Digital Commons Network^™

Comorbidity Network Analysis Using Graphical Models For Electronic Health Records, Bo Zhao, Sarah Huepenbecker, Gen Zhu, Suja S Rajan, Kayo Fujimoto, Xi Luo

Faculty, Staff and Student Publications

IMPORTANCE: The comorbidity network represents multiple diseases and their relationships in a graph. Understanding comorbidity networks among critical care unit (CCU) patients can help doctors diagnose patients faster, minimize missed diagnoses, and potentially decrease morbidity and mortality.

OBJECTIVE: The main objective of this study was to identify the comorbidity network among CCU patients using a novel application of a machine learning method (graphical modeling method). The second objective was to compare the machine learning method with a traditional pairwise method in simulation.

METHOD: This cross-sectional study used CCU patients' data from Medical Information Mart for the Intensive Care-3 (MIMIC-3) dataset, …

Enabling Structural Resilience Of Street-Involved Children And Youth In Kenya: Reintegration Outcomes And The Flourishing Community Model, Michael L Goodman, Sarah E Seidel, Andrew Springer, Aleisha Elliott, Christine Markham, Hani Serag, Philip Keiser, Ben Raimer, Lauren Raimer-Goodman, Christine Gatwiri, Kelvin Munene, Stanley Gitari

Faculty, Staff and Student Publications

Introduction: Millions of children and youth live on city streets across the globe, vulnerable to substance use, abuse, material and structural neglect. Structural resilience, the re-establishment of access to structural goods within a society such as housing, education, and healthcare following some interruption, provides an orientation for research and interventional efforts with street-involved children and youth (SICY). Further, a structural resilience framework supports organizing interactions between levels and sectors of a socio-ecology.

Methods: Following the expressed interests of Kenyan SICY, and consistent with emerging policy interests at national and global levels, we assess reintegration trajectories of Kenyan SICY (n …

Pregnancy-Related Covid Worry, Depressive Symptom Severity, And Mediation Through Sleep Disturbance In A Low-Income, Primarily Latinx Population In California’S Central Valley, Jennifer N Felder, Patience A Afulani, Kimberly Coleman-Phox, Serwaa S Omowale, Charles E Mcculloch, Lauren Lessard, Miriam Kuppermann

Faculty, Staff and Student Publications

Purpose: This study (1) assessed the psychometric properties of a pregnancy-related COVID worry scale, (2) explored variations in pregnancy-related COVID worry over the course of the pandemic, and (3) examined associations between pregnancy-related COVID worry and depressive symptom severity, and evaluated sleep disturbance as a mediator.

Methods: Data were drawn from an ongoing randomized trial comparing the effectiveness of two enhanced forms of prenatal care. The current analysis includes baseline pre-randomization data collected from participants who enrolled November 2020-November 2021 (n = 201). Participants were pregnant individuals with low income and primarily Latinx.

Results: Our 7-item scale was valid and …

Maternal Perceptions Of Vaccinating Boys Against Human Papillomavirus (Hpv) In Seoul, South Korea: A Descriptive Exploratory Qualitative Study, Jihye Choi, Christine Markham, Irene Tamí-Maury, Sooyoun Kim, Paula Cuccaro

Faculty, Staff and Student Publications

Human Papillomavirus (HPV) vaccination is of paramount importance to reduce HPV-associated cancers in both genders. In South Korea, the prophylactic vaccine is recognized as prevention of cervical cancer with little attention given to male HPV vaccination. The purpose of this study was to explore perceptions of male HPV vaccination and underlying factors for vaccine hesitancy among mothers of unvaccinated boys in Seoul, Korea using a qualitative method. We used a purposive sampling strategy to recruit mothers of unvaccinated middle school-aged boys living in one of the 25 districts in Seoul, supplemented by a snowball sampling approach. We conducted one-on-one telephone …

The Experiences Of Resettled Liberian Refugees: A Research Study On Whether Public Assistance Can Affect Their Living Standards., Mwalimu Steve Boley

