examined the impact of isolation during TB treatment on adolescents, who may be more vulnerable to its negative effects.

Methods This study took place from 2018 through 2019 in Lima, Peru, where the Ministry of Health mandates the exclusion of patients with TB from educational institutions for at least 2 months. Using semi-structured guides, we conducted individual in-depth interviews with adolescents …

Ecmo: A Representative Descriptive Analysis Of 2018 Florida Billing Data, Robert F. Sparks

MUSC Theses and Dissertations

Since the inception of Extracorporeal Membrane Oxygenation (ECMO) in the early 1970’s, technological advances and increased understanding and implementation of ECMO protocols have produced exponentially better outcomes. With improved outcomes, use of ECMO has dramatically risen in the last several decades. The purpose of this study is to define the modalities of ECMO and their purposes, as well as potential complications and contraindications. Furthermore, research was conducted into determining important factors in patient outcomes such as patient characteristics, readmission rates, and success of the therapy. Patient data was scrutinized to determine if any categorical particularly affected the overall costs and …

Needs Assessment For Community Health Center In Cantel Guatemala, Justin R. Gassner

MUSC Theses and Dissertations

Background: Implementation of a medical clinic is part of the strategic plan for Colegio Mark, a primary and secondary school in Cantel, Guatemala with a 41-year relationship with Colonial Presbyterian Church in Kansas City, Missouri. Due to resource constraints, prioritization of top health concerns and implementation of targeted solutions is key. The aim of this needs assessment is to determine how best to improve health outcomes in Cantel. Methods: Information was collected through 17 qualitative interviews, then analyzed through an affinity diagram with strengths, weakness, opportunities, and threats (SWOT analysis) as the categories. The findings were plotted on an impact …

Strategies To Reduce Flight Attendant Voluntary Turnover, Jorge Tobar

Walden Dissertations and Doctoral Studies

Flight attendant voluntary turnover can lead to staffing shortages that can cause severe disruptions to flight schedules, damage the airlines’ reputations, and negatively affect revenues, which are significant challenges for airline leaders. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies airline leaders use to reduce flight attendant voluntary turnover. Data were collected from four leaders from four U.S. airlines in the southwestern United States using semistructured interviews and reviews of organizational documents. Five themes emerged from thematic analysis: improving compensation and benefits packages, implementing rewards and recognition programs, increasing supervisory support, expanding …

Guidelines For Managing Dysautonomia Dysfunction, Angela Coleman Webb

Walden Dissertations and Doctoral Studies

Dysautonomia dysfunction (DD) is a disorder of the autonomic nervous system. Over 70 million people suffer from some type of DD, and the average length of time from symptoms to diagnosis is 6 years. Most facilities and providers choose not to treat DD due to the number of symptoms and the difficulty of being able to diagnose correctly. The purpose of this project study was to create guidelines for the diagnosis, treatment, and management of DD. The research question addressed the effectiveness of these guidelines to help nurses and providers caring for patients with DD provide better care. Watson’s theory …

Social Capital And Food Insecurity In Two Counties In Wisconsin, Yvonne Denise Greer

Walden Dissertations and Doctoral Studies

Hunger and food insecurity are public health issues with 38 million people in the US struggling with food hardship. This study examined if there was a relationship between four types of social capital (SC) (bonding, bridging, community structural-formal, and community structural-informal), income, and food insecurity risk (FIR), in two counties in Wisconsin. A quantitative descriptive correlational study design involving multiple linear regression analysis and the integral model framework was conducted with cross-sectional secondary data from the 2014-2016 Survey of the Health of Wisconsin. Participants were from Milwaukee (n = 335) and Dane County (n = 235). Results revealed that in …

Family Childcare Providers’ Perspectives On Participating In Quality Improvement Using National Association For Family Child Care Accreditation, Mary Muhs

Walden Dissertations and Doctoral Studies

Few family child care providers attain accreditation in the research state and little research existed as to why family childcare providers make the decision to participate or not in National Association for Family Child Care Accreditation (NAFCC). The purpose of this qualitative study was to explore perspectives and experiences of family childcare providers, in the research state, regarding the decision-making process related to their participation in NAFCC Accreditation. The conceptual framework consisted of both andragogy and growth mindset; guiding the research questions to explore providers’ perspectives and experiences about the decision-making process related to participating in quality improvement initiatives and …

Nursing Education For Central Line-Associated Bloodstream Infections In Intensive Care Units, Carren Sandra Mullings

Walden Dissertations and Doctoral Studies

Central line associated blood stream infections (CLABSIs) are the most acquired hospital infection in the United States. CLABSI is caused by bacteria that enter the bloodstream through a central line. In the United States, CLABSI has a mortality rate of 18%, and every year 250,000 people are infected. Of these, 30,000 patients die due to CLABSI infections, hospital stays are prolonged, and hospital costs are increased. Patients in an intensive care unit (ICU) are more exposed to CLABSI because of procedures that break tissues and skin, such as the insertion of a central line. A gap in practice was identified …

