Medicine and Health Sciences Commons^™

A Correlational Study Of Telework Frequency, Information Communication Technology, And Job Satisfaction Of Home-Based Teleworkers, Shana P. Webster-Trotman

Walden Dissertations and Doctoral Studies

In 2008, 33.7 million Americans teleworked from home. The Telework Enhancement Act (S. 707) and the Telework Improvements Act (H.R. 1722) of 2009 were designed to increase the number of teleworkers. The research problem addressed was the lack of understanding of factors that influence home-based teleworkers' job satisfaction. Job dissatisfaction has been found to have a significant impact on voluntary turnover. The purpose of the study was to assess the relationship among telework frequency, information communication technology (ICT), and job satisfaction. The research questions were designed to answer whether correlational relationships exist among telework frequency, ICT, and job satisfaction and …

Managing Health Care In A Libyan Public Hospital: A Case Study, Alexandria K. Osborne

Walden Dissertations and Doctoral Studies

Libyan citizens who can afford private health care are opting out of the public health care system. They have a perception that the quality of public health care has deteriorated. The negative perceptions have resulted in a lack of trust by many of Libyan's citizens in the Libyan public health care system and consequently to unequal access to quality health care. The purpose of this study was to identify the factors that have led to the negative perceptions and mistrust. The conceptual support for the study was based on a construct of trust that defines trust as the state of …

Racial /Ethnic Differences In Susceptibility And Intention To Smoke On Smoking Behavior Among Adolescents, Kafilat Tolani Jimba

Walden Dissertations and Doctoral Studies

Every year, more than 400,000 Americans die prematurely because of tobacco use, and most users began smoking during their teen years. Adolescent tobacco use remains the nation's most preventable threat to life and health. A better understanding of the relationships between susceptibility to smoking and intention to smoke on smoking behavior by ethnicity, age, and gender is useful for program planners and health educators in designing ethnic, age, and gender specific strategies for tobacco control and prevention initiatives. The purpose of this study was to test the relationships between susceptibility to smoking and intention to smoke on smoking behavior among …

The Relationship Between Leadership Styles And Performance Success In Hospitals, Beverly J. D. Hernandez

Walden Dissertations and Doctoral Studies

Upheavals in the health care landscape threaten the sustainability of contemporary hospital organizations. Yet there is limited research regarding the characteristics of leaders within successful hospitals. The problem is the leadership styles needed to effectively run hospital organizations have not been identified and/or established. The purpose of this study was to develop a model of congruent leadership styles linked to the success of hospitals in one metropolitan city. The research questions sought to uncover (a) consistent leadership styles within successful hospitals, and (b) what, if any, relationship exists between leadership styles and measures of success. Examination of the literature uncovered …

The Mediating Role Of Psychological Distress In The Relationship Between Adverse Childhood Experiences And Adult Smoking, Tara Wynn Strine

Walden Dissertations and Doctoral Studies

While research has indicated that impaired mental health partially mediates the relationship between adverse childhood experiences (ACEs) and alcohol and illicit drug use, little research has examined potential mediators in the relationship between ACEs and smoking, the number one cause of preventable mortality in the United States. Accordingly, this study examined the potential mediating effect of psychological distress on the relationship between ACES and smoking using data from Wave II of the ACE Study, a cross-sectional study completed between June and October of 1997 on a sample of adult health maintenance organization members (N = 7,211). The theoretical underpinnings for …

National Survey On Equine Assisted Therapy: An Exploratory Study Of Current Practitioners And Programs, Patricia J. Mcconnell

Walden Dissertations and Doctoral Studies

Equine facilitated psychotherapy (EFP), a new field in psychology, is an alternative method of therapy that uses horses to facilitate therapeutic outcomes. There is minimal peer reviewed literature and few published studies examining efficacy. The conceptual lens of this study was grounded theory, as there is insufficient evidence of theoretical frame-works guiding equine assisted therapy. The purpose of this exploratory concurrent mixed methods study was to examine the theoretical foundation of practitioners; program make up; client populations; efficacy of program; and why the horse serves as the therapeutic catalyst of this model. A 43-item survey was sent to 800 programs, …

Immigration And Obesity In African American Adults Residing In The United States, Julius N. Ade

