Medicine and Health Sciences Commons^™

Ferritin: An Iron Deficiency Biomarker In Collegiate Female Distance Runners, Ty Bigelow

Graduate Theses, Dissertations, and Problem Reports (ETD)

Context: Iron deficiency is a concern in distance runners due to the implications that hemoglobin production becomes impaired limiting oxygen uptake and tissue oxidation in the body. Ferritin is a biomarker used to diagnose iron deficiency. The related signs and symptoms of iron deficiency are associated with decreased performance and prolonged recovery. Objective: The purpose of this study was to investigate whether the change in ferritin levels affect measures of performance, measures of recovery, and rate of perceived exertion in female endurance runners. Design: The study was a descriptive longitudinal study. Setting: The study was conducted at a Mid-Atlantic Division …

Predictors Of Poor Pregnancy Outcomes Among Pregnant Women In Island Maternity, Nigeria, Letam Nwi-Ue

Walden Dissertations and Doctoral Studies

Pregnancy outcomes have improved tremendously in developed countries. Notwithstanding, it is still a huge challenge in developing countries, especially Sub-Saharan Africa. In 2015 in Nigeria, about 145 women died daily from pregnancy-related causes. Similarly, nearly 2,300 children under 5 years were lost in the same year. Nigeria consistently underperformed in some of the critical pregnancy indicators such as maternal and neonatal mortality, second worst only to India in the world. Studies on poor pregnancy outcomes are scarce in Nigeria. The purpose of this quantitative, retrospective cross-sectional study was to use local evidence to ascertain the risk factors that predict poor …

Factors That Influence Place Of Delivery Choice Among Expectant Mothers In Ghana, Baba Ibrahim Mahama

Walden Dissertations and Doctoral Studies

Several factors may affect the choice of place of delivery among expectant mothers in Ghana and few studies have examined the choice of place of delivery with a focus on differences between rural and urban areas. In this study, the factors that influence the choice of place of delivery among expectant mothers in both rural (Tolon District) and urban (Tamale) settings in the northern part of Ghana were identified and compared using the conceptual framework provided by Thaddeus and Maine. A mixed-method study was used to examine expectant mothers and their responses related to factors that affect their choice of …

Cameroonian Immigrants ' Behaviors, Beliefs And Knowledge Of Type 2 Diabetes: In Minnesota, Brendabell Ebanga Njee

Walden Dissertations and Doctoral Studies

Nondiabetic immigrants from Cameroon who migrate to Minnesota lack knowledge of risk factors associated with type 2 diabetes and face challenges accessing health care services. Nondiabetic immigrants from Cameroon lack culturally appropriate health care services and therefore find it difficult to follow providers' recommendations. This phenomenological study explored the perceptions and experiences of nondiabetic immigrants from Cameroon regarding access to affordable, quality health care services as well as their behaviors, beliefs, and knowledge of type 2 diabetes self-management. Bronfenbrenner's social ecological model provided the theoretical framework. Research questions addressed access to affordable health care services, knowledge, and perception of type …

Socioeconomic Status, Water, Sanitation, Hygiene, And Economic Cost Of Childhood Diarrheal Diseases In Uganda, Sarah Birungi Nahalamba

Walden Dissertations and Doctoral Studies

Worldwide, diarrhea is the second leading cause of death in children aged under 5, yet it is both preventable and treatable. Several studies have established the effects of exposure to inadequate water, sanitation, and hygiene (WASH) on diarrhea prevalence, but little was known on how the interactions of socioeconomic status and WASH influence the economic cost of treatment of diarrhea. This retrospective cross-sectional survey study was focused on assessing the correlation between socioeconomic status, WASH, and household cost of treatment of diarrhea among children aged under 5 in Uganda using the multiple exposure-multiple effect model. Secondary data from the 2015/16 …

Effects Of Nonadherence To Hiv/Aids Drugs On Hiv-Related Comorbidities In Eastern Nigeria, Chizomam Laura Ojukwu

Walden Dissertations and Doctoral Studies

Developing countries like Nigeria continue to have HIV epidemic challenge due to the scarcity of evidence-based information and lack of resources to boost HIV education. The study population, Owerri, is one of the states in Nigeria with a high incidence rate of HIV. The purpose of this phenomenological study was to explore the experiences of people living with HIV/AIDS regarding the effects of nonadherence to HIV/AIDS drugs. The integrated theory of health behavior model provided the framework for the study. I collected, transcribed, and analyzed interview data to identify clusters and themes. Results showed that various factors influenced and (e.g., …