Walden Dissertations and Doctoral Studies

AbstractThe study investigated the extent to which the thoughts, feelings, and attitudes of resettled Liberian refugees in the Delaware Valley region have been affected by their use of public assistance and the overall effect that it has had on their living standards. It also explored whether participants in the study would likely persuade other resettled Liberian refugees in their community to utilize available public assistance programs as a means of improving their living standard. The study utilized Humanist Theory as the theoretical framework to interpret its findings. The research methodology was based on phenomenological approach in which a generic demographic …

Teacher Strategies For Reducing The Achievement Gap For Ell Students, Stephanie Diane Collins

Walden Dissertations and Doctoral Studies

AbstractAn influx in Hispanic English language learners (ELLs) in Atlanta public schools has led to a broadening of the achievement gap between ELLs and native English speakers, causing higher failure rates and fewer career possibilities for Hispanic ELLs upon school completion. The purpose of this basic qualitative study was to investigate the kinds of strategies K through eighth grade teachers use to reduce this achievement gap, specifically in English and math. Vygotsky’s social learning theory guided this study, a key aspect of which is the role dialect and language play in determining a student’s development. The study focused on how …

Customer Relationship Management In The Hotel Industry, Lakewa Davis

Walden Dissertations and Doctoral Studies

The inability to satisfy customers in the hospitality industry is a concern for business managers, as a decrease in customer satisfaction can lead to unhappy customers, which adversely affects business performance and profitability. Grounded in the customer relationship management theory, the purpose of this qualitative multiple-case study was to explore how managers of boutiques improve customer satisfaction and increase profitability. Participants were four boutique hotel managers in the metro Detroit area who successfully improved customer satisfaction and increased profitability. Data were collected from semistructured interviews, customer reviews, hotel website documents, customer indices, and hotel industry reports. Data were analyzed using …

A Phenomenological Examination Of Single Mothers Rising Out Of Poverty, Shaunta Hemingway

Walden Dissertations and Doctoral Studies

Transitional factors that help mothers to acquire higher education, community resources, and stable employment and the family dynamics that impact their success are often shadowed by domestic violence, chronic poverty, substance use, mental health, and public assistance. There are 12 million single-parent households in the United States, of which 80% represent single mothers as primary caregivers to children; the majority of which are living below the poverty level. Few extant studies have employed a strengths-based approach to investigate how single mothers rise out of poverty. The purpose of this qualitative phenomenological study was to gain an understanding of the lived …

Examining The Relationship Between Undergraduate Female Students Marijuana Use And Gpas, Darrel E. Hicks

Walden Dissertations and Doctoral Studies

Marijuana use has been linked to poor undergraduate student academic performance, yet cannabis continues to be the substance most often used by college students. The purpose of the current research was to add to the limited body of literature about the relationship between female undergraduate marijuana use and lower GPAs. The study explored how marijuana use impacted the GPAs of undergraduate African American females. The research question addressed whether a significant relationship exists between marijuana use and lower GPAs for this population. Complex adaptive systems theory was the lens used to better understand the phenomenon during a time of rapid …

Instructional English As A Second Language Practices For Oral Proficiency Development In Chinese English As A Second Language Classrooms, Wallace C. Norwood

Walden Dissertations and Doctoral Studies

AbstractForeign language instructors inconsistently implement instructional practices to support Chinese high school students’ learning of oral English language. Although China has several programs to enhance English second language related competencies and assist students in completing mandatory exams, instructional methodologies do not always allow for achievement of these goals. The purpose of this basic qualitative study was to explore the perceptions of foreign language teachers working in the Hangzhou region of China, specifically regarding their implementation of instructional strategies to support Chinese high school students’ learning of oral English language. Sato and McNamara’s general-purpose second-language oral competency theory served as the …

Preincarceration Collaborative Religious Coping Strategies Of Black Males With A History Of A Criminal Offense, Pearlette E. Springer

Walden Dissertations and Doctoral Studies

African Americans are 56% of the incarcerated population in the United States. Black males spend an average of 13.4% of their working lives incarcerated and 82.6% of their working lives addressing the stigma and restrictions associated with incarceration. The purpose of this study was to address a gap in research by exploring the preincarceration collaborative religious coping strategy experiences of Black males with a history of criminal offenses. Pargament’s theory of collaborative religious coping strategy guided the research, interview questions, and data analysis. The qualitative narrative approach with purposeful and snowball sampling was used to recruit and collect data from …

