Medicine and Health Sciences Commons^™

Evaluation Of The Antimicrobial Activity Of Four Endodontic Sealers Against Streptococcus Mutans And Enterococcus Faecalis Using The Agar Diffusion Test, Dakota Alan Bailey

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Evaluation of the Antimicrobial Activity of Four Endodontic Sealers Against

Streptococcus mutans and Enterococcus faecalis Using the Agar Diffusion Test

Dakota A. Bailey, D.D.S.

Introduction: The antimicrobial activity of root canal sealers may contribute to the elimination of residual microorganisms that persist following chemomechanical preparation. Limited research has directly compared contemporary bioceramic sealers with traditional sealers against both Streptococcus mutans and Enterococcus faecalis. NeoSEALER EzFlo is a recently introduced bioceramic sealer with limited published antimicrobial data. The purpose of this study was to evaluate the antimicrobial activity of EndoSequence BC HiFlow, NeoSEALER EzFlo, AH Plus Jet, and Kerr Pulp …

Implementation Of A Ventilator-Associated Pneumonia Bundle To Reduce The Incidence Of Ventilator-Associated-Pneumonia And Improve Patient Care, Taylor Ryan Rice

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Ventilator-associated pneumonia (VAP) is a concerning complication that can

develop from complications when a patient is placed on a mechanical ventilator. Endotracheal

intubation puts patients at risk for micro aspiration, which can lead to VAP.

Evidence Review: Nine articles were selected for review; after critical appraisal, seven were

kept for further review. Evidence in these articles shows that using evidence-based methods in a

VAP bundle can decrease the length of stay, mechanical ventilator days, and the incidence of

VAP.

Purpose: The purpose of this project was to improve oral care for intubated patients and keep

the incidence of VAP …

Advancing Interoperability Through Governance And Sustainability: A Qualitative Comparative Case Study Of State Health Information Exchanges In The United States, Karterria Finkley

College of Graduate Studies: Theses & Dissertations

This study presents a comprehensive comparative analysis of state-level Health Information Exchanges (HIEs) across all 50 U.S. states and the District of Columbia, examining how governance structures, consent frameworks, funding models, and technical infrastructure influence interoperability maturity, sustainability, and adoption. Guided by Systems Theory and Donabedian’s Structure Process Outcome framework, the research employs a mixed-methods comparative case design integrating systematic documentary review, qualitative thematic analysis, and a policy-anchored analytic scoring methodology. Structural and policy characteristics were operationalized through standardized ordinal (1-5) metrics and aggregated into composite indices representing governance capacity, consent inclusivity, financial sustainability, and technical readiness. This approach enabled …

Association Between Internet Use For Health Information And Alzheimer’S Disease Diagnosis Among Older Adults With Diabetes In The United States: Examining Racial And Gender Disparities, Henry M. Zeidan

College of Graduate Studies: Theses & Dissertations

This study uses data from the National Health and Aging Trends Study (NHATS) Round 13, collected in 2024, to examine whether internet use for health information is associated with Alzheimer’s disease diagnosis among older adults with diabetes in the United States. Given the rising adoption of digital health, understanding who benefits from online health resources is increasingly important. The research also examines whether these associations differ across racial and gender groups, offering insight into potential disparities in digital health engagement and cognitive outcomes. Findings from this study will inform clinical practice, public health programming, and strategies to ensure equitable access …

Exploring Psychological Safety And Workforce Experiences Among Employees In Recovery Community Organizations In The Southern United States: A Qualitative Study, Claire-Lorentz Ugo-Ike

College of Graduate Studies: Theses & Dissertations

This qualitative study explored how employees in Recovery Community Organizations (RCOs) in the Southern United States experience psychological safety and how these experiences shape employee well-being and their intentions to stay or leave their organizations. Guided by Edmondson’s Psychological Safety Theory and the Job Demands-Resources (JD-R) model, the study examined how leadership practices, workplace culture, and the emotional demands of recovery support work shape employees’ perception of safety, support, and sustainability in the workforce. Semi-structured interviews were conducted with 19 RCO employees working in various peer support roles. Thematic analysis identified five major themes: (1) leadership behaviors shape psychological safety …

