Medicine and Health Sciences Commons^™

Relationships Among Vitamin D Deficiency, Metabolic Syndrome, Smoking Behavior, And Physical Activity, Ethan Pham

Walden Dissertations and Doctoral Studies

Aging increases the risk of both vitamin D deficiency and metabolic syndrome. Vitamin D deficiency and metabolic syndrome may be related, although there are mixed findings. Furthermore, literature suggests other factors such as physical fitness activity and smoking behavior are associated with Vitamin D deficiency and the development of metabolic syndrome. A number of studies have documented associations between Vitamin D levels and physical fitness activities, while other studies found correlations between Vitamin D levels, metabolic syndrome, and smoking behavior. However, no previous study has examined the links between physical fitness activity, smoking behavior, Vitamin D levels, and the risks …

Inpatient Rehabilitation, Diabetes, And The Risk Of Clostridium Difficile Infection, Kerry A. Flint

Walden Dissertations and Doctoral Studies

Clostridium difficile is a frequent cause of healthcare-associated infections (HAI) and is associated with increased risk of morbidity and mortality. Studies suggest environmental and host characteristics increase patient's susceptibility to C. difficile infection (CDI). However, few studies have examined the risk of CDI among those with diabetes or patients in the acute rehabilitation (AR) setting. A case-control study, using secondary data (n = 473), evaluated the relationship between CDI and diabetes and identified modifiable environmental exposures. An ecosocial framework was used to examine the relationship between these two complex diseases among hospitalized patients in an AR setting. Results of the …

Effects Of Social Support On Health-Seeking Behaviors Among African-American Men Who Have Sex With Men, Chan Moore

Walden Dissertations and Doctoral Studies

The rate of HIV/AIDS infections among African American men who have sex with men (MSM) is alarming. There has been a challenge in reducing HIV/AIDS among the African American MSM population due to internal and external factors that affect their decision making. The theory of social support and reasoned action were applied to gain knowledge on the lived experiences and perceptions of African American MSM as related to social support and seeking health care, which can help fight the heavy impact HIV/AIDS has placed on this population. Data was collected from 14 African American men who openly identified as MSM. …

Effects Of Patient Protection And Affordable Care Act On Behavioral Health Access, Godwin Oshegbo

Walden Dissertations and Doctoral Studies

About 50% of adults in the United States suffer from at least 1 mental health challenge in their lifetime. Annually, mental health and substance use disorders cost the United States about $800 billion, leaving individuals with unaffordable cost of care and the nation with diminished productivity and revenue. With the Essential Health Benefits and Medicaid expansion under the Patient Protection and Affordable Care Act (PPACA), healthcare resources were created to address gaps in behavioral healthcare. There is a need to understand how the healthcare law has influenced the availability of behavioral health services and access to needed care. This study …

Perceptions Of Healthcare Workers Toward Influenza Vaccination, Amos Adedokun

Walden Dissertations and Doctoral Studies

Even though influenza vaccinations were provided free to all healthcare workers in the United States, healthcare workers were not 100% compliant. The non-compliance with influenza vaccinations may expose their patients, their families, and the public at large to a high-risk source of influenza infection. This study's research questions included how registered nurses perceived influenza and influenza vaccination; registered nurses' self-reported incidents with influenza vaccination; and factors that contributed to registered nurses' non-compliance with influenza vaccination. Guided by the theory of reasoned action and the theory of planned behavior, the purpose of this qualitative study was to determine the factors that …

Childhood Lead Exposure And Attention-Deficit/Hyperactivity Disorder Symptoms: A Meta-Analysis, Megan Glenn Brown

Walden Dissertations and Doctoral Studies

Lead exposure during childhood is a significant global public health concern as the potential effects of exposure can result in the need for long-term treatment, diminished productivity in society, and financial strain on the health care system. There is strong evidence of a relationship between lead exposure and attention-deficit/hyperactivity disorder (ADHD); however, there is a gap in the current literature regarding the relationship between lead exposure and specific symptoms of ADHD and the strength of that relationship. The purpose of this meta-analysis was to examine and help quantify this relationship. Cohen's d was used as the standardized mean effect size …

Geographic Variations In Antenatal Care Services In Sierra Leone, Eunice Nyambura Chege

