Medicine and Health Sciences Commons^™

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 …

Rem Initiative To Develop Educational Strategies For Inductions Of Labor, Chandra Evette Jones-Worthing

Walden Dissertations and Doctoral Studies

Inductions of labor that occur prior to 39 weeks' gestation can pose increased risks for the mother-baby dyad. In the target setting, there is a gap in knowledge among the pregnant women about options for delivery, hospital policies and procedures, and what to expect in the labor and delivery experience. Because of this gap in knowledge, the pregnant patient is unable to make informed decisions regarding her needs, expectations, and care. This lack of knowledge has resulted in a 40-50% rate of inductions of labor at the target site, which is well above the 2014 national average of 25%. In …

Improvement In The Retention Of Graduate Nurses In A Long-Term Acute Care Hospital, Angie Lim Torres

Walden Dissertations and Doctoral Studies

The high turnover rate of graduate nurses is a challenge in the United States' hospitals because of high job dissatisfaction rates. The premature disaffiliation of the graduate nurses is costly for organizations and can significantly affect the quality and safety of patient care due to the inadequate supply of adequately prepared staff nurses, particularly in the long-term acute care hospitals. The purpose of the project was to decrease the turnover rate of graduate nurses in a long-term acute care setting from 40% to 20% through modification of the nurse residency program by applying an intervention based on Bauer and Erdogan's …

Factors Affecting Completion Of Childhood Immunization In North West Nigeria, Sule Abdullahi

Walden Dissertations and Doctoral Studies

North West Nigeria has the lowest vaccination rate of the geopolitical regions of the country. The purpose of this cross-sectional study was to examine associations between the parents'/caregivers' biological, cultural, and socioeconomic factors and the completion or noncompletion of routine immunization schedules. Andersen's behavioral model provided the framework for the study. Data were obtained from the 2013 National Demographic Health Survey. Descriptive statistics were calculated for all variables. Chi-square tests were used for categorical predictor variables, simple logistic regression models were used for the age variable, and multiple linear regression models were used for the biological, cultural, and socioeconomic variables …

Understanding The Lived Experiences Of Hispanic Immigrants With Diabetes Toward Disease Self-Management, Dahlia Connors

Walden Dissertations and Doctoral Studies

The Hispanic population has a higher incidence of diabetes and poorer health outcomes compared to other populations in the United States. Although previous research has reported that cultural and ethnic beliefs play a role in poorer diabetes self-management by Hispanic individuals, limited studies have been focused on the barriers to self-management from the perspectives of Hispanic immigrants. The purpose of this qualitative study was to gain an understanding, through oral history narrative, of the experiences of Hispanic immigrants living with diabetes. In this study, the influence of cultural and ethnic beliefs on diabetes self-management in Hispanic immigrants in the Bronx …

Relationship Between Health Literacy And End-Stage Renal Disease Among Type Ii Diabetics, Joelle M. Stolte

Walden Dissertations and Doctoral Studies

The progression of End Stage Renal Disease (ESRD) among type II diabetics is preventable, yet complications continue to plague many. Reports show that 29.1 million people (9.3%) in the United States have diabetes, and 40% of those individuals develop ESRD. Four research questions explored the relationship between ESRD, health literacy, and healthcare. Data from 2010-2015 from the National Institute of Health (NIH) was quantitatively analyzed. The conceptual framework was the revised health service utilization theory. The target population included 3939 diverse males and females between the ages of 20-75 diagnosed with type II Diabetes. Results from Chi-square, cross-tabulation, binary, and …

Impact Of Acculturation On Body Mass Index In Haitians, Nirva Berthold

Walden Dissertations and Doctoral Studies

Longer-term immigrants residing in the United States exhibit physical health decline related to higher body mass index (BMI). Theories on immigrant acculturation have been used to examine health patterns by length of stay in the United States. The purpose of this cross-sectional study, guided by the Schwartz model of acculturation, was to examine the effect of acculturation and length of stay in the United States on BMI in a sample of Haitian immigrants living in the Northeast Metropolitan area. The research question was used to examine the effects of acculturation and length of stay on BMI in the convenience sample …

