Medicine and Health Sciences Commons^™

Completion Of Preventive Health Care Actions By Older Women With Hiv/Aids, Patricia Kay Correll

Walden Dissertations and Doctoral Studies

The widespread use of highly active antiretroviral therapy (HAART) has resulted in longer lifespans for HIV seropositive women in the United States, during which preventive health care is recommended. Failing to complete recommended cancer screening tests can result in cancer being diagnosed at a later stage with a poorer prognosis. The purpose of the study, based on the ecosocial theory, was to describe the sociodemographic and clinical variables of HIV seropositive women who failed to complete recommended screening tests for breast, cervical, and colorectal cancers, and determine if the presence of hypertension, obesity, diabetes, depression, or tobacco use impacted the …

Assessment Of Vitamin D Levels And Depression Among Adults In The United States, Troy Jean-Luc Owens

Walden Dissertations and Doctoral Studies

Vitamin D is essential to optimizing health; vitamin D deficiency (VDD) can increase risk of hypertension, cardiovascular disease, and insulin resistance. VDD occurs when individuals do not receive sufficient oral intake or obtain adequate sun exposure. Previous researchers indicated there is a relationship between VDD and depression, while others have indicated there is no relationship. The purpose of this study was to examine the relationship between vitamin D levels and depression, and how this relationship might be moderated by an individual's demographic characteristics (gender, age, smoking status, or marital status). This study was a quantitative data analysis of archival data …

Predictors Of Obesity Among Nigerian Immigrants In The United States, Olawunmi Obisesan

Walden Dissertations and Doctoral Studies

Obesity has been identified as a significant risk factor for chronic diseases, contributing to health disparities in minority and vulnerable populations. Though research has identified an increased risk for obesity in the Hispanic immigrant population, there is little or no research on the heterogeneity of obesity predictors in specific immigrant populations in the United States. This study examined the predictors of obesity in the Nigerian immigrant population in the United States. Guided by the social ecological model and the segmented assimilation theory, this cross-sectional study collected primary data from 205 Nigerian immigrants in the United States using the CDC's Behavioral …

Sociodemographic Predictors Of Medication Nonadherence Among Latinos Diagnosed With Diabetes Type Ii, Bianca L. Tristan

Walden Dissertations and Doctoral Studies

Latinos of low socioeconomic status are disproportionately affected by diabetes Type II complicated by poor adherence to diabetes Type II medications and management programs. Self-management of diabetes Type II is a tool used to teach health education to patients with diabetes. The objective of this retrospective quantitative study was to explore if there are predictors of nonadherence to diabetes Type II medications and programs among Latinos with diabetes Type II. Data from 200 patient records from a community clinic in Fresno County California were analyzed using both bivariate and multivariate analysis. Selected sociodemographic independent variables were age, gender, income, migrant …

Psychosocial Determinants Of Elective Cesarean Section Deliveries In Selected Obstetric Facilities In Nairobi, Kenya, Tom Joseph Oguta

Walden Dissertations and Doctoral Studies

Cesarean section (CS) rates have generally increased across the world in the past decade. Reducing elective cesarean section (ECS) rates is imperative as many countries aim to maintain threshold CS rates at or below 15%, the level recommended by the United States' National Institutes of Health. Women are believed to consider ECS for various interconnected psychosocial reasons, but few quantitative studies have investigated these factors. This prospective cohort study was based on the social ecological model (SEM) and the theory of planned behavior (TPB) models, and identified the psychosocial predictors of ECS among 1,268 expectant women in 2 hospitals in …

Differentiating Demographic Factors In Latino Patients With Type 2 Diabetes, Carol Lynne Manning

Walden Dissertations and Doctoral Studies

The American Diabetes Association (ADA) data suggest that Latinos share a greater burden of disease than do non-Latino Whites with type 2 diabetes. As a result of poor glycemic control, Latinos also suffer consequences such as blindness, kidney disease, and limb amputation more often than do other ethnic groups. The purpose of this study was to compare demographic factors of Latinos with well-controlled type 2 diabetes, as measured by a HgbA1c of 7 or less (n = 118) to Latinos not well controlled (n = 105). This cross sectional study used a secondary data set with a sample selected from …

Genome-Wide Association Study On The Sleep Symptom Of Post Traumatic Stress Disorder, Tammy Pooler