How Teachers Support Students' Nutrition And Healthy Choices To Reduce Childhood Obesity, Angela Munns

Walden Dissertations and Doctoral Studies

Obesity is an issue that negatively effects the health and wellbeing of children across theU.S. The problem addressed by this study was the increasing percentage of obesity among elementary students in a southeastern school district. Guided by Bandura’s social learning theory, the purpose of this basic qualitative study was to explore the perceptions of elementary teachers about increasing student obesity and the challenges they faced in teaching students about health issues in the local school setting. Ten elementary teachers who had knowledge of nutrition and awareness of the student obesity and overweight issues at the study site participated in semistructured …

Factors Affecting Fetal Death Among Women With Cesarean Section(S) In The United States, Iheanyi Emmanuel Nwosuh

Walden Dissertations and Doctoral Studies

AbstractThe United States has a higher rate of fetal death compared to other industrialized nations. Although many studies on the factors that contribute to fetal death have been conducted among women in general, little of this phenomenon is known among women who have had a previous Cesarean section (C-section). The purpose of this study was to explore the factors of fetal death among women with a previous C-section(s) and offer suggestions for interventions. The social determinants of health theory was used with other social constructs to provide a theoretical and conceptual framework for the study. As part of the cross-sectional …

Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques

Walden Dissertations and Doctoral Studies

AbstractZika virus is an infectious disease caused by the bite of an infected mosquito that has been linked to increased rates of microcephaly and other devastating birth defects. The existing body of knowledge has focused on the individual-level factors that influence a person’s decisions about prevention activities and risk perceptions related to Zika virus. The purpose of this study was to determine the relationship between state-level plans for prevention and education and individual-level risk perceptions. Rosenstock’s health belief model lays a foundation for why individuals make the health decisions they do and helps explain how these can be influenced for …

Title I Middle School Teacher And Principal Perspectives On Inquiry-Based Science Instruction, Kirsten R. King

Walden Dissertations and Doctoral Studies

Title I middle schools face challenges delivering effective inquiry-based science instruction within the framework of Title I requirements. The purpose of this basic qualitative study was to explore Title I middle school teacher and principal perspectives on and experiences with the challenges of delivering inquiry-based science instruction within the framework of Title I requirements. Dewey’s theories of experiential learning and Vygotsky’s theory of sociocultural constructivism provided the conceptual framework for this study. The research questions focused on teacher and principal experiences with inquiry-based science instruction and the impact Title I school policies and practices had on the delivery of inquiry-based …

Developing Resiliency Knowledge In New Graduate Nurses Through Self-Care Education, Keera Byrd

Walden Dissertations and Doctoral Studies

During the transition to practice, new graduate nurses (NGNs) face conflict and uncertainty influenced by lack of resiliency and self-care knowledge. In a rural hospital, NGNs had minimal standardized guidance during the transition to practice. Without a proper understanding of resiliency and self-care knowledge, NGNs could not adapt to change and risked leaving the profession or harming patients. A self-care staff education project was developed to improve knowledge of resiliency in a group of NGNs. Self-care deficit theory provided the framework for the project. Sources of evidence published between 2017 and 2022 were used as well as previously analyzed data …

Enterprise Resource Planning Implementation Strategies In Small- And Medium-Sized Manufacturing Enterprises, Tatianna Gilliam

Walden Dissertations and Doctoral Studies

The difficulty SME leaders of manufacturing firms experience in the executing of enterprise resource planning (ERP) systems threatens the longevity of innovative change within firms seeking to adopt ERP systems. Grounded in the diffusion of innovation theory, the purpose of this multiple case study was to examine critical success factors used to successfully implement ERP systems. The participants were four ERP business leaders of small to medium size manufacturing firms based on the east and west coasts of the United States. Data were collected using semistructured online interviews and a review of company documents. Through thematic analysis, five themes were …

Staff Education For Implementation Of A Mobile Phone App For Diabetes Self-Management, Iheoma Christiana Madubuike

Walden Dissertations and Doctoral Studies

AbstractDiabetes is a global public health problem responsible for increased healthcare costs, altered quality of life, and significant morbidity and mortality. Mobile applications have become an effective lifestyle modification tool for ongoing individual diabetes monitoring and management; however, the project site had not been using this technology with their diabetes patients. Guided by the chronic care model, this staff education project explored the likelihood that clinicians in a family practice group in the Southeast region of the United States would implement a mobile application for their patients following an evidence-based education session. The staff education project was developed using evidence …

Staff Nurse Education On Best Practices For Preventing Blood-Borne Pathogen Exposures, Moriohunmubo Grace Omonayin