Family Relational Experiences During Major Transitions With A Chronic Illness, Juanita Sibayan

Walden Dissertations and Doctoral Studies

Although health care transitions have received some attention in the literature, few researchers have emphasized family relational experiences and communication during major changes while living with a chronic illness. The purpose of this phenomenological study was to understand the lived experience of parents and their adult children while transitioning from pediatric to adult care of a chronic illness. The bio-psychosocial theory, family systems theory, and attachment theory established the context for this study. A criterion-based sampling technique and snowball sampling were used to recruit 7 parents and 6 of their adult children aged 18 to 30 years who were diagnosed …

Improving Care Transitions In Patients With Heart Failure: An Integrative Literature Review, Heather Mae Mclain

Walden Dissertations and Doctoral Studies

Heart failure (HF) hospital readmission reductions are linked to nursing interventions that include scheduling a hospital follow-up appointment with the patient's health care provider within a week of discharge. Yet, patients often leave the hospital without an appointment scheduled. The focus of this integrative literature review was on analyzing data that associated follow-up within 7 days with reduced 30-day readmissions. A search of articles using CINAHL, MEDLINE, Cochrane Database of Systematic Reviews, and ProQuest databases resulted in 4,813 articles retrieved using the following search terms: heart failure, readmissions, follow-up appointments, and heart failure guidelines. Scholarly articles selected for inclusion were …

Effects Of Simulated Clinical Experiences On Empathy, Self-Confidence, And Satisfaction In Nursing Students, Dawn Riess

Walden Dissertations and Doctoral Studies

Empathetic communication enhances the nurse-patient relationship and improves patient outcomes and needs to be taught and evaluated during simulated clinical experiences. Experience in healthcare education has shown students' empathy levels decrease over time. The purpose of this quasi-experimental pretest posttest, study was to compare nursing students' empathy levels, self-confidence, and satisfaction with simulation between the use of the high-fidelity manikin simulator (HFMS) and a standardized patient (SP) used during their simulated clinical experience. Kolb's experiential learning theory was used to guide the study through the four phases specific to simulation and learning. Convenience sampling was used to recruit 135 nursing …

Discharge Calls And Avoiding Hospital Readmissions, Wanda Lee Cassavettes

Walden Dissertations and Doctoral Studies

Hospital readmissions are disruptive and costly for patients and hospitals. As hospital discharge instructions are a key nursing responsibility, this project implemented a nurse follow-up phone call intervention within 12-48 hours of patient discharge from an indigent care facility in the Great Lakes region of the United States. The project was designed to understand whether follow-up phone calls from nurses that clarified discharge instructions, symptom management, and medications would be associated with decreased readmission rates within 30 days post-discharge among chronic care patients. The theoretical framework was the health belief model, which proposes that the patient's knowledge of illness severity, …

How Fine Particulate Matter Modifies Preterm Birth Risks In Korea, Hyun Jin Choi

Walden Dissertations and Doctoral Studies

Despite the increasing interest in preterm birth risk associated with maternal exposure to the current level of fine particulate matter (PM2.5) in Korea, there is little information on differences in PM2.5 exposure and its impact on preterm birth. This study was designed to examine the effects of Korea's air quality on preterm birth, including the possibility of moderation and mediation. This work was also designed to investigate manipulable factors for PM2.5 exposure. The theoretical framework of this quantitative and observational study included the social ecological theory and systems theory. The conceptual framework of this partially ecologic and retrospective cohort study …

Metabolic Energy Requirements During Load Carriage: Implications For The Wildland Firefighter Arduous Pack Test, Jeffrey T. Strang, Christopher J. Alfiero, Charles Dumke, Brent Ruby, Matthew Bundle

Graduate Student Theses, Dissertations, & Professional Papers

Despite extensive and ongoing scientific study into the metabolic requirements of load carriage, an understanding quantifying the effect of speed, load, sex and body mass has yet to come forth and the extent to which established models predict these requirements is largely untested. Specifically, because existing experimental efforts have typically focused on relatively modest walking speeds using loads representing a fixed portion of the subject’s mass, extending the available predictions to applications where individuals complete a common task carrying an identical absolute load provides estimates of unknown accuracy. PURPOSE: Here, we measured the energy use in a large subject group …

