Medicine and Health Sciences Commons^™

The Paleoepidemiology Of Enterobius Vermicularis (Nemata: Oxyuridae) Among The Loma San Gabriel At La Cueva De Los Muertos Chiquitos (600–800 Ce), Rio Zape Valley, Durango, Mexico, Johnica J. Morrow, Karl Reinhard

Karl Reinhard Publications

One hundred coprolites excavated from La Cueva de los Muertos Chiquitos (600–800 CE) in the Rio Zape Valley of present-day Durango, Mexico, were examined for the presence of helminth eggs utilizing standard archaeoparasitological techniques. Eggs of the human pinworm (Enterobius vermicularis) were recovered from 34 of the 100 coprolites examined. Eggs of parasites were photographed and measured before egg concentration values were calculated for each positive sample. Egg concentration values demonstrated an overdispersed pattern of distribution among the samples (66% uninfected, 25% less than 100 eggs/g, 8% between 100 and 500 eggs/g, and 1% more than 500 eggs/g). …

Taphonomic Considerations On Pinworm Prevalence In Three Ancestral Puebloan Latrines, Morgana Camacho, Alena M. Iñiguez, Karl Reinhard

Karl Reinhard Publications

For archaeological studies it is always necessary to consider taphonomic factors that could have influenced in ancient material preservation. Parasite eggs are usually highly degraded in ancient sites dated from all periods of time and taphonomic factors are mentioned to explain absence and low quantity of eggs found. In this study, we compare parasite egg recovery of three Great House latrines: two from Aztec Ruins (Rooms 219 and 225) and one from Salmon Ruins. We compared through statistical regression the recovery of eggs with the abundance of two classes of decomposers: mites and nematodes. These microorganisms have relation with nematode …

New Evidence Of Ancient Parasitism Among Late Archaic And Ancestral Puebloan Residents Of Chaco Canyon, Rachel E. Paseka, Carrie C. Heitman, Karl Reinhard

Karl Reinhard Publications

Archaeoparasitology provides a unique perspective on the health and habits of ancient cultures through the identification of parasite remains in archaeological materials. We identified eggs of the human whipworm, Trichuris trichiura, in coprolites recovered from Late Archaic (1926–1751 cal. BCE) and Ancestral Puebloan (1039–1163 cal. CE) sites in Chaco Canyon, New Mexico. Our findings represent the earliest record of T. trichiura in North America, the first record of the species from Chaco Canyon, and the first record of a macroparasite from a Late Archaic site (Atlatl Cave) on the Colorado Plateau. T. trichiura is common in the …

Autologous Bone Flap Resorption Years After Subtemporal Craniotomy, John Oladapo Obafunwa, Emily E. Hammerl, David Jaskierny, Livia A. Taylor, Lynette Russell, Karl Reinhard

Karl Reinhard Publications

In Spring of 2012, the partially undressed and skeletonized remains of a homeless adult Hispanic male was found in a fairly open wooded area in Nebraska. The remains showed evidence of extensive pathologies, which included healed traumas and surgeries. Examination of the decedent's medical records revealed that he had a history of kidney and liver problems, alcohol abuse, several traumas including a major head injury that necessitated a craniotomy, and radiological features of neurocysticercosis. The autologous bone flap, which was replaced after the craniotomy, had resorbed significantly away from the edges of the injury. Death was variously attributed to craniocerebral …

Hybrid Privacy-Preserving Clinical Decision Support System In Fog-Cloud Computing, Ximeng Liu, Robert H. Deng, Yang Yang, Ngoc Hieu Tran, Shangping Zhong

Research Collection School Of Computing and Information Systems

In this paper, we propose a framework for hybrid privacy-preserving clinical decision support system in fog cloud computing, called HPCS. In HPCS, a fog server uses a lightweight data mining method to securely monitor patients' health condition in real-time. The newly detected abnormal symptoms can be further sent to the cloud server for high-accuracy prediction in a privacy-preserving way. Specifically, for the fog servers, we design a new secure outsourced inner-product protocol for achieving secure lightweight single-layer neural network. Also, a privacy-preserving piecewise polynomial calculation protocol allows cloud server to securely perform any activation functions in multiple-layer neural network. Moreover, …

Does Insulin Therapy Matter? Determinants Of Diabetes Care Outcomes, Jennifer A. Andersen, Larry Gibbs

Department of Sociology: Faculty Publications

Objective: To evaluate adherence to care standards for people with diabetes (PWDs) on insulin therapy versus PWDs who are not on insulin therapy, controlling for social determinants.