Hepatitis C Among Persons Who Inject Drugs In New York State: Progress Towards Elimination, Meredith A. Barranco

Electronic Theses & Dissertations (2024 - present)

Background: Hepatitis C virus (HCV) infection is one of the leading causes of liver disease in the United States (US) and worldwide. In the United States today, HCV is transmitted primarily through injection drug use (IDU) and therefore disproportionately impacts persons who inject drugs (PWID), a population with a range of complex social and health needs. HCV is not vaccine-preventable but can be cured in over 90% of cases with an 8–12-week course of daily direct-acting antiviral (DAA) medication. Since approval of curative medications in 2014, various jurisdictions have developed plans to eliminate HCV. In 2021, the New York State …

The Effects Of Vitamin K On Neuronal Ferroptosis, Chelsey P. Eighmey

Electronic Theses & Dissertations (2024 - present)

Dementia is a crippling illness affecting millions worldwide causing significant public health burdens with long-term care. The lack of treatment options results in many years of suffering for affected individuals and their loved ones who often become primary caretakers. Decades of study have focused on treating dementia with little-to-no success, so an emphasis is needed on attempting to prevent disease progression altogether. This research explored vitamin K as a potential strategy for prevention of dementia onset or progression through the mechanism of suppressing ferroptosis. Ferroptosis is a type of cell death suggested to contribute to the hallmark traits of Alzheimer’s …

Understanding The Syphilis Resurgence Among Females Of Childbearing Age: Informing Prevention Efforts In New York State, Salvatore Currenti

Electronic Theses & Dissertations (2024 - present)

Syphilis is caused by Treponema pallidum and transmitted through direct contact with infected mucosal lesions and via vertical transmission during pregnancy (i.e., congenital). Transmission of syphilis to an infant during pregnancy (i.e., congenital syphilis [CS]) can lead to early fetal death, stillbirth, neonatal death, preterm birth, low birthweight, and congenital infection in infants. The United States (U.S.) is experiencing epidemic increases in both females of reproductive age with syphilis and infants with CS. In New York State (NYS), these trends have also occurred, especially after COVID-19 emergence, and increases in reported cases and incidence rates are comparable to national statistics. …

Associations Between Neighborhood Physical And Social Stressors During Sensitive Developmental Periods And Substance Use In Early Adulthood, Abigail M. Ulofoshio

Electronic Theses & Dissertations (2024 - present)

Background

Substance use is a major public health problem. Neighborhood disadvantage and related stressors have been linked to increased substance use in adolescence and early adulthood, although findings are mixed. No studies have explored whether the timing or accumulation of neighborhood stressors in childhood and adolescence impact substance use in early adulthood. This study aims to investigate to what extent physical and social neighborhood stress during sensitive developmental periods influence substance use dependency and illicit substance use in early adulthood.

Methods

We analyzed an imputed sample (n = 7,494) from the Avon Longitudinal Study of Parents and Children (ALSPAC), a …

Tools Used To Measure Fear Avoidance Behaviour In The Management Of Mild Traumatic Brain Injury (Concussion), Liam Sherwood

Theses: Doctorates and Masters

Concussion can present challenges with respect to diagnosis and management. Fear avoidance behaviour and beliefs may be perpetuating factors in the clinical course of concussion. Understanding which patients may adopt such behaviours and beliefs can offer important information to allow tailoring of clinical management and implementing strategies to minimise the risk of progression to persisting post-concussion symptoms.