A Qualitative Grounded Theory Approach To Reducing Breast Cancer Disparities In The Latina Population, Dbora Schrett

Walden Dissertations and Doctoral Studies

Breast cancer is the leading cause of death among Latinas. Several barriers persist when accessing health care and utilization of healthcare services such as annual mammograms, leading to a late-stage diagnosis or death related to breast cancer illness. Consequently, this study was important to further examine potential risk factors such as beliefs, cultural context, health insurance, and socioeconomic status for this population. Further, gaps in research provide limited evidence of risk factors adversely influencing high morbidity and mortality incidence. The purpose was to focus on disparities in breast cancer experiences within Latina communities in the United States. A qualitative foundation …

Association Of Body Mass Index With Blood Pressure Among 1.7 Million Chinese Adults, Khurram Nasir

All Publications

No abstract provided.

Effect Of Hemiepiphysiodesis On The Growth Plate: The Histopathological Changes And Mechanism Exploration Of Recurrence In Mini Pig Model., Jing Ding, Jin He, Zhi-Qiang Zhang, Zhen-Kai Wu, Fang-Chun Jin

Manuscripts, Articles, Book Chapters and Other Papers

Purpose: Hemiepiphysiodesis has been widely used to correct angular deformity of long bone in immature patients. However, there is a limited knowledge about the biomechanical effect of this technique on the histopathological changes of the growth plate and the mechanism of recurrence of malformation after implant removal. We aimed to evaluate the biomechanical effect of hemiepiphysiodesis on the histopathological changes of the growth plate and the mechanism of recurrence of malformation after implant removal in Bama miniature pigs, and to explore the role of asymmetric stress during this procedure.

Methods: Eight 3-month-old male Bama miniature pigs sustained surgeries on the …

Practice Survey: Adherence Monitoring And Intervention In Pediatric Gastroenterology And Hepatology., Michele H. Maddux, Shawna Ricks, Julie A. Bass, James F. Daniel, Ellen Carpenter, Kimberely Radford

Manuscripts, Articles, Book Chapters and Other Papers

Purpose: Despite significant medication nonadherence rates among youth with pediatric gastroenterology and hepatology disorders, little is known about current adherence practices in pediatric gastroenterology care. This study summarizes current practices surrounding adherence monitoring and intervention in pediatric gastrointestinal (GI) and hepatologic care in the USA.

Participants and methods: One hundred and fifty-four pediatric GI providers completed an online survey designed to examine current practices surrounding adherence monitoring and intervention, specific strategies used to monitor and treat poor adherence, and the barriers currently experienced in relation to adherence monitoring and intervention.

Results: Practices varied greatly in terms of when and how …

Comparing Daily Drivers Of Problem Drinking Among Older And Younger Adults: An Electronic Daily Diary Study Using Smartphones, Alexis Kuerbis, Hayley Treloar Padovano, Sijing Shao, Jessica Houser, Frederick Muench, Jon Morgenstern

Publications and Research

Background—By 2030, numbers and proportions of older adults with substance-use problems are expected to increase. While risk factors for problem drinking in late life have been identified, it remains unknown whether these factors drive daily drinking among older problem drinkers. This study examined the daily drivers of drinking among problem drinkers, moderated by age, utilizing ecological momentary assessment (EMA). Method—Participants (N=139), ages 20–73, received daily EMA online surveys completed via a smartphone prior to initiation of treatment. Multilevel modeling tested the moderating impact of age on within- and between-person relationships between drinking and focal predictors (mood, loneliness, boredom, stress, poor …

Microtubule Imaging Reveals Cytoskeletal Deficit Predisposing The Retinal Ganglion Cell Axons To Atrophy In Dba/2j, Denis Sharoukhov, Festa Bucinca-Cupallari, Hyungsik Lim

Publications and Research

PURPOSE: Glaucoma is characterized by progressive loss of the retinal ganglion cells (RGCs) and their axons. Here we test an outstanding notion that microtubules (MTs) within RGC axons degrade before the loss of morphology (‘‘MT hypothesis’’).