Walden Dissertations and Doctoral Studies

Despite antenatal care presenting opportunities to identify and monitor women at risk, use of recommended antenatal care services remains. Barriers preventing use of antenatal services vary between countries, and limited knowledge exists about the link between geographical settings and antenatal service use. The objective of this cross-sectional quantitative study was to explore geographical variations and investigate how social demographic characteristics affect use of antenatal care for women in Sierra Leone using the Andersen behavioral model. The data used were from the 2016 maternal death surveillance report of the whole counrty (N =706). Logistic regression analysis was used to determine the …

Effect Of Lung Cancer Treatment On Health-Related Quality Of Life, Festus Frempong Dokyi

Walden Dissertations and Doctoral Studies

Advances in lung cancer treatment among older adults require a risk-benefit analysis for health professionals, patients, and family members to assess increased survival and health-related quality of life (HRQL). The purpose of this study was to assess the effect of lung cancer treatment with surgery or tumor ablation on HRQL domains. A lung cancer quality of life model guided the study. The research design was a quantitative ancillary study in which 70 participants were recruited from those who had already consented to undergo a randomized clinical trial of lung cancer treatment. Data consisted of repeated administrations (baseline, 1- and 3-months) …

Access To Primary Care In Pennsylvanian Rural Townships, Ann Eneh

Walden Dissertations and Doctoral Studies

Access to primary care is limited in rural communities across the United States. Evidence supports primary care as the cornerstone of healthcare. The purpose of this project was to explore community perceptions of barriers to primary care access with the aim of learning about ideas for possible interventions that could improve primary care access for Mifflin County residents. Penchansky and Thomas's model of healthcare access provided the theoretical framework for this qualitative phenomenological study. Using a community-based research approach, semistructured, open-ended telephone interviews and qualitative surveys were conducted with 26 participants, including physicians, nurses, and residents. Data were analyzed using …

Impact Of Social Support On Malaria Management By Burundian Community Health Workers, Bonaventure Bazirutwabo

Walden Dissertations and Doctoral Studies

Malaria is the main cause of mortality for children under the age of 5 in Burundi. The access to malaria diagnostics and treatment is hampered not only because of logistical issues, but also due to the lack of qualified human resources and their inequitable distribution across the country. To mitigate the lack of human resources for health, the government of Burundi, along with its partners, shifted some tasks to community health workers (CHWs) to cover unmet healthcare needs for selected diseases such as malaria, diarrhea, and pneumonia. The purpose of this study was to determine whether the social support provided …

Low-Income Uninsured Perceptions, Beliefs, And Level Of Knowledge Concerning Primary Care Services, Pamela Ann Brown

Walden Dissertations and Doctoral Studies

In the United States, there is an issue with low-income uninsured patients using emergency services for nonurgent conditions instead of using primary care services. Primary care services are more beneficial than emergency services for such patients, in that they can receive continual or follow-up care through primary care and thus achieve better health outcomes over the long term. Though information is available concerning factors in (or the rationale for) low-income uninsured patients choosing the emergency department (ED) instead of primary services for nonurgent conditions, research focusing on low-income uninsured patients' perspectives, beliefs, and level of knowledge about this matter is …

The Impact Of Lemongrass, Oregano, And Thyme Essential Oils On Candida Albicans' Virulence Factors, Jennifer Marie Eddins

Walden Dissertations and Doctoral Studies

Increased systemic infections and growing resistance of Candida species in immunosuppressed people have prompted research for additional treatment options. The purpose of this quantitative study was to investigate the potential of lemongrass, oregano, and thyme essential oils tested individually, combined, and combined with the antifungal agents fluconazole and caspofungin to kill Candida albicans isolates in a controlled laboratory setting. This study was grounded on the theoretical concepts of the epidemiologic triangle model. The experimental data collected were used to investigate risk factors related to age, gender, race, and comorbidities. Kill rates of lemongrass, oregano, and thyme essential oils individually and …

Factors Associated With Menthol Cigarettes Smoking Among Youths Ages 12 To 19, Eniye Emmanuel Eguae