In this thesis, I:

-       systematically reviewed the current measurement tools used to assess fear avoidance behaviours and beliefs associated with concussion;

-       explored the experience of clinicians, researchers and people with lived experience of concussion in relation to fear avoidance behaviours;

- …

The Development Of A Midwifery Specific Tool To Identify The Barriers And Enablers To Change Within The Midwifery Setting, Sara Davis

Theses: Doctorates and Masters

Despite being well-positioned to identify service gaps and propose improvements, many midwives lack the knowledge, skills, confidence, or tools to effect practice change. Implementation science (IS) offers a structured approach to moving evidence-based innovations into practice; however, existing IS theories, models, and frameworks do not reflect the unique context of midwifery practice. The first step in the intentional implementation of an evidence-based practice innovation is to conduct a context assessment to identify factors that may facilitate or impede its uptake. There are numerous evidence-based checklists for this, but none capture all the influences on midwifery practice environments.

In this study, …

The Development And Pilot Evaluation Of An Out-Of-Hospital Immersive Birthing Simulation Training Application For Paramedics And Ambulance Officers Using Virtual-Reality Technology, Michella Hill

Theses: Doctorates and Masters

Out-of-hospital births (OOHBs) are births which occur outside a hospital setting. This includes planned home births attended by midwives, or unplanned OOHBs where the intention was to birth in a hospital or maternity centre, however, occurs in an unintended location. Prehospital clinicians, inclusive of registered paramedics and volunteer ambulance officers (VAOs) infrequently attend OOHBs, as most births occur in maternity wards as anticipated. OOHBs comprises < 1% of emergency ambulance requests and requires specialised skills for prehospital clinicians to competently manage birthing and potential complications. As exposure to birthing is so rare, these specialised skills and knowledge are underutilised and subject to rapid decay. Compounding the problem, obstetrics is infrequently taught across undergraduate education, in-service training, or within individual clinician’s continuing professional development. Placements shadowing midwives are scarce due to nursing and medical students receiving priority. Previous research regarding OOHBs is limited, nonetheless suggests prehospital clinicians are underprepared to manage an OOHB, which has serious patient safety implications. The present research sought to explore prehospital clinicians’ preparedness and confidence in managing OOHBs. It also investigates whether a digital training solution such as virtual reality (VR) simulation may reduce the theory-practice gap and assist in competency retention.

Publication one provides a comprehensive methodology outline which is applied to Study One; a scoping review of prehospital clinician and birth parent experiences with OOHBs. Risk factors, complications and interventions provided by prehospital clinicians, as …

Ornithine Metabolism In Retinal Pigment Epithelium And Retina And Implications In Gyrate Atrophy, Artjola Puja

Graduate Theses, Dissertations, and Problem Reports (ETD)

Ornithine aminotransferase (OAT) is a mitochondrial enzyme that regulates ornithine metabolism by converting ornithine to pyrroline-5-carboxylate, a precursor for proline and glutamate synthesis. Deficiency of OAT causes systemic ornithine accumulation and leads to gyrate atrophy (GA) of the choroid and retina, a hereditary disorder characterized by progressive chorioretinal degeneration and irreversible vision loss. Chorioretinal atrophy typically starts at the mid-peripheral retina and progresses toward the macula. Although elevated ornithine is considered toxic to the eye, how ornithine is metabolized in ocular tissues and why OAT deficiency causes selective, region-specific vulnerability remain unclear. We combined ex vivo and in vivo stable …

A Mixed Methods Study Of The Transition To Adult Health Care For Sexual Minority Young Adults With Chronic Pain: Understanding The Impact Of Stigma, Cecily Newel Conour

Graduate Theses, Dissertations, and Problem Reports (ETD)

Sexual minorities with chronic pain are likely to experience stigma stemming from their sexual identity and chronic pain. Pain stigma and sexual minority stigma are associated with increased health disparities and differences in health care utilization, particularly for adults. The transition to the adult health care system appears to be a critical point to understand the impact of stigma on health care utilization to then improve outcomes. With a sample of 48 sexual minority young adults with chronic pain, the current study investigated transition experiences using an explanatory, sequential mixed-methods design that was both observational and cross-sectional. Participants completed quantitative …