Walden Dissertations and Doctoral Studies

Obesity increases risk for heart disease, hypertension and other chronic diseases, and it affects minority ethnic groups disproportionately. However, it is unknown if African American immigrant adults, an increasing segment of the population, are at higher risk for obesity than African American non-immigrant adults residing in the United States. This study examined the association of obesity and immigrant status by comparing African American immigrant adults now residing in the United States to the general population of African American adults. The socio-ecological model provided the conceptual framework for this study. This study used a cross-sectional quantitative self-administered web-based survey to collect …

The Use Of Human Patient Simulators To Enhance The Clinical Decision Making Of Nursing Students, Sharon Kay Powell-Laney

Walden Dissertations and Doctoral Studies

One of the newest teaching modalities in nursing education is the use of human patient simulators (HPS). An HPS simulation scenario creates a software program vignette in which students interact with a manikin to practice caring for critical patients in a risk-free environment. Although used extensively in schools of nursing, there is little research that examines if these expensive simulators improve the clinical decision-making ability of nursing students. The purpose of this experimental differentiated treatment study was to assess if HPS technology leads to increased clinical decision-making ability and clinical performance more than the teaching modality of a paper and …

Using A Structured Decision Making Protocol To Stratify Caseloads In The Child Support Program, Steven J. Golightly

Walden Dissertations and Doctoral Studies

Although structured decision making and risk assessment protocols have successfully been used in human service programs, little research has been done on their applicability in the child support program. In this study, problems identified with child support case management were examined, along with positive and negative attributes of various risk assessment tools utilized in other arenas. The overall research problem asserted that there are no structured decision making protocols in the child support program to support case assignment by enforcement difficulty. The primary research question asked whether or not a process stratified by risk and level of enforcement difficulty could …

Social Capital Variables As Predictors Of Hiv Risk-Taking Behaviors Among Sub-Saharan African Immigrants In The United States, Gbadebo Ogundiran Ogungbade

Walden Dissertations and Doctoral Studies

Vulnerable populations, including immigrants, are often at risk for human immunodeficiency virus (HIV) infection because of their risk-taking behaviors. This study investigated risk-taking behavior for HIV infection among Sub-Saharan African (SSA) immigrants in United States. Using social capital as a theoretical foundation, the study aimed to address the question, is there any association between social capital assets of educational opportunity, employment, and eligibility for social assistance and HIV risk-taking behavior, defined as condom use before sex (CUBS) among SSA immigrant in the U.S? Potential participants were recruited through religious and social organizations in a southwestern US state. The survey generated …

A Phenomenological Inquiry Of Chronic Homeless Individuals' Challenges To Independence, Dewana Hall

Walden Dissertations and Doctoral Studies

Homelessness is a comprehensive social problem affecting approximately 744,000 people in the U.S. Despite consistent efforts from politicians, state and local leaders, and service providers, the number of homeless people continues to rise. Although there are some explanations in the literature to account for the increase of homelessness, the literature tends to not include the voices of the homeless themselves. The purpose of this phenomenological study, which used Maslow's hierarchy of needs as its conceptual framework, was to understand the life experiences of members of the homeless population, as perceived by four male residents of a mission in an eastern …

The Effect Of Direct Contact On Public Attitudes Towards People Living With Human Immunodeficiency Virus (Hiv) And Acquired Immune Deficiency Syndrome (Aids) In Zimbabweans, Mavis Mashingaidze

Walden Dissertations and Doctoral Studies

Stigma surrounding HIV and AIDS poses a significant threat to the curtailing of the epidemic by acting as a barrier to HIV testing and disclosure of serostatus. Previous research in the United States found personal knowledge of someone with HIV/AIDS to be a predictor of lower levels of HIV/AIDS-related stigma. However, no study to date has examined this relationship in Zimbabweans. Allport's contact hypothesis was hypothesis was the theoretical frame used to assess the effect of direct contact on public attitudes towards people living with the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in Zimbabweans with the …

Clinical Recognition Of Obstructive Sleep Apnea In A Population-Based Sample, Mark R. Zellmer

Walden Dissertations and Doctoral Studies

Obstructive sleep apnea (OSA), a disorder in which the airway intermittently collapses and obstructs during sleep, is associated with increased cardiovascular and cerebrovascular morbidity and mortality, increased risk of motor vehicle accidents, metabolic syndrome, hypertension, and depression. Treatment of OSA attenuates or reverses many of these associated risks. However, most cases of OSA are unrecognized and untreated. The two most recent studies using 1990s data found that only 6.5 - 15.4% of OSA cases, depending on severity, are clinically recognized in mixed gender populations. Based on a conceptual framework of improved physician awareness of OSA, and reduced diagnostic access bias …