Walden Dissertations and Doctoral Studies

Menthol is added to cigarettes to make smoking more convenient. Menthol is considered a contributing factor that makes smoking appealing to youths and their continuous smoking initiation, which progresses to regular cigarette smoking and addiction, especially among youths ages 12 to 19. Menthol encourages approximately 4,000 youths to experiment with smoking daily in the United States, of which approximately 1,000 become active smokers. Not enough is known regarding the influence of menthol on youth smoking initiation/smoking behavior. A quantitative analysis of data from the 2014 National Youth Tobacco Survey (NYTS) was used to explore the association between age, race/ethnicity, gender, …

Development And Validation Of A Measure Assessing Blind Patients' Perceptions Of Their Healthcare Providers' Stereotype Content, Nazanin Mina Heydarian

Open Access Theses & Dissertations

People with disabilities (PWDs) constitute about 15-20% of the total population. Health disparities among PWD's are due, in part, to stereotypes about PWDs as incompetent. These stereotypes may lead some healthcare providers (HCP) to patronize PWDs, over-focus on the PWDs' impairments and potentially neglect their presenting problem. Moreover, if the PWD violates stereotypical assumptions, the HCP may actively interfere with the PWD's goals. This Dissertation focused on the blind population because this is a large, stigmatized and understudied subpopulation of PWDs. In Study 1, the content of stereotypes about blind patients in the clinical setting were examined from the patient …

Education Models For Teaching Adults About Modifying Dietary Carbohydrate And Controlling Weight, Vincient Cleamons

Walden Dissertations and Doctoral Studies

The prevalence of diabetes and other pathophysiological conditions has been correlated with the incidence of obesity. A large portion of an adult community in the northwestern United States suffers from excessive weight that has been linked to premature mortality rates and certain forms of diabetes. Excess calories from carbohydrate have been shown to increase weight. Therefore, diets that are modified in carbohydrate and calories may help mitigate weight and obesity comorbidities. This qualitative, single case study's purpose was to explore the methods health care professionals use for teaching adults about controlling weight. Altheide and Johnson's analytic realism theory, in which …

Snac_Oshc: Exploring A Multifaceted Approach To Develop Outside Of School Hours Care As A Health Promoting Setting, Karen Forde

Theses : Honours

Background: Outside of school hours care (OSHC) services are underutilised as health promoting settings, yet are well positioned to influence health behaviours. OSHC Professionals are ideally placed to become positive influencers in this setting, although may require training to confidently perform this role.

Aim: This research trialed a multifaceted intervention strategy to increase OSHC Professional’s confidence and competencies, to support a health promoting OSHC environment with a nutrition and PA activity focus.

Design and Methods: This exploratory study adopted a mixed methods approach. The three-pronged, multifaceted intervention included: a workshop, a closed Facebook group, and a website. 19 OSHC Professionals, …

Prevalence Of Methicillin-Resistant Staphylococcus Aureus (Mrsa) Colonization In Medical Students At The El Paso/Cd. Juarez Border Region, Samantha Michelle Meza

Open Access Theses & Dissertations

Background: Due to the constant use, misuse, and over-prescription of antibiotics, antibiotic resistance has become a global public health threat. Methicillin-Resistant Staphylococcus aureus (MRSA) continues to prevail in healthcare settings and is the cause of many nosocomial infections worldwide. A risk factor for developing an active MRSA infection is the colonization of the pathogen in the anterior nares. Over the past two decades, MRSA infections have increased in both the hospital and the community setting, often infecting healthy individuals lacking common risk factors. Healthcare workers with constant exposure to MRSA are more likely to be colonized and can potentially serve …

A Test Of Criteria For Determining "Optimal" Ppor Model Reference Groups: Measuring Excess Infant Deaths In The Border Region, Alexis Nicole Ramos

Open Access Theses & Dissertations

Background: Infant mortality is one of the strongest indicators of social and economic development in all countries. Understanding infant mortality is critical for understanding the health of nations. Strategies for lowering infant death rates are needed. The Perinatal Periods of Risk Model (PPOR) is an approach that allows communities to determine when infant death and excess death is occurring by categorizing death into four perinatal categories. Excess infant deaths are determined by defining a reference group with the lowest mortality rate, and then comparing the reference group rate to other subgroups. The typical reference group has been defined as white, …

Understanding The Multidimensional Factors That Influence Hiv Testing Among Women In The Democratic Republic Of Congo, Danielle Walker