Resilience And Reactivity: The Relation Between John Henryism And Cardiovascular Responses To Laboratory Stressors In An Appalachian Sample, Emma Raycher Thompson

Graduate Theses, Dissertations, and Problem Reports (ETD)

John Henryism active coping (JHAC), named for folk hero John Henry, is defined as the perception that one can overcome stressors through hard work (James et al., 1983). This construct has been tied to numerous health outcomes, showing a negative influence on cardiovascular health (Bennett et al., 2004). Many researchers have examined the relation between JHAC and cardiovascular reactivity to stress, though findings are mixed. Further, despite the legend of John Henry occurring in Appalachia, and traits associated with John Henryism, such as resilience, being prominent within this region, no study has examined the relation between JHAC and reactivity in …

Accessing Campus Mental Health Services In A Nigerian Southwestern University: Barriers To Academic Success, Caroline Dada

Electronic Theses and Dissertations

Mental health disorders are a significant health concern among higher education institutions in sub-Saharan Africa, including Nigeria. A substantial treatment gap exists in the Nigerian healthcare system, and this gap is further worsened by cultural and religious barriers, which reinforce stigma that discourages students from seeking professional help. This qualitative narrative inquiry explored the barriers students encountered when accessing mental health services at a university in Southwestern Nigeria, to increase service access. Qualitative semistructured interviews were conducted with seven professional mental health providers at a university counseling center between March and April 2025. Inductive thematic analysis was used to identify …

Going Nuclear: Exploring Mtor’S Transcriptional Role In Regulating Estrogen Receptor Positive Breast Cancer, Alek S. Torres

NYMC Student Theses and Dissertations

Global changes in gene expression are orchestrated by an array of transcription factors regulated by both extracellular and intracellular signals. The mechanistic target of rapamycin (mTOR) is a protein kinase that ubiquitously mediates signaling networks across every cell type, in two active complexes, mTORC1 and mTORC2. By phosphorylating its downstream targets, these classically cytosolic complexes regulate protein homeostasis, metabolism, cell growth, proliferation and survival. However, evidence from prostate cancer studies reveals mTOR and its partners can occupy the nucleus, where its interaction with chromatin (in complex with transcription factors) has been shown to regulate gene expression at the level of …

Translating Evidence Into Action: Understanding How Community- Based Practitioners Make Intervention Implementation Decisions In Practice, Kristin C. Bennett

Dissertations and Theses (Open Access)

This study examined how community-based practitioners implement public health interventions in practice settings to identify gaps between existing implementation frameworks and real-world practice. Six farmers' markets in Southeast Texas served as cases to understand implementation decision-making by community-based practitioners addressing food access challenges. A qualitative case study approach was employed, using semi-structured interviews with program adopters and key stakeholders to examine how practitioners addressed food access problems, selected interventions, and navigated implementation decisions. This methodology captured the contextual nature of implementation decision-making in community settings. The findings revealed that program adopters recognized health problems through lived experience rather than formal …

A Study Of Perceptions, Readiness, Benefits, And Barriers Related To Exoskeleton Adoption In New Jersey’S Warehousing Sector, Terry Asante

Theses

The warehousing industry in New Jersey remains a vital component of the region's logistics network, employing more than 200,000 workers who routinely engage in lifting, bending, overhead reaching, and other physically demanding activities. These exposures contribute to musculoskeletal disorder (MSD) rates that exceed national averages, particularly affecting the low back and shoulders. Nationally, MSDs account for an estimated $420 billion in combined direct and indirect costs each year, underscoring the need for interventions that can effectively reduce biomechanical strain. Industrial exoskeletons have emerged as a potential solution, with prior research demonstrating reductions in muscle activation, perceived exertion, and fatigue during …

Staff Education To Improve Patient Outcomes Through Bedside Shift Report In A Skilled Nursing Facility, Ngum Avwontom