Illness Uncertainty, Ways Of Coping, And Psychological Adjustment Among 18--25-Year-Olds With Anaphylactic Food Allergy, Susan J. Cohen

Walden Dissertations and Doctoral Studies

The prevalence of food allergy is increasing, with adolescents and young adults being the group most likely to die from food-induced anaphylaxis. Behavioral and psychological factors contribute to this risk. This study investigated the relationship between illness uncertainty (as measured by the Mishel Uncertainty in Illness Scale Community Form) and emotion- and problem-focused coping (as measured by the Ways of Coping Scale), to see if they contributed to psychological adjustment (as measured by the Depression Anxiety Stress Scale-21) in this population. A cognitive diathesis-stress model was used to explain individual differences in adjustment. Multiple regression was used to test illness …

Risk Factors For Development Of High Blood Pressure And Obesity Among African American Adolescents, Monique Shanta White

Walden Dissertations and Doctoral Studies

Childhood obesity has reached epidemic proportions in the United States and has been linked to hypertension, especially among African American youth. Optimistic bias leads youth to underestimate their susceptibility to negative health outcomes. Public health officials want to reduce risk factors to result in significant long term reduction in cardiovascular disease. The purpose of this study was to explore adolescent behavior practices in a school district and prevalence of high blood pressure and obesity in that population. The health belief model guided the framework for this study. Research questions examined relationship between individual health risk practices and optimistic bias on …

Dysrhythmia Monitoring Practices Of Nurses On A Telemetry Unit, Susan Jane Schultz

UNF Graduate Theses and Dissertations

Standards of practice for hospital electrocardiogram monitoring were recommended in 2004 by the American Heart Association; however they are not widely followed. Many nurses monitor in a single lead regardless of diagnosis and are unable to differentiate wide QRS complex tachycardias. The purpose of this project was to evaluate the effectiveness of an interactive web-based education program combined with unit-based collaborative learning activities on both telemetry staff nurses‘ knowledge of dysrhythmias and their monitoring practices for patients at risk for wide QRS complex tachycardias. This interventional, one group before-and-after cohort study design consisted of four components: interactive web-based educational program …

Racial /Ethnic Disparities In Hypertension In United States Residents: A Cross-Sectional Study Of Potential Explanatory Covariates, Franklin I. Opara

Walden Dissertations and Doctoral Studies

Racial/ethnic disparities persist in hypertension (HTN) prevalence in the United States, and African Americans are disproportionately affected. The incidence is more than two-folds in African Americans compared to Caucasians, and mortality is highest among African Americans. Understanding the risk factors in HTN and how these factors vary across racial/ethnic groups is essential to reducing the mortality among African Americans. This study examined the prevalence of HTN among a sample non-institutionalized U.S. residents (N = 30,852), assessed racial/ethnic disparities and determined factors associated with racial/ethnic variance in HTN. A cross-sectional design was used to address these aims, utilizing the National Health …

Manual Handling Workload And Musculoskeletal Discomfort Among Warehouse Personnel, Terrance N. Knox

Walden Dissertations and Doctoral Studies

Work-related musculoskeletal disorders (WRMSD), specifically physical and muscular discomfort in the upper arm, lower arm, thigh, lower leg, wrist, shoulders, back, or neck, are among the most frequently reported workplace injuries in the United States. The dearth of knowledge about the types of workloads that may contribute to the development of WRMSD was the impetus of this research. The study aimed to identify antecedents of WRMSD among warehouse workers in order to reduce WRMSDs and increase productivity as expressed in a systems perspective on industrial health. The research questions examined the prevalence of specific WRMSDs, the relationship of high-risk tasks …

The Effect Of Crushed Ice Quantity On Interface And Intramuscular Temperatures During And Following Immersion, Christopher James Nelson

