Medicine and Health Sciences Commons^™

Fear Of Falling Assessment And Interventions In Community-Dwelling Older Adults: A Mixed Methods Case Study, Amanda S. Cappleman

Honors Undergraduate Theses

Background: Fear of falling has significant adverse physical and psychological effects for the community-dwelling older adult. Objective: The purpose of this study was to assess fear of falling in community-dwelling older adults and explore participant perceptions of fear of falling assessments and interventions. Methods: A mixed methods case study was utilized to gain an in-depth understanding of older adults' perceptions. It consisted of quantitative data collection by objective measures and qualitative data collection by four individual in-depth interviews. A sample of four community-dwelling adults aged 65 years and older and living in Orlando, Florida, completed the study in their home …

Factors Contributing To The Negative And Unhealthy Psychological Conditions In The Ed Rn, Ariana M. Nieves

Honors Undergraduate Theses

The emergency department is a stressful environment. Emergency department registered nurses (ED RNs) are at an increased risk of development of negative and unhealthy psychological conditions due to their frequent exposure to stress and traumatic events. These conditions include post-traumatic stress disorder, compassion fatigue, and burnout syndrome, which are already known to be common in the emergency department registered nurse population. It is important to understand the factors that influence the development of these psychological conditions in order to provide better education to nurses regarding prevention of the development of these psychological conditions. This literature review aimed to identify articles …

Mapping Of Lymphatic Filariasis In Loiasis Areas: A New Strategy Shows No Evidence For Wuchereria Bancrofti Endemicity In Cameroon, Samuel Wanji, Mathias Eyong Esum, Abdel Jelil Njouendou, Amuam Andrew Mbeng, Patrick W Chounna Ndongmo, Raphael Awah Abong, Jerome Fru, Fanny F. Fombad, Gordon Takop Nchanji, Glory Ngongeh, Narcisse V. Ngandjui, Peter Ivo Enyong, Helen Storey, Kurt C. Curtis, Kerstin Fischer, Joseph R. Fauver, Daphne Lew, Charles W. Goss, Peter U. Fischer

Journal Articles: Epidemiology

BACKGROUND: Mapping of lymphatic filariasis (LF) caused by Wuchereria bancrofti largely relies on the detection of circulating antigen using ICT cards. Several studies have recently shown that this test can be cross-reactive with sera of subjects heavily infected with Loa loa and thus mapping results in loiasis endemic areas may be inaccurate.

METHODOLOGY/PRINCIPAL FINDINGS: In order to develop an LF mapping strategy for areas with high loiasis prevalence, we collected day blood samples from 5,001 subjects residing in 50 villages that make up 6 health districts throughout Cameroon. Antigen testing using Filarial Test Strip (FTS, a novel platform that uses …

Improving Socioeconomic Status May Reduce The Burden Of Malaria In Sub Saharan Africa: A Systematic Review And Meta-Analysis, Abraham Degarege, Kristopher Fennie, Dawit Degarege, Shasank Chennupati, Purnima Madhivanan

Journal Articles: Epidemiology

BACKGROUND: A clear understanding of the effects of housing structure, education, occupation, income, and wealth on malaria can help to better design socioeconomic interventions to control the disease. This literature review summarizes the relationship of housing structure, educational level, occupation, income, and wealth with the epidemiology of malaria in sub-Saharan Africa (SSA).

METHODS: A systematic review and meta-analysis was conducted following the preferred reporting items for systematic reviews and meta-analyses guidelines. The protocol for this study is registered in PROSPERO (ID=CRD42017056070), an international database of prospectively registered systematic reviews. On January 16, 2016, available literature was searched in PubMed, Embase, …

Does Education Improve Health In Low- And Middle Income Countries? Results From A Systematic Review, Stephanie Psaki, Barbara Mensch, Erica Chuang, Andrea J. Melnikas

Poverty, Gender, and Youth

Despite enormous progress in expanding school enrollment globally, improvements in health have not always followed, raising important questions: Does education, in fact, enable women, men and their families to be healthier? And if so, how? To fill this gap in knowledge, the GIRL Center conducted a systematic review of the evidence for the effects of education on health in low- and middle-income countries.