METHODS: The integrity of axonal MTs was interrogated by intrinsic second-harmonic generation (SHG) microscopy. Using DBA/2J mice as a model of glaucoma and DBA/2J-Gpnmbþ as a nonglaucomatous control, the relationship between MT disruption and morphology was quantitatively examined as a function of age and sex in the fresh retinal wholemounts.

RESULTS: The mean SHG density (i.e., the mean SHG intensity per thickness) was significantly …

Risk Factors For Short- And Long-Term Outcomes In Children With Stec-Hus/D, Judith Sebestyen Vansickle, Tarak Srivastava, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

Background. Hemolytic uremic syndrome (HUS) is one of the common causes for acute kidney injury in childhood. Objective. The goals of our study were to identify risk factors for short-term complications and long-term outcomes of chronic kidney disease (CKD) in Shiga toxin-producing Escherichia coli (STEC)-HUS and other diarrhea positive (D+) HUS. Methods. Retrospective chart review was obtained of 58 pediatric patients treated for STEC-HUS and other D+ HUS between February 2002 and January 2011. Results. Thirty-three patients (56.9%) required dialysis. Dialysis was more likely initiated if a patient was a female (P < .012), oliguric (urine output < 0.5 mL/kg/h, P < .0005), or hemoglobin (HGB) level >10 g/dL …

Structure Of The Picornavirus Replication Platform: A Potential Drug Target For Inhibiting Virus Replication, Meghan Suzanne Warden

Chemistry & Biochemistry Theses & Dissertations

Picornaviruses are small, positive-stranded RNA viruses, divided into twelve different genera. Members of the Picornaviridae family cause a wide range of human and animal diseases including the common cold, poliomyelitis, foot and mouth disease, and dilated cardiomyopathy. The picornavirus genome is replicated via a highly conserved mechanism involving a presumed cloverleaf structure located at the 5’ noncoding region of the virus genome. The 5’ cloverleaf consists of three stem loops (B, C, and D) and one stem (A), which interact with a variety of virus and host cell proteins during replication. In this dissertation, human rhinovirus serotype 14 (HRV-14) SLB …

Effects Of Knee Sleeves On Knee Mechanics During Squats At Variable Depths, Alexandria A. Trypuc

Human Movement Studies & Special Education Theses & Dissertations

The squat is a functional, compound and multi-joint exercise that targets several muscles of the lower body and is widely used in both athletics and many exercise programs. This exercise has been the subject of many studies, comparing different squat variations and examining how external gear, such as squat suits and knee wraps impact the exercise. The aim of this study was to assess the effects of wearing neoprene knee sleeves on lower extremity kinematics, kinetics, and muscle activations during weighted back squats. Fifteen resistance trained men and women, aged 28±5 years, from the local fitness community and university campus …

Transport Of Bmaa Into Neurons And Astrocytes By System XC-, Rebecca Albano, Doug Lobner

Biomedical Sciences Faculty Research and Publications

The study of the mechanism of β-N-methylamino-l-alanine (BMAA) neurotoxicity originally focused on its effects at the N-methyl-d-aspartate (NMDA) receptor. In recent years, it has become clear that its mechanism of action is more complicated. First, there are certain cell types, such as motor neurons and cholinergic neurons, where the dominate mechanism of toxicity is through action at AMPA receptors. Second, even in cortical neurons where the primary mechanism of toxicity appears to be activation of NMDA receptors, there are other mechanisms involved. We found that along with NMDA receptors, activation of mGLuR5 receptors and effects on the …

What Does The Fos Say? Using Fos-Based Approaches To Understand The Contribution Of Stress To Substance Use Disorders, Jayme R. Mcreynolds, John P. Christianson, Jordan M. Blacktop, John Mantsch

