Medicine and Health Sciences Commons^™

Dna Methylation Pattern Of Cpg Site In The Promoter Region Of Calca-Alpha Gene As A Putative Epigenetic Biomarker In Neonatal Sepsis- A Prospective Observational Study In South India, Rudra Rupesh Reddy Narsapurapu, Deepti Thandaveshwara, Anshu Kumar Yadav, Akila Prashant

Digital Journal of Clinical Medicine

Background: Recently, several studies have been reported on epigenetic modifications of DNA as a predisposing factor for several diseases among neonates and adults. Here we aimed to study the changes in the DNA methylation pattern in the promoter region of the CALCA gene among the neonates suspected to have sepsis in a tertiary care hospital.

Methodology: All the neonates suspected to have sepsis based on the inclusion criteria during the study period were included in the study as cases. Normal healthy neonates were included in the study as controls. Positive cases were isolated from suspected cases based on …

Strategies For Preventing And Mitigating Counterfeit Medication From Entering The U.S. Supply Chain, Denise Blais

Walden Dissertations and Doctoral Studies

Some pharmaceutical brand protection managers lack strategies to mitigate financial losses from counterfeit prescription drugs. A multilayered approach involving guiding principles, supply chain security, investigations, enforcement, advocacy, and awareness can help mitigate potential financial losses and keep patients safe. Guided by the Six Sigma define, measure, analyze, improve, and control (DMAIC) model and the fraud triangle conceptual framework, the purpose of this multiple case study was to explore strategies brand protection managers use to mitigate financial losses from counterfeit prescription drugs. Data collection included three semi-structured interviews using Zoom. Analyzing data entailed transcribing and coding themes within data and relating …

Assessing Online Faculty Likelihood To Refer Students To University Mental Health Services, Karin Evans

Walden Dissertations and Doctoral Studies

The negative impact of mental health concerns experienced by college students has prompted faculty teaching in-person to become gatekeepers, assisting students in accessing mental health services. COVID-19 has changed the learning environment and presented a need to explore the role online faculty play as gatekeepers. The purpose of this study was to investigate online faculty’s willingness to refer students to university mental health services by applying factors shown to influence in-person faculty in context of the health belief model. Using a quantitative, non-experimental, cross-sectional study design, 182 online faculty completed an online survey assessing the likelihood of making a referral …

Factors That Predict Prescription Opioid Misuse By Type Of Healthcare Insurance Coverage, Keon Green

Walden Dissertations and Doctoral Studies

The opioid epidemic remains one of the leading causes of unintended deaths in the United States and is still one of the focal points of the public health field. Previous research has increased awareness of the opioid crisis and has focused on sociodemographic factors that may cause or predict prescription opioid misuse. The purpose of this study was to investigate sociodemographic factors that may predict prescription opioid misuse while controlling for healthcare insurance. The theoretical foundation for this secondary data analysis project was the socioecological model using the 2019 National Survey on Drug Use and Health. The population was 56,136 …

Predictors Of Health Literacy Scores In The Adolescent Oncologic Population, Amber N. Jenkins

Walden Dissertations and Doctoral Studies

Recent research showed a relationship between low health literacy in adult oncology patients, poor communication with providers, misconceptions about disease and treatment options, and the inability to adhere to treatment plans. Comparative literature addressing adolescent health literacy contained insufficient evidence of these relationships. The purpose of this exploratory cross-sectional quantitative study, based on the health literacy skills framework, was to assess the health literacy of adolescents treated in the oncology department at an academic children’s hospital in Missouri to determine whether there was a significant relationship between individual health literacy scores of this population based on age, sex, number of …

Sociodemographic Factors As Predictors Of Low Influenza Vaccination In Chicago, Illinois, Ingrid L. Jeske

