Medicine and Health Sciences Commons^™

The Experience Of Transition To Self-Management For Saudi Adolescents With Type I Diabetes, Aeshah M. Almulhim

Dissertations

In Saudi Arabia (SA), between 2011 and 2021, there has been a 108% increase in death rates due to diabetes. Every year, around 3,800 Saudi children and adolescents under the age of 19 are diagnosed with Type I Diabetes (TIDM). Saudi adolescents with TIDM have less glycemic control than adults and younger children. If left untreated, inadequate glycemic control may hasten the onset of diabetes complications and early death. As adolescents with TIDM grow older, they are expected to take on more independence in Self-Management (SM) of their diabetes. The poor clinical outcomes of adolescents with diabetes, the onset of …

Evaluating Sympton Clusters In First-Time Ischemic Stroke Survivors Who Discharge From The Hospital To Home, Paula De La Pena

Dissertations

The purpose of this study was to examine symptoms and relationships between those symptoms in first-time ischemic stroke survivors who discharge home after their initial stroke. Current measurement of recovery after stroke places emphasis on the physical aspects of recovery when current literature suggests that other, more subtle symptoms may be equally contributory to recovery. This descriptive, exploratory research study was conducted via a secondary analysis of both structured and unstructured data in a study cohort of 115 first-time ischemic stroke survivors from a tertiary academic medical center in the Midwest. Unstructured clinical notes were analyzed for the presence of …

A Phenomenological Study: Implicit Bias In The Hiring Practices Of Health Care Organizations (Perception, Impact On Workforce Diversity, Mitigation Methods, And Implementation Assessment), Mohamed Boubrik

Dissertations

Purpose: The purpose of this phenomenological study was to explore how implicit bias influences hiring practices within health care organizations. Specifically, it investigated the perceptions of hiring professionals regarding implicit bias, its impact on workforce diversity, the strategies used to mitigate it, and the effectiveness of those strategies in real-world implementation.

Methodology: This qualitative study employed a phenomenological approach to capture the lived experiences of hiring professionals in Southern California health care organizations. A random sampling method was used to select participants across various health care facilities. Data collection was conducted through semistructured interviews, using a validated interview protocol as …

The Role Of Support And Prayer In Enhancing The Psychological Well-Being Of Cancer Patients In Canada, Emmanuel N. Mbah

Dissertations

Purpose of the Study

The purpose of the study was to investigate the role of family support, friends' support, community support, and prayer on the psychological well-being of cancer patients in Canada.

Methodology

A survey research method was used in this study. The survey was distributed through the QuestionPro audience and had 721 viewers, 674 respondents, and 400 participants (i.e., those who completed the survey). The survey completion rate was 59.35%, with an average completion time of 9 minutes. Most participants were Christians (62.0%), some were unaffiliated (29.5%), and the remaining participants were either Muslims, World Religion, Buddhism, Hinduism, etc. …

The Relationship Between Mindfulness, Emotion Regulation, And Anxiety Levels Among College Students In Saudi Arabia, Tahani Aljuaid

Dissertations

Problem

Anxiety is one of the most common psychological issues affecting youth globally and is particularly prevalent among Saudi adolescents and college students. Studies in Saudi Arabia have reported anxiety rates ranging from 48.9% to 66.2% among adolescents and high levels of generalized anxiety among university students, especially females (Aldosary et al., 2023; Alhabeeb et al., 2023). Poor emotion regulation has been identified as a key factor associated with anxiety and other mental health difficulties. In recent years, mindfulness has gained attention as a protective factor that promotes better emotion regulation and reduces anxiety symptoms. Despite this growing recognition, there …

Perceptions Of Influence And Collaboration Amongst Healthcare Providers, Nurses And Allied Health Professionals, Barbara Harrison

Dissertations

Problem

While attention to interprofessional collaboration is increasingly present in academic settings and in clinical practice, there is little understanding of the role power, specifically the scope of influence, plays in interprofessional collaboration.

