Digital Commons Network^™

Impact Evaluation Of The Brfss In New York On Obesity Prevention For Weight Loss Among Women, Nikisha Skeete

Walden Dissertations and Doctoral Studies

Abstract Obesity has increased among the adult population, specifically women, in the United States within the past few decades. While the increase in obesity has been linked to a lack of physical activity and poor dietary intake, obesity lacks contextual analysis within adult women as a group. The purpose of this quantitative study was to examine the impact of the Behavioral Risk Factor Surveillance System (BRFSS) on obesity prevention for weight loss in women. Health behavior change theory, the transtheoretical theory model, and the health behavior model guided this study. The research questions were designed to examine whether modifiable lifestyle …

The Lived Experience Of Older, Independent Residents During The Covid-19 Pandemic, Karen Graeb Stanley

Walden Dissertations and Doctoral Studies

The growing older population confronting the risks of the COVID-19 pandemic have a story to tell of their experiences that may influence the way society confronts future pandemics. Little research has been done on older adults in independent living communities and their experiences with the COVID-19 pandemic. This study aimed to fill that gap using the biopsychosocial model as a framework to guide the exploration of the research question addressing the lived experiences of older, independent residents during the COVID-19 pandemic. Using a basic qualitative analysis design, a purposive sample of 10 participants from a continuing care retirement community were …

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 …

Weight Management Clinical Practice Guidelines For The Obese, Pre-Diabetic, And Diabetic Population, Dawn Williams

Walden Dissertations and Doctoral Studies

AbstractDiabetes is among chronic or lifestyle-related illnesses posing health care challenges at epidemic proportions, pressuring health care systems infrastructure for positive outcome-driven practices and sustainable costs, as continued research suggests that obese people are up to 80 times more likely to develop type 2 diabetes. In June 2021, a weight-loss and wellness center serving this high-risk population established recommended guidelines for Hemoglobin A1C (HbA1C) screening and education. During the initial 3 months of implementation, data findings captured 37% in a total of 220 with elevated HbA1C levels. The gap in practice is that the Wellness Center did not have a …

Exploring The Behavioral Health Clinician Shortage At A Rural Midwestern U.S. Agency, Tracy L. Wilson

Walden Dissertations and Doctoral Studies

Behavioral health clinician shortages are a significant and ongoing problem in the United States, especially in rural areas, which have higher rates of homelessness, suicide, substance use, and violence rates than urban areas. The purpose of this qualitative case study was to explore factors contributing to the behavioral health clinician shortage in a rural midwestern U.S. public health department. The goal was to gain a better understanding of this shortage and explore strategies and solutions for recruiting and retaining behavioral health clinicians at the agency’s facilities. The Baldrige excellence framework undergirded the investigation. Data sources included interviews with three administrative …

Self-Monitoring In Military Consumer Research, Alan Oliver Wright

Walden Dissertations and Doctoral Studies

Underutilized military products exist among soldiers and can reduce safety, performance, and morale. The purpose of this study was to determine the extent to which self-monitoring constructs (Self-Monitoring, Acting, Extraversion, and Other-Directedness), gender, leadership, length of service, deployments, and combat experience predict military consumer attitudes. Self-monitoring theory describes differences in expressive control and self-presentation to predict consumer attitudes and behavior. High self-monitors alter their consumer behavior to gain social favor and low self-monitors base their consumer decisions on product quality, functionality, and internally held views of self. An archival dataset was used with 220 active-duty soldiers who provided liking ratings …

Serglycin Is Involved In Tgf-Β Induced Epithelial-Mesenchymal Transition And Is Highly Expressed By Immune Cells In Breast Cancer Tissue, Marta Tellez-Gabriel, Xavier Tekpli, Trine M Reine, Beate Hegge, Stephanie R Nielsen, Meng Chen, Line Moi, Lisa Svartdal Normann, Lill-Tove R Busund, George A Calin, Gunhild M Mælandsmo, Maria Perander, Achilleas D Theocharis, Svein O Kolset, Erik Knutsen

Faculty, Staff and Student Publications

Serglycin is a proteoglycan highly expressed by immune cells, in which its functions are linked to storage, secretion, transport, and protection of chemokines, proteases, histamine, growth factors, and other bioactive molecules. In recent years, it has been demonstrated that serglycin is also expressed by several other cell types, such as endothelial cells, muscle cells, and multiple types of cancer cells. Here, we show that serglycin expression is upregulated in transforming growth factor beta (TGF-β) induced epithelial-mesenchymal transition (EMT). Functional studies provide evidence that serglycin plays an important role in the regulation of the transition between the epithelial and mesenchymal phenotypes, …