Research design and methods: Utilizing the United States 2015 Behavioral Risk Factor Surveillance System Survey, this study used logistic regression analyses to estimate differences in self-care behaviors, healthcare provider quality of care, and diabetic complications for individuals on insulin therapy and individuals not on insulin therapy.

Results: PWDs on insulin therapy are more likely to adhere to self-care measures (self-glucose checks [OR: 7.57], self-foot checks [OR: 1.27], diabetes class participation [OR: 1.96]), adherence …

“Just Because A Doctor Says Something, Doesn’T Mean That [It] Will Happen”: Self-Perception As Having A Fertility Problem Among Infertility Patients, Ophra Leyser-Whalen, Arthur L. Greil, Julia Mcquillan, Katherine M. Johnson

Department of Sociology: Faculty Publications

Only some individuals who have the medically defined condition ‘infertility’ adopt a self-definition as having a fertility problem, which has implications for social and behavioral responses, yet there is no clear consensus on why some people and not others adopt a medical label. We use interview data from 28 women and men who sought medical infertility treatment to understand variations in self-identification. Results highlight the importance of identity disruption for understanding the dialectical relationship between medical contact and self-identification, as well as how diagnosis acts both as a category and a process. Simultaneously integrating new medical knowledge from testing and …

Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu

Department of Nutrition and Health Sciences: Faculty Publications

Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming.

Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data.

Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non- Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI 1.142, 3.257) compared to H.pylori negative …

ปัจจัยคัดสรรที่มีความสัมพันธ์กับพฤติกรรมการใช้ยาตามเกณฑ์ ของผู้ป่วยมะเร็งที่รักษาด้วยยาต้านมะเร็งชนิดรับประทาน ในโรงพยาบาลระดับตติยภูมิ, บุณฑ์ราตรีส์ วานิชรัตนกุล, สุรีพร ธนศิลป์, จรรยา ฉิมหลวง

Journal of Nursing Research, Innovation, and Health

วัตถุประสงค์ : ศึกษาความสัมพันธ์ระหว่างปัจจัยคัดสรรกับพฤติกรรมการใช้ยาตามเกณฑ์ของผู้ป่วยมะเร็งที่รักษาด้วยยาต้านมะเร็งชนิดรับประทาน\n\nรูปแบบการวิจัย : การวิจัยแบบบรรยายเชิงความสัมพันธ์\n\nวิธีดำเนินการวิจัย : กลุ่มตัวอย่างคือผู้ป่วยที่ได้รับการวินิจฉัยเป็นโรคมะเร็งระยะเริ่มต้นจนถึงระยะลุกลามและรักษาด้วยยาต้านมะเร็งชนิดรับประทาน ในโรงพยาบาลระดับตติยภูมิ 3 แห่ง จำนวน 121 คน คัดเลือกด้วยวิธีการสุ่มหลายขั้นตอน รวบรวมข้อมูลด้วยแบบสอบถามข้อมูลส่วนบุคคล การเจ็บป่วย แรงสนับสนุนทางสังคมจากครอบครัว การรับรู้ความรุนแรงของอาการและของโรคมะเร็ง การรับรู้ประโยชน์ของการรักษา ความเชื่อเกี่ยวกับความจำเป็นต่อการกินยาและความกังวลต่อการกินยา และพฤติกรรมการใช้ยาตามเกณฑ์ ซึ่งมีความตรงตามเนื้อหา มีค่าสัมประสิทธิ์แอลฟ่าครอนบาค เท่ากับ .94, .92, .89, .89, .89, .77 และ .82 ตามลำดับ วิเคราะห์ข้อมูลโดยสถิติสหสัมพันธ์เพียร์สัน\n\nผลการวิจัย : ค่าเฉลี่ยของพฤติกรรมการใช้ยาตามเกณฑ์ของผู้ป่วยมะเร็งที่รักษาด้วยยาต้านมะเร็งชนิดรับประทานอยู่ในระดับที่ดี (X ̄ = 4.50, SD = 0.36) แรงสนับสนุนทางสังคมจากครอบครัว และความเชื่อเกี่ยวกับความจำเป็นต่อการกินยามีความสัมพันธ์ทางบวก และความเชื่อเกี่ยวกับความกังวลต่อการกินยามีความสัมพันธ์ทางลบกับพฤติกรรมการใช้ยาตามเกณฑ์ (r = .40, p < .05, r = .24, p < .05 และ r = -.24, p < .05 ตามลำดับ)