Delivering Results In Girls' Education: How To Evaluate What Works, What Doesn't, And What We Don't Know, Stephanie Psaki

Poverty, Gender, and Youth

Girls around the world face daunting challenges when it comes to enrolling in primary school, completing secondary school, and gaining the basic knowledge and skills they need to be empowered, healthy, and productive adults. Many governments and organizations have risen to meet that challenge through policies and programs designed to remove common barriers to girls’ education. But as the number of actors in this space grows, and resources to address these challenges remain scarce, it is essential to ensure that investments are targeted toward the most effective policies and programs. This brief lays out the basics of program evaluation. The …

Examining The Effects Of Energy Drinks On Academic Performance, Alyssa P. Roberson

College of Graduate Studies: Theses & Dissertations

Reports of energy drink (ED) consumption have grown among the United States population. Research suggests reasons for consumption vary across populations, including increased attention and enhanced endurance performance. However, ED consumers could suffer from negative effects of ED, including health problems, caffeine overdose, and death. Energy drink consumption is also linked to substance use. Despite risks of consuming ED, heavy use of EDs remains among college students, often to help with academic performance; however, research has not examined effects of ED consumption on perceived and actual academic performance. This study evaluated relationships among ED consumption, self-efficacy, and academic performance in …

Using The Theory Of Reasoned Action To Analyze African American College Students Intentions To Participate In Bio Banking Research, Bethrand O. Ugwu

College of Graduate Studies: Theses & Dissertations

The proliferation of biobanks has created new opportunities for researchers to conduct cutting-edge research that was not possible a decade ago. The results of early studies using biospecimens in cancer research have been encouraging. However, researchers are concerned about the applicability of the new knowledge that is being produced to racially diverse subgroups because African American (AA) participation in biobanking research is low. The current study assessed how AA college students’ attitudes and social norms influenced their intentions to participate in biobanking research. This research was guided by Ajzen and Fishbein’s Theory of Reasoned Action as the analytic lens. Methods: …

Examining Factors Associated With Minority Turnover Intention In State And Local Public Health Organizations: The Relationship Among Diversity Climate, Career Growth Perception, Job & Organizational Satisfaction And Turnover Intention., Ashley Kennedy Mitchell

College of Graduate Studies: Theses & Dissertations

Research shows that a diverse workforce can increase workplace satisfaction, organizational performance, and retention (Konrad, 2006; Choi, 2013; McKay et al., 2007). There is a need to understand governmental public health workforce turnover to ensure the retention of public health minority workers, the capitalization on diversity benefits, and the services needed to provide for a more diverse population. This study aimed to assess the impact of the workforce environment, particularly employee perceptions of the diversity climate, individual career growth, and job and organizational satisfaction, on minority state and local health worker turnover intention. Data were analyzed from the 2017 The …

"Evaluation Of Medication Adherence Through The Use Of Home Assisted Telemanagement", Kingsley Ezihe Ngameduru

Walden Dissertations and Doctoral Studies

Medication nonadherence can have serious consequences for patient outcomes. Home-automated telemanagement systems have supported increased levels of adherence among patients. This project explored whether the use of a home telemanagement program (HTM) would improve medication adherence in clinic patients diagnosed with hypertension (HTN). The health belief model, social learning theory, the self-regulation model and the theory of reasoned action guided this project. Providers in a primary care clinic completed the 4-question Morisky, Green, and Levine adherence scale with 50 HTN patients previously enrolled in a HTM. Survey results revealed that after 2 years in the program, patients were still forgetting …

Clinical Resource Practice Scenarios To Mitigate Bullying, Sabrina Renea Brown-Oliver

Walden Dissertations and Doctoral Studies

Workplace bullying is repeated, aggressive action towards a victim, which especially affects new graduate nurses and can inhibit growth and lead to nursing burnout and staff turnover. The purpose of this Doctor of Nursing Practice project was to develop a clinical resource educational module. The case scenarios were developed using literature on workplace bullying and lateral violence. Clegg's circuits of power theory framework demonstrate how organizational authoritative nursing power struggles that exist as a circular flow between different nursing group members, and the American Nurses Association (ANA) Practice Standards and Code of Ethics guided the assertive communication. The case scenarios …