Cancer Prevention Behaviors In Workers Of A Referral Cancer Center In Mexico City: A Pilot Study On Early Detection Awareness For Cancer, Nancy Reynoso-Noverón, Shine Chang, Luis Alonso Herrera-Montalvo, Abelardo Meneses-García

Faculty, Staff and Student Publications

Background: Prevention strategies for cancer are necessary. Health workers who often serve as role models bear responsibility for prevention counseling and programs. However, whether their habits and behaviors reflect prevention goals are unknown. We describe the prevalence of cancer risk factors and prevention behaviors in health workers of a referral cancer center in Mexico City.

Methods: Cross-sectional study in which workers of the National Cancer Institute were invited to participate in a prevention program, risk factor survey, and nutrition, psychological, and genetic counseling were included. The likelihood of cancer was calculated based on the presence of risk factors. Factors associated …

Analysis Of Variation In Pre-Procedural Fasting Duration For Common Inpatient Gastrointestinal Procedures, Vorada Sakulsaengprapha, Michael Daniel, Jiarui Cai, Diego A. Martinez, Simon C. Mathews

2020-Current year OA Pubs

BACKGROUND: Gastrointestinal procedures generally require pre-procedural fasting to optimize sedation safety. While the American Society of Anesthesiologists (ASA) recommends no intake of clear liquids and solid food 2-4 and 6-8 hours respectively prior to endoscopic procedures, the actual nil per os (NPO) duration for these procedures in practice is unknown. Our objective was to analyze NPO duration for patients undergoing these procedures and to determine its association with clinical and administrative variables.

METHODS: Inpatient data from 2016-2018 for the three procedures was extracted from electronic medical records and administrative data at a single-center tertiary academic medical center. Various statistical tests …

High-Resolution Metabolomics Of Exposure To Tobacco Smoke During Pregnancy And Adverse Birth Outcomes In The Atlanta African American Maternal-Child Cohort, Youran Tan, Dana Boyd Barr, P Barry Ryan, Veronika Fedirko, Jeremy A Sarnat, Audrey J Gaskins, Che-Jung Chang, Ziyin Tang, Carmen J Marsit, Elizabeth J Corwin, Dean P Jones, Anne L Dunlop, Donghai Liang

Faculty, Staff and Student Publications

Exposure to tobacco smoke during pregnancy has been associated with a series of adverse reproductive outcomes; however, the underlying molecular mechanisms are not well-established. We conducted an untargeted metabolome-wide association study to identify the metabolic perturbations and molecular mechanisms underlying the association between cotinine, a widely used biomarker of tobacco exposure, and adverse birth outcomes. We collected early and late pregnancy urine samples for cotinine measurement and serum samples for high-resolution metabolomics (HRM) profiling from 105 pregnant women from the Atlanta African American Maternal-Child cohort (2014-2016). Maternal metabolome perturbations mediating prenatal tobacco smoke exposure and adverse birth outcomes were assessed …

Rhamnose Is Superior To Mannitol As A Monosaccharide In The Dual Sugar Absorption Test: A Prospective Randomized Study In Children With Treatment-Naïve Celiac Disease, Lori R Holtz, Julie Hoffmann, Laura Linneman, Mai He, Thomas C Smyrk, Ta-Chiang Liu, Nurmohammad Shaikh, Cynthia Rodriguez, Roy B Dyer, Ravinder J Singh, William A Faubion

2020-Current year OA Pubs

BACKGROUND AND AIM: We sought to correlate two different measures of gut permeability [lactulose:mannitol (L:M) and lactulose:rhamnose (L:R)] to the severity of duodenal histopathology in children with and without elevated antibodies to tissue transglutaminase (tTG). A secondary objective was to correlate gut permeability with celiac disease (CD) serology and indices of inflammation and bacterial product translocation.