Walden Dissertations and Doctoral Studies

Posttraumatic stress disorder (PTSD) is a psychiatric condition that presents with 3 main symptoms're-experiencing, avoidance/numbing, and hyper arousal'after an individual experiences a traumatic event. Recent evidence suggests a potential genetic basis for PTSD and a sub symptom of hyper arousal, sleep, as a potential pathway for PTSD development, but no study has identified candidate genes associated with specific symptoms such as sleep difficulty. Based on a conceptual framework in which specific genes are associated with the onset of PTSD, this study used a genome-wide association

study (GWAS) method with a case control study design to compare the genomes of individuals …

Albumin Levels In Hispanic Dialysis Patients With And Without Type Ii Diabetes, Hector Hernandez

Walden Dissertations and Doctoral Studies

Albumin provides the vital scaffolding for growth and tissue repair and supports oncotic blood pressure and hemodynamics. In hemodialysis patients, albumin aids with fluid removal by drawing excess fluid from edematous tissues back into the blood where it can then be removed by a dialyzer. The hyperglycemia seen in dialysis patients with Type II diabetes progressively damages kidney glomeruli, which permits albumin seepage into the urine, thus lowering serum albumin. The conceptual framework underpinning this research is the van't Hoff theory of osmotic pressure. Under this framework, the solute-solvent relationship largely contributes to the osmotic movement of fluid. The purpose …

Sewer Overflows And The Vector Mosquito Proximity To Human West Nile Virus Infections, Andrea Simone Bowers

Walden Dissertations and Doctoral Studies

DeKalb and Fulton Counties, which share the metropolitan Atlanta area, have seen an increase in West Nile infected vector mosquitoes; the increase is associated with close proximity to combined sewer overflow facilities. Despite completion of the remediation system in 2008, the mosquito population testing positive for West Nile virus has increased each year from 2010 through 2012. Guided by the Geographical Information System framework and using spatial analysis and regression analyses, this study described and quantified the relationship between sewer system overflows and amplification of vector mosquitoes; an additional goal was to investigate their proximity to human cases of West …

Crash Risk Associated With Cellular Phone Use While Driving, Tiffani Ann Fordyce

Walden Dissertations and Doctoral Studies

There are inconsistencies in the published literature on the effect of cellular phone use while driving. The objective of this study was to estimate an adjusted nationwide crash rate associated with cell phone use while driving and to compare statewide crash rates prior to and following the implementation of legislation banning cell phone use while driving. Crash rates in nationally representative databases were calculated based on imputed values for cell phone use using the propensity score method. The imputed nationwide crash rate for fatal crashes (1.61 per 100 fatal crashes) and all crashes (1.409 per 100 crashes) represented a 2 …

The Role Of Sociodemographic Characteristics And Antiretroviral Prophylaxis On Risky Sexual Behavior Among Men Who Have Sex With Men, Leonard Obodo

Walden Dissertations and Doctoral Studies

Recent multicenter, randomized, double blind clinical trials have shown no association between HIV preexposure prophylaxis (PrEP) and increased sexual risk behavior among high-risk men who have sex with men (MSM). However, little research has been conducted under natural conditions devoid of clinical trial controlled environment to confirm the lack of association between PrEP and increased sexual risk behavior. Also, research has shown conflicting associations between sociodemographic characteristics and sexual risk behavior among MSM. In this cross-sectional, web-based, primary data analysis, MSM who reside in United States of America (USA) and who make use of PrEP for HIV prevention were examined …

The Association Of Lead With Cataracts And Vision-Related Problems In Perimenopausal Women, Imogene Drakes

Walden Dissertations and Doctoral Studies

Around the world, women are subject to an earlier incidence of cataracts, have a higher risk for cataracts, and also have a higher risk for other vision-related problems than men. Previous research has indicated an association between endogenous lead stored in long bones and cataracts in men over 60 years of age; however, a similar study in women did not reveal an association. This case control study was conducted to investigate whether perimenopausal mobilization of endogenous lead serves as a possible causative factor for women's generalized vision issues and cataract incidence in particular. Secondary data were gathered from 1,416 women …

Third-Degree Family Health History And Perception Of Disease Risk, Liana Carrasco Romero