Drug Prices, Dying Patients, And The Pharmaceutical Marketplace: A New Conditional Approval Pathway For Critical Unmet Medical Needs, Robert A. Bohrer

Faculty Scholarship

Prescription drugs have been a major topic in the news for much of the past year. There are two issues which appear often: first, the very high prices of new drugs, particularly the "specialty" drugs developed for serious diseases; and second, the time required for FDA approval in relation to the perceived need for earlier access to new therapies for critically ill patients. Much less in the news, but lurking behind both issues, is the need for better information for physicians and patients to use in making decisions about prescribing and taking drugs, and for insurance companies and the government …

Direct-To-Consumer Ads Are Misleading: Concise Statements Of Effectiveness Should Be Required, Robert A. Bohrer

Faculty Scholarship

Direct-to-consumer (DTC) advertising of prescription pharmaceuticals has been the subject of much criticism and the issue has become even more pressing with the Trump administration’s proposal to require the disclosure of prices in DTC ads. In this article I argue that a more powerful approach to the problem of DTC ads would require the disclosure of the effectiveness of the advertised drugs, at least as found in the clinical trials submitted for FDA approval. To support the need for an effectiveness disclosure, I describe the problem of DTC ads and examine representative ads to illustrate the potential of such ads …

Vitamin D Receptor Gene Polymorphisms Knowledge And Breast Cancer In Texas, Ejike Roland Egwuekwe

Walden Dissertations and Doctoral Studies

Breast cancer is a world health problem and is a leading cause of cancer-related death among women in the United States. However, breast cancer risks were reported to be reduced through exposure to Vitamin D through its Receptors identified as the p53 target gene. The purpose of this study was to assess the associations between VDR gene polymorphisms knowledge/awareness and decisions to reduce breast cancer risks and likelihood of mammogram screening among women in Texas. Data from survey were used. Roy adaptation model was the theoretical framework that guided this quasi- experimental, quantitative research. The dependent variables were decisions to …

Community Education Through A Stroke Champion Program, Michele Gribko

Walden Dissertations and Doctoral Studies

Stroke is the fifth leading cause of death and primary cause of long-term disability in the United States. Public awareness of stroke symptoms and ability to activate the emergency medical system (EMS) quickly are essential for early treatment. At a large Joint Commission-certified Comprehensive Stroke Center with over 6,000 employees, a stroke champion program that included both clinical and nonclinical volunteers was initiated to determine whether stroke champion volunteers could learn and disseminate information about stroke symptoms and the importance of activating EMS within their community. Roger's diffusion-of- innovation framework was used to design and evaluate the outcome of the …

Pregnant African American Women Breastfeeding Intentions, Beliefs, Attitudes And Perspectives, Janelle S. Mcclain, Phd

Walden Dissertations and Doctoral Studies

Breastfeeding is the best infant feeding source of nutrition for infants in their early stages of development. However, there is a fundamental gap in the number of African American women that initiate breastfeeding compared to White, Asian, and Hispanic mothers. Social cognitive theory was used to explore the breastfeeding intentions, beliefs, perceived barriers, and perceptions on breastfeeding through a basic qualitative research method. To capture the essence of the lived experiences of African American pregnant women, a purposeful sample of 13 African American pregnant women were invited to participate in the study. Two focus groups discussions pertaining to breastfeeding intentions …

Relationship Between Transformational Leadership And Perceived Meaning In Work, Denise Adams

Walden Dissertations and Doctoral Studies

Researchers have conducted correlational studies on transformational leadership and perceived meaning in work; however, researchers have not used an experimental design to examine the relationship between transformational leadership and perceived meaning in work. The purpose of this study was to determine whether reading information on transformational leadership, which focused on charisma and individualized consideration, influenced participants' hypothetical judgment of perceived meaning in work. The quantitative study included a 2 x 2 between-subjects design in which information on the independent variables of charisma and individualized consideration was manipulated in a description of a hypothetical leader. The dependent variable was the hypothetical …

Measuring Effects Of Childhood Adversity On Resilience Level Of Army Veterans, Stephanie Rausch