Risk Factors Associated With The Contraction Of Ebola Virus Disease In Liberia, Beyan Yancy Sana

Walden Dissertations and Doctoral Studies

Ebola virus disease (EVD) is a highly transmittable disease with high mortality rate. The purpose of this study was to examine risk factors associated with the contraction of EVD in Liberia. A retrospective cross-sectional design was used to analyze secondary data collected on 1,658 patients admitted to Ebola treatment units in Liberia, using the social ecological model as a theoretical framework. Descriptive statistics and the chi-square test for association and logistic regression were used to analyze the data. The findings of this study revealed that funeral attendance, exposure to body fluids, and contact with a living sick person were associated …

Safe Chemical Handling By Agrochemical Users In Plateau State, Nigeria, Adaobi Ifeoma Ekwempu

Walden Dissertations and Doctoral Studies

Agrochemical use has been increasing in both developing and the developed nations. The unsafe handling and use of agrochemicals can lead to accumulation of hazardous chemicals in the body, causing adverse effects on health. This quantitative cross sectional study sought to understand the level of awareness, practices, and perceptions of safe chemical handling by agrochemical using the Theory of Planned Behavior. This study was conducted among 260 farmers in Plateau State, Nigeria. Data on background knowledge and practices of safe agrochemical handling by farmers were collected using a structured paper based, interviewer-€administered questionnaire. Descriptive statistics revealed that the most practiced …

Recruiting Strategies For Increasing The Number Of Emergency Medical Technician Personnel, Carolyn Denise Mack

Walden Dissertations and Doctoral Studies

Demand for the emergency medical technician (EMT) is 2 times greater than that of all other occupations. Sustainability of ambulance services (AS) personnel is dependent upon the recruitment of EMTs into the industry. The purpose of this multiple case study was the exploration of the recruiting strategies that AS administrators used to increase the number of EMTs. Herzberg's 2 factor theory of motivation was the conceptual framework for this study. The data collection instrument included semistructured interviews with 6 AS company executives in southeastern New Mexico and southwestern Texas. Secondary data and document from each state's emergency medical services personnel …

Acculturation And Diabetes Among New York's Bangladeshi Immigrants, Renee Mehrra

Walden Dissertations and Doctoral Studies

There are more than 3.4 million South Asians in the United States. Among this subgroup, Bangladeshis in New York have a high prevalence of Type 2 diabetes ranging from 15 to 24% compared to the general population. This study examined the effect of acculturation through length of stay in the United States and understanding of the English language, and the role of gender on self-efficacy (SE) and diabetes self-management among 336 New York Bangladeshi immigrants between the ages of 21 and 75 who had been diagnosed with type 2 diabetes with A1C -‰¥ 6.5%, as verified by their medical record …

Randomized Trial Of Polychromatic Blue-Enriched Light For Circadian Phase Shifting, Melatonin Suppression, And Alerting Responses., J. P. Hanifin, S. W. Lockley, K. Cecil, K. West, M. Jablonski, B. Warfield, M. James, M. Ayers, B. Byrne, E. Gerner, C. Pineda, M. Rollag, G. C. Brainard

Department of Neurology Faculty Papers

Wavelength comparisons have indicated that circadian phase-shifting and enhancement of subjective and EEG-correlates of alertness have a higher sensitivity to short wavelength visible light. The aim of the current study was to test whether polychromatic light enriched in the blue portion of the spectrum (17,000 K) has increased efficacy for melatonin suppression, circadian phase-shifting, and alertness as compared to an equal photon density exposure to a standard white polychromatic light (4000 K). Twenty healthy participants were studied in a time-free environment for 7 days. The protocol included two baseline days followed by a 26-h constant routine (CR1) to assess initial …

Recommendations For African American Family Caregivers Of Adult With Congestive Heart Failure., Callista Chika Ejim

Walden Dissertations and Doctoral Studies

African Americans suffer disproportionately higher incidence of congestive heart failure (CHF) at an earlier age of onset and with more rapid progression compared to other races. Due to this escalating prevalence of CHF within the African American population and the lack of culturally responsive support for the caregiving role, African American family caregivers of adult CHF patients face greater challenges and suffer increased caregiver burden, stress, depression, and financial strain compared to European American caregivers. The purpose of this project was to conduct a systematic literature review to find the recommendations that target African American family caregivers of adult CHF …

