Medicine and Health Sciences Commons^™

The Impact Of Mental Health First Aid Training On Law Enforcement Officer Mental Health Literacy, Cindy J. Blankenship

Walden Dissertations and Doctoral Studies

An increasing number of juvenile offenders with untreated mental health issues are entering the justice system. Lack of adequate training of criminal justice personnel enhances the possibility of this population being arrested which is creating an overwhelming problem for stakeholders. This study sought to determine if the implementation of Mental Health First Aid (MHFA) Training impacted law enforcement officers’ (LEOs’) mental health literacy. This mixed-methods study used a quasi-experimental, one-group, pretest-posttest design, with a qualitative survey. Participants consisted of a sample of 28 LEOs from a rural Southeastern United States law enforcement agency. Study findings indicated that MHFA training increased …

Reduce Postpartum Complications By Improving Postpartum Care Appointment Attendance, Shayla Tennille Buckler

Walden Dissertations and Doctoral Studies

This evidence-based project (EBP) was developed to increase postpartum appointment attendance to improve maternal outcomes for postpartum women. The practice problem was that the postpartum women who received prenatal care failed to return for postpartum care at a community clinic in north east Texas. The practice-focused question explored whether an educational intervention with the nursing staff would increase postpartum appointment attendance. The framework used was Pender’s Health Promotion Model. The preintervention data were retrieved from an electronic medical record (EMR) generated report that provided the number of postpartum appointments attended 30 days before the intervention. The nursing staff received a …

Meat Intake And Prostate Cancer In African American Men, Uchenna Njoku

Walden Dissertations and Doctoral Studies

African American men have more prostate cancer and are more than twice as likely to die of the disease as Caucasian men, and the reasons for this racial disparity have not been clarified. Identifying lifestyle and dietary risk factors of prostate cancer is an important public health issue. Studies on the association between meat intake and prostate cancer risk have produced inconsistent results. The purpose of this cross-sectional quantitative study was to determine whether there is an association between total meat intake and total prostate cancer risk among African American men when controlling for age, income, educational level, physical activity, …

Behavioral, Demographic, And Clinical Determinants Of Hiv Serostatus In Zambian Women, Debebe Masresha Gebreyohannes

Walden Dissertations and Doctoral Studies

The rate of human immunodeficiency virus (HIV) infection shows a diminishing trend at the global level while it shows increasing in intensity of mortality, morbidity, and burden in Sub-Saharan Africa. The intertwined behavioral, demographic, and clinical determinants fueled the incidence of infections in Zambian women. The purpose of this study was to determine the association between demographic, behavioral, and clinical determinants with HIV serostatus in Zambian women. With the conceptual framework of the World Health Organization’s Commission for Social Determinants of Health (CSDH) and quantitative method of MANOVA, this study examined Zambian Demographic Health Survey data for Zambian women of …

Impact Of Education On Hiv Testing Among African American Women In The United States, Florence Matimbah Mbangowah

Walden Dissertations and Doctoral Studies

Improved and increased human immunodeficiency virus (HIV) testing among African American women in the United States could facilitate early detection of the virus. The purpose of this cross-sectional quantitative study was to determine if there was a significant association between HIV testing participation and education level (i.e., high school, college, post-college level) based on access to healthcare after accounting for insurance, income, employment, marital status, English language proficiency, and vision quality. The integrated theory of health behavior change, the theoretical framework used for this research, proposes that changes in health behavior can be improved by various factors such as fostering …

Care Management And Readmission Among Elderly African American Patients With Chronic Illnesses, Vivien Lyn Salmon

Walden Dissertations and Doctoral Studies

More than 70 million Americans aged 50 years and older suffer from at least 1 or more chronic condition and use the emergency department frequently. By 2025, chronic illness will affect an estimated 164 million Americans or nearly 49% of the population. The rapid rise in chronic illness is due to a combination of an aging population, longer life expectancies, and poor lifestyle choices. This quantitative study provided a statistical analysis on the impact of care management on readmissions among African Americans between the ages of 65 and 80, with diabetes, hypertension, asthma, or multiple chronic conditions. Logistic regression was …