Walden Dissertations and Doctoral Studies

Chronic diseases are a significant cause of illness and mortality in the United States. Hereditary predisposition to chronic diseases is a useful indicator for identifying people at risk for disease development. An ideal tool for determining this predisposition is the CDC, NIH, and AAFP recommended third-degree family health history (FHH). The aim of this quantitative, cross-sectional study, based on the theoretical frameworks of social constructivism and the health belief model, was to assess the possible influence between the completed third-degree FHH and the participant's perception of disease risk. Two-hundred seventy-three participants were recruited from health care facilities and from the …

Quantitative Study Of Clostridium Difficile Incidence Related To Influenza And Antimicrobial Use, Eileen M. Yaeger

Walden Dissertations and Doctoral Studies

In the United States, influenza causes approximately 36,000 deaths and over 200,000 hospitalizations each year with elderly most often affected. Clostridium difficile infection (CDI) is another major health care challenge and pressing public health issue associated with 14,000 deaths and over 335,000 hospitalizations annually. The use of antibiotics has been implicated in the development of CDI. This study's purpose was to test the relationship of seasonal influenza incidence and antiviral/antibiotic use in CDI development among hospitalized patients. Grounded in the epidemiologic wheel model of man-environment interactions, this retrospective observational study described and analyzed data from a proprietary, laboratory, and pharmacy-based …

Association Between Psychological Trauma From Assault In Childhood And Metabolic Syndrome, W Sumner Davis

Walden Dissertations and Doctoral Studies

Metabolic syndrome and its component conditions of hypertension, obesity, and insulin resistance are on the increase in United States. Metabolic syndrome substantially increases the risk of cardiovascular disease and type 2 diabetes (T2D). To date, no published study has examined the relationship between psychological traumas from physical and/or sexual assault in childhood and metabolic syndrome or its components. This study, using the psychoneuroimmunology (PNI) model, investigated associations between psychological trauma (physical/sexual abuse) in childhood and metabolic syndrome in adulthood using data from the Midlife in the United States II (MIDUS-II) study. This research was undertaken to investigate whether a history …

Vitamin D Deficiency And Immune Function In African American, Hiv-Infected Men, Rana H. Ismail

Walden Dissertations and Doctoral Studies

Vitamin D deficiency is common in individuals diagnosed with HIV and is known for its detrimental health effects. Its recognition as a potent immune-modulator with possible immune health implications in HIV disease progression was the main impetus for this study. The association between Vitamin D and CD4 count falls short of being consistent and is too weak to allow conclusions. Similarly, the literature is inconsistent with regard to the impact of Vitamin D supplementation on CD4. This observational, retrospective chart review study aimed to explore the relationship between Vitamin D deficiency and CD4 count/percent, and to evaluate whether changes in …

Disparities In Monoclonal Antibody Treatment Of Elderly Metastatic Colorectal Cancer Patients, Krista Marie Schroeder

Walden Dissertations and Doctoral Studies

Multiple research studies have demonstrated racial, socioeconomic status (SES), and neighborhood disparities in first-line treatment of colorectal cancer patients, including those with metastatic colorectal cancer. However, disparities in adjunct monoclonal antibody treatment disparities have not been explored. The purpose of this study was to assess racial, SES, and neighborhood disparities in adjunct monoclonal antibody treatment of elderly metastatic colorectal cancer patients. The research was rooted in 3 theories: the fundamental cause theory, the diffusion of innovations theory, and theory of health disparities and medical technology. Data from the SEER-Medicare database and logistic regression were used to assess the relationship between …

Inflammatory Markers Associated With Disease Progression Of Cardiorenal Syndrome, Srikanta Banerjee

Walden Dissertations and Doctoral Studies

An increase in cellular inflammatory biomarkers directly increases the risk of cardiovascular disease (CVD). Using the social ecological and biomedical theories, the study examined quantitatively how specific inflammatory biomarkers are associated with cardiorenal syndrome (CRS), a potential complication of hypertension and diabetes, and how sociodemographic factors modify this association in the U.S. adult population. A retrospective secondary data analysis of the data collected from National Health and Nutrition Examination Survey (NHANES) 1999-2010 was utilized to evaluate these hypotheses. High sensitivity C-reactive protein, homocysteine (hcy), and fibrinogen had a modifying effect on Type 4 (chronic reno-cardiac etiology), Type 2 CRS (chronic …

Germline Mutations In Chek1 And Chek2 In Women With Ovarian, Peritoneal, Or Fallopian Tube Cancer, Maria Isabel Harrell