Walden Dissertations and Doctoral Studies

Outbursts of seasonal influenza contribute to morbidity and mortality in the United States. Influenza is a contagious disease caused by influenza viruses. The main subtypes of the influenza virus are Type A and Type B. Influenza vaccines are among the most effective methods in preventing the spread of the influenza virus because they offer the best immune defense. However, health care providers face significant challenges due to low patient compliance with current vaccine recommendations and misinformation. Scholars have yet to expand and further explore the reasons for the gap in influenza vaccination between White individuals and minorities, such as the …

Primary Care Physicians’ Knowledge, Attitudes, And Practices Regarding Lyme Disease In High- Versus Low-Incidence Lyme Disease Midwestern States, Alexander Karnga

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this quantitative cross-sectional study, guided by the barriers to physician behavior change (BPBC) framework, was to address the gaps in the Lyme disease empirical literature by examining whether there were significant differences in Lyme disease knowledge, attitude, and practices between primary care physicians in Wisconsin, a high-incidence Midwestern Lyme disease state, and Michigan, a low-incidence Lyme disease Midwestern state. The study was conducted with 65 physicians (53.8% male and 46.2% female). The study hypotheses were tested by conducting a one-way multivariate analysis of covariance (MANCOVA), controlling for physicians’ years of practice (the number of patients seen per …

Typhoid Fever Among Low-Income Women Living In Gujranwala, Pakistan., Tehmina S. Khan

Walden Dissertations and Doctoral Studies

Approximately 21 million individuals suffer from typhoid fever (TF) globally, and most outbreaks occur in Southeast Asia. The incidence of TF is high in Pakistan, particularly in low socioeconomic areas, and a new drug-resistant strain makes it difficult to control the spread of TF. There is a pressing need for up-to-date and accurate data regarding the attitudes, beliefs, and habits leading to the spread of TF infection among individuals living in low socioeconomic areas of Pakistan. This qualitative, phenomenological study was grounded in the health belief model and explored factors that influence the spread of TF among women of childbearing …

Gender And Risk Behaviors Association With Hepatitis-B Infections Among Liberia Military Personnel, Joseph B N Kowo Jr

Walden Dissertations and Doctoral Studies

The increasing number of hepatitis B-related deaths in the Armed Forces of Liberia was due to the lack of understanding of the associated risks with the disease. Gender, substance use, and condom use have been researched as related risk factors for hepatitis B virus infection (HBV). The goal of this study was to determine if gender (male or female) and risk factors (substance use, alcohol abuse, and condom use) predicted hepatitis B infections after adjusting for age, marital status, education, and military rank among Liberia military population. The theory that grounded this study was Bronfenbrenner’s socio-ecological model (SEM) which posits …

Improving Nurses' Knowledge Of Patient Self-Management Of Sickle Cell Disease, Angel Amaura Mccullough

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is a chronic illness affecting over 100,000 Americans annually. SCD causes severe pain, which may require frequent hospital admissions for pain control. A high level of patient self-care knowledge is needed to prevent readmissions. Patients usually receive self-care education at hospital discharge from nurses, who may not know about self-care in SCD. Inadequate patient education on self-management of SCD at hospital discharge can lead to hospital readmissions. There was a gap in knowledge among RNs regarding SCD self-care at the local facility. This doctoral project was intended to educate nurses about SCD self-management to increase their …

The Relationship Between Team Engagement And Physician Engagement, Lynne Miles

Walden Dissertations and Doctoral Studies

AbstractWhile physician engagement has previously been shown to be related to both turnover and burnout, there are no studies that focus primarily on the relationship between the physician and team. The purpose of this quantitative study was to examine the relationship between team engagement and physician engagement. The theoretical framework used to guide this research study is the neoclassical organizational theory. The secondary data source was from an engagement survey taken by employed team members and physicians. The independent variable is team engagement. The dependent variable is physician engagement. The instrument for the study is valid and reliable and was …

Overeating As A Coping Response To Workplace Gender Discrimination: The Role Of Resilience And Social Support, Rosemarie Charmain Mitchell