Health System Access To Maternal And Child Health Services In Sierra Leone, Alhassan Fouard Kanu

Walden Dissertations and Doctoral Studies

The robustness and responsiveness of a country's health system predict access to a range of health services, including maternal and child health (MCH) services. The purpose of this cross-sectional study was to examine the influence of 5 health system characteristics on access to MCH services in Sierra Leone. This study was guided by Bryce, Victora, Boerma, Peters, and Black's framework for evaluating the scaleup to millennium development goals for maternal and child survival. The study was a secondary analysis of the Sierra Leone 2017 Service Availability and Readiness Assessment dataset, which comprised 100% (1, 284) of the country's health facilities. …

Improving Hypertensive Therapy Outcomes Among African Americans, Tanya Sullivan

Walden Dissertations and Doctoral Studies

The effects of nonadherence to prescribed blood pressure medication adversely impacts

African Americans (AA) in comparison to their European American counterparts. The

associated health consequences of uncontrolled hypertension include heart failure, stroke,

and renal dysfunction. And the treatment of the complications negatively impacts quality

of life and contributes to increased health care costs. To address the problem at 1 clinic, a

quality improvement (QI) project was developed by the clinic nursing staff, but the

project had never been evaluated. The project included blood pressure measurements

assessed among AA patients before and after implementation of a 4-item Morisky

Medication-Taking Adherence Scale …

Papanicolaou Test Status Among Inner-City Adolescent Girls In Accra, Ghana, Collins Kwesi Asamoa-Afriyie

Walden Dissertations and Doctoral Studies

Cervical cancer is an emerging public health problem in developing countries. Globally, it is the 3rd most common malignancy in women after breast and colorectal cancers and 4th most frequent cancer in women, with an estimated 570,000 new cases and 311,000 deaths in 2018. Cervical cancer screening in the developed countries is credited with the reductions in cervical cancer morbidity and mortality during the last 50 years. However, nearly 90% of cervical cancer deaths occur in less developed countries. Ghana has a cervical cancer rate of 26.4%. Further, it is the highest cancer incidence faced among women 25 to 44 …

Public Education/Public Health Perspectives On Collaboration-Influence On High School Completion, Claudette Virginia Campbell

Walden Dissertations and Doctoral Studies

The research problem focused on the use of collaboration by managers, supervisors, consultants, and professional staff in a department of public education and health to address disparities in on-time high school completion rates. The purpose of the study was to examine the perspectives of individuals in these public sectors on the use of collaboration as a means to improve on-time high school completion rates for African American and Hispanic students. The theoretical foundation and conceptual framework for the study were John Rawls's theory of justice and Amartya Sen's capability approach. The key research question involved how individuals in the public …

Health Care Determinants Of Cervical Cancer Screening In Harare Zimbabwe, Dominic Chifamba

Walden Dissertations and Doctoral Studies

Cervical cancer is the second leading cause of cancer deaths among women of all age groups in Zimbabwe, and mortality and incidence continue to increase. The purpose of this quantitative cross-sectional study was to assess the factors that influence the utilization of cervical cancer screening services by Zimbabwean women living in Harare, Zimbabwe. Because personal beliefs influence screening, this study was guided by the health belief model (HBM). A total of 394 women whose ages ranged from 18 to 65 years were recruited from a health care facility in Harare. A 40-item closed-ended questionnaire was used to assess participants' knowledge, …

Adherence To Art Among Hiv Infected Female Sex Workers In Nigeria, Abass Babatunde Yusuf

Walden Dissertations and Doctoral Studies

A lack of adherence to antiretroviral therapy (ART) increases the risk of onward human immunodeficiency virus (HIV) transmission and mortality. The purpose of this cross-sectional study based on Andersen's conceptual framework was to test the associations between age, marital status, job/occupational status, education, membership in a peer support group, community, and facility ARV drug refill and alcohol and substance use, and adherence to ART among female sex workers (FSWs) who are 15 years and older in Rivers and Cross Rivers states Nigeria. Data were abstracted from existing program data collected between January 2015 and December 2017 by Heartland Alliance International, …

Assessment Of Tuberculosis Underreporting By Level Of Reporting System In Lagos, Nigeria, Mustapha Gidado