Walden Dissertations and Doctoral Studies

Ovarian cancer is the deadliest gynecological malignancy affecting women. Diagnosis often occurs late due to non-specific symptoms, but if detected early, there is excellent chance for survival. One of the most important risk factors is family history. Up to 24% of cases are due to inherited loss-of-function mutations in genes involved in the DNA damage response. The theory underlying hereditary cancers is Knudson's two-hit theory of cancer causation, where two hits are necessary for cancer to occur in an individual: one in the germline and one in the tissue. The genes, CHEK1 and CHEK2, are modulators of the DNA damage …

U.S. Army Enlisted Soldiers' Adherence To Prescribed Malaria Chemoprophylaxis In Afghanistan, Michael Paul Brisson

Walden Dissertations and Doctoral Studies

Over the past 13 years, the United States Army has been engaged in armed conflict within Afghanistan. Unfortunately, the United States Army has been forced to evacuate soldiers from the battlefield because of malaria, a parasitic disease that is endemic in Afghanistan. Even though the U.S. Army has adopted an effective chemoprophylaxis protocol, soldiers' adherence to their prescribed medication has been historically low. This research addressed a gap in literature regarding the adherence rates of U.S. Army enlisted soldiers to their prescribed oral malaria chemoprophylaxis. In addition, this research investigated self-reported reasons for soldiers' nonadherence to this medication. The study …

Herpes Virus Infections, Inflammatory Markers And Risk Of Developing T2dm And Cvd: An Analysis Of Nhanes With Adults, Aged 20-49, 1999-2010, Margarita Irizarry-De La Cruz

Walden Dissertations and Doctoral Studies

Herpes simplex viruses (HSVs), are among the most virulent and widespread pathogens; they affect 60-90% of the population worldwide. Substantial evidence indicates a possible association between pathogens and chronic disease. HSVs, among other viruses, have been associated with increased risk for inflammatory diseases. However, prior findings have been inconsistent on the role of infection in triggering autoimmune response and chronic disease. This study builds on the premise that pathogens can induce an inflammatory response and increase the risk for disease development. A representative U.S. sample from NHANES, a national population-based cross-sectional survey, was used to examine the relationship between HSVs …

Evaluation Of The System Attributes Of Timeliness And Completeness Of The West Virginia Electronic Disease Surveillance System' Nationaledss Based System, Rebecca Lee Fahey

Walden Dissertations and Doctoral Studies

Despite technological advances in public health informatics, the evaluation of infectious

disease surveillance systems data remains incomplete. In this study, a thorough

evaluation was performed of the West Virginia Electronic Disease Surveillance System

(WVEDSS, 2007-2010) and the West Virginia Electronic Disease Surveillance System NationalEDSS -Based System (WVEDSS-NBS; March 2012 - March 2014) for Category II infectious diseases in West Virginia. The purpose was to identify key areas in the surveillance system process from disease diagnosis to disease prevention that need improvement. Grounded in the diffusion of innovation theory, a quasi-experimental, interrupted, time-series design was used to evaluate the 2 data …

Impact Of Goodwill Organizations And Community Collaboration On Aids-Orphans' Needs In Nyanza Province, Kenya, Anthonia Nwagbo

Walden Dissertations and Doctoral Studies

A number of researchers have explored the toll of AIDS on the children who have become orphans as a result of the disease; others have investigated the roles of aid-giving agencies on the alleviation of the orphans' situation. However, despite researchers' pointing to the germaneness of community and goodwill agency liaison, no study had examined the impact of such collaboration on the resources available to the orphans. To this end, the heads-of-household of 532 AIDS orphans under 18 years old in Kenya's Nyanza province were surveyed to investigate the impact of community-referral on the state of AIDS orphans with regard …

The Association Between Rheumatoid Arthritis And Type 2 Diabetes Mellitus, Magaly Perez Nieves

Walden Dissertations and Doctoral Studies

A research report from the Centers for Disease Control and Prevention (CDC) indicated that more than 50% of people with diabetes mellitus (DM) in the United States (U.S.) also have arthritis. The diabetes population is disproportionately affected by arthritis, but there has been limited and inconsistent research to confirm the association between type 2 diabetes mellitus (T2DM) and rheumatoid arthritis (RA). The current study aimed to identify an association between T2DM and RA for noninstitutionalized U.S. adults between 1999 and 2012 using a nationally representative sample from the National Health and Nutrition Examination Survey (NHANES) database (n =31,488 ). A …

