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2021

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Full-Text Articles in Medicine and Health Sciences

Anxiety Explains Self-Differentiation: Implications For Bowenian Approaches To Marriage And Family Therapy, Reagan Thomas, John Shelley-Tremblay, Harvey Joanning Jan 2021

Anxiety Explains Self-Differentiation: Implications For Bowenian Approaches To Marriage And Family Therapy, Reagan Thomas, John Shelley-Tremblay, Harvey Joanning

University Faculty and Staff Publications

This study examined the Bowenian construct of Self- Differentiation (SD), defined as the degree to which a person can think according to their personal beliefs while remaining emotionally connected to the family. This study examined the degree to which negative emotionality accounted for the relationship between SD and Relationship Satisfaction (RS). Emotional Cutoff (EC) emerged as the sole predictor of RS. When Trait Anxiety (TA) was entered into the model it mediated between EC and RS. We discuss the importance of treating anxiety of the individual in family therapy and that SD may best be understood when taking anxiety into …

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Viral Factors Influencing Early Infection Events During Ex-Vivo Kshv Infection, Ramina Nabiee Jan 2021

Viral Factors Influencing Early Infection Events During Ex-Vivo Kshv Infection, Ramina Nabiee

Pharmaceutical Sciences (PhD) Dissertations

The enigma of Kaposi Sarcoma Herpes Virus infection, and its persistence despite a quarter century of research on the virus, has given rise to an immediate need for addressing fundamental questions about basic immunology and virology knowledge regarding this virus. Kaposi Sarcoma Herpes Virus (KSHV), also known as Human Herpesvirus 8 (HHV8), is the etiological agent of Kaposi Sarcoma (KS) and other lymphoproliferative cancers, such as Multicentric Castleman’s Disease (MCD), Primary Effusion Lymphoma (PEL), and a newly discovered rare disease called KSHV Inflammatory Cytokines Syndrome (KICS). Epidemic KS, also known as AIDS-KS, is the most common cancer in untreated HIV …

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Aldo-Keto Reductases And Cancer Drug Resistance, Trevor M. Penning, Sravan Jonnalagadda, Paul C. Trippier, Tea Lanišnik Rižner Jan 2021

Aldo-Keto Reductases And Cancer Drug Resistance, Trevor M. Penning, Sravan Jonnalagadda, Paul C. Trippier, Tea Lanišnik Rižner

Journal Articles: Pharmaceutical Sciences

Human aldo-keto reductases (AKRs) catalyze the NADPH-dependent reduction of carbonyl groups to alcohols for conjugation reactions to proceed. They are implicated in resistance to cancer chemotherapeutic agents either because they are directly involved in their metabolism or help eradicate the cellular stress created by these agents (e.g., reactive oxygen species and lipid peroxides). Furthermore, this cellular stress activates the Nuclear factor-erythroid 2 p45-related factor 2 (NRF2)-Kelch-like ECH-associated protein 1 pathway. As many human AKR genes are upregulated by the NRF2 transcription factor, this leads to a feed-forward mechanism to enhance drug resistance. Resistance to major classes of chemotherapeutic agents (anthracyclines, …

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Impact Of Social Barrier Removal On Primary Care Use By Managed Care Enrollees, Pamme Lyons-Taylor Jan 2021

Impact Of Social Barrier Removal On Primary Care Use By Managed Care Enrollees, Pamme Lyons-Taylor

Walden Dissertations and Doctoral Studies

Personal health represents a complex relationship among social, physical, and emotional factors that can be influenced by health-seeking behaviors. Prior research indicates that greater use of preventive services leads to longer life and lower healthcare costs. For some populations, evidence suggests that social barriers hinder access to preventive services. To better understand the relationship between social factors and the other personal-health factors, de-identified healthcare claims and social service encounter data for 4,480 low-income individuals enrolled in Medicare Advantage or Managed Medicaid at one national health insurance were examined using a retrospective, quasi-experimental design for services rendered between October 1, 2014 …

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Effects Of Cultural And Lived Experiences On Health Access Of Chamorro People On Saipan, Esther Lizama Muna Jan 2021