Walden Dissertations and Doctoral Studies

Blood-borne pathogens (BBPs) are an occupational risk confronted by many health care workers. Nurses are routinely exposed to Hepatitis B, Hepatitis C, and human immunodeficiency virus. A literature review, which included retrieval of peer-reviewed quantitative articles, systematic reviews, and mixed-methods studies published between 2014 and 2021 supported the need for nurses to be knowledgeable about prevention of BBP exposures and the processes to follow after an incident. The project aimed to educate staff nurses on the best practices for preventing the risk for and transmission of BBPs. A pretest–education–posttest format was used to assess knowledge before and after the presentation …

Evaluation Of A Public School District Nutrition Education Program In Southern California’S San Diego County, Donielle Cohen

Walden Dissertations and Doctoral Studies

The prevalence of obesity among children and adolescents has markedly increased in several developed countries in recent years. Researchers have examined different factors that contribute to overweight and obesity in children and adolescents but have not fully explored the psychological impact of obesity on this population. The effectiveness of nutrition education programs in addressing the effects of obesity is also understudied. The primary purpose of this evaluative case study was to examine the impact of the Harvest of the Month nutritional educational program, which was adopted by San Diego County public schools in 2005, on the nutritional habits and psychosocial …

Educators' Perspectives On Coordination Of Transition Programming For Early Childhood Students With Asd In Inclusive Settings, Lashundra Dees

Walden Dissertations and Doctoral Studies

Coordination of special education prekindergarten (PK) to kindergarten (K) transition programming for children with autism spectrum disorder (ASD) represents significant changes for students within inclusive school environments. The problem addressed by this basic qualitative study involved barriers, challenges, supports, and successes in the coordination of transition programming from PK to K for students with ASD. This study addressed a gap in the literature on educators' perspectives on the coordination of transition programming. Bronfenbrenner’s ecological systems theory framed this study that explored the perspectives of 11 educators. Data were collected from semistructured digitally audio recorded interviews conducted with six PK and …

The Impact Of Electronic Cigarettes Use On Traditional Cigarette Uses Among U.S. Adolescents, Ismail Mensah Dwumfour-Poku

Walden Dissertations and Doctoral Studies

The increased usage of e-cigarettes among adolescents in the United States (U.S.) is a major public health concern. According to the Centers for Disease Control and Prevention (CDC), nicotine, an active ingredient in e-cigarettes, is the most addictive drug in use today. The purpose of the current study was to explore the relationship between smoking of e- cigarettes and the risk of smoking traditional cigarettes among middle and high school students in Grades 6 through 12 in the U.S., and to determine if demographic factors contribute to this predisposition. This, quantitative cross-sectional study used the social ecological model as the …

Relationship Between Early Years’ Activities Of Daily Living And Alzheimer’S Disease Onset, Linyi Fan

Walden Dissertations and Doctoral Studies

A few promising studies have indicated that activities of daily life (ADL) may be a useful way of predicting Alzheimer’s Disease (AD). However, the existing cross-sectional studies fail to show how ADLs in early years predict AD, and how social factors influence health either in addition to or in interaction with individual risk factors. Using a social epidemiology framework, this study examined the relationship between early years’ ADL and the development of AD in later years. This quantitative study included 4,526 participants derived from the Health and Retirement Study (HRS) dataset. The dependent variable was whether the participant has been …

Filling The Protection Gaps For Climate Change And Disaster-Induced Migrants, Kimberly A. Erickson

Human Rights Brief

No abstract provided.

Temperature Management During Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy, Maria F. Ramirez, Juan Jose Guerra-Londono, Pascal Owusu-Agyemang, Keith Fournier, Carlos E. Guerra-Londono

Anesthesiology Articles

In addition to attaining complete or near complete cytoreduction, the instillation of select heated chemotherapeutic agents into the abdominal cavity has offered a chance for cure or longer survival inpatients with peritoneal surface malignancies. While the heating of chemotherapeutic agents enhances cytotoxicity, the resulting systemic hyperthermia has been associated with an increased risk of severe hyperthermia and its associated complications. Factors that have been associated with an increased risk of severe hyperthermia include intraoperative blood transfusions and longer perfusion duration. However, the development of severe hyperthermia still remains largely unpredictable. Thus, at several institutions, cooling protocols are employed during cytoreductive …

Tolle Lege Works Published In 2022, Mcquade Library

Bibliographies

Compiled Tolle Lege bibliography of works published by members of the Merrimack College Community in 2022. Works include journal articles, books, book chapters, conference presentations and posters, and more.