ปัจจัยคัดสรรที่สัมพันธ์กับอาการกลืนลำบาก ในผู้สูงอายุโรคหลอดเลือดสมอง, ชนิดา ไวยสุตรา, ศิริพันธุ์ สาสัตย์

Journal of Nursing Research, Innovation, and Health

วัตถุประสงค์: เพื่อศึกษาความสัมพันธ์ระหว่างปัจจัยคัดสรรกับอาการกลืนลำบากในผู้สูงอายุโรคหลอดเลือดสมอง\n\nแบบแผนการวิจัย: การวิจัยแบบบรรยายเชิงความสัมพันธ์\n\nวิธีดำเนินการวิจัย: กลุ่มตัวอย่างคือผู้สูงอายุโรคหลอดเลือดสมองที่เข้ารับการรักษาในหอผู้ป่วยใน จำนวน 88 คน สุ่มกลุ่มตัวอย่างแบบหลายขั้นตอน เครื่องมือวิจัยคือแบบบันทึกข้อมูลส่วนบุคคล แบบทดสอบสภาพสมองฉบับภาษาไทย และแบบประเมินความสามารถในการปฏิบัติกิจวัตรประจำวัน ความตระหนักรู้ในอาการกลืนลำบาก ความรุนแรงของโรคหลอดเลือดสมอง ความพร้อมก่อนการกลืน และการกลืน ผ่านการตรวจสอบความตรงเชิงเนื้อหา และมีค่าความเที่ยงสัมประสิทธิ์แอลฟาครอนบาคเท่ากับ .84, .94, .92, .73 .91 และ .80 ตามลำดับ วิเคราะห์ข้อมูลด้วยสถิติเชิงพรรณนา สัมประสิทธิ์สหสัมพันธ์ของเพียร์สันและสัมประสิทธิ์สหสัมพันธ์พอยซ์ไบซีเรียล\n\nผลการวิจัย: 1) ผู้สูงอายุโรคหลอดเลือดสมองมีอาการกลืนลำบากร้อยละ 59.1 2) อายุและความรุนแรงของโรคหลอดเลือดสมองมีความสัมพันธ์ทางบวกกับอาการกลืนลำบากในผู้สูงอายุโรคหลอดเลือดสมอง อย่างมีนัยสำคัญทางสถิติที่ระดับ .05 (r = .257; .820 ตามลำดับ) 3) ความสามารถในการปฏิบัติกิจวัตรประจำวันและความตระหนักรู้ในอาการกลืนลำบากมีความสัมพันธ์ทางลบกับอาการกลืนลำบากในผู้สูงอายุโรคหลอดเลือดสมอง อย่างมีนัยสำคัญทางสถิติที่ระดับ .05 (r = -.795; -.657 ตามลำดับ) และ 4) การรู้คิดมีความสัมพันธ์กับอาการกลืนลำบากอย่างมีนัยสำคัญทางสถิติที่ระดับ .05 (rpb = .581)\n\nสรุป: พยาบาลสามารถใช้ผลการวิจัยนี้เพื่อเป็นแนวทางการจัดการทางการพยาบาลเพื่อฟื้นฟูการกลืนในผู้สูงอายุโรคหลอดเลือดสมองเป็นไปอย่างมีประสิทธิภาพ