METHODS: We prospectively randomized children undergoing endoscopy with abnormal (

RESULTS: Of the 54 cases with positive celiac serology, 31 and 69% had modified Marsh 0/1 scores or ≥3a, respectively. Circulating tTG IgA correlated with the modified Marsh score (

CONCLUSIONS: L:R, but not …

Establishment And Validation Of Pre-Therapy Cervical Vertebrae Muscle Quantification As A Prognostic Marker Of Sarcopenia In Patients With Head And Neck Cancer, Brennan Olson, Jared Edwards, Catherine Degnin, Nicole Santucci, Michelle Buncke, Jeffrey Hu, Yiyi Chen, Clifton D Fuller, Mathew Geltzeiler, Aaron J Grossberg, Daniel Clayburgh

Faculty, Staff and Student Publications

Background: Sarcopenia is prognostic for survival in patients with head and neck cancer (HNC). However, identification of this high-risk feature remains challenging without computed tomography (CT) imaging of the abdomen or thorax. Herein, we establish sarcopenia thresholds at the C3 level and determine if C3 sarcopenia is associated with survival in patients with HNC.

Methods: This retrospective cohort study was conducted in consecutive patients with a squamous cell carcinoma of the head and neck with cross-sectional abdominal or neck imaging within 60 days prior to treatment. Measurement of cross-sectional muscle area at L3 and C3 levels was performed from CT …

Loss Of Function Of Wfs1 Causes Er Stress-Mediated Inflammation In Pancreatic Β-Cells, Shuntaro Morikawa, Lindsey Blacher, Chinyere Onwumere, Fumihiko Urano

2020-Current year OA Pubs

Wolfram syndrome is a rare genetic disorder characterized by juvenile-onset diabetes mellitus, optic nerve atrophy, hearing loss, diabetes insipidus, and progressive neurodegeneration. Pathogenic variants in the

Diabetic Retinopathy As A Predictor Of Cardiovascular Morbidity And Mortality In Subjects With Type 2 Diabetes, Joan Barrot, Jordi Real, Bogdan Vlacho, Pedro Romero-Aroca, Rafael Simó, Didac Mauricio, Manel Mata-Cases, Esmeralda Castelblanco, Xavier Mundet-Tuduri, Josep Franch-Nadal

2020-Current year OA Pubs

This study aimed to evaluate the predictive value of diabetic retinopathy (DR) and its stages with the incidence of major cardiovascular events and all-cause mortality in type 2 diabetes mellitus (T2DM) persons in our large primary healthcare database from Catalonia (Spain). A retrospective cohort study with pseudo-anonymized routinely collected health data from SIDIAP was conducted from 2008 to 2016. We calculated incidence rates of major cardiovascular events [coronary heart disease (CHD), stroke, or both-macrovascular events] and all-cause mortality for subjects with and without DR and for different stages of DR. The proportional hazards regression analysis was done to assess the …

Hdl Composition, Heart Failure, And Its Comorbidities, Ahmed Diab, Carla Valenzuela Ripoll, Zhen Guo, Ali Javaheri

2020-Current year OA Pubs

Although research on high-density lipoprotein (HDL) has historically focused on atherosclerotic coronary disease, there exists untapped potential of HDL biology for the treatment of heart failure. Anti-oxidant, anti-inflammatory, and endothelial protective properties of HDL could impact heart failure pathogenesis. HDL-associated proteins such as apolipoprotein A-I and M may have significant therapeutic effects on the myocardium, in part by modulating signal transduction pathways and sphingosine-1-phosphate biology. Furthermore, because heart failure is a complex syndrome characterized by multiple comorbidities, there are complex interactions between heart failure, its comorbidities, and lipoprotein homeostatic mechanisms. In this review, we will discuss the effects of heart …

Case Report: "Primary Immunodeficiency"-Severe Autoimmune Enteropathy In A Pediatric Heart Transplant Recipient Treated With Abatacept And Alemtuzumab, Elizaveta Kalaidina, Elizabeth C Utterson, Deepa Mokshagundam, Mai He, Shalini Shenoy, Megan A Cooper

2020-Current year OA Pubs

Disorders of immune dysregulation following heart transplantation in children have been reported; however, the management of such disorders remains uncertain and challenging. In this case report, we describe a clinical course of a child with severe autoimmune enteropathy after a heart transplant in infancy and detail a treatment approach with abatacept and alemtuzumab. A 21-month-old girl with a medical history of congenital dilated cardiomyopathy and heart transplantation at 2 months was evaluated for chronic hematochezia. The patient underwent an extensive workup, including endoscopic biopsy which showed crypt apoptosis, similar to that seen with graft-versus-host disease (GVHD). Results of her immune …

Barriers And Facilitators To Diabetes Screening And Prevention After A Pregnancy Complicated By Gestational Diabetes, Drishti D. Sinha, Roxann C. Williams, Laura N. Hollar, Hannah R. Lucas, Bethany Johnson-Javois, Heidi B. Miller, Amanda Stoermer, Graham A. Colditz, Aimee S. James, Cynthia J. Herrick

2020-Current year OA Pubs

OBJECTIVE: Gestational diabetes mellitus (GDM) is increasing in the United States, with higher rates among minoritized racial and ethnic populations and lower income populations. GDM increases risk for type 2 diabetes (T2DM), and postpartum diabetes screening and prevention are imperative. This qualitative study examines barriers and facilitators to postpartum T2DM screening and prevention among non-privately insured individuals with a history of GDM in a state prior to Medicaid expansion.