Effects Of Cultural And Lived Experiences On Health Access Of Chamorro People On Saipan, Esther Lizama Muna

Walden Dissertations and Doctoral Studies

More than half of the population of the Commonwealth of the Northern Mariana Islands had not visited their primary care provider for a year in 2016. The Chamorro people are less willing to seek or access care than other ethnic groups. This qualitative study aimed to understand the Chamorro people's access and utilization of Saipan's health care services to improve their access and, ultimately, their health. The theoretical frameworks included Penchansky and Thomas's theory of access to explore the Chamorro people of Saipan's lived experiences with availability, accessibility, accommodation, affordability, and acceptability of health care services, as well as Spector's …

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Enhancing Parental Compliance In Managing Attention Deficit Hyperactivity Disorder, Claudia E. K-Ackah Jan 2021

Enhancing Parental Compliance In Managing Attention Deficit Hyperactivity Disorder, Claudia E. K-Ackah

Walden Dissertations and Doctoral Studies

Medication adherence in children is essential in ensuring that treatment approaches are successful and lead to positive health outcomes for the patient. However, with the young child largely dependent on the abilities and drive of parents and caregivers, adherence to the treatment regimen for children diagnosed with attention-deficit/hyperactivity disorder (ADHD) can be challenging. A systematic literature review using the preferred reporting items for systematic reviews and meta-analysis (PRISMA) model was used to locate, analyze, and synthesize sources to identify current evidence-based strategies used by health care providers for enhancing parental compliance in managing the child with ADHD. Reported in themes, …

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Empowerment, Personality, And Leader-Member Exchange Quality In Physicians, Tony S. Reed Jan 2021

Empowerment, Personality, And Leader-Member Exchange Quality In Physicians, Tony S. Reed

Walden Dissertations and Doctoral Studies

Nearly 100,000 people suffer injury or death each year due to errors in the United States healthcare system. Researchers have identified that empowerment by physicians can address this significant social issue. Despite this knowledge, qualifications to empowering behaviors in physicians have not been identified. A quantitative nonexperimental correlation approach was used to determine the role that personality type and high-quality leader-member exchange may play in the physician’s ability to create empowerment at academic medical centers in the United States. The theoretical framework of empowering leadership, Jung’s psychological types, and leader-member exchange quality informed the research design and contributed to the …

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The Use Of Technology For Seeking Health Information In Persons With Cancer, Jasvir Zonobi Jan 2021

The Use Of Technology For Seeking Health Information In Persons With Cancer, Jasvir Zonobi

Walden Dissertations and Doctoral Studies

Cancer is a growing public health concern. The U.S. cancer prevalence nearly doubled from 8.1 million in 1996 to 15.5 million in 2016 and is expected to rise by an additional 68% from 2016 to 2040. Many cancer survivors use technology (e.g., smartphones) for health information seeking (HIS) for health-related self-efficacy (HRSE) to self-manage the health issues (e.g., physical impairment, chronic disease) they face. However, limited research exists regarding cancer survivors' use of HIS technology for HRSE. The self-efficacy theoretical framework, multiple logistic regression analyses, and the data from 2019 Health Information National Trends Survey were used in the current …

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Neurodiversity And Workplace Social Capital Effects On Employee Attitudes And Intentions, Alice Edwards Jan 2021

Neurodiversity And Workplace Social Capital Effects On Employee Attitudes And Intentions, Alice Edwards

Walden Dissertations and Doctoral Studies

Neurodivergent employees have higher turnover rates than their neurotypical peers, andmuch remains unknown about how to improve their workplace experience. The purpose of this quantitative study was to examine the relationships between neurodiversity and workplace social capital on job satisfaction and turnover intent. Social cognitive career theory (SCCT) informed the study design. Working adults (N = 1,243) in the United States recruited using convenience sampling and MTurk participated through an anonymous online survey. Data analysis was conducted using three-way ANOVA and mediation. Significant three-way interactions were found between gender, job classification, and likelihood of having attention deficit hyperactivity disorder (ADHD) …

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Exploring Barriers To Care: Provider Efforts To Improve Retention In Urban-Rural Clusters, Kenyata M. Fletcher Jan 2021