Method

Targeted cross-sectional sampling was used to select possible candidates to participate in this quantitative study. An email invitation was sent to healthcare providers, nurses and allied healthcare professionals in a multi-hospital healthcare system in the mid-western United States of America. Willing participants proceeded to the Microsoft Forms survey via an embedded link which was available to them for eight days. The survey sought demographic information, and …

The Impact Of Professionalism Education And Formative Feedback In Doctor Of Physical Therapy Students Utilizing The Abbreviated Cpi Feedback Form In The On-Campus Clinic Environment, William L. Scott

Dissertations

Problem

The American Physical Therapy Association (APTA) developed the Clinical Performance Instrument (CPI) to assess the professional behaviors required for a Doctor of Physical Therapy (DPT) student to be considered "entry level" in their clinical training. Feedback from our clinical partners has indicated that, historically, students from the Andrews University DPT program have scored lower than students from other programs in several areas of the CPI during their clinical experiences. According to subjective reports from our clinical partners, these areas included safety, professional behavior, accountability, communication, and critical thinking. These five areas have been the focus of our efforts in …

An Exploration Of The Clinical Senior Nursing Student Preceptor Relationship, Kimberly Nicole Dunker

Dissertations

Problem

The use of clinical preceptors for training is well documented in the literature as an effective strategy for helping students, new graduates, and RNs orient to their roles in healthcare facilities. The need to ensure that the preceptor is adequately trained and then matched to a preceptee for a successful relationship is a challenge. The healthcare facility does its best to identify a preceptor and ensure adequate training is completed and there is a willingness to facilitate the experience. The academic institution is required to ensure that preceptors are chosen based on criteria outlined by the board of nursing …

Predictors Of General Education Teachers' Self-Efficacy For Educating Autistic Students: Enactive Mastery Experiences, Vicarious Experiences, Verbal/Social Persuasions, And Physiological And Affective States, Renette Portecop-Prentice

Dissertations

Problem

Autism is a complex neurodevelopmental condition that presents challenges not only for autistic individuals, but also for their families, healthcare providers and school professionals. A significant number of children with autism spend most of their school day in general education classrooms with teachers who may lack autism-specific training and are unfamiliar with evidence-based practices for supporting autistic students. This lack of training or relevant resources specific to autism may impact teacher self-efficacy for educating autistic students, which in turn may affect instructional decisions and student outcomes. Guided by Bandura’s theoretical framework, this study examined the relationships among autism-specific training …

Healthcare Providers’ Lived Experiences During Pivotal Change, Lisa Raynelle Shelley

Dissertations

This phenomenological study examined healthcare providers’ lived experiences of psychological safety and administrative leader behaviors that influenced those experiences during pivotal change. While much research addressed psychological safety among frontline healthcare staff, a gap was noticed concerning providers. This study aimed to investigate the impact of psychological safety and administrative support on provider engagement, emotional response, and retention during periods of significant change. Data were collected via a survey containing multiple-choice and open-ended questions, followed by semi-structured interviews. Four findings emerged. First, the providers’ pivotal events generated themes of “workplace power dynamics,” “systemic and organizational change,” “transformational crisis,” and “physical …

Developing Chemically Defined Serum-Free Medium For Leukemic Blast And Stem Cell Expansion, Carmen Eva Finley

Dissertations

The relapse and chemotherapy resistance are the major challenges of acute myeloid leukemia (AML) treatment, driven by a rare population of leukemia stem cells (LSCs). LSCs are unique types of cells which evade standard chemotherapies and can regenerate AML post-treatment. Targeting LSC therapy remains limited, in part due to the lack of reliable in vitro AML culture systems to grow LSCs for drug discovery. This study aimed to engineer a chemically defined, serum-free 2D in vitro culture condition that supports either the expansion of leukemic blasts (LBs) or primary human LSCs by optimizing current protocols for hematopoietic stem cells (HSCs) …

The Bacterial Sensing Nuclear-Oligomerization Domain 2 Receptor In The Brain: Location And Potential Function, Julia Smyth

Dissertations

Nucleotide-binding oligomerization domain-2 (NOD2) is a cytosolic receptor, activated by bacterial peptides that initiates innate immune responses through nuclear factor-κB (NF-κB), mitogen-activated protein kinase (MAPK), and Caspase-1 pathways. While the role of NOD2 in inflammation outside the central nervous system (CNS) is well-established, especially in the gastrointestinal system, its expression and function in the brain remain poorly defined. Previous genetic studies suggest a link between NOD2 and neurological and psychiatric conditions, including stroke, Parkinson’s disease, and schizophrenia. However, information regarding NOD2 expression, localization, and function in the CNS is limited. In this work, we investigated NOD2 expression, localization, and regulation …