METHODS: Thirty-six non-privately insured women with a history of GDM completed semi-structured interviews. Four focus groups and seven interviews were conducted with 30 nurse practitioners, physicians, physician assistants, nurses and registered …

Deep Learning Auto-Segmentation Of Cervical Skeletal Muscle For Sarcopenia Analysis In Patients With Head And Neck Cancer, Mohamed A Naser, Kareem A Wahid, Aaron J Grossberg, Brennan Olson, Rishab Jain, Dina El-Habashy, Cem Dede, Vivian Salama, Moamen Abobakr, Abdallah S R Mohamed, Renjie He, Joel Jaskari, Jaakko Sahlsten, Kimmo Kaski, Clifton D Fuller

Faculty, Staff and Student Publications

Background/purpose: Sarcopenia is a prognostic factor in patients with head and neck cancer (HNC). Sarcopenia can be determined using the skeletal muscle index (SMI) calculated from cervical neck skeletal muscle (SM) segmentations. However, SM segmentation requires manual input, which is time-consuming and variable. Therefore, we developed a fully-automated approach to segment cervical vertebra SM.

Materials/methods: 390 HNC patients with contrast-enhanced CT scans were utilized (300-training, 90-testing). Ground-truth single-slice SM segmentations at the C3 vertebra were manually generated. A multi-stage deep learning pipeline was developed, where a 3D ResUNet auto-segmented the C3 section (33 mm window), the middle slice of the …

Mothers’ Perceptions Of Quality Of Life After A Prison Nursery Program, Gwendolyn D. Burke

Walden Dissertations and Doctoral Studies

AbstractRoughly 1,400 babies are born annually to incarcerated women in the United States. A few mothers keep their babies with them in a prison nursery program. Most incarcerated women return to living in a community setting. The purpose of this qualitative study was to explore the experience of mothers transitioning from a prison nursery program to a community-based program with their prison-born child and their perception of their quality of life (QOL) postincarceration. Sen’s capability approach of well-being, including a multidimensional measure of QOL, was the theoretical foundation for this study. In-depth semistructured interviews were used to explore the experience …

Obesity's Impact Among Asian Americans In Southern California, Alyssa Mae Sunga Carlos

Walden Dissertations and Doctoral Studies

Obesity continues to be an important public health issue in the United States, especially among minority populations. However, one minority group experiences the lowest obesity rate: Asian Americans. As a result, there is not much research available involving the impact of obesity and weight gain among this population. The purpose of this basic qualitative exploratory study was to improve the understanding of obesity’s impact on the Asian American population, specifically in Southern California, whose goals were to lose weight and become more informed about obesity’s impact on health. The study consisted of three main research questions. Twenty-five participants were interviewed …

Understanding Effective Parental Involvement Activities Across Ses, Monique Antoinette Carrington Young

Walden Dissertations and Doctoral Studies

Parental involvement is pivotal for impoverished middle school students to achieve academic achievement. The purpose of this study was to evaluate the relationship of parental involvement activities and academic achievement for impoverished middle school students. Epstein’s six parental involvement types was the theoretical framework for the research study. The six independent variables of parental involvement were parenting, volunteering, learning at home, decision making, communicating, and collaborating with community The relationship for each parental involvement activated to academic achievement as measured by grade point average was evaluated. A quantitative research design was applied using archival data from the U.S. Department of …

The Mother-Daughter Attachment-Bond In Adulthood After Childhood Sexual Abuse, Dionne Carla Dauphin

Walden Dissertations and Doctoral Studies

AbstractChildhood sexual abuse (CSA) may have a significant impact on the attachment bond between adult women and their mothers when CSA is disclosed during childhood. When CSA is known by the mother during the period of abuse, and she failed to intervene on behalf of her daughter, there can be long-lasting effects on the mother-daughter attachment bond in the future. There is a gap in the research literature regarding the attachment bond between the mother-daughter dyad in adulthood influenced by CSA known by the mother during the period of abuse. The purpose of this phenomenological study was to understand the …