Methods To Increase The Rate Of Childhood Vaccinating, Mary Beth Tillman

Walden Dissertations and Doctoral Studies

Vaccinations such as polio, diphtheria, varicella, and meningitis help to protect a child from life-threatening illnesses which have previously been contained by routine vaccinations. However, misinformation, negative press, and other contributing factors, have influenced caregivers to refuse to vaccinate their children placing the children at risk for contracting the disease. The Centers for Disease Control and Prevention recommends regular vaccinations for children beginning as newborns, yet the vaccination rate remains below acceptable levels. This project was developed to provide an educational program guided by Orem’s self-care theory and intended to increase nurses’ knowledge of vaccination and ultimately vaccination rates. A …

Reducing Congestive Heart Failure Hospital Readmission Through A Practice Guideline, Michelle Hamric

Walden Dissertations and Doctoral Studies

Patients with congestive heart failure (CHF) are at increased risk for hospital readmission within 30 days of discharge. The gap in practice involves the coordination of care for patients with CHF in the transition from hospital to home. Patients with CHF are at increased risk for hospital readmission due to barriers involving self-care, communication, and coordination of care. The purpose of this project was to implement a clinical practice guideline (CPG) that used a predictive tool and clinical pathway for coordination of care for CHF patients at increased risk for hospital readmission within 30 days. The DNP project involved using …

Sociopolitical Determinants Of Parental Acceptance Of Childhood Vaccination In Abuja, Nigeria, Lawrence Madu Ohammah

Walden Dissertations and Doctoral Studies

Despite the efficacy of vaccines, some parents still reject vaccination of their children, resulting in low vaccination coverage, a greater burden of vaccine-preventable diseases, and high infant mortality. The purpose of this study was to investigate the sociopolitical determinants of vaccination status among children, aged 0-24 months, and identify the factors that drive vaccine hesitancy. The social ecological model served as the theoretical framework. The study research design was a quantitative cross-sectional survey. An interviewer-administered questionnaire was used to collect primary data from parents and caregivers in 384 randomly selected households from 48 settlements in the Abuja Municipal Area Council. …

Hiv Positive African American Women’S Lived Experiences And Clinical Outcomes, Christie Olejemeh

Walden Dissertations and Doctoral Studies

African American (AA) women are disproportionately affected by HIV/AIDS. The infection rate for AA women continues to increase, and literature lacks information specifically on education for AA women regarding viral suppression at diagnosis. The purpose of the study was to understand the lived experiences of AA women living with HIV in the District of Columbia, particularly how they acquired knowledge of viral suppression. To understand their experiences with antiretroviral medications, viral suppression, discrimination, and stigma, this qualitative study applied a hermeneutic phenomenological approach. The theories of resilience and empowerment were applied. Ten HIV positive AA women living in the District …

Preparing Clinical Faculty To Teach And Reinforce Hourly Rounding, Lisa Bailey

Walden Dissertations and Doctoral Studies

A gap exists in the knowledge of clinical faculty teaching prelicensure students about hourly rounding. The purpose of this project was to develop an educational program to prepare clinical faculty teaching student nurses to conduct hourly rounding. Hourly rounding trained faculty ensure safe practice by students and adherence to hospital policies. Hourly rounding includes the 4 Ps, which entails the assessment of “potty”, pain, position, and possession/periphery. Models and theories used to inform the project included the American Academy of Pediatrics’ 10-step process for developing training courses, Knowles’ theory of adult learning, Kirkpatrick's evaluation model, and the Accreditation Commission for …

Guidelines For Chronic Back Pain: An Education Module For Health Providers, Ron Pascual

Walden Dissertations and Doctoral Studies

Effective chronic back pain management and patient self-care guidelines are necessary for healthcare providers treating patients with complaints of low back pain (LBP). The purpose of this doctoral project was to provide an evidence-based educational program aimed at improving the knowledge and skills of healthcare professionals regarding the Center for Disease Control (CDC) and American Chronic Pain Association (ACPA) guidelines, emphasizing alternative pain management treatments. The staff education project was supported by the biomedical pain model and chronic care model. A panel of 3 experts including the clinic’s board-certified anesthesiologist and pain management specialist, clinical manager, and leading medical director …

Exploring Health Literacy In The Acute Care Setting In A Rural Border Region, Shiloh Williams