Self-Awareness And Self-Efficacy In The Novice Professional Phase Of Marriage And Family Therapists After Person Of The Therapist Training, A Comparative Survey, Rubio Betsabé

Dissertations

The study focuses on examining the influence of person-of-the-therapist or self-of-the-therapist training on therapists’ self-reports of self-awareness (as a conscious awareness of one’s internal states and interactions with others) and self-efficacy (perceived beliefs in personal capabilities to perform in ways that give control over events that affect their lives) at the novice professional stage of their career. The study will examine the experiences reported by mental health providers actively providing clinical care by utilizing a survey design focusing on person of the therapist connecting through alumni lists and online solicitation. This research adds to the current literature by using a …

What Works In Telehealth Play Therapy? An Appreciative Heuristic Inquiry, Veronica Ann Ball

Dissertations

With the onset of coronavirus disease 2019 (COVID-19) in the United States in March 2020 (World Health Organization, 2020), professional counselors providing traditional in-person play therapy found themselves in a quandary regarding the delivery of services during a global pandemic (Evans, 2022; Mitchell, 2020; Whaibeh et al., 2020). Online counseling proffered a means to prevent the disruption of services, respond to the need for emerging counseling services, and comply with social restrictions (Evans, 2022). Prior to the pandemic, telehealth play therapy was used sparingly (Haslam & Harris, 2011; Smith et al., 2021), and many child-serving mental health professionals lacked training …

What About The Children? An Exploration Of Family Counselors' Play Therapy Training And Preparedness To Integrate Children Into Family Counseling, Patricia J. Walker Monical

Dissertations

Children are an important part of families, yet family counselor education programs often do not incorporate training for including children in family counseling. At some point in their careers, family counselors and therapists will encounter clients who have children 3–12 years old. The problem is that since these professionals often receive little to no training in play therapy and thus do not typically include young children in family therapy, these younger family members are often overlooked. Research has confirmed that, due to a lack of sufficient training and supervision in play therapy, many family therapists report feeling unprepared to work …

Learning Paradigms For Rhythm Detection And Generation Using Mathematical Models, Biophysical And Artificial Neural Networks, Prianka Bose

Dissertations

Humans possess an inherent ability to recognize evenly-spaced rhythms, known as isochronous rhythms, owing to the brain's predisposition to entrain to external auditory stimuli with regular temporal intervals. The central focus of this research is to understand how the brain learns and retains rhythmic time intervals in the context of music. This dissertation studies rhythm detection and generation through mathematical models, biophysical networks, and artificial neural networks, addressing both isochronous and non-isochronous patterns.

A primary focus of the thesis is on isochronous rhythms. In particular, given a perturbation to an isochronous rhythm such as a tempo change or phase shift …

Machine Learning Methods For Pattern Recognition Analysis Of Genomic And Molecular Data, Kuang Du

Dissertations

While immune therapies achieve remarkable success in treating various cancers, only a subset of patients achieves a durable clinical response, and many exhibit innate or acquired resistance. Precision medicine aims to tailor treatments to individual patients based on specific biological markers, ensuring that each patient receives the therapy most likely to be effective. Predictive biomarkers and gene signatures offer potential for more personalized treatment strategies by identifying patients likely to benefit. Recent studies suggest that gene signatures, comprising sets of genes, hold predictive value for certain clinical variables. Typically derived from biological expert knowledge, these signatures demonstrate substantial predictive potential, …

Improving Diabetes Self-Management Skills Among Adults With Type 2 Diabetes Through Weekly Education, Carthia Joachim

Dissertations

Type 2 Diabetes Mellitus is one of the major health issues worldwide, which has led to many health complications, such as cardiovascular disease, nerve damage that leads to limb amputation, kidney damage, and even death (Sameer et al., 2020). Lack of self-care management is one of the reasons diabetes is becoming such an issue in society. Studies have shown that T2DM outcomes can be improved by implementing diabetes self-management education (DSME) (Hailu et al., 2019). The study evaluated the effectiveness of DSME intervention in adult patients with T2DM over 12 weeks in Orlando, Florida. Using a structured education program, the …