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 …

Organizational Barriers To Effective University Student Mental Health Services, Felicia Evans-Edwards

Walden Dissertations and Doctoral Studies

This study was focused on organizational barriers to effective university student mental health services access in the department of student resources (DSR) at a for-profit university in the northeastern United States. Once such barriers are addressed, faculty may be more successful in reaching out to students needing mental health services who are not self-identifying as needing these services. The Baldrige excellence framework guided this descriptive case study to examine the organizational barriers that prevent university leadership from creating clear policies and procedures for faculty to refer students to mental health services. Data sources included interviews with the behavioral health leader …

Chronic Kidney Disease And Depressive Disorders Among Adult Non-Hispanic African Americans And Whites In Georgia, Omatola Gordon-Rose

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD), depressive disorders, and mental health are significant health issues in the United States. The purpose of this study was to examine the association of CKD and depressive disorders and days of poor mental health in adults living in Georgia, controlling for race/ethnicity, socioeconomic status, gender, age, diabetes mellitus status, high blood pressure status, marital status, and number of adults in the household. The study was a descriptive, quantitative, cross-sectional design with secondary data analysis, and the framework used was Wilson and Cleary health-related quality of life measures. The 2019 Behavioral Risk Factor Surveillance System Survey weighted …

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 …

The Role Of Health And Diet In The Development Of Metabolic Syndrome Stratified By Race, Sex, And Age, Michael D. Harada

Walden Dissertations and Doctoral Studies

Obesity is now recognized as a disease in need of treatment by the medical profession and is associated with other chronic diseases including hypertension, hyperglycemia, hypertriglyceridemia, insulin-resistance, and reduced levels of high density lipoproteins. Metabolic syndrome (MetS) occurs when a combination of at least three of these chronic conditions are comorbid with each other. The purpose of this quantitative cross-sectional study was to find significant health and nutritional predictors of MetS status across race, sex, and age. The evolutionary mismatch hypothesis and health belief model provided the framework for this study. Data were collected from 2,303 participants from the 2015-2016 …

Parents’ Perceptions: Strategies To Motivate Lower-Elementary Children’S Virtual Emergency Learning During Covid-19, Brittany Harden

Walden Dissertations and Doctoral Studies

During the 2020–2021 school year, many students were forcibly shifted from traditional in-person learning to virtual emergency response learning (ERL) due to the COVID-19 pandemic. During this shift, many lower-elementary school students suffered socially, emotionally, and academically due to lack of infrastructure, social isolation, and the loss of direct instruction from educators. Because of this loss, many parents had different responsibilities to their children’s social, emotional, and academic well-being. Research has not provided practical, motivational strategies used by parents to motivate their lower-elementary school children during virtual ERL during COVID-19 pandemic. The purpose of this study was to examine parents’ …

Healthcare Management Strategies For Achieving Sustainable Departmental Productivity Improvements, Timothy Hargrove

Walden Dissertations and Doctoral Studies

Healthcare organizations’ leaders' lack of strategies to effectively deploy and monitor departments’ productivity goals affect overall organizations’ performance. Healthcare leaders who fail to deploy and monitor departmental productivity strategies effectively are limited to enhancing healthcare organizations’ performance outcomes. Grounded in transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies healthcare organizations’ leaders use to effectively identify, deploy, and monitor departments’ goals for improving their overall organization's performance. The participants were 20 healthcare leaders who successfully demonstrated success in improving their organizations’ departmental-specific productivity performance. Data were collected using semistructured interviews and a review of …

Lead Toxicity, Attention–Deficit Hyperactivity Disorder, And Gun Violence Among Young African American Men, Gwendolyn Hooker-Mcintosh

Walden Dissertations and Doctoral Studies

Violence among adolescents and young adults is a major public health concern in the United States, but it disproportionally affects African Americans. This racial disparity is especially concerning in New Orleans, Louisiana, where fatal and nonfatal shootings have been consistent since 2010 for young African American men. Also, Louisiana ranks third in the nation in prevalence of attention–deficit hyperactivity disorder (ADHD) among children. African Americans in New Orleans have lived in areas known to have greater concentrations of lead in the soil, and African American children and their parents have a lower level of awareness of lead toxicity. The purpose …