Walden Dissertations and Doctoral Studies

Gender discrimination in the workplace continues to be a persistent source of stress for women even after 5 decades of antidiscrimination legislation in the United States. Women are more likely than men to cope with stress by overeating, which is a risk factor for chronic illnesses and obesity. Much less is known about the protective factors that could weaken the association between perceived stress and overeating. The purpose of this quantitative study was to address this gap in the literature by examining whether resilience and social support are moderators of the overeating response for women who have experienced gender discrimination …

School Lunch Timing And Student Body Mass Index, Megan Monteith

Walden Dissertations and Doctoral Studies

Obesity continues to be a leading public health issue in the United States. Many chronic diseases are associated with obesity, including hypertension, diabetes, and several forms of cancer. There are multiple known contributing factors to obesity; however, historically, there has been little research focusing on time of day eating as a possible risk factor for obesity, especially childhood obesity. Childhood obesity is a significant risk factor for adult obesity. Obese children and adolescents are five times more likely to be obese in adulthood. The theoretical foundation for this study was the social ecological model. In this secondary correlational analysis using …

Educating Nurse Practitioners On Factors Associated With Compassion Fatigue, Alicia Moonesar

Walden Dissertations and Doctoral Studies

Nurse Practitioners (NPs) across Canada continue to endure the escalating demands of increasing patient workloads, the deficiency of inadequate resources, and the paucity of leadership support. The ongoing exposure to these and other challenges often contributes to a complex work environment that may result in compassion fatigue (CF). CF can be operationally defined as a state of exhaustion and dysfunction because of prolonged exposure to compassion stress and all that it evokes. The need for education and prevention of CF is critical as the prevalence of CF is on the rise. Guided by Watson’s Theory of Human Caring and Benner’s …

Exploring Vaccination Hesitancy Among Nonmandated Nurses And Health Care Workers, Germaine Lazett Nelson

Walden Dissertations and Doctoral Studies

COVID-19 vaccinations have been mandated for most healthcare professionals providing direct patient care, but there are a group of nonmandated healthcare professionals who have been hesitant to receive the vaccine. Given prolonged hesitancy among key health professionals charged with providing direct patient care, it is crucial to understand why they are hesitant; their apprehension may impact the pool of professionals available to provide direct patient care. This is a cross-sectional quantitative study that included an online survey. The health belief model served as the theoretical framework. The research questions addressed whether there is an association between type of patient care …

Understanding The Perspectives Of African American Gay And Bisexual Men Toward Hiv, Victor Onwezi , Ikechukwu Nwanguma

Walden Dissertations and Doctoral Studies

There is an urgent need to stop the HIV epidemic among African American gay and bisexual men in the United States. The purpose of this basic qualitative study was to identify the health issues responsible for the HIV epidemic among African gay and bisexual men. Two theoretical frameworks that guided the study were the transtheoretical model and the syndemic theory. The study's research involved understanding African American gay and bisexual men's perspective toward HIV infections and their understanding of possible reasons HIV rates appear to increase in their community. Semi-structured telephone interviews and field notes were used to collect primary …

Birthplace Decision Making Experiences Of The Ugep Women Of Southern Nigeria, Thomas Okoi Ofem

Walden Dissertations and Doctoral Studies

The purpose of this basic qualitative study was to explore and describe how behavioral, normative, and control beliefs shape women's birthplace decision-making experiences. The study sought to better understand how Ugep women of southern Nigeria decided where to give birth after attending antenatal care. Using the theory of planned behavior as a framework, a purposeful sample of nine women aged 25 to 35 years who attended antenatal clinic at least twice at the selected primary health facility but gave birth at home during the past year was recruited. Data collection was through face-to-face, semistructured interviews. Audio recordings of interviews were …

Diabetes Distress Among Adults Living In Texas, Jenny Chinedu Ogadi

Walden Dissertations and Doctoral Studies

About 34.2 million Americans (approximately 10.5% of the total U.S. population) live with diabetes. African Americans are twice as likely to be diagnosed with diabetes and more likely to be less compliant with treatment medication regimens and suffer from related complications, compared to non-Hispanic Whites. Such disparities brought attention to the need to investigate and understand better the diabetes distress of diverse groups of diabetics. The purpose of this cross-sectional study was to examine the relationships between demographic factors (race, age, gender, and educational level), diabetes education, diabetes management, and diabetes distress of adult diabetics in Texas. The theory of …