Walden Dissertations and Doctoral Studies

Abstract Problem: Inconsistent shift handoff communication in skilled nursing facilities (SNFs) contributes to adverse patient outcomes, including medical errors, falls, and pressure ulcers. Bedside shift reports (BSRs) are an evidence-based, patient-centered strategy to mitigate these risks, yet implementation at the project site was inconsistent. Methods: This staff education project implemented a standardized BSR program in a 100-bed SNF over seven weeks. The intervention trained 18 nursing staff (RNs, LPNs, CNAs) on BSR using the Situation-Background-Assessment-Recommendation (SBAR) communication framework. A pre- and post-test design was used to evaluate the impact on staff knowledge, shift report duration, and patient safety outcomes, including …

Associations Between Health-Seeking Behaviors And Social Support For Adult Black Women In The United States, Patricia Saint Cyr-Hager

Walden Dissertations and Doctoral Studies

A persistent gap exists involving health outcomes for Black women in the United States, regardless of socioeconomic status when compared to Black men and White women. This qualitative case study involved exploring the influence of social support on health-seeking behaviors among Black women. Sixteen participants, between ages 22 to 49 from nine states, were recruited. Data was collected using semi-structured interviews based on the social support theory. An analysis of the network composition showed that family members (including mothers, fathers, sisters, and partners), friends, community support groups not connected to social media, and online community support groups were the most …

The Association Between E-Cigarette Use And Community Mattering Among Adolescents In Maine, April Hughes

Walden Dissertations and Doctoral Studies

E-cigarette use among U.S. high school students is a significant public health issue. Factors such as mattering, sexual orientation, and gender identity (SOGI) influence e-cigarette use among adolescents, yet few studies have explored the relationship between mattering and e-cigarette use when considering SOGI. This quantitative study explored the association between past 30-day e-cigarette use and mattering among Maine high schoolers while controlling for SOGI and grade level. This correlational cross-sectional study used the 2023 Maine Integrated Youth Health Survey data, and the socioecological model served as the theoretical foundation. A multivariate binary logistic regression analysis indicated a significant association between …

Investigation On The Effects Of Hypoxia-Mimicking Agents In Cancer Progression And Oxidative Stress In Hepatocellular Carcinoma, June Wong Xin Ni

Student Works (2020-2029)

Hypoxia, or oxygen deprivation, is a common pathological feature found in hepatocellular carcinoma (HCC). Hypoxia-inducible factor (HIF) is the master transcription factor of oxygen homeostasis, eliciting a wide range of cellular adaptive responses to either enhance oxygen delivery or reduce oxygen consumption. HIF is primarily regulated by two types of oxygen sensors, the prolyl hydroxylase domain-containing proteins (PHDs) and factor-inhibiting HIF (FIH). In tumours, HIF functions as a double-edged sword whereby it could either promote or hinder tumour progression. This is mainly contributed by the pleiotropic nature of hypoxia and tumour heterogeneity. Recently, there is a growing interest in the …

For Evidence-Based Suicide Risk Assessment, Monica Molah

Walden Dissertations and Doctoral Studies

This clinical practice guideline (CPG) project was developed to address a practice gap regarding the lack of systemic approach to suicide assessment in adult patients. This Doctor of Nursing Practice (DNP) project identified a significant gap in care at a private mental health clinic, which lacked a consistent, evident-based approach to suicide risk assessment. The inconsistency increased the likelihood of under-identifying at risk patients, posing substantial medical-legal and patient safety concerns. The practice-focused question guiding this project was: Does the evidence support the development of a CPG for suicide risk screening that receives an AGREE II quality score by an …

Assessing The Impact Of Substance Abuse On Occupational Injuries Using Workers Compensation Claims In Ohio, Samson Agboola