Strategies To Retain Employees In The Mental Health Workplace, Chauncey Janielle Strange

Walden Dissertations and Doctoral Studies

Employee turnover continues to be an issue in the mental health community as mental health business leaders lack strategies to retain employees. Retention strategies are essential to promote continuity, funding, and profitability for mental health agencies and quality service care for patients. Grounded in Bass’s transformational leadership theory, the purpose of this qualitative single case study was to explore strategies mental health business leaders use to retain employees. Participants comprised three mental health center managers from a state agency in northern Louisiana who contributed to employee retention. Data were collected using semistructured interviews and a review of organization performance evaluations, …

Moderators Of Peripheral Neuropathy On Overall And Cardiovascular Mortality In People Without Diabetes, Adeoye Muideen Adenekan

Walden Dissertations and Doctoral Studies

Peripheral neuropathy (PN), a group of common heterogeneous disorders with varied etiologies, is associated with substantial morbidity and mortality. PN presents both as a diagnostic and therapeutic challenge to physicians and other healthcare providers. Socioeconomic moderators of PN in adults without diabetes in the United States have not been well studied. The consequences of PN can be devastating and include foot ulcers, amputations, a general decline in the quality of life, and death. The overall prevalence of PN in the United States is 13.5% in adults with diabetes and 11.6% in adults without diabetes. Clearly, these statistics indicate a public …

Educating Nurses On Failure To Rescue Due To Treatment Delay, Ganiyu Olasheni Adewale

Walden Dissertations and Doctoral Studies

Studies have found a shortfall in nurses' skills in caring for patients with a significant risk of failure to rescue in an acute care setting. The practice gap the healthcare facility was experiencing today was a gap in relation to failure to rescue with an increased rate of sentinel cases. There was a knowledge deficit among critical care nurses. The importance of educating nursing staff is to increase their knowledge and help decrease the occurrence of failure to rescue in an acute care setting. The practice-focused question for this education project asked if educating nursing staff with a medical-surgical competency …

Strategies That Small And Medium-Size Business Owners Use To Repay Bank Loan Obligations In Lagos, Nigeria, Taiwo Bamikole Ala

Walden Dissertations and Doctoral Studies

The failure of businesses to repay loans adversely affects credit markets. Small and medium-sized (SME) business owners in Lagos, Nigeria, are concerned because financial institutions are unwilling to provide credit because of the low loan repayment performance of those who have received credit in the past. Grounded in the theory of planned behavior, the purpose of this qualitative multiple-case study was to explore strategies some SME owners use to successfully repay bank loan obligations to sustain their businesses. The participants were three SME owners in Lagos, Nigeria, who successfully repaid their bank loans. Data were collected using semistructured interviews and …

Enrollment In Science, Technology, Engineering, And Math Courses After Enactment Of Texas' House Bill 5, Carlana Cla'shette Allen

Walden Dissertations and Doctoral Studies

Student participation and performance in science, technology, engineering, and math (STEM) have been an education concern in the United States for years. In 2013, Texas lawmakers passed House Bill 5 (HB5) to support increases in STEM awareness, particularly among ethnic minority and female students. To date, no studies have been conducted on the impact, if any, of HB5 on Texas high school students’ course selections in STEM areas. Further, it is unknown whether the impact that does exist is equally distributed across socioeconomic status (SES), race/ethnicity, and gender groups. The purpose of this nonexperimental correlational quantitative study was to determine …

Special Education Teachers’ Perceptions Of Cognitive–Behavioral Interventions In The Classroom For Adolescent Autistic Students With Anxiety, Kasey Jane Aposhian

Walden Dissertations and Doctoral Studies

Adolescents with autism spectrum disorder (ASD) often struggle with comorbid disorders like anxiety. However, special education teachers may lack the training to implement specific interventions in the classroom setting for adolescents with ASD and anxiety. This qualitative action research study was conducted to examine how special education teachers work with adolescents diagnosed with both ASD and anxiety. Bandura’s reciprocal determinism concept guided this study by explaining that the classroom environment and adolescents’ cognition and behavior should be considered when implementing cognitive–behavioral therapy (CBT) for students with ASD and anxiety. The two research questions asked participants to describe their ability to …