Disparities In Cervical Cancer Survival Amongst White And African American Women, Lucius Amandi-Tasie Ogoke

Walden Dissertations and Doctoral Studies

Cervical cancer disproportionately impacts racial and ethnic minorities in the United States. The continuum in the disturbing morbidity and mortality trends declined markedly in 2020. However, there are more than 13,000 diagnosed cases, and almost 4,300 related deaths, and significant racial disparities in cervical cancer survival persist. The socio-ecological model served as the theoretical framework. Chi-square tests and binary logistic regression analyses were used to analyze data from the National Cancer Institute Surveillance, Epidemiology, and Ends Results Summary. The purpose of the study was to assess the association between race/ethnicity-related disparities in sociodemographic, histopathological, and treatment-related factors and cervical cancer …

Staff Nurses Lack Of Knowledge And Opioid Use At The Veteran Administration, Cathy J. Ramey

Walden Dissertations and Doctoral Studies

AbstractStaff Nurses’ Lack of Knowledge and Opioid Use at the Veteran Administration By Cathy Ramey

MS, University of Phoenix, 2014BS, Chamberlain University, 2008

Dissertation Submitted in Partial Fulfillment Of the Requirements for the Degree of Doctor of Nursing Practice

Walden University November 2022

Abstract Opioids are often prescribed for pain management, which may have led to high rates of opioid addiction among veteran populations. The problem identified in this DNP project was the nurses’ lack of knowledge regarding pain management and the use of opioids in the veteran’s (VA) hospital where the project commenced. Using the Analyse, Design, Develop, Implement, …

Staff Education On The Benefits Of Pharmacogenetic Testing For Chronic Pain Management, Laura April Robinson

Walden Dissertations and Doctoral Studies

Chronic pain management is a growing concern in the medical community with one out of three people in America suffering from chronic pain. This educational practice-focused project identified the value of educating a group of primary care providers (PCP) on pharmacogenetic (PGx) testing offering genetic-based prescribing choices and reducing trial and failure in treating chronic pain patients. The practice-focused question explored if there would be support regarding learning gained by the providers following an evidence-based education process on PGx testing, as shown from pretest to posttest results. The educational model was guided by the analysis, design, development, implementation, and evaluation …

Fire Safety Education And Increasing Functioning Smoke Detectors In Residential Apartments, Enrique Fernandez Robinson

Walden Dissertations and Doctoral Studies

The lack of functioning smoke detectors poses significant life safety risks to people in low-income residential communities. In 2019, a fire incident occurred in an urban Maryland community due to the lack of a functioning smoke detector. Although no deaths or injuries resulted, there was significant property damage and resident displacement. The purpose of this study was to assist a local fire department in an urban area of the state of Maryland with developing and implementing a fire safety community outreach program designed to reduce the percentage of residential homes in a low-income community without functioning smoke detectors. A qualitative …

Educating Nurses On Sbar Tool Implementation For End-Of-Shift Reporting, Doreen Rose-Park

Walden Dissertations and Doctoral Studies

Patient information transfer during nursing end-of-shift reporting remains a complicated process that lacks universal standardization. This lack of standardization was illustrated at the project site, a detention center in the northeastern United States. Deficiencies and gaps in the health care information of patients during end-of-shift reporting lacked consistence and congruency. This project was developed and implemented to educate the nursing staff at the project site on using the situation–background–assessment–recommendation (SBAR) tool during patient information transfer at cell-side in the facility infirmary. The practice-focused question that guided this project was whether a staff education on an SBAR communication tool designed to …

Why Some Cancer Patients Chose Fasting Instead Of, Or With, Conventional Treatments, Richard Alvin Sacks