The Nurse Faculty Compassion Instrument: A Methodological Study, Nancy Pritchard

Dissertations

As nursing shortages rise, nursing faculty have the important responsibility of increasing the number of nursing school graduates that enter the nursing profession. Unfortunately, attrition and retention continue to prevent nursing students from graduating on time or at all. Nursing faculty compassion has been identified as one important factor that could decrease nursing student attrition and increase nursing student retention and program completion. Compassion is a concept built upon the constructs of forming connections, empathetic behaviors, student suffering and faculty recognition of needs, and alleviation of suffering. No existing instruments measure all of these constructs. Some existing tools that measure …

Relationship Of Stress, Family, And Social Support, And Job Satisfaction To Burnout Among Family Nurse Practitioners Employed In Primary Care Clinics In Mississippi, Laura-Jean Scott Brooks

Dissertations

In the realm of healthcare, burnout is the invisible monster that has infiltrated every facet of the industry with grossly visible results. From provider turnover to patient errors, burnout has lifelong effects on the healthcare provider and patient care. This researcher seeks to study variables and the relationship to burnout among Family Nurse Practitioners who practice in primary care in Mississippi. The Review of the Literature demonstrated a lack of findings in burnout among family nurse practitioners. Most of the literature reviewed focused on burnout among registered nurses. The guiding hypothesis of the research study was that social and family …

Academic Nurse Leaders’ Application Of Bolman And Deal’S Leadership Orientation Framework, Jasmine Bratton

Dissertations

While Academic Nurse Leaders (ANLs) are vital to the functioning and quality of nursing programs in academic settings, many enter their roles with limited or no prior academic leadership and management experience. The inadequate preparation and development of ANLs remains a critical concern. For this reason, ANLs positions can be challenging and hard to fill. Although ANLs can hold various titles and positions across different academic institutions, this study specifically focuses on Deans, Directors, and Department Chairs working in the New York State area. Bolman and Deal’s (2021) four-frame model of leadership offers a framework that can be used to …

Elucidating The Mechanism Of Interleukin-17a Signaling In The Pathogenesis Of West Nile Virus, Farzana Nazneen

Dissertations

West Nile Virus (WNV), a neurotropic flavivirus transmitted by mosquitoes, is a leading cause of viral encephalitis in the United States and remains a significant public health concern. Unfortunately, no vaccine or therapeutic intervention is available against WNV infection. Previous studies, including ours, demonstrated that interleukin-17A (IL-17A) signaling increases the cytotoxic potential of CD8⁺ T cells to facilitate WNV and parasite clearance; however, the molecular mechanism is not understood. IL-17 receptor C (IL-17RC) is an obligatory co-receptor with IL-17 receptor A (IL-17RA) for signaling induced by IL-17A, IL-17A/F, and IL-17F. In this study, we found that IL-17RC deficient ( …

Public Health Implications Of State-Level Public Health Organizational And System Structures, Cameron Ferguson Hays

Dissertations

Public health thought leaders such as the Institute of Medicine and National Academies of Science, Engineering, and Medicine have long been concerned about the lack of standardization among state-level public health systems (IOM, 1988; NASEM, 2023). However, little research studies these systems, their structures, and whether structural constructs affect population health outcomes.

This study attempted to examine the structural constructs that make up these systems and the impact of those constructs using an exploratory sequential mixed-methods design. Variables from management science were qualitatively extracted from materials describing all 50 state-level public health systems. Those variables were then analyzed using a …

Intelligent Health Monitoring Systems Via Flexible Hybrid Electronics And Machine Learning, Masoud Panahi

Dissertations

Advanced data analytics approaches, such as artificial intelligence (AI), are increasingly being integrated into all aspects of patient care. This integration is paving the way for minimally invasive or non-invasive treatment modalities. By combining recent advancements in fabrication technology and computing ingenuity, wearable devices now enable continuous health monitoring and provide data for AI-driven analysis. These intelligent devices seamlessly integrate with the Internet of Things (IoT), enabling remote or “at-home” patient monitoring.

This dissertation study investigates the integration of recent advancements in flexible hybrid electronics (FHE) and machine learning (ML) to develop intelligent health monitoring systems. The developed FHE-based health …

Disruptive Clinician Behavior: A Qualitative Descriptive Study Of Non-Native English-Speaking Nurses, Seyoung Baik

Dissertations

Background: Disruptive clinician behaviors among healthcare staff are an increasing concern, negatively affecting patient safety. In 2015, 16% of nurses in the U.S. were foreign-born (Shaffer et al., 2022), and 25% of New York and California nurses were immigrants (Shaffer et al., 2021). Nurses' migration to the U.S. has been exploding. Non-native English-speaking nurses experience complications, problems, and discord in their workplace with coworkers.