The Predictors Of Obesity In Young Adults, Dominic Richard Tarinelli

Walden Dissertations and Doctoral Studies

Obesity is becoming an increasing health concern for young adults. There have been numerous studies on the potential predictors of obesity. However, few studies have researched the predictors of obesity in young adults. Guided by the health belief model, this quantitative cross sectional study investigated the potential predictors of obesity in young adults. The 2011 Behavioral Risk Factor Surveillance System was used to gather data on the potential predictors of obesity, including physical activity, health care coverage, excessive alcohol consumption, and demographic characteristics on 1,511 young adults, aged 18-34 years, who were living in New York State. Data were analyzed …

Emergency Medical Service Worker Knowledge Of And Compliance With Occupational Exposures To Infectious Diseases, Debra Ann Wrentz-Hudson

Walden Dissertations and Doctoral Studies

Firefighter Emergency Medical Service (EMS) responder personnel are at a high risk for occupational exposures to bloodborne and airborne infectious pathogens due to their unpredictable work duties in the pre-hospital environment. Not much is known about the compliance with Universal Precautions (UP) among firefighter EMS responders' personnel with regards to occupational exposures to infectious diseases. The purpose of this cross-sectional research study was to determine the relationship between compliance with UP, knowledge of UP, attitudes towards UP, occupational practices, and occupational exposures to bloodborne and airborne pathogens to prevent transmission of infectious disease among firefighter EMS responder personnel in the …

Female Genital Mutilation/Circumcision: Culture And Sexual Health In Igbo Women In Dallas-Fort Worth, Texas, Dorothy Ebere Ukoha

Walden Dissertations and Doctoral Studies

Female genital mutilation (FGM) is practiced primarily in many African countries as well as some in Asia and the Arab Peninsula; however, it also takes place elsewhere around the globe among those who migrate from countries to which it is indigenous. This study was designed (a) to investigate the prevalence of FGM among the Igbo women in the Dallas-Fort Worth (DFW) area in Texas and (b) to understand the factors that support the continuation of the practice and the effects on women's sexual health. Using a quantitative approach to examine a variety of social variables aligning with the ecological framework, …

The Role Of Religious Vaccination Exemptions In The Ocean County, New Jersey Pertussis Outbreak, Siobhan Bridget Pappas

Walden Dissertations and Doctoral Studies

Pertussis, also known as whooping cough, is a vaccine-preventable disease that is on the rise in the United States, a trend which has been attributed to vaccination exemption. Indeed, the pertussis outbreak that occurred in February, 2012 in Ocean County, New Jersey was associated with vaccine exemption. Considering that pertussis is deadly to young children, it is important to understand why this disease rate is on the rise. The research questions were focused on whether a relationship existed between pertussis status (no, yes) and exemption status (no, yes), sex (male, female), and county type (Middlesex, Ocean, or Other), using a …

Social Network Correlates Of Hcv And Hiv Transmission Risk Behaviors Among Injecting Drug Users, Victor Emanuel Reyes-Ortiz

Walden Dissertations and Doctoral Studies

Drug injection is an increasingly important risk factor in the transmission of blood-borne pathogens, including the hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The purpose of the study was to examine the influence of social network factors on HCV and HIV. The study was grounded in social network theory and sought to determine whether social network characteristics affect high-risk sexual and drug injection behavior as well as self-reported HIV and HCV status. The study design was a quantitative cross-sectional survey. A total of 181 participants in a needle exchange program completed a survey in Spanish assessing individual drug …

Social Determinants Of Health Inequality And Life Expectancy Among Women Of Edo State, Nigeria, Daniel Aromeh Odekina

Walden Dissertations and Doctoral Studies

Health inequality conflates a huge number of economic, social, and political issues. These issues, together described as social determinants, determine a population's health through influencing health status and life expectancy. The research purpose of this study was to examine how social determinants affected the life expectancy of the women of Edo State, based on secondary data from Nigeria's 2008 demographic and health survey (NDHS). The theories that guided the study were self-efficacy beliefs of the social cognitive theory and physical self-concept of the health belief model. This quantitative cross-sectional study examined the associations between socioeconomic status, nutritional status, literacy/educational attainment, …