Dissertations and Theses @ UNI

Context: Latent heat of fusion of ice increases heat removal. Thus, a greater ice to water ratio during cooling and following immersion could enhance cooling efficacy. Moreover, a greater ice to water ratio could shorten treatment durations without reducing residual cooling effectiveness. Objective: Compare interface and muscle temperatures during and post-immersion using 2 ice to water ratios and treatment durations. Design: Crossover trial. Setting: Laboratory. Patients or Other Participants: Sixteen active volunteers (age= 21 ± 2yrs, ht= 173.0 ± 12.1cm, mass= 75.0 ± 12.4kg, skinfold= 21.7 ± 4.0mm, and girth= 37.2 ± 3.0cm) in accordance with university IRB. Interventions: During …

"A Cage Of Ovulating Females" : Mary Breckinridge And The Politics Of Contraception In Rural Appalachia, Dana Allen Johnson

Theses, Dissertations and Capstones

Mary Breckinridge and the Frontier Nursing Service have been the focus of intense scholarly effort over the last twenty years. Scholarship on Mary Breckinridge has centered on her healthcare reform work in Appalachia and its effects on the local residents and culture. This thesis examines the oral contraceptive trial that the FNS performed in Leslie County in the late 1950s and early 1960s. Although Breckinridge and the FNS maintained a restrictive contraceptive stance, they paradoxically permitted the contraceptive trial to be conducted on their patients in Leslie County. The decision to participate in the contraceptive trial resulted from a complex …

Treatment Strategies In Acute Myelogenous Leukemia : Investigating Hsp90 And P53 As Targets, Jennifer M. Napper

Theses, Dissertations and Capstones

Acute myelogenous leukemia (AML) is the deadliest of the lymphatic and bone marrow cancers. Patients diagnosed with AML have a five year survival rate of 23.4%. AML is characterized by an accumulation of undifferentiated and functionless myeloid precursors in the bone marrow and blood. Heat shock protein 90 (Hsp90) inhibitors, such as 17-AAG, an analog of geldanamycin (GM), are currently undergoing phase I, and II and III clinical trials for various cancers with mixed results. I found distinct responses to 17-AAG treatment among the AML cell lines tested. I also discovered two mutant TP53 alleles in Kasumi-3 cells, an AML …

Moral Distress And Avoidance Behavior In Nurses Working In Critical Care And Non-Critical Care Units, Mary Jo De Villers

Dissertations

Significance: Nurses facing impediments to what they perceive as moral practice may experience inner turmoil, frustration, and moral distress. These scenarios may culminate in resignation from employment at the individual level, increased attrition at the systems level, and poor patient outcomes, including increased morbidity and mortality.

Purpose: To explore the relationships between moral distress and avoidance thoughts and behavior between nurses currently practicing in critical care and non-critical care settings.

Methods: A descriptive cross-sectional comparative design was used. The sample was comprised of a randomized subset of 370 critical care nurses, a convenience sample of 87 nurses from a nursing …

Knowledge, Attitudes, And Behaviors Of African American Women Regarding Breast Cancer Screening, Lilian Uwuseba

Walden Dissertations and Doctoral Studies

Breast cancer is one of the most widespread chronic diseases and a major cause of death among women in the United States. African American women have a higher incidence of breast cancer than their counterparts from other ethnic/racial groups. The purpose of this cross-sectional survey of 126 African American females from the western US metropolitan area was to assess knowledge, attitudes, and behavior with respect to breast cancer manifestation, detection services, and the role of mammography in breast cancer prevention and control. The health belief model guided this study. A 41-item, ethnically sensitive, self-administered, and gender-specific instrument, the Champion Revised …

Perspectives Of Executive Women: Life Choices And Balancing Career With Marriage And Children, Wendy James

Walden Dissertations and Doctoral Studies

This qualitative study investigated the experiences of executive women and their choices in balancing work with marriage and children. Research on women in the workplace tends to conflate categories of hourly workers, part-time employees, and middle- and upper-management careers. Yet, the literature on balancing career and family life does not adequately portray the experiences of executive women. The purpose of the study was to discover executive women's perceptions about their career, how they chose their path, and how their career choices affected their decisions about marriage and children. The research questions for this study examined: (a) The effect of executive …

Job Satisfaction, Job Involvement, And Perceived Organizational Support As Predictors Of Organizational Commitment, Jennifer Parker Ayers