Walden Dissertations and Doctoral Studies

Health literacy is important to ensuring patients have the necessary knowledge and skills needed to actively participate as a member of their own healthcare team. Patients with low health literacy are at increased risk for poor outcomes and limited participation in decisions affecting their health or treatment plan. Using the Social Ecological Model (SEM) as a framework, the purpose of this study was to determine the relationship between medical-surgical registered nurses, medical-surgical patients and the registered nurse’s (RN) assessment of their patient’s health literacy of those who live in a rural-border region. The study’s sample consisted of 84 pairs of …

Lived Experience Of Concept-Based Educated Novice Nurses Transition To Practice, Kim Hostetter

Walden Dissertations and Doctoral Studies

Novice nurses often feel unprepared to transition to practice, which results in increased turnover, which is costly to healthcare organizations and can compromise patient care. Many schools have transitioned to a concept-based curriculum, to move away from traditional content-saturated nursing education. The purpose of this study was to explore the lived experiences of novice nurses educated in a concept-based curriculum as they transitioned to practice. Benner’s novice-to-expert framework and Tanner’s clinical judgment model guided understanding of the behavior of the nurses during the transition period. This interpretative phenomenological study was used to understand new graduates’ perception of their experiences as …

Risk Factors For Polysubstance Abuse: A National Secondary Data Analysis Study, Dakota Mcmurray

Walden Dissertations and Doctoral Studies

Substance abuse is a serious public health problem in the United States and globally. Abuse of more than one substance is considered polysubstance abuse and can cause more harm than abuse of only one substance. Polysubstance abuse compounds the problems of addiction because of the variety of substances that may be used and the resulting side effects. This quantitative cross-sectional secondary data analysis, guided by the socio-ecological theory, assessed patient characteristics and how predictive they were for polysubstance abuse. The study sample of 986 patients was analyzed by binomial logistic regression to assess the association between patient-related factors and polysubstance …

Implementation And Sustainability Of Emergency Department Wait Time Management Strategies, Arnold F. Resto Del Valle

Walden Dissertations and Doctoral Studies

The problem of excessive wait time in the Emergency Department (ED) is a barrier to receiving access to assessment and treatment for patients seeking care in the United States. This project sought to understand the success factors that help implement and sustain wait time management strategies (WTMS) and ensure reduction of wait times in hospital Emergency Departments. This study addresses the gap in practice of few documented success factors that are proven methods in clinical practice for reducing patient wait time or sustainability. Retrospective studies, randomized controlled trials, and prospective observational studies were included in this project. An exhaustive comprehensive …

Use Of Managerial Epidemiology By Healthcare Leaders In Ambulatory Settings, Chantelle Schenning

Walden Dissertations and Doctoral Studies

Despite many health reforms, the United States continues to struggle with limited healthcare access, exponential healthcare costs, and poor quality of care. Overcoming these challenges requires healthcare leaders’ effective navigation of industry transformation towards population health and a shift in patient volume to ambulatory healthcare settings. Research has demonstrated that the use of managerial epidemiology, an application of epidemiology tools and principles to management decision-making within healthcare organizations, can better serve the health of the population and could improve the triple aim of inadequate access, high costs, and poor quality. However, the adoption of this practice is weak and its …

Measuring Knowledge Of Chronic Kidney Disease (Ckd) Among Community College Students, Jacquelyn Caldwell Moore

Walden Dissertations and Doctoral Studies

Chronic Kidney Disease (CKD) once detected is easily treated; however, it has become a major health problem associated with increased morbidity and mortality rates, creating an economic burden worldwide. While approximately 24 million Americans over the age of 20 suffer from CKD, there is a lack of awareness among the general population. Using a pre/post assessment, this quantitative study measured the impact of a 75-minute workshop on 126 community college students' knowledge of kidney disease, perception of its severity, and perceived susceptibility. The theoretical framework for the study was the health belief model, which suggests that individuals will make positive …

Effectiveness Of End Of Shift Bedside Report, Glory Abuajah

Walden Dissertations and Doctoral Studies

AbstractNursing shift reports are the primary communication mechanism for outgoing nurses to transfer information about a patient to oncoming nurses. Nurse shift reports and nurse handovers are two of the most critical patient care processes that can support patient safety and reduce medical errors. But many nurses do not recognize the evidence supporting the practice of bedside reporting (BSR). In response to this practice problem, this project involved education on the importance of BSR on a telemetry unit in line with the best available evidence. The goal of the staff education project was to educate the staff on the value …