Walden Dissertations and Doctoral Studies

Veteran suicide is a public health issue that requires more research to understand the multidimensional factors, such as resilience, that lead someone to suicide. Adverse childhood events (ACEs), such as poverty and abuse, have affected how resilience is developed. This study examined the association between childhood factors of socioeconomic status, parental discipline, and being a military child, and adult resiliency level. Dienstbier's theory of mental toughness framed the study, which posits that a child who experiences mild ACEs and has time to recover between events, will be more resilient than children who experience serious ACEs, and children who experience little …

Adhesive Transparent Chlorohexidine Gluconate Tegaderm™ Gel Dressing For Central Venous Catheter, Peter Kimiti Mwangi

Walden Dissertations and Doctoral Studies

Central-line-associated bloodstream infections (CLABSIs) occur during the insertion or change of the dressing of the central venous catheter (CVC) and are reportable healthcare-associated infections at the state and the national level. The purpose of this systematic review of the literature was to evaluate and synthesize available evidence to establish the effectiveness of using an adhesive transparent chlorohexidine gluconate (CHG) Tegaderm™ gel dressing for CVC in the prevention of CLABSIs. The logic model was used as a framework to guide the review of the literature to establish how an intervention that is not currently practiced can contribute to CVC prevention of …

Dicer Regulates Activation Of The Nlrp3 Inflammasome, David M. Ojcius, Ardavan Jafari, Laxmi Yeruva, Christian W. Schindler, Ali A. Abdul-Sater

All Dugoni School of Dentistry Faculty Articles

Inflammation plays a critical role in initiation of adaptive immunity, pathogen clearance and tissue repair. Interleukin (IL)-1β is a potent pro-inflammatory cytokine and therefore its production is tightly regulated: its secretion requires the assembly of a macromolecular protein complex, termed the inflammasome. Aberrant activation of the inflammasome has been linked to debilitating human diseases including chronic inflammatory and autoimmune diseases. Thus, there is a great interest in understanding how inflammasomes are regulated. Here we show that Dicer, an enzyme necessary for the production of mature micro-RNAs (miRNAs), is required for optimal activation of NLRP3 inflammasomes in bone marrow macrophages. Our …

The Effect Of Maternity Care Practices On The Duration Of Breastfeeding, Lisette Rodriguez

Walden Dissertations and Doctoral Studies

The natural practice of breastfeeding has been strongly noted as one of the most cost-effective, health promoting, disease-prevention strategies of the 21st century. Although primary health organizations recommend exclusive breastfeeding for the first 6 months of life with added complementary foods and continued breastfeeding up to 2 years of age or longer, many mothers do not breastfeed their infants for the recommendation length of time. Applied policies and health practices, such as those described under the 10 Steps to Successful Breastfeeding and The International Code of Marketing of Breast Milk Substitutes, have been noted as contributing factors that can considerably …

Reducing Compassion Fatigue In Hospice Nurses Through Education, Gregory Daniel Friesz

Walden Dissertations and Doctoral Studies

Compassion fatigue is a secondary stress reaction that results from providing care to those undergoing traumatic life events. Frequent exposure to dying patients with complex medical concerns has been identified as a contributing factor to compassion fatigue and resultant turnover among hospice nurses. The purpose of this project was to assess whether the provision of education to hospice nurses regarding compassion fatigue resulted in a demonstrable improvement in their levels of compassion fatigue. Watson's theory of human caring and Roy's adaptation model provided the theoretical foundation for this project. The practice-focused question for this project asked whether a reduction in …

The Association Between Leapfrog's Healthcare Organizational Grades And 30-Day Mortality Rates, Steven Michael Armstrong

Walden Dissertations and Doctoral Studies

U.S. healthcare consumers have access to various provider ratings from several organizations that are meant to assist in selecting their healthcare providers. Leapfrog Hospital Safety Grades is one such rating system that professes to allow consumers the ability to select the best hospital for their care. However, since consumers ranking mortality risk as their most important concern, it is essential to determine if Leapfrog grades align with consumer expectations. Andersen's Phase-4 behavioral model of healthcare utilization was used as the foundation for understanding healthcare consumer preferences. This study was designed to determine if Leapfrog grades are predictive of CMS 30-day …