Walden Dissertations and Doctoral Studies

Abstract

Tuberculosis (TB) is the leading cause of death from a single infectious disease. Unfortunately, 4.1 million cases were missed in 2017 globally, and Nigeria contributes 9% of the missing TB cases. At least 73% of the estimated TB cases in Nigeria were not reported in 2017 to the National TB Program (NTP); therefore, the true burden of TB was not certain, and this affected planning for prevention and control of TB. This quantitative secondary data analysis (NTP Lagos TB Inventory study database) guided by the integrated behavioral model assessed TB underreporting based on the TB reporting process in Nigeria. …

Child Malnutrition In A Developing Country: A Persistent Challenge In Haiti, Jeanne M. Constant-Edma

Walden Dissertations and Doctoral Studies

Malnutrition is characterized by the insufficient intake of certain nutrients and the inability of the body to absorb or use these nutrients. This health problem continues to be a persistent challenge among children under 5 years of age in developing countries, including Haiti, despite food aid provided. The purpose of this study was to determine the association between dietary habits in children under 5 years of age in Haiti and their malnutrition status. Community organization theory was used to determine the association between determinants of health such as dietary habits, parents' knowledge and experience, cultural eating habits, socioeconomic status, and …

Antenatal Care And Maternal Sociocultural Determinants Of Childhood Immunization In Northern Nigeria, Amaka Tonia Okafor

Walden Dissertations and Doctoral Studies

Immunization has been recognized globally as a cost-effective public health intervention. However, despite its benefits, children in northern Nigeria are still adversely affected by the negative consequences of inadequate uptake of immunization. The purpose of this study was to assess antenatal care and maternal sociocultural determinants that influence childhood immunization within 2 months of birth in northern Nigeria. Constructs of social cognitive theory were applied to this retrospective correlational cross-sectional inquiry involving women 15-49 years old in northern Nigeria. Secondary data (the 2013 Nigeria Demographic and Health Survey) were analyzed using univariate, bivariate and multivariate logistic regression. Statistically significant (p < 0.05) predictors of uptake of childhood immunization within 2 months of birth were the person who delivered antenatal care, the number of antenatal care visits, the number of tetanus injections, maternal educational level, religion, wealth index, husband/partner educational level, and the person who decides on health care. Educated Christian women from middle-class or rich homes, whose husbands/partners were also educated and who jointly decided on health care, made numerous contacts with health care professionals, and received at least one tetanus injection during antenatal care, had a higher likelihood of immunizing their children within 2 months of birth. The positive social change implications for this study include providing evidence of deterrents to childhood immunization that could lead to relevant policies and interventions leading to healthier children, communities, and society.

Doctor Of Nursing Practice Roles In Academia, Jodi Renee Raisor

Walden Dissertations and Doctoral Studies

Over 15,000 master’s and doctoral degree students in the United States were denied admission to nursing schools in 2014 because of insufficient nursing faculty. In 2016, over 64,000 undergraduate and graduate students were unable to gain admission to nursing school due to the effects of faculty shortages. This project explored the role of the Doctor of Nursing Practice (DNP)-prepared nurse in academic settings using a systematic review of the literature to determine the role of DNP-prepared nurses in academia. Souza’s systematic review model and Melnyk’s levels of evidence were used to guide the search, review, and the selection of scholarly …

Assessment Of Risk Perception For Lyme Disease In New Jersey, Sunungurai Tongesayi

Walden Dissertations and Doctoral Studies

Lyme disease (LD) is emerging as one of the major global health challenges of the 21st century. Although data on the diagnosis and treatment of LD is available, research focusing on people's perceptions of LD appears to be limited. Because individual perceptions can significantly affect compliance with preventative measures, such data are critical for the design and successful implementation of interventions to control the disease. The purpose of this qualitative phenomenological study was to explore risk perceptions and knowledge of LD among residents of a county in the U.S. state of New Jersey where the disease is prevalent. The health …

Oral Health Literacy And Oral Hygiene Habits In A Kentucky Appalachian Community, Katie D. Schill

Walden Dissertations and Doctoral Studies

This study sought to identify the level of oral health literacy held by people who live in transitional and distressed Kentucky Appalachian areas and if this effects how often they are using oral hygiene techniques. Data were also collected to describe the attitudes Kentucky Appalachian adults hold toward oral hygiene and oral health status. Current documentation shows that poor oral health remains a public health threat in this population despite efforts such as school-based sealant programs and increased dental insurance coverage. This study followed a quantitative design and 99 participants were polled using a survey specifically developed for this study's …