Exploring Barriers To Care: Provider Efforts To Improve Retention In Urban-Rural Clusters, Kenyata M. Fletcher

Walden Dissertations and Doctoral Studies

AbstractOver the years, the infection rates for HIV in the United States has changed partly due to lack of engagement and medication adherence which can lead to substantial declines in individual health. Factors that contribute to the individual’s adherence can include transportation cost, childcare, and lack of finances to name a few. These barriers can often be decreased with the help of supportive service providers and improvement in the patient-provider relationship. Currently, there is limited research that explores how to reduce patient barriers to care, specifically in rural areas. This qualitative study examines how Illinois health care providers help HIV-positive …

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Examining Nursing Home Staff Turnover Rate In Long-Term Care Organizations In The United States, Dandrea Vanettra Kittles Jan 2021

Examining Nursing Home Staff Turnover Rate In Long-Term Care Organizations In The United States, Dandrea Vanettra Kittles

Walden Dissertations and Doctoral Studies

AbstractEvery year, many nursing assistants in the United States leave their positions. The high level of turnover can be disruptive to patient care and costly to organizations needing to replace workers; another consequence can be increased job dissatisfaction among remaining staff. Despite the high turnover in nursing facilities, there remains a research gap regarding the factors that promote employee retention. The purpose of this study was to examine nursing assistants’ beliefs about job satisfaction as an approach to prevent job turnover and retain high-achieving staff in nursing homes in the United States among the older adult population. Herzberg’s motivation-hygiene theory …

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Risk Factors Associated With Childhood Vaccination Coverage In Afghanistan, Iqbal Mawani Jan 2021

Risk Factors Associated With Childhood Vaccination Coverage In Afghanistan, Iqbal Mawani

Walden Dissertations and Doctoral Studies

Globally, vaccination is among the most successful and cost-effective public health practices in the prevention of infectious diseases. The purpose of this study was to examine the child, parental, and geographical risk factors that influence childhood vaccination coverage in Afghanistan. The health belief model and socio-ecological model was used in this study as the theoretical framework to examine the effects of these risk factors on vaccination coverage among children in Afghanistan. Univariate, bivariate, and multivariate tests were conducted within the secondary data analysis of the 2015 Afghanistan national Demographic and Health Survey dataset. Of the 32,420 children aged 0 to …

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Challenges To Successful Health Care Transition Among Hiv Positive Youth With Perinatal Acquisition, Tyler Andrew Termeer Jan 2021

Challenges To Successful Health Care Transition Among Hiv Positive Youth With Perinatal Acquisition, Tyler Andrew Termeer

Walden Dissertations and Doctoral Studies

To ensure stability in the continuum of health care for HIV-positive youth with perinatal acquisition, there is a need for a successful transition from pediatric to adult primary care. However, there are a growing number of perinatally infected HIV-positive young persons remaining in pediatric care beyond the age of 21. Using Mohr’s program theory and a phenomenological approach, the lived experiences of Ohio HIV clinicians were examined to determine why many perinatally infected HIV-positive youths are remaining in pediatric care beyond the age of 21. Audio recorded video interviews via SKYPE were conducted with 12 participants, transcribed, underwent thematic analysis, …

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Health Care Provider Program On The Management Of Obesity, Erlinda P. Bhat Jan 2021

Health Care Provider Program On The Management Of Obesity, Erlinda P. Bhat

Walden Dissertations and Doctoral Studies

Research has shown that educational programs have led to developing the professional skills and behaviors of front-line health care providers who care for overweight or at-risk obese patients. The purpose of this project was to provide an educational program on best practices for weight management to health care providers at a large military clinic. The project question was developed to assess whether the educational program increased the knowledge and confidence of health care providers in the management of obesity. Utilizing Pender's health promotion model, a quasi-experimental study was conducted in which 15 health care providers, including licensed and unlicensed personnel …

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Lived Experiences Of Pakistani American Women Who Sought Mental Health Treatment, Marriam Ashraf Jan 2021

Lived Experiences Of Pakistani American Women Who Sought Mental Health Treatment, Marriam Ashraf