Retention Strategies For Managers Of Generation Y Employees, Michael Askari

Walden Dissertations and Doctoral Studies

Employee turnover may lead to increased business costs, degradation of employee mental health, and more taxes on social programs. Managers of Generation Y employees are concerned with turnover because Generation Y employees tend to leave within 12 months of being hired. Grounded in the job embeddedness theory, the purpose of this qualitative multiple-case study was to explore management retention strategies to reduce Generation Y turnover. The participants were six managers of Generation Y employees from six retail businesses who successfully retained employees for more than 12 months. Data were collected using semistructured interviews, journal notes, and a review of public …

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 …

Thirty-Second Mindful Body Scan Meditation For Bedside Nurses, Shruti Balwalli-Udyawer

Walden Dissertations and Doctoral Studies

Compassion fatigue, or secondary traumatic stress, is a state of physical and mental exhaustion caused by an inability to cope with the everyday environment that reduces the ability of the nurse to provide high-quality health care to a patient. The purpose of this staff education project, guided by Selye’s general adaption syndrome , was a 6-week, 30-second mindfulness exercise program to promote stress reduction for cardiac step-down and medical-surgical nurses. In this quantitative, pre- and posttest study, the Perceived Stress Scale was completed by a sample of 24 nurses who met the inclusion criteria. The practice focused whether educating nurses …

Increasing Knowledge Of Emergency Department Nurses On Recognizing Aggressive Patient Behavior, Kandee Barnes

Walden Dissertations and Doctoral Studies

Emergency department (ED) nurses are exposed daily to workplace violence putting them at risk for injury from aggressive patients. A gap in practice was identified in an urban ED in a state in the Southeastern United States. ED nurses at this site do not have the knowledge to recognize and reduce aggressive patient behavior. The guiding practice-focused question addressed whether educating ED nursing staff on recognizing aggressive patient behavior would increase knowledge. To address the gap, an educational session was developed based on a comprehensive literature search, with the assistance of an expert panel and using the analyze, design, develop, …

A Comparison By Ethnicity Of Usage Of Medication, Intubation Use, And Mortality Rates Of Covid-19 Patients In An Urban Hospital, Howard Rubin Baruch

Walden Dissertations and Doctoral Studies

Evidence from an urban hospital initially revealed that ethnicity had no bearing on treatment modalities or mortality among patients admitted and diagnosed with COVID-19 symptoms from January 1, 2020 to January 1, 2021. The purpose of this study was focused on answering three principal research questions concerning evidence at one hospital of differences in medication used, whether intubation was used, and mortality by ethnicity for those treated for COVID-19 while controlling for age, gender, and co-morbidities. The health belief model served as the theoretical framework. Data was collected from 1188 patient charts, and binary logistic regression was used to test …

Emotional Intelligence And Safety Culture In Business Aviation, Sonnie Bates

Walden Dissertations and Doctoral Studies

With a lack of research regarding the relationship between emotional intelligence and safety culture in the aviation industry, safety professionals have inadequate information to reduce human error, the leading cause of tragic aircraft accidents. The purpose of this study was to determine the extent to which there is a relationship between emotional intelligence and safety culture in the business aviation industry. This study was grounded on Reason’s theoretical model for safety culture, enhanced by Wang and Sun, and the emotional intelligence framework by Salovey and Mayer, enhanced by Jordan and Lawrence. A quantitative descriptive correlational approach was used with convenience …

An Examination Of Counselor Turnover And Its Impact On Quality Behavioral Health Services, Leslie M. Beale

Walden Dissertations and Doctoral Studies

Behavioral health organizations often face the challenge of high employee turnover rates, which can critically affect their ability to treat mental illnesses successfully. High counselor turnover at one such organization, BHOX, threatens the provision of timely access to quality mental care. This qualitative case study examined counselor turnover and its impact on the quality of behavioral health services. The Baldrige Excellence Framework was used to guide this descriptive case study of a nonprofit behavioral health organization on the East Coast of the United States, which serves men and women struggling with mental health disorders and substance abuse addictions. The data …