Walden Dissertations and Doctoral Studies

The purpose of this study was to determine whether or not there is a significant relationship between job satisfaction, job involvement, perceived organizational support, and organizational commitment among educators. A review of the literature revealed there is limited research that examined organizational behaviors among educators. Organizational commitment has been identified as a leading factor impacting an employee's level of success in various organizations. There remains a gap in the current literature regarding specific attitudinal behaviors influencing organizational commitment across various levels of education. Organizational commitment among educators employed at the primary, secondary, and postsecondary levels was examined. The sample for …

The Impact Of Stakeholder Collaboration On Effectiveness Of Health Program Implementation In Ghana, Samuel Kwami Agbanu

Walden Dissertations and Doctoral Studies

Healthcare providers increasingly recognize the importance of collaboration among stakeholders in cost-effective healthcare delivery. While collaborative relationships offer great advantages, little research has addressed their relevance in an international development aid context, particularly in sub-Saharan Africa. The region is a major recipient of international development support, yet health indicators on HIV/AIDS, malaria, tuberculosis, and child and maternal mortality indicate the health of the region is among the weakest worldwide. This sequential mixed method, descriptive study of a USAID-funded community health program in Ghana examined the nature of collaboration among six stakeholders and impact of this collaboration on effectiveness of program …

The Association Between Parental Perceptions Of Children's Residential Mental Health Treatment And The Parent-Child Relationship, Susanne Elizabeth Preston

Counseling & Human Services Theses & Dissertations

Residential mental health treatment for children as an intervention for children is increasing, potentially affecting the relationship within families. The purpose of this study was to examine the parental perspectives of the associations between the parent-child relationship and children's residential mental health treatment. This study explored parental perspectives of specific aspects of the parent-child relationship: parental support, satisfaction with parenting, parental involvement, communication, and limit setting-and the association between these aspects and the child's residential mental health treatment. Paired samples t-tests were conducted; resulting in statistically significant changes on all scales measured, with varying effect sizes. Results indicated parents …

Role Of Oxidative Reactive Species And Antioxidants In Metabolism And Transport Of Therapeutic Drugs, Svetlana Verenich

Theses and Dissertations

Oxidative stress (OS) is a frequent complication of various disease conditions such as Alzheimer’s and Parkinson’s disease, atherosclerosis, preeclampsia, rheumatoid arthritis, diabetes including gestational diabetes, etc. OS is defined as an imbalance between the production of reactive species and the ability of an organism to detoxify the reactive intermediates and repair the damage. As a result of OS, the excess of reactive species such as oxygen superoxide (O2-), hydroxyl radical (OH), peroxynitrite (ONOO−), 4-hydroxynonenal (4HNE), etc., have a tendency to react with nearby proteins/nucleic acids/lipids changing their functionality or inactivating them completely. The organism has many ways to protect itself …

Alternative Regulation Of The Alginate Algd Operon By An Activated Algb In Nonmucoid Pseudomonas Aeruginosa Is Dependent On Sigma 54, Jean Kim

Theses and Dissertations

Alginate overproduction by Pseudomonas aeruginosa, which causes a mucoid phenotype, is a major virulence factor associated with chronic pulmonary infections in cystic fibrosis patients. Expression of the algD operon for alginate biosynthesis requires three major regulators in association with the ECF sigma factor, σ22, in mucoid strains that are typically defective in anti-sigma factor, MucA. One such algD regulator is AlgB, a member of the NtrC family of two-component systems, which typically utilize σ54. However, neither σ54 nor the cognate sensor kinase (KinB) of AlgB are required for algD expression in such mucoid strains. I hypothesized that KinB-phosphorylated AlgB must …

In-Vitro Metabolism And Protein Binding Of 5-Hmf, A Potential Antisickling Agent, Taghrid Obied

Theses and Dissertations

Purpose. 5-HMF is a potential antisickling agent forming a Schiff-adduct with hemoglobin (Hb). In-vitro studies were designed to identify the metabolic pathways of 5-HMF in human hepatic cytosol, to assess inter-species differences in its hepatic metabolism, and to predict in-vivo PK properties. Moreover, metabolism of 5-HMF in human RBCs was investigated. Finally, in-vitro studies were done to characterize 5-HMF binding kinetics with human Hb and albumin (HSA). Methods. NAD+ reduction was monitored at 340 nm in human hepatic cytosol for 5-HMF (26 mM) and prototypical ADH and ALDH substrates in the presence or absence of their inhibitors. Furthermore, concentration-dependency studies …