ผลของโปรแกรมการจัดการตนเองของบุคคลและครอบครัว ต่อภาวะน้ำเกินในผู้สูงอายุโรคไตวายเรื้อรัง ที่รับการฟอกเลือดด้วยเครื่องไตเทียม, ธนัยรัตน์ รุ้งพราย, ทัศนา ชูวรรธนะปกรณ์

Journal of Nursing Research, Innovation, and Health

วัตถุประสงค์ : ศึกษาผลของโปรแกรมการจัดการตนเองของบุคคลและครอบครัวต่อภาวะน้ำเกินในผู้สูงอายุโรคไตวายเรื้อรังที่รับการฟอกเลือดด้วยเครื่องไตเทียม\n\nรูปแบบการวิจัย : การวิจัยกึ่งทดลอง\n\nวิธีดำเนินการวิจัย : กลุ่มตัวอย่างคือ ผู้สูงอายุโรคไตวายเรื้อรังที่ฟอกเลือดด้วยเครื่องไตเทียมในคลินิกศูนย์แพทย์พัฒนาและผู้ดูแลจำนวน 40 คู่ โดยจับคู่ผู้สูงอายุด้านเพศ อายุ และรายได้และสุ่มเข้าเป็นกลุ่มทดลองและกลุ่มควบคุมกลุ่มละ 20 คน กลุ่มทดลองได้รับโปรแกรมการจัดการตนเองของบุคคลและครอบครัวต่อภาวะน้ำเกิน กลุ่มควบคุมได้รับการพยาบาลตามปกติ เครื่องมือทดลองคือ โปรแกรมการจัดการตนเองของบุคคลและครอบครัวตามแนวคิดของ Ryan and Sawin เก็บรวบรวมข้อมูลโดยใช้แบบบันทึกภาวะน้ำเกิน วิเคราะห์ข้อมูลด้วยสถิติเชิงพรรณนาและการทดสอบค่าที\n\nผลการวิจัย : \n1) ค่าเฉลี่ยของภาวะน้ำเกินในผู้สูงอายุโรคไตวายเรื้อรังที่ฟอกเลือดด้วยเครื่องไตเทียม หลังได้รับโปรแกรมการจัดการตนเองของบุคคลและครอบครัว ค่าต่ำกว่าก่อนได้รับโปรแกรมอย่างมีนัยสำคัญทางสถิติที่ระดับ .05\n\n2) ค่าเฉลี่ยของผลต่างของภาวะน้ำเกินในผู้สูงอายุโรคไตวายเรื้อรังที่ฟอกเลือดด้วยเครื่องไตเทียม กลุ่มที่ได้รับโปรแกรมการจัดการตนเองของบุคคลและครอบครัว มีต่ำกว่ากลุ่มที่ได้รับการพยาบาลตามปกติอย่างมีนัยสำคัญทางสถิติที่ระดับ .05\n\nสรุป : โปรแกรมฯ มีประสิทธิผลในการลดภาวะน้ำเกินในผู้สูงอายุโรคไตวายเรื้อรังที่ได้รับการฟอกเลือดด้วยเครื่องไตเทียม

Evaluation Of A Handheld Gluten Detection Device, Steve L. Taylor, Julie A. Nordlee, Shyamali Jayasena, Joseph L. Baumert

Department of Food Science and Technology: Faculty Publications

A portable, handheld gluten detection device, the Nima sensor, is now available for consumers wishing to determine if gluten is present in food. By United States regulation, gluten-free foods should contain < 20 ppm of gluten. Thirteen gluten-free foods (muffins, three different types of bread, three different types of pasta, puffed corn snack, ice cream, meatballs, vinegar and oil salad dressing, oatmeal, and dark chocolate) were prepared; each food was spiked on a weight-to-weight basis with gluten levels of 0, 5, 10, 20, 30, 40, and 100 ppm before processing or preparation. Unprocessed and processed foods were tested with the handheld gluten sensor and by two gluten-specific enzyme-linked immunosorbent assays (ELISAs) on the basis of the R5 and G12 monoclonal antibodies, respectively. The portable gluten detection device detected gluten in all food types at the 30-ppm addition level, failing to detect gluten in only 5 (6.4%) of 78 subsamples. At the 20-ppm addition level, the portable gluten detection device failed to detect gluten in one type of pasta but detected gluten residues in 63 (87.5%) of 72 other subsamples. The device was able to detect gluten at the 10-ppm addition level in 9 of the 13 food matrices (41 of 54 subsamples, 75.9%) but not in the three types of pasta and the puffed corn snack. The gluten-sensing device did not perform reliably at the 5-ppm addition level in 11 of 13 food matrices (exceptions: ice cream and muffins). In contrast, the ELISA methods were highly reliable at gluten addition levels of ≥ 10 ppm in all food matrices. The portable gluten detection device yielded a low percentage of false-positive results (4 of 111, 3.6%) in these food matrices. Thus, this handheld portable gluten sensor performed reliably in the detection of gluten in foods having ≥ 20 ppm of added gluten with only 18 (5.9%) of 306 failures, if results of the one type of pasta are excluded. The device worked with greater reliability as the gluten levels in the foods increased.