Screening For Depression In Immigrants In Their Host Country, Hortense Bissila

Walden Dissertations and Doctoral Studies

AbstractThe initial need for care for depression is greater for immigrants, who encounter linguistic, cultural, structural, and attitudinal hurdles to mental health care that render them more susceptible to increased levels of depressive symptoms compared to populations of hosting country. The aim of this Doctor of Nursing Practice project was to educate frontliners in the community on how to assess for depression in immigrants in culturally congruent ways. This project addresses gap in mental health care practice that needs urgent redress in promoting self-cultural competence and raising awareness to assess for depression on immigrants. To meet the aims of the …

Mortgage Broker Strategies To Overcome The Volatility Of Inconsistent Sales, Marissa Blackwell

Walden Dissertations and Doctoral Studies

Many mortgage brokers leave the mortgage industry because of unforeseen changes andvolatility. Mortgage brokers are concerned with adequate strategies to mitigate industry volatility and inconsistent sales, which is important to successful sustainability during challenging times. Grounded in relationship marketing theory, the purpose of this qualitative single case study was to explore the strategies seven mortgage brokers from a single organization used to sustain sales during volatile times. Data were collected using semistructured interviews by telecommunication, a reflective journal, LinkedIn, Facebook, and broker websites. Through thematic analysis, three themes emerged: maintaining a presence with new and existing clients, understanding client needs, …

How Healthcare Big Data Analytics Information Asymmetry Influences Organizational Design Absorptive Choices, Neil Black

Walden Dissertations and Doctoral Studies

Although the relationship between big data analytics (BDA) organizational, firm, and financial performance is well supported, little attention has been paid in extant research to exploring the organizational design issues resulting from information asymmetry caused by BDA; in particular, organizational absorptive choices that include acquisitions, mergers, reorganization, executive changes, or board of director adjustments. The purpose of this qualitative single case study within a U.S. hospital was to explore the conditions and circumstances that influence absorptive organizational design choices of hospital administration. The theoretical base of this study is Pfeffer and Salancik’s resource dependence theory (RDT). Logic model data analysis …

An Evaluation Of Community-Based Juvenile Firesetting Programs Through The Custodial Lens, Peter William Blaich

Walden Dissertations and Doctoral Studies

Using general strain theory and social learning theory as the foundation, this generic qualitative study addressed whether interventions and prevention services for juvenile firesetters in the City of Charlotte–Mecklenberg County met needs from the perspectives of critical stakeholders. Data were collected through in-depth interviews with 12 parents/guardians of justice-involved adolescent fire offenders. Interviews were transcribed and analyzed using a six-step procedure for thematic analysis by Braun and Clarke. The study's results revealed that the current juvenile firesetters intervention and prevention program is perceived as inadequate when applied without input from the adolescent’s parent or guardian. The participants perceived the need …

Personal Hardiness As An Unexamined Component Of The Healthy Volunteer Effect, Angelique E. Blann

Walden Dissertations and Doctoral Studies

Clinical trials are the standard for approving medicines for public use. To conduct trials, researchers depend on a declining number of volunteers. The healthy volunteer effect, a phenomenon in which participants demonstrate better outcomes than their peers, limits the generalizability of trial outcomes. The healthy volunteer effect does not fully explain the outcome difference between volunteers and nonvolunteers. The purpose of this cross-sectional quantitative study was to examine personal hardiness as an unexplored component of the healthy volunteer effect and determine whether personal hardiness is associated with willingness to participate. Hardiness was a personality construct that represented resilience to stress. …

Finding The High-Performance Border Enforcement Agent, Douglas Allen A'Hern

Walden Dissertations and Doctoral Studies

There are well defined systemic challenges to managing, recruiting, and retaining the best border enforcement agents available amongst given candidates. The ability to identify and define specific attitudes and attributes within those agents who are considered high performers is something that could be of tremendous value to law enforcement agency managers. The need for information to cultivate the highest level of performance is magnified given the events in the United States that followed the death of George Floyd at the hands of law enforcement in May of 2020. In the effort to identify those attributes within high performance border agents, …