Exploring A Nursing Faculty’S Perceived Level Of Engagement With High-Fidelity Simulation Experiences, Filipina Hernandez

Walden Dissertations and Doctoral Studies

AbstractResearchers from several disciplines concluded that deep engagement in an organization is critical to its success. However, little is known about a nursing faculty’s engagement experiences with high-fidelity simulation (HFS), which could establish the critical link between deep engagement and HFS’ successful integration in nursing programs. Grounded in the alternative model of engagement in learning, bridging this knowledge gap was the purpose of this study. The research question of this phenomenological study explored the nursing faculty’s perceived level of engagement with their HFS experiences. A purposeful sampling of 10 nursing faculty were interviewed using semistructured interview process. Van Kaam’s interpretative, …

Advanced Cancer Patient Preferences For Receiving Molecular Profiling Results, Megan Best, Phyllis Butow, Chris Jacobs, Ilona Juraskova, Jacqueline Savard, Bettina Meiser, David Goldstein, Mandy Ballinger, Nicci Bartley, Christine Napier, Grace Davies, David Thomas, Kathy Tucker, Timothy Schlub, Ainsley J. Newson

IES Papers and Journal Articles

Objective: This study aimed to discern preferences for receiving somatic molecular profiling (MP) results in cancer patients who have given consent to undergo testing.

Methods: We conducted a mixed‐methods study to explore patients’ views on which MP results they would like to receive and why. Advanced cancer patients (n=1299) completed questionnaires after giving consent to participate in a parent genomics study and undergoing MP. A subset of patients (n=20) participated in qualitative interviews.

Results: Almost all (96%) participants were interested in receiving results which would direct cancer treatment (i.e. were actionable). A smaller majority wanted to access results which were …

Factors Associated With Patients Who Leave Emergency Departments Without Being Seen, Eva E. Koci

Walden Dissertations and Doctoral Studies

AbstractPatients leaving an emergency department (ED) without being seen by a provider are a significant problem in United States for patient health. Research on leaving without being seen (LWBS) has been conducted; but very few researchers have examined patients with Tricare or military members. This quantitative study explored the association between patients’ social demographic characteristics (age, gender, race, ethnicity), triage levels, visit characteristics (hour of arrival, day of the arrival), and LWBS rates. The theoretical framework for this study was the Donabedian theory. Secondary data from Agency for Healthcare Administration located in Florida were examined. The research questions explored whether …

Evaluating The Hospitals General Service Readiness Index In Guinea For Enhancing Their Performances, Mohamed Elmahady Camara

Walden Dissertations and Doctoral Studies

The healthcare system of Guinea has reported low scores on service availability and readiness assessment (SARA); the scores indicated the low availability of quality drugs, vaccines, medical equipment, and other technologies and involves a continuous history of poor quality-performance metrics. Thus the operational health problems in Guinea could be summarized as health problems (high rate of maternal, neonatal, and infant mortality, high prevalence of communicable and non-communicable diseases) and health system problems (lack of appropriate governance). Therefore, amelioration of the quality of health care and patient safety is needed. The objective of this study was to consider Guinea hospital performance …

Impact Of Medical Device Integration On Real-Time Visibility Of Electronic Medical Records, Justin Fuller

Walden Dissertations and Doctoral Studies

Health care leaders are expected to make sound decisions regarding the equipment they purchase for use by personnel. One topic of consideration is the ability of the equipment to integrate with an organization’s electronic medical record, known as medical device integration (MDI). One aspect of MDI is the ability for information gathered at the patient bedside to be viewable in real time, or as close to it as possible. The real-time visibility (RTV) of information refers to the time it takes for information gathered by one individual to be visible to another. The purpose of this systematic review of the …

Getting The End Of Life Care Conversation Started, Lisa Ann Mccabe-Evans

Walden Dissertations and Doctoral Studies

AbstractEducation is needed among the health care collaborative team to address the lack of end of life conversation, the underutilization of hospice leading to patients’ end of life wishes not being met, the increased depression among bereaved loved ones, and the increased health care costs at the end of life. Nurses reduce the patient’s physical and emotional stress by helping guide conversations and answer questions to meet the needs of patients and their loved ones. This project addressed the practice-focused question to determine if nursing knowledge and expressed intentions about end of life care increase as shown via the difference …