Concepts In Animal Parasitology: Example Chapter Section, Manuscript Of The Aspidogastrea By Klaus Rohde, Klaus Rohde

Concepts in Animal Parasitology

This is an example chapter section for Concepts in Animal Parasitology. It is a manuscript of the section titled The Aspidogastrea, written by by Klaus Rohde. This is an example of a section written without using the optional template for Parts 2-5 of the textbook. The associated images are included in a supplemental file.

Perceptions Of Nursing As A Career By African American College Students Attending Historically Black Colleges And Universities, Brenda Marie Owens

Walden Dissertations and Doctoral Studies

Previous studies and official organizations have indicated that African Americans are underrepresented in the healthcare workforce and that patients belonging to minority groups feel they are treated slightly differently in healthcare settings. Limited research examines perceptions of the nursing profession among a variety of demographic groups, and exploratory investigations into the perceptions of nursing as a career by African Americans are limited. The purpose of this quantitative descriptive study was to explore perceptions of nursing as a career by African American students who attend an undergraduate program at a historically black college or university (HBCU) in an attempt to further …

Strategies For Sustaining Small Businesses In The U.S. Health Care Sector, James Utobunwa Nwachukwu

Walden Dissertations and Doctoral Studies

In the United States, many small businesses fail within the first 5 years due to poor implementation of sustainability strategies. Researchers and business practitioners have indicated that small business owners face challenges on how to maintain their businesses beyond 5 years due to lack of sustainability strategies. The purpose of this qualitative multiple case study was to explore the strategies that health care small business owners and managers in New York State use to maintain their businesses beyond 5 years. Sustainability development theory was used for the study's conceptual framework. Semistructured face-to-face interviews were conducted with 6 purposively-selected participants who …

Evaluating Nursing Pain Assessment Documentation With The Pediatric Client, Aziza Alexander

Walden Dissertations and Doctoral Studies

Pain is often seen as a primary complaint in the pediatric emergency department (ED). Assessment and documentation of pain are integral to effective pain management, and nurses are responsible for documenting pain assessment. Nursing documentation is essential for ensuring continuous, safe, high-quality care. Evidence shows nurses are inadequately documenting pain assessment and reassessment and not always using appropriate pain scales in a busy, cosmopolitan children's hospital ED. The practice-focused question that guided this project was: How does an educational module and change in electronic health record pain assessment flowsheet increase the nurses' compliance with initial documentation of pain? An educational …

Patient Navigation Program In Oncolgy Clinical Practice, Mercy George

Walden Dissertations and Doctoral Studies

Cancer diagnoses affect millions of people in the United States each year. Today, cancer patients face many challenges when trying to navigate the complex healthcare system. Patient navigation programs were developed to address and overcome barriers patients may face as they make their way through the healthcare system. The purpose of this project was to provide an analysis and discussion of the current published literature to provide evidence for improving care coordination and patient satisfaction in the oncology clinical setting with a patient navigator program. The practice-focused question for this project asked if a patient navigator program for adult cancer …