Strategies To Develop A New Nurse Residency Program, Casandra Allen

Walden Dissertations and Doctoral Studies

The ongoing shortage of registered nurses is a nationwide phenomenon. Many factors contribute to the dissatisfaction and stress of new graduate nurses during the initial transition phase of their career. The lack of peer and leadership support is among the many factors that lead to constant turnover. New nurses entering the workforce are caring for patients with more complex health problems. The Commission on Collegiate Nursing Education (CCNE) has developed standards for accreditation of entry-to-practice nurse residency programs (NRP). The purpose of this DNP project was to propose a formal evidenced-based nurse residency program to the stakeholders of an acute …

Structured Education Using Scenario-Based Training In Cerner Electronic Medical Records, Ruby Aruldass

Walden Dissertations and Doctoral Studies

Nurse practitioners are trained to use the electronic medical record (EMR) to document. Documentation in the EMR is often found to be incomplete, inaccurate, and unreliable, which affects the quality of care and patient safety outcomes. The purpose of the project was to improve the efficiency and effectiveness of nurse practitioners' documentation in the EMR. Malcolm Knowles' adult learning theory was used in this project to develop the education program. Kirkpatrick's training evaluation model was also used to analyze and evaluate the project. The study population included 5 primary care nurse practitioners in an ambulatory care setting using Cerner EMR. …

Recruiting Strategies For A Nonprofit Health Care Facility, Jairo Borja

Walden Dissertations and Doctoral Studies

Although predictions for the supply of registered nurses (RNs) is projected to increase to 3,849,000 by 2025, the demand for RNs is projected to grow to 3,509,000. The purpose of this single case study was to explore the strategies some recruiters in a nonprofit health care facility used to recruit RNs. The conceptual lens used for this study was general systems theory. Through a purposeful sample of 3 recruiters at a nonprofit health care facility located in New York, data collection occurred through semistructured interviews, reviewing job boards and the company website, and taking field notes the day of the …

Increasing Uninsured Patients' Compliance With Return Primary Care Visits, Dorothy Clare Carleton

Walden Dissertations and Doctoral Studies

Patients who are unable to comply with their health care regimen are almost 3 times more likely to have an adverse health outcome and are more likely to suffer irreversible progression of a chronic disease process. Increasing patient return clinic visits is essential, not only to curtail rapidly rising costs of health care but also to improve patient outcomes. This project focused on an uninsured patient population of a clinic in a rural community in the southeastern United States. The purpose of the project was to conduct a systematic review of the literature and identify the barriers and motivating factors …

Implementing Guidelines To Improve Hand Hygiene Compliance, Doreen Millicent Currie

Walden Dissertations and Doctoral Studies

Hand hygiene is the term for removing microorganisms with disinfecting agents, alcohol-based rub, or soap and water. Evidence supported the low rates of hand hygiene compliance among health care workers. This project addressed this gap in practice at a large acute care facility through an educational training program. Data from the facility on hand hygiene compliance revealed a compliance rate of 63%. The problem question explored whether an educational program on hand hygiene improve compliance. The focus of the program was to provide education on the World Health Organization's My 5 Moments for Hand Hygiene and the 7-step technique for …

Improving Access To Cancer Care For The Rural Community With Telehealth, Cheryl Ann Fiscelli

Walden Dissertations and Doctoral Studies

After a diagnosis of cancer, timely access to oncology care is a priority. For patients living in a rural community, there are many challenges such as proximity to cancer care, reduced access to state-of-the art therapies, lack of coordinated care, and limited access to clinical trials. A multidisciplinary consultation (MDC) via telehealth can improve access to care for rural oncology patients. The purpose of this project was to determine the effects of telehealth MDC on the time in days from diagnosis to the first treatment with the goal of persuading the project site to implement a telehealth MDC. The data …

Enhancing Comfort Care Techniques In The Pediatric Inpatient Setting, Nicole Rae Mansky

Walden Dissertations and Doctoral Studies

The benefits of pharmacological and nonpharmacological interventions for children undergoing painful medical procedures are well documented in extant nursing literature; however, such techniques continue to be underused in practice. Improving comfort during medical procedures is necessary to enhance the patient and family experience. The purpose of this project was to provide education to nursing staff about pediatric pain theories and evidence-based practice recommendations that support the use comfort interventions for pediatric patients of all ages. The practice-focused question addressed the development of an educational program designed to enhance staff knowledge of comfort intervention options and the benefits provided to patients. …