Walden Dissertations and Doctoral Studies

Abstract Conventional cancer treatment consists of some combination of three therapies: chemotherapy, surgery and radiation. The purpose of this study was to understand why some individuals diagnosed with cancer elected to follow an alternative course of treatment, consisting of fasting on juices or water only rather than, or in addition to, conventional cancer treatment. The theory chosen to guide this study was the Markula Center for Applied Ethics framework for ethical decision making. Research questions were designed to understand the decision-making process of study participants in choosing fasting on juice or water only, rather than, or in addition to, the …

Sociodemographic And Behavioral Predictors Of Obesity Among Female Asian Indian Immigrants In The United States, Afiya Saleem

Walden Dissertations and Doctoral Studies

Individuals from low-income countries such as those in the Asian region migrate to high-income countries and adopt obesogenic behaviors like sedentary lifestyles and high fat and sugar intake. This results in increased susceptibility to obesity, diabetes mellitus, cardiovascular disease, and stroke. Previous research has demonstrated that migrants from South Asian countries are at an increased risk of developing obesity, type 2 diabetes, and hypertension; however, little is known about the factors that contribute to this phenomenon. This was a quantitative, cross-sectional study guided by the social-ecological model. This study used secondary data from the National Health Interview survey to investigate …

Relationship Between Student-Centered, Active Learning Strategies And Student Success In An Undergraduate Nursing Course, Camden Seal

Walden Dissertations and Doctoral Studies

In 2010, the Institute of Medicine issued a report calling for the transformation of undergraduate nursing education to prepare new graduates for the complexities of practice. To improve preparation for practice, faculty responded by incorporating student-centered, active learning strategies (SCALS); however, the effectiveness of SCALS has not been examined. The purposes of this descriptive correlational study, guided by Brunner’s constructivist theory, were to determine the relationship between (a) a nurse educator’s use of SCALS and the percent of students that successfully completed the course, (b) an educator’s self-perception of their learner-centeredness and the use of SCALS, and (c) an educator’s …

Public Safety Personnel And The Use Of Peer-To-Peer Mental And Emotional Support Through Social Media, Tiffany R. Shinton-Truitt

Walden Dissertations and Doctoral Studies

The emotional and mental health of public safety personnel has been a topic that is continuing to receive attention. Being exposed to multiple traumatic events takes a mental and emotional toll on those who place their lives in harm’s way to help others. The study was based on social cognitive theory which focused on self-efficacy through social influences and environment. The purpose of this study was to understand the experience of public safety personnel’s training regarding their perceptions to mitigate emotional stress; the experience of public safety personnel with seeking mental health services; experience of public safety personnel with the …

Beyond The Basics: Educating Nurses At The Bedside About Evidence-Based Practice, Katherine D. Simpson

Walden Dissertations and Doctoral Studies

The nursing profession is a large and dynamic part of the healthcare industry with the greatest percentage of nurses practicing at the bedside. An increase in nursing professionalism with evidence-based practice has emerged over the past several decades. However, evidence continues to support a lack of knowledge among registered nurses in implementing evidence-based patient care at the bedside and the need for education related to evidence-based practice. The analysis, design, development, implementation, and evaluation model of instructional design framed this Doctor of Nursing Practice project. The purpose of the project was to fill the practice gap through the planning, implementation, …

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 …

Impact Of Poverty On Antibiotic Prescribing Rates In The United States Through Mediation Effects Of Underlying Health Conditions, Nato Tarkhashvili

Walden Dissertations and Doctoral Studies

Resistance to antibiotics among bacteria develops largely due to frequent use of antibiotics in human and animal medicine. Little is known about how patients’ socioeconomic factors, in conjunction with chronic health conditions, impact antibiotic prescribing rates in the United States. The research questions aimed to explore the relationship between poverty and antibiotic prescribing rates while also adjusting for confounders such as population aged ≥ 65, physician density, prevalence of obesity, diabetes, and chronic obstructive pulmonary disease (COPD). The relationships were evaluated using a quantitative, ecological study design using the ecosocial theory and mediation analysis of 2020 survey results provided by …