Implementation Of The Crafft Cannabis Screening Tool, Barbara Loeprich

Walden Dissertations and Doctoral Studies

Cannabis use among teenagers in Canada is a concern because of the long-term and irreversible effects cannabis has on the developing body and mind. Nurses can be instrumental in screening for cannabis abuse by implementing a tool to assess for substance use disorder (SUD) and triage drug users to appropriate treatment. This project focused on how to implement the CRAFFT screening tool while gaining insight of the practitioner's knowledge base about the tool and how SUD is being screened for, currently. The CRAFFT screening tool aligns with the DSM-IV's SUD diagnosis criteria, allowing for efficient identification of those at risk …

Advanced Cancer Patients' Medical Decision-Making While Experiencing Financial Toxicity, Heather L. Morel

Walden Dissertations and Doctoral Studies

Financial toxicity (FT) is the impact that out of pocket (OOP) costs of cancer care have on patients' well-being, leading to lower quality of life, less compliance with prescribed therapy, and poorer outcomes, including increased mortality. The purpose of this study was to understand the impact of FT on advanced cancer patients' lives and their health care decision-making. Fuzzy trace theory provided the framework for examining how patients use gist and verbatim when making health care decisions while experiencing FT. Gist refers to main ideas that are often infused with emotional overlays that people use to make risky decisions, while …

The Role Of Family Structure In The Abuse Of Children, Ramona Okonya

Walden Dissertations and Doctoral Studies

Every year, about 1 million children are abused in the United States and an average of 4.5 of those children die daily at the hands of caretakers, parents, relatives, or friends. Using the ecological model as a guide, the purpose of this study was to investigate the relationship between family structure and specific types of child maltreatment utilizing cases from an agency in Montgomery, Alabama, in 2012-2013. Approximately 727 cases of child maltreatment were reviewed. Logistic regression results indicate married and common law families' children are 1.83 times more likely to experience sexual abuse than the reference category (single) (OR= …

The Novice Licensed Professional Counselor's Perceived Preparedness To Use Self-Disclosure, Nicole Pfaff

Walden Dissertations and Doctoral Studies

Self-disclosure is used by feminist, humanistic, client-centered, and a variety of other counselors to build therapeutic alliances with clients. However, little research has been conducted on counselors' perceptions of their preparedness to use self-disclosure. This exploratory multiple-case study used attachment theory as a framework to explore the perceptions of novice licensed professional counselors' preparedness to use self-disclosure. The 12 participants who participated in face-to-face interviews practiced as licensed professional counselors in Delaware, New Jersey, or Pennsylvania. The participants described how they learned, practiced, and used self-disclosure. After analyzing interview data through cycle coding and peer review, themes emerged showing participants' …

Incorporating Technology To Decrease Heart Failure Readmission Rates, Vernell Thames

Walden Dissertations and Doctoral Studies

The rate of hospital readmissions within 30 days of discharge of heart failure (HF) patients affects patient outcomes, the financial stability of the health care facility, and the economy. Hospitals focus on strategies that will decrease the HF readmission rates by cultivating evidence-based interventions that improve patients' transition from the hospital to the community, including promoting self-management of their condition. The purpose of this quality improvement project was to develop, implement, and evaluate the use of health information technology along with written forms of plans of care to assist HF patients in managing their care, divert the HF patients to …

Child Sexual Abuse And Prenatal Care: Understanding Screening, Modifications, And Proper Care, Wendy Abbott-Egnor

Walden Dissertations and Doctoral Studies

Research has shown that 1 in 9 women in prenatal care have a history of childhood sexual abuse. Pregnant women with a history of childhood sexual abuse are at increased risk of depression, somatization, preterm contractions, posttraumatic stress symptomology, and re-traumatization. The purpose of this study was to bridge the gap in literature between research and practice. Data was collected from practitioners regarding the care and treatment of pregnant women with a childhood sexual abuse history. It was hypothesized that screening practices and modification to care and treatment based on practitioner knowledge of prior sex abuse history will vary by …

Transition Of Care Guideline For Reducing Heart Failure Hospital Readmission, Geeti Farrahi

Walden Dissertations and Doctoral Studies

Heart failure (HF) patients are among the populations with the highest rates of hospital readmission within 30 days of discharge. Because of the 2010 Health Care Reform legislation, healthcare organizations are subject to financial penalty when a patient population exhibits excess readmissions. A significant reason for readmission of HF patients is a gap in the transition of care from hospital to home. The purpose of this doctoral project was to develop a practice guideline of best practices for transitioning HF patients from hospital to home. The transitional care model and care transitions intervention provided the theoretical underpinnings for developing this …