Neoangiogenesis And Blood-Brain Barrier Dysfunction In Human Tsc Brain Lesions, Kimberly Sansalone, Pelin Dilsiz, Howard Weiner, Orrin Devinsky, Delia M. Talos

Phase 1

Introduction: Tuberous sclerosis complex (TSC) is a genetic disorder characterized by the presence of multiple benign tumors throughout the body and brain. Patients with TSC experience severe cognitive dysfunction and therapy-resistant seizures, which can be associated with refractory epilepsy and poor developmental outcomes. We hypothesize that neoangiogenesis, disruption of the blood-brain barrier, and leakage of serum proteins into the brain parenchyma play vital roles in the pathogenesis of TSC.

Methods: In order to assess blood-brain barrier integrity, cortical tissue samples from TSC patients with intractable seizures, non-TSC patients with therapy-resistant epilepsy, and control subjects were immunolabeled for the serum …

Lew,1wr1 Rat Shows An Increased Risk Of Developing Malignant Forms Of Nafld, Luis Mercado

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

No abstract provided.

Interferon Beta Activity Is Modulated Via Binding Of Specific S100 Proteins, Alexei S. Kazakov, Alexander D. Sofin, Nadezhda V. Avkhacheva, Alexander I. Denesyuk, Eugenia I. Deryusheva, Victoria A. Rastrygina, Andrey S. Sokolov, Maria E. Permyakova, Ekaterina A. Litus, Vladimir N. Uversky, Eugene A. Permyakov, Sergei E. Permyakov

Molecular Medicine Faculty Publications

Interferon-β (IFN-β) is a pleiotropic cytokine used for therapy of multiple sclerosis, which is also effective in suppression of viral and bacterial infections and cancer. Recently, we reported a highly specific interaction between IFN-β and S100P lowering IFN-β cytotoxicity to cancer cells (Int J Biol Macromol. 2020; 143: 633–639). S100P is a member of large family of multifunctional Ca2+-binding proteins with cytokine-like activities. To probe selectivity of IFN-β—S100 interaction with respect to S100 proteins, we used surface plasmon resonance spectroscopy, chemical crosslinking, and crystal violet assay. Among the thirteen S100 proteins studied S100A1, S100A4, and S100A6 proteins exhibit strictly Ca2+-dependent …

Liquid–Liquid Phase Separation By Intrinsically Disordered Protein Regions Of Viruses: Roles In Viral Life Cycle And Control Of Virus–Host Interactions, Stefania Brocca, Rita Grandori, Sonia Longhi, Vladimir N. Uversky

Molecular Medicine Faculty Publications

Intrinsically disordered proteins (IDPs) are unable to adopt a unique 3D structure under physiological conditions and thus exist as highly dynamic conformational ensembles. IDPs are ubiquitous and widely spread in the protein realm. In the last decade, compelling experimental evidence has been gathered, pointing to the ability of IDPs and intrinsically disordered regions (IDRs) to undergo liquid–liquid phase separation (LLPS), a phenomenon driving the formation of membrane-less organelles (MLOs). These biological condensates play a critical role in the spatio-temporal organization of the cell, where they exert a multitude of key biological functions, ranging from transcriptional regulation and silencing to control …

Intrinsic Disorder In Tetratricopeptide Repeat Proteins, Nathan W. Bibber, Cornelia Haerle, Roy Khalifa, Bin Xue, Vladimir N. Uversky

Molecular Medicine Faculty Publications

Among the realm of repeat containing proteins that commonly serve as “scaffolds” promoting protein-protein interactions, there is a family of proteins containing between 2 and 20 tetratricopeptide repeats (TPRs), which are functional motifs consisting of 34 amino acids. The most distinguishing feature of TPR domains is their ability to stack continuously one upon the other, with these stacked repeats being able to affect interaction with binding partners either sequentially or in combination. It is known that many repeat-containing proteins are characterized by high levels of intrinsic disorder, and that many protein tandem repeats can be intrinsically disordered. Furthermore, it seems …