Walden Dissertations and Doctoral Studies

AbstractDespite the research on how mental illness manifests in the United States, there is more to be known about mental health in the Pakistani American population. The goal of this qualitative phenomenological study was to understand the lived experiences of Pakistani American women who sought mental health treatment. Ecological theory provided the framework for the study. Data were collected from semi structured interviews with 10 participants via telephone and face-to-face conversations. Data were analyzed using managing, reading, memoing, describing, classifying, interpreting, representing, and visualizing techniques. Findings indicated that seeking help for mental health played a positive role in participants being …

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A Phenomenological Exploration Of How Nursing Experience Shapes The Transitional Performance Of Primary Care Nurse Practitioners, Helen Okeke Jan 2021

A Phenomenological Exploration Of How Nursing Experience Shapes The Transitional Performance Of Primary Care Nurse Practitioners, Helen Okeke

Walden Dissertations and Doctoral Studies

AbstractPoor access to healthcare and a shortage of primary care providers in underserved communities paved the way for reliance on advanced practice registered nurses (APRNs). This increased reliance on APRNs as primary care providers necessitates expanded public policy on APRN practice; however, information on APRN transitional experiences remains inadequate to inform policymakers effectively. Illinois’ Nurse Practice Act requires APRNs to incorporate the scope of practice of registered nurses into their practice but does not describe what that experience should be. Using Kanter’s theory of organizational structural empowerment and Benner’s novice to expert nursing model as theoretical lenses to ground the …

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Human Immunodeficiency Virus And Homelessness Among U.S.-Born And Foreign-Born Tuberculosis Cases In Georgia, Semra Ramosevac Jan 2021

Human Immunodeficiency Virus And Homelessness Among U.S.-Born And Foreign-Born Tuberculosis Cases In Georgia, Semra Ramosevac

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, tuberculosis (TB) is an infectious disease caused by bacteria and can easily spread in the U.S. and worldwide. TB infections in the U.S. have been much lower compared to other countries around the world in the last 40 years, but with the recent increase in an immigrant foreign-born population, there is a serious risk of the spread of TB. The goal of the study was to look into U.S.-born vs. foreign-born populations among TB/HIV/homeless cases in the state of GA from 2014 to 2018. The quantitative study was performed using secondary …

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Psychosocial Support During Pregnancy: A Narrative Inquiry Of Low-Income Unmarried Women In Iowa, Summer D. Parrott Jan 2021

Psychosocial Support During Pregnancy: A Narrative Inquiry Of Low-Income Unmarried Women In Iowa, Summer D. Parrott

Walden Dissertations and Doctoral Studies

Pregnant women who experience high levels of stress and who lack support are at higher risk for negative birth outcomes for themselves and their offspring including preterm labor, low birthweights, and a myriad of other short- and long-term health and behavioral consequences across the lifespan of the child. Unmarried or socioeconomically disadvantaged women lack the most common resources used to protect against the negative effects of stress during pregnancy. A research gap existed regarding the specific types of psychosocial support perceived by low-income unmarried women to be most beneficial at buffering their perceived prenatal stress. The ecological model and the …

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Evaluation Of A Cardiac Surgery Nurse Navigator Quality Improvement Program, Eileen Joy Watkins Jan 2021

Evaluation Of A Cardiac Surgery Nurse Navigator Quality Improvement Program, Eileen Joy Watkins

Walden Dissertations and Doctoral Studies

AbstractPatients who have had cardiac surgery may experience longer hospital stays and increased readmission rates when there is poor care coordination between patients, families, and the healthcare team. Poor care coordination leads to unclear expectations of each phase of care, decreased compliance with postoperative care regimen resulting in increased length of stay, patient and family dissatisfaction, and increased rates of readmission. This project evaluated a Cardiac Surgery Nurse Navigator (CSNN) Quality Improvement program to address care coordination and improve length of stay and readmission rates for cardiac surgery patients. The goal was to determine whether the CSNN program was effective …

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Impact Of Information Breaches On Health Care Records, Anton Antony Arockiasamy Jan 2021