Predicting Certification Success For The Family Nurse Practitioner, Tammy Lee Gravel

Walden Dissertations and Doctoral Studies

High-stakes licensure or certification examinations are required for many health professions disciplines to ensure safe entry-level practice. Accrediting agencies set a benchmark for graduates' first-time licensure or certification success as a measure of program effectiveness. Failures of graduates on licensure or certification examinations may directly affect the school's recruitment and retention of qualified students and faculty, as well as institutional financial viability. A health science university has added Health Education System, Inc. (HESI) standardized examinations using computer adaptive testing into the family nurse practitioner (FNP) master's program to support certification success, although research on these advanced practice examinations as related …

Assessing Nurses' Safety Attitudes In Preventing Clabsi, Seraphine Ikwueme

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infection (CLABSI) has been widely studied because of its impact on patient morbidity, mortality, and overall health care costs. Research has shown that nurses' attitudes and perceptions regarding safety are critical to developing and maintaining clinical environments that are safe, prevent CLABSI, and assure better health outcomes. The practice-focused question for this project sought to determine the safety attitudes exhibited by registered nurses on a medical-surgical unit at the practice site. The Stetler model was used as a framework to guide the study. The Safety Attitude Questionnaire (SAQ) measured attitudes and perceptions regarding teamwork, safety, job satisfaction, …

Public Health Strategies For Strengthening Prehospital Injury Responses In St. Lucia, Delwin Oliver Ferguson

Walden Dissertations and Doctoral Studies

Traumatic injuries have steadily increased during the last two decades, affecting over 5.8 million persons annually and have become a global public health issue. Since 2008, 80% of all deaths from noncommunicable diseases and trauma, approximately 29 million occurred in developing countries. Sixteen thousand young adults worldwide have died due to traumatic injuries. Additionally, injuries account for over 15% of the global burden of diseases, with approximately 90% of these injuries occurring in developing countries like St. Lucia. The purpose of this qualitative descriptive study was to examine policy gaps in prehospital traumatic injury responses and explore implementing Essential Public …

Strategies To Sustain A Physician-Led Primary Care Practice, Ashley Polidori

Walden Dissertations and Doctoral Studies

Since 2008, physician-led primary care practices have decreased as physician's encounter sustainability challenges because of government regulations and the requirements of the Affordable Care Act. The problem is that some physician-led primary care practice leaders lack strategies to sustain a medical practice longer than 5 years. The purpose of this study was to explore strategies primary-care practice leaders use to sustain a practice longer than 5 years. This study followed a case study design, including a purposeful sampling of 3 physician-led primary care practice leaders in southern Indiana. Open-ended semistructured interviews were conducted and triangulated with company policies and procedures …

Changes In Beliefs About Aggression In Baton Rouge Youth Peace Olympics Participants, Shonta Manuel

Walden Dissertations and Doctoral Studies

Youth violence in the Baton Rouge inner-city area continues to create heightened concerns for the communities as well as the financial and healthcare systems. Even though violence prevention programs are in place in the area, no decline has been recorded in those who are being affected by violence. Due to lack of research in this field, a need for a sound research study exists to understand how Youth Peace Olympics (YPO) community-based program may be related to changes in attitudes about aggression and violence. A correlational cross-sectional research design was used to evaluate participants' beliefs about aggression, measured using the …

Increasing Patients' Understanding Of Prescribed Medication Adherence, Valarie Finley Thomas

Walden Dissertations and Doctoral Studies

The cost of healthcare in the United States has increased due to growing numbers of patients who live with chronic health problems, such as heart disease. The cost of healthcare is compounded by the cost in terms of complications of cardiovascular disease secondary to medication non-adherence. Education about medication use and adherence, safety, and side effects was needed for patients in a cardiovascular unit to improve adherence to medications as prescribed. Results of a health care provider (HCP) and nursing staff needs assessment provided by the site showed the need for improved cardiovascular medication education. The project focused question asked …