Influence Of Low Rate Of Reporting Of Adverse Events Following Immunization On Immunization Dropout, Samuel Errie Yenyi

Walden Dissertations and Doctoral Studies

Immunization protects millions of children. Yet, many children drop out of immunization in Jigawa State of north Nigeria. This cross-sectional quantitative correlational study based on the Health Belief Model was designed to determine whether the dropout from routine immunization (RI) was influenced by low rate of reporting of adverse events following immunization (AEFI) to health facilities by caregivers. Primary data was collected from 307 caregivers with dropout children using structured interviewer-administered questionnaire. The data were analyzed using logistic regression and descriptive statistics. The results showed that 61.3% of the children had AEFI and dropped out. Rate of reporting of AEFI …

Preconception Health And Preterm Birth Differences Among U.S.-Born And Foreign-Born Black Women, Sheree Holmes Keitt

Walden Dissertations and Doctoral Studies

Foreign-born Black women giving birth in the United States have superior preterm birth outcomes compared to their U.S-born Black peers. Many studies have focused on tobacco use and medical risk factors, but few have focused solely on preconception health. The purpose of this study was to examine preconception health and preterm birth differences among U.S.-born and foreign-born Black women. Three theoretical frameworks guided this study: the life course theory, healthy migrant theory/immigrant paradox, and weathering theory. Primary research questions assessed (a) if there were an association between chronic preconception risk factors, prepregnancy obesity, diabetes, and hypertension, in U.S.-born and foreign-born …

"Exploring Telehealth Feasibility For Hiv Status In Individuals Aged 17 To 34 In Southwestern Nigeria", Michael Funso Olaniyi

Walden Dissertations and Doctoral Studies

Abstract

The use of smart phones among young people in Southwestern Nigeria has grown since the early 1990'€™s while traditional healthcare access had continued to deteriorate. HIV care centers have been concentrated in large cities, but earlier studies had shown higher prevalence of HIV in rural areas that constituted a larger portion of the population. However, existing studies had not adequately explored the use of mobile phones to supplement traditional healthcare access. The purpose of this study was to assess the feasibility of telehealth for healthcare access among individuals aged 17-34 with positive HIV status and those at high risk …

Cultural Competence Of Public Health Nurses Who Care For Diverse Populations, Althea Michelle Otuata

Walden Dissertations and Doctoral Studies

Despite advances in health, science, and technology, U.S. healthcare lags in providing access to care and quality care to racial and ethnic minorities. Cultural competence has been noted as a strategy to improve access and quality. The purpose of this project was to assess public health nurses' cultural competence before and after participating in cultural competence informational modules. Two conceptual models were used in this project for theoretical guidance: Leininger's cultural care diversity and universality theory and Campinha-Bacote's process of cultural competence. To assess the nurses' cultural competence, the Cultural Competence Self-Assessment Checklist questionnaire was e-mailed to 57 public health …

Examining Cultural Humility And Intersectionality In Mental Health Treatment, Sandra Y. Herrera-Spinelli

Walden Dissertations and Doctoral Studies

Cultural awareness is an ethical standard in the social work profession and, as the diversity in the United States continues to grow, it is a social work practice problem when cultural awareness is not implemented in mental health settings. The National Association of Social Workers revised the cultural awareness standards to include cultural humility and intersectionality as practice indicators. The purpose of this action research study was to examine how clinical social workers demonstrated cultural humility and intersectionality in mental health settings. Person-centered theory guided this study and a total of 17 clinical social workers in New Mexico participated in …

Faculty Incivility And Academic Nurse Administrator Job Satisfaction, Kimberly S. Lindquist

Walden Dissertations and Doctoral Studies

Academic nurse leaders hold an essential role in preparing future nurses who have the skills and abilities to meet complex healthcare system. However, vacancies in academic leadership positions are on the rise and may be connected to faculty incivility which affects job satisfaction of academic nurse leaders. The purpose of this descriptive correlational study, guided by Herzberg'€™s two-factor theory, was to explore the relationships between perceptions of and experiences with faculty incivility and job satisfaction in a population of academic nurse leaders. Leader perceptions of and experiences with faculty incivility were measured using the Workplace Civility/Incivility Survey and leader job …