Impact Of Information Breaches On Health Care Records, Anton Antony Arockiasamy

Walden Dissertations and Doctoral Studies

Although there were almost 3.5 million reported information breaches of health care data in the first quarter of 2019, health care providers do not know the extent of digital and nondigital breaches of patient medical records. The purpose of this quantitative, comparative study was to identify the difference between the individual patient records affected by digital versus nondigital breaches for three types of health care entities in the United States, health care providers, health care plans, and health care clearinghouses. Allman’s privacy regulation theory, the National Institute of Standards and Technology Privacy Framework, and ecological systems theory comprised the theoretical …

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Motivational Interviewing: A Strategy To Improve Health Professional's Communication, Lanita James Jan 2021

Motivational Interviewing: A Strategy To Improve Health Professional's Communication, Lanita James

Walden Dissertations and Doctoral Studies

Miscommunication between patients and healthcare professionals is common in U.S. hospitals and is considered one of the chief factors in reduced patient satisfaction with care. Collaboration with the nurse researcher who reviewed the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) data for a local hospital noted that negative ratings were directly related to the miscommunication between the patient and care providers. Further identified that the nursing staff was not knowledgeable about evidenced-based strategies needed to communicate effectively with the patients. The purpose of this DNP project was to develop an education program to increase nurses' knowledge about …

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Service Providers' Perceptions Of Stigma And Its Impact On Mental Health Services, Arthur Gabriel Montes Jan 2021

Service Providers' Perceptions Of Stigma And Its Impact On Mental Health Services, Arthur Gabriel Montes

Walden Dissertations and Doctoral Studies

Stigma is one of the most significant barriers to access and utilization of mental health services in the United States. Delays in receiving mental health services significantly contribute to health disparities and poor health outcomes. Social workers play an integral part in implementing best practices within health care settings and reducing health inequities impacting vulnerable populations. The purpose of this qualitative action research study was to explore social work service providers perceptions' toward stigma and how it affects mental health services among patients in California's Medicaid program. Stigma theory was applied to gain an understanding of how stigma interacts and …

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Assessing The Risk Of Developing Liver Cancer Among Adults In The United States, Magbor Oben Jan 2021

Assessing The Risk Of Developing Liver Cancer Among Adults In The United States, Magbor Oben

Walden Dissertations and Doctoral Studies

The risk of developing liver cancer among adults in the United States remains asignificant threat due to an increasing prevalence of the disease. Despite the identification of some biological, environmental, and socioeconomic risk factors, uncertainty exists as to the role of sociodemographic factors. In this study, participants (N=27,804), age 18 and over, were assessed for liver cancer outcome specific to three factors liver disease, insurance coverage, and access to healthcare. With the person-centered care model as the framework, data from the 2016 National Health and Interview Surveys were subjected to the selection criteria and quantitatively analyzed using binary logistic regression. …

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Evidence-Informed Health Care Transition Policy In California’S Title V Programs For Medical Complexity, Anthony Pallitto Jan 2021

Evidence-Informed Health Care Transition Policy In California’S Title V Programs For Medical Complexity, Anthony Pallitto

Walden Dissertations and Doctoral Studies

Inadequate health care transition policy continues to cause interruptions or setbacks in the continuity of medical care and lapses in health insurance coverage for adolescents in California's Title V programs for individuals with medically complex cases. Yet, there is a paucity of empirical health care transition research to develop an effective health care transition policy for children with medical complexity who are enrolled in California’s Title V program. The purpose of this explanatory case study was to explore the potentiality of translating evidence from a quasi-experimental health care transition primary research project into evidence-informed health care transition policy. The research …

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Preventable Error Reduction Leadership Strategies Of Nurse Managers In A Hospital Setting, Sedrick Diego Bedolla Jan 2021

Preventable Error Reduction Leadership Strategies Of Nurse Managers In A Hospital Setting, Sedrick Diego Bedolla

Walden Dissertations and Doctoral Studies

AbstractPreventable medical errors in the healthcare industry account for hundreds of thousands of patient deaths annually. Nurse managers strive to develop strategies to reduce incidences of preventable medical error and increase patient safety in their organization to improve performance and reduce harm in the healthcare industry. Grounded in the complex adaptive systems theory, the purpose of this qualitative single case study was to explore strategies nurse managers use to reduce the rate of preventable medical errors among employees. The participants comprised 6 nurse managers who successfully used strategies to lower the rate of preventable errors in a healthcare facility in …