Biomedical Sciences Faculty Research and Publications

Despite extensive research efforts, drug addiction persists as a largely unmet medical need. Perhaps the biggest challenge for treating addiction is the high rate of recidivism. While many factors can promote relapse in abstinent drug users, the contribution of stress is particularly problematic, as stress is uncontrollable and pervasive in the lives of those struggling with addiction. Thus, understanding the neurocircuitry that underlies the influence of stress on drug seeking is critical for guiding treatment. Preclinical research aimed at defining this neurocircuitry has, in part, relied upon the use of experimental approaches that allow visualization of cellular and circuit activity …

Survival Rates Of Stainless Steel Crowns And Multi-Surface Composite Restorations Placed By Dental Students In A Pediatric Clinic, Badia A. Zahdan, Aniko Szabo, Cesar D. Gonzalez, Elaye Okunseri, Christopher Okunseri

School of Dentistry Faculty Research and Publications

Purpose: This study examined survival rates of multi-surface composite restorations and stainless steel crowns (SSCs) placed by students in a pediatric dental clinic as well as the length of time it takes for restorations to be replaced with stainless steel crowns. Study design: Data from electronic dental records for all children with at least one 2-surface composite restorations or SSCs on a primary first or second molar from January 1, 2007 to September 30, 2015 were analyzed. The primary outcome was the time to a new restoration or SSC on the same tooth, with time to a crown as a …

Current Approaches And New Developments In The Pharmacological Management Of Tourette Syndrome., Julio Quezada, Keith A. Coffman

Manuscripts, Articles, Book Chapters and Other Papers

Tourette syndrome (TS) is a neurodevelopmental disorder of unknown etiology characterized by spontaneous, involuntary movements and vocalizations called tics. Once thought to be rare, TS affects 0.3-1% of the population. Tics can cause physical discomfort, emotional distress, social difficulties, and can interfere with education and desired activities. The pharmacologic treatment of TS is particularly challenging, as currently the genetics, neurophysiology, and neuropathology of this disorder are still largely unknown. However, clinical experience gained from treating TS has helped us better understand its pathogenesis and, as a result, derive treatment options. The strongest data exist for the antipsychotic agents, both typical …

A Frame-Based Nlp System For Cancer-Related Information Extraction, Yuqi Si, Kirk Roberts

Faculty, Staff and Student Publications

We propose a frame-based natural language processing (NLP) method that extracts cancer-related information from clinical narratives. We focus on three frames: cancer diagnosis, cancer therapeutic procedure, and tumor description. We utilize a deep learning-based approach, bidirectional Long Short-term Memory (LSTM) Conditional Random Field (CRF), which uses both character and word embeddings. The system consists of two constituent sequence classifiers: a frame identification (lexical unit) classifier and a frame element classifier. The classifier achieves an F

Are Psychedelics Effective In Treating Anxiety Associated With A Lifethreatening Disease?, Kayla Wilwohl

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective Evidence Based Medicine (EBM) review is to determine whether or not “Are psychedelics effective in treating anxiety associated with a lifethreatening disease?”

STUDY DESIGN: Review of two double-blind, randomized, placebo-controlled pilot studies and one randomized controlled trial (RCT).

DATA SOURCES: All studies were published in peer-reviewed journals found via the use of PubMed Database.

OUTCOMES MEASURED: The outcome measured in this EBM was the effect of psilocybin or LSD on the reduction in anxiety. Reduction in anxiety was measured using either the Hamilton Anxiety Rating Scale (HAM-A) or the State-Trait Anxiety Inventory (STAI). Participants …

Do Dynamic Ankle Foot Orthotics (Dafo) Improve Gait In Pediatric Patients With Spastic Diplegic Cerebral Palsy (Cp)?, Matthew F. Valentine

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not dynamic ankle foot orthotics (DAFO) improve gait in pediatric patients with spastic diplegic cerebral palsy (CP).

STUDY DESIGN: Review of two randomized controlled trials with crossover from 2009 and 2015 and one blinded randomized controlled trial from 2006.

DATA SOURCES: All articles were presented in English and were taken from peer reviewed sources using PubMed and Google Scholar. All articles were published between 2006-2016.

OUTCOMES: Outcomes of investigation measured are quantitative walking velocity measured via gait analysis and functional ability during ambulation using the Gross Motor …