Biofilms: Formation, Research Models, Potential Targets, And Methods For Prevention And Treatment, Yajuan Su, Jaime T. Yrastorza, Mitchell Matis, Jenna Cusick, Siwei Zhao, Guangshun Wang, Jingwei Xie

Journal Articles: Pathology and Microbiology

Due to the continuous rise in biofilm-related infections, biofilms seriously threaten human health. The formation of biofilms makes conventional antibiotics ineffective and dampens immune clearance. Therefore, it is important to understand the mechanisms of biofilm formation and develop novel strategies to treat biofilms more effectively. This review article begins with an introduction to biofilm formation in various clinical scenarios and their corresponding therapy. Established biofilm models used in research are then summarized. The potential targets which may assist in the development of new strategies for combating biofilms are further discussed. The novel technologies developed recently for the prevention and treatment …

Performance Of The Universal Vital Assessment (Uva) Mortality Risk Score In Hospitalized Adults With Infection In Rwanda: A Retrospective External Validation Study, Riley Hazard, Danstan Bagenda, Andrew J. Patterson, Julie T. Hoffman, Steven J. Lisco, Olivier Urayeneza, Polyphile Ntihinyurwa, Christopher C. Moore

Journal Articles: Anesthesiology

BACKGROUND: We previously derived a Universal Vital Assessment (UVA) score to better risk-stratify hospitalized patients in sub-Saharan Africa, including those with infection. Here, we aimed to externally validate the performance of the UVA score using previously collected data from patients hospitalized with acute infection in Rwanda.

METHODS: We performed a secondary analysis of data collected from adults ≥18 years with acute infection admitted to Gitwe District Hospital in Rwanda from 2016 until 2017. We calculated the UVA score from the time of admission and at 72 hours after admission. We also calculated quick sepsis-related organ failure assessment (qSOFA) and modified …

An Investigation Of The Sled-Push Exercise In Older Adults: Physiological Quantification, Perceived Enjoyment And Body Discomfort, Micheal A. Baumann

Graduate Research Theses & Dissertations

Healthy aging is defined as the process of maintaining and developing functional ability that allows a state of mental and physical wellbeing. Physical activity, particularly exercise training, has been highly recommended for individuals of all ages, especially older adults, as way to maintain, improve or restore functional ability and health. Different modalities and types of exercise have been successfully tested in older adults but not much is known about the potential of the sled-push exercise in this population, a modality that has been highly used among athletes to improve cardiorespiratory fitness, muscle strength and endurance, and core stability. PURPOSE: The …

Fielding Vaccines-Challenges And Opportunities In Outbreaks, Complex Emergencies, And Mass Gatherings, Laura J. Fischer, Robert C. Rains, Sherry M. Brett-Major, Mikiko Senga, Debra Holden, David Brett-Major

Journal Articles: Epidemiology

With the recent COVID-19 pandemic, the importance of vaccine development, distribution, and uptake has come to the forefront of the public eye. Effectively fielding vaccines during an emergency-whether that emergency is a result of an infectious disease or not-requires an understanding of usual vaccine-related processes; the impact of outbreak, complex emergencies, mass gatherings, and other events on patients, communities, and health systems; and ways in which diverse resources can be applied to successfully achieve needed vaccine uptake. In this review, both the emergency setting and briefly vaccine product design are discussed in these contexts in order to provide a concise …

Differential Methylation Patterns In Lean And Obese Non-Alcoholic Steatohepatitis-Associated Hepatocellular Carcinoma, Emma Hymel, Kurt W. Fisher, Evi A. Farazi

Journal Articles: Epidemiology

BACKGROUND: Nonalcoholic fatty liver disease affects about 24% of the world's population and may progress to nonalcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma (HCC). While more common in those that are obese, NASH-HCC can develop in lean individuals. The mechanisms by which HCC develops and the role of epigenetic changes in the context of obesity and normal weight are not well understood.

METHODS: In this study, we used previously generated mouse models of lean and obese HCC using a choline deficient/high trans-fat/fructose/cholesterol diet and a choline supplemented/high trans-fat/fructose/cholesterol diet, respectively, to evaluate methylation differences in HCC progression in lean versus …

Psychological Impacts Of Covid-19 On Older Adults, Maria Coletta Angiolillo

Renée Crown University Honors Thesis Projects - All

No abstract provided.

Measuring Effectiveness In Community-Based Palliative Care Programs: A Systematic Review, Erin Vernon, M. Courtney Hughes, Monica Kowalczyk

Faculty Articles, Papers, and Other Scholarship

Community-based palliative care (CBPC) serves seriously ill individuals by integrating care for symptom and stress relief with local health care systems. This review provides the first systematic review of the literature to date on the effectiveness of CBPC programs and includes their measures of success, challenges faced, and characteristics of the populations served. A systematic review on CBPC program effectiveness was conducted across four electronic databases for academic articles published through August 2021. PRISMA reporting guidelines were followed throughout this review, study quality was assessed using the Mixed Methods Appraisal Tool, and results were summarized in a narrative synthesis. The …