Walden Dissertations and Doctoral Studies

Occupational injuries remain prevalent across various industries, resulting in significant financial burdens for both organizations and employees through increased workers’ compensation claims. One potential contributing factor is substance use in the workplace, which has been linked to decreased productivity, impaired judgment, and workplace conflict. Despite these risks, the relationship between substance use and occupational injuries remains underexplored. As such, grounded in constructivism and interpretivism, this study investigated the extent to which substance use influences injury outcomes and whether its role is underestimated in workplace incident reporting by analyzing worker’s compensation claims in Ohio. A mixed-methods approach was employed, combining a …

Care Navigator Role In The Management Of Patients' Access At A Mental And Behavioral Health Clinic, Bernadine Grinage

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Bernadine Grinage has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Sue Bell, Committee Chairperson, Nursing Faculty Dr. Diane Whitehead, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2025 Abstract The practice issue cited by clinical staff of a rural mental and behavioral clinic (RMBHC) was fragmented versus holistic care, increase emergency room (ER) visits, inadequate access and patient attrition rate …

Black Nurses In Leadership Roles: Resources And Opportunities Needed For Advancement, Patrick W. Petty

Walden Dissertations and Doctoral Studies

The lack of diversity in healthcare management is a social issue that can lead to increased implicit bias and adverse effects on patient care and quality. This study examined the underrepresentation of Black RNs in leadership roles within healthcare. The purpose of this qualitative descriptive study was to explore the perceptions of Black RNs in leadership regarding the opportunities and resources they need for advancement, as outlined in three research questions. A sample of 10 BSN nurses responded to 10 semi-structured interview questions, grounded in critical race theory. Codes were developed from responses, resulting in nine themes and 16 sub-themes, …

Staff Education On Evidence-Based Practice On External Factors That Impact Management Of Chronic Hypertension In African American Patients, Stella Ngozi Paul

Walden Dissertations and Doctoral Studies

This doctoral staff education project was developed to address a significant gap in nursing practice, specifically the limited knowledge of outpatient clinical staff regarding cultural, social, and health literacy factors that influence the management of chronic hypertension in African American (AA) patients. Through this project, I aimed to equip clinical staff with evidence-based, culturally competent strategies to promote equitable, patient-centered care. This project was guided by the following practice-focused question: Can an evidence-based practice educational session on how external factors impact the management of chronic hypertension in the AA population enhance staff knowledge and understanding? Using the analysis, design, development, …

Exploring The Role Of Astrocyte System Xc– In Excitatory/Inhibitory Balance, Samantha Olivia Sutton

Theses - ALL

Astrocytes play a central role in maintaining excitatory/inhibitory (E/I) balance in the central nervous system by supporting intracellular glutathione (GSH) synthesis and regulating extracellular glutamate. System xc– (Sxc–), an obligate cystine/glutamate antiporter encoded by SLC7a11, couples the import of L-cystine with the export of L-glutamate. It is highly expressed throughout the cortex, hippocampus, striatum, and cerebellum, where its activity provides cystine—the rate-limiting substrate for cysteine-dependent GSH production—and contributes to ambient glutamatergic tone. Although global loss of Sxc– alters seizure threshold and redox homeostasis, whether these effects arise specifically from the loss of astrocytic Sxc– has remained unresolved. This thesis examined …

Perceptions Of Lumbee Tribe Members On Participating In Diabetes Type Ii Prevention Practices, Jeremy Wesley Lowery

Walden Dissertations and Doctoral Studies

Type II diabetes (DB2) is one of the leading causes of death in the United States, whether directly or as a comorbidity. This is especially alarming for Native Americans, who have the highest DB2 prevalence and death rates when compared to their non-Native American peers. This qualitative phenomenological study explored the lived experiences of Lumbee Tribe members in Robeson County regarding DB2. The health belief model was used as a lens through which to understand and interpret findings. In-person semi-structured audio-recorded interviews were conducted with 12 participants recruited through social media. Data were coded and analyzed using deductive thematic analysis. …