Aim: The purpose of this qualitative descriptive study was to explore and understand non-native English-speaking nurses’ experiences with disruptive clinician behaviors in the U.S.

Specific aims were to 1) create a comprehensive description of the experiences …

Examining Mentoring As A Catalyst For Nurse Work Engagement And Professional Development, Cherryl A Rainey

Dissertations

Abstract

Research literature has identified mentoring as a strategic intervention for employee professional development. The Business and Psychology disciplines have used mentoring widely for employee development, but it has not been used extensively in nursing.

Nursing has unique challenges and is constantly changing with a need to meet some of those needs by advancing the development of nurses to serve as leaders and fill positions due to nurse shortages and high turnover rates. Mentoring has also been identified as a vehicle to promote work engagement.

The purpose of this study was to examine mentoring as a catalyst for nurses’ professional …

Genomics Insights Into Anti-Platelets Therapy: Unraveling Of Variants And The Implementation Of Clopidogrel-Guided Therapy In The United Arab Emirates, Lubna Qasem Khasawneh

Dissertations

Anti-platelet therapy is a cornerstone in the management of cardiovascular diseases such as Acute Coronary Syndrome (ACS) and stroke. These medications are essential for reducing the risk of thrombotic events by preventing platelet aggregation. However, variations in cardiovascular pharmacogenes can significantly impact the metabolism, efficacy, and safety of anti-platelet therapies, making personalized medicine increasingly important for optimizing treatment outcomes. Pharmacogenomic testing has emerged as a crucial tool in tailoring anti-platelet therapy, particularly for patients with subtherapeutic responses due to genetic factors. While extensive research has been conducted globally to identify and study the effect of the pharmacogenomic variants that influence …

Mouse Mammary Tumor Virus (Mmtv) Genomic Rna (Grna) Packaging: Selective Grna Encapsidation Is Facilitated By Long-Range Interactions (Lris) That Facilitate Specific Gag Binding, Suresha G. Prabhu

Dissertations

Mouse mammary tumor virus (MMTV) is a betaretrovirus that induces breast cancer and sporadically, T-cell lymphomas in mice. MMTV serves as a pertinent model for elucidating the mechanism(s) of oncogenesis and the genetics associated with the development of mammary tumors. Being a rodent retrovirus, MMTV is phylogenetically distant from human and other primate retroviruses; thus, positioning it ideally as a potential vector of choice for human gene therapy. This may circumvent safety concerns such as recombination with other related endogenous human retroviruses. In addition, MMTV is distinct from most other retroviruses, but similar to lentiviruses, in that it has the …

Conceptions Of Latinos And Latinas About The Grieving Process And Associate Concepts Of Dying, Death, Bereavement, And Loss: A Covid-19-Post-Pandemic Case Study, Rosario Garcia Ortiz

Dissertations

The purpose of this study was to recognize the grieving process and the related concepts of Latinos who lost a loved one to the COVID-19 pandemic. Death and dying have been studied in the United States, with limited studies focusing on the Latino culture. The COVID-19 pandemic was a devastating experience for the world and continues to be studied for understanding and lessons in the aftermath. This research included four participants from the Latino culture who lost a loved one during the COVID-19 pandemic. An inductive approach and data analysis were used to form theoretical constructs. Three main categories were …

Fabrication And Evaluation Of Multicomponent Biomimetic Scaffolds For Bone Tissue Engineering, Mozan Osman Hassan

Dissertations

Bones have an inherent ability to remodel, but critical-size defects can hinder regeneration, leading to delayed healing or non-union fractures. Traditional bone grafts have limitations, such as donor site morbidity and immune rejection, driving the need for synthetic bone substitutes. Bone tissue engineering (BTE) addresses this by developing biomimetic scaffolds that replicate bone properties. This research aimed to fabricate composite scaffolds from strontium (Sr) and zinc (Zn) doped nano-hydroxyapatite (nHAp), collagen, and poly(lactide-co-glycolide) (PLGA). Different doping percentages of Sr/Zn (1%, 2.5%, 4%) were used to fabricate the scaffolds using supercritical CO2 (ScCO2) and electrospinning techniques. Scaffolds were then analyzed for …