Open Access Theses & Dissertations

Approximately 37 million people worldwide are infected with the Human Immunodeficiency Virus (HIV), with the majority located in sub-Saharan Africa where women are more likely than men to become infected. Even though universal models such as the "HIV Continuum of Care" and the "Bar Before the Bars" exist that provide a context to identify barriers and tools to build the capacity for HIV testing and linkage to care, sub-Saharan Africa remains an HIV epicenter accounting for 72% of all worldwide HIV-related deaths in 2016. HIV testing rates vary significantly among many Central African countries; the DRC in particular has one …

Nutrition Label Accuracy And The Theory Of Triadic Influence: The Impact Of Knowledge On Healthy Food Choices In A Predominantly Hispanic Sample, Mosi Staudt Dane'el

Open Access Theses & Dissertations

Unhealthy food choices and the outcomes of those choices are a significant concern in the United States. Multiple governmental agencies recommend using nutrition labels to promote healthier food choices. This study investigated this claim using the theory of triadic influence to examine the efficacious use of nutrition labels on food choices. The theory of triadic influence presents a model of variables that affect food choice, including knowledge pathways on which this study focuses. Within the model, we expected increased scores on two measures of health knowledge to predict nutrition label understanding, which predict healthy food attitudes. Next, we expected that …

Environmental And Genetic Factors Affecting Antibiotic Resistance Of Extended Spectrum Î?-Lactamase Bacteria From The Rio Grande River In El Paso, Tx And Cd. Juarez, Mexico, Maria D. Fuentes

Open Access Theses & Dissertations

Background: The Rio Grande River provides a major source of potable and agricultural water for the population of the Texas/Mexico border region. Cattle farming and ranching are the most prevalent activities, which may contribute to the microbial burden of pharmaceuticals into our state's water resources. Antibiotics, presumably released into the environment by discharges originating from waste-water treatment plants, septic disposal systems, animal feeding operations and urban runoff have a definite impact on the ecosystem and may contribute to an increase in antibiotic resistance. We hypothesized that waters of the Rio Grande River contained Multi Drug Resistant Organisms (MDRO) and mobile …

Formative Evaluation Of The Health Belief Model As A Valid Theoretical Framework For "The Diabetes Garage", Renee Alexandria Orrantia

Open Access Theses & Dissertations

Background & Significance. Recent studies estimate the prevalence of diabetes among Hispanics/Latinos (H/L) to be 16.9% and 18.7% among H/L men specifically. To address this disparity, the Diabetes Garage (DG), a culturally tailored Diabetes Self-Management Education and Support (DSME/S) program, was designed to engage H/L men in diabetes self-management. Because seriousness of diabetes best predicts men’s engagement in self-care, the Health Belief Model (HBM) was chosen as the central theoretical framework. The HBM hypothesizes that the cue to action (i.e. DG) increases men’s perceived diabetes risk/severity/threat, self-efficacy in self-care, and health outcomes. Aims & Objectives. This research was aimed to …

Predictive Relationship Between Treatment Adherence, Glycated Hemoglobin And Diabetic Complications Among Jamaicans, Christian Anaba Nwaukwa

Walden Dissertations and Doctoral Studies

Patient nonadherence to physicians' prescribed therapeutic regimen is the greatest challenge in the effective treatment of patients with diabetes worldwide. Scientific evidence has revealed that nonadherence to prescribed medication could result in diabetic complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathic diabetic foot ulcers. The purpose of this study was to explore predictive relationships between levels of adherence to antidiabetic medications, patient HbA1c levels, and diabetic complications among Jamaicans, an understudied population. The research question that guided this study was: Do the patient level of adherence and HbA1c levels have any predictive relationship with the severity of diabetic complications …

Health Literacy And Hypertension Management In Haitian Immigrants, Suzie Jean

Walden Dissertations and Doctoral Studies

Patient compliance and health care communication are impacted by health literacy. Poor health choices, frequent hospital visits, noncompliance with health regimens, and higher health costs are all associated with low health literacy. The purpose of this cross-sectional study was to determine whether there was an association between health literacy as measured by primary language spoken in the home (Creole vs. English) and hypertension self-management as measured by regular use of medication and cutting down on foods high in salt, and whether there was an association between Haitian men, women, their education level, or level of poverty in relation to health …

Preventing The Spread Of Illness In College Residence Hall Populations, Lacey Burkholder, Katherine Allensworth, Haley Schaffter

Williams Honors College, Honors Research Projects

Illness contributes to a decrease in student class attendance which can lead to increased academic stress. Decreasing the spread of illness among those living in residence halls is essential to academic success. The purpose of this systematic review was to identify interventions implemented in residence halls on college campuses to reduce the spread of illness. The PICO question directing the research for this study asks, “How do interventions affect the spread of illness in university residence hall populations?”. The research conducted was completed by means of a systematic review of literature including 20 peer reviewed articles published between 1999-2017 from …

Concerning Trends In Allopathic Medical School Faculty Rank For Indigenous People: 2014–2016, Erik Brodt, Amanda Bruegl, Erin K. Thayer, M. Patrice Eiff, Kelly L. Gonzales, Carlos J. Crespo

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Trends in faculty rank according to racial and ethnic composition have not been reviewed in over a decade.

Objective: To study trends in faculty rank according to racial and ethnicity with a specific focus on Indigenous faculty, which has been understudied.

Methods: Data from the Association of American Medical Colleges’ Faculty Administrative Management Online User System was used to study trends in race/ethnicity faculty composition and rank between 2014 and 2016, which included information on 481,753 faculty members from 141 US allopathic medical schools.

Results: The majority of medical school faculty were White, 62.4% (n = 300,642). Asian …

Gender Differences In Sexual And Reproductive Health Protective And Risk Factors Of Batswana Adolescents: Implications For Parent And Adolescent Interventions, Christina J. Sun, Esther S. Seloilwe, Mabel Magowe, Kefalotse S. Dithole, Kim S. Miller, Janet S. St. Lawrence

OHSU-PSU School of Public Health Faculty Publications and Presentations

Adolescents in sub-Saharan Africa and in Botswana in particular continue to bear the brunt of the HIV epidemic. This analysis assessed gender differences among theory-based sexual and reproductive health protective and risk factors in a cross-sectional sample of 228 Batswana adolescents. Incongruence between preferred and actual sources of sexual information and several important gender differences in parent-adolescent relationships, psychosocial influences, and adolescent sexual behaviors were identified. Parents were the fourth most common source of information about sex; yet, over three-quarters of adolescents preferred to have parents teach them about sex. Boys reported more positive relationships with their parents and girls …

Efficacy Of Methods Available To Remove Environmental Tobacco Smoke In Vehicles, Brian Albert Nielson

Walden Dissertations and Doctoral Studies

Environmental tobacco smoke (ETS) is a serious public health threat. Residual ETS in vehicles unknowingly exposes future occupants to environmental tobacco smoke. Reducing or removing exposure to ETS has been proven to reduce long-term health complications. This quasi-experimental study investigated 5 cleaning methods and their effect on air particulate matter2.5 (PM2.5) along with the correlation between air nicotine levels and PM2.5 levels. Study variables included cleaning methods as the independent variable, and changes in air nicotine and PM2.5 levels as the dependent variables. This study is framed within primary prevention and risk reduction based on the harm reduction theory. The …

Exploring Sports Participation And Sexual Risk Behaviors In High School Males, Jessica L. Dupree

Walden Dissertations and Doctoral Studies

Casual sex culture, also known as hook-up culture, is an experience adversely affecting teens in America. The intent of this study was to test the association between sports participation and sexual risk behaviors among high school males. For the purpose of this study, sports participation, the independent variable, was defined by having played on a sports team in the last 12 months. The sexual risk behaviors, dependent variables, were defined by sexual engagement with multiple partners, drug and alcohol use before intercourse, and sex without condoms. The ecological model provided the theoretical foundation for the study. Secondary analysis of the …

Gender, Social Support, And Resiliency In Suicidal Ideation Among U.S. Army Soldiers, John Franklin Ambrose

Walden Dissertations and Doctoral Studies

Suicidal behaviors have continued to increase in the United States (U.S.) Army population since the beginning of the wars in Iraq and Afghanistan. Suicide rates are higher in men compared to women; yet, the rate of suicidal ideation is higher in women than men. The purpose of this study was to determine if there is a correlation between suicidal ideation and protective factors, if social support and resiliency are different for men and women within the U.S. Army population, and if gender acts as a moderating variable between suicidal ideation and protective factors. The interpersonal-psychological theory of suicidal behavior was …