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Primary Care Providers’ Perceptions Of Adolescent Friendly Health Services In Relationship To Adolescent Pregnancy, Jill Marie Ensminger Jan 2021

Primary Care Providers’ Perceptions Of Adolescent Friendly Health Services In Relationship To Adolescent Pregnancy, Jill Marie Ensminger

Walden Dissertations and Doctoral Studies

According to recent research, adolescent health continues to be a public health concern. The purpose of this qualitative research was to identify the perceptions of primary care providers regarding adolescent friendly health services and the relationship to adolescent pregnancy. The theoretical and conceptual framework used for this research included the social ecological model and the recommendations of the World Health Organization (WHO) for providing adolescent friendly health services. Using a phenomenological qualitative research approach, interviews were conducted over the telephone. Data analysis included hand coding with emerging themes and subthemes in relationship to each research question. The results of the …

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An Educational Intervention To Reduce Central Venous Catheter Infection Rates, Bolanle Olajuyigbe Jan 2021

An Educational Intervention To Reduce Central Venous Catheter Infection Rates, Bolanle Olajuyigbe

Walden Dissertations and Doctoral Studies

AbstractCentral venous catheters (CVC) are essential in both critical and noncritical care settings. Despite benefits such as the administration of medications, blood products, and parenteral nutrition, CVCs are also associated with infections known as central–line associated blood stream infections (CLABSI). Linked to knowledge deficit and noncompliance in following evidence-based care bundles by nurses, it is important that nurses are empowered through education to provide quality care to reduce CLABSI rates. Thus, a staff education program was developed to answer the practice-focus question: if an organized education program increases the knowledge of medical-surgical nurses on central line care and management procedures …

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Examining Clinicians' Perspectives Screening For Depression In Patients With Type 2 Diabetes Mellitus, Vickie Lavette Bland Jan 2021

Examining Clinicians' Perspectives Screening For Depression In Patients With Type 2 Diabetes Mellitus, Vickie Lavette Bland

Walden Dissertations and Doctoral Studies

The United States has a significant diabetes problem. This chronic disease affects the body physically and mentally. One of the emotional effects of diabetes is depression. Depression is often present in individuals with diabetes, chiefly in those with type 2 diabetes mellitus (T2DM). While depression is common in T2DM and can interfere with treatment adherence, clinician screening for depression in T2DM patients is low. The purpose of this study was to examine clinicians' attitudes, behaviors, and perceptions concerning screening patients with T2DM for depression. Through a qualitative case study approach centered on reasoned action theory, 3 physicians and 5 nurse …

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Students' Perceptions Of Persistence In Two-Year Radiologic Technology Programs, Billie Jo Huffstetler Jan 2021

Students' Perceptions Of Persistence In Two-Year Radiologic Technology Programs, Billie Jo Huffstetler

Walden Dissertations and Doctoral Studies

Obtaining a health care degree benefits individuals and society; however, 2-year radiologic technology programs in a metropolitan area of the southern United States continue to struggle with student persistence from enrollment to graduation. Exploring student persistence is important to college administrators, faculty, and students because of the predicted growth in the profession of radiologic technology. The purpose of this basic qualitative study was to explore students' perceptions of their experiences at the local college that encouraged them to persist to graduation or quit attending. Deci and Ryan's self-determination theory and Bean and Metzner's nontraditional undergraduate attrition model served as the …

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Effect Of Professional Exclusion Among Respiratory Therapists In The Icu, Tiffany Lubken Jan 2021

Effect Of Professional Exclusion Among Respiratory Therapists In The Icu, Tiffany Lubken

Walden Dissertations and Doctoral Studies

This study was conducted to test how social exclusion, experienced through a culture of healthcare hierarchy, influenced the feelings/attitudes of respiratory therapists (RTs) who are excluded from discussions of end-of-life (EOL) care. Data analysis was conducted using a multivariate analysis of variance to address the research questions. A quantitative nonexperimental survey research design incorporating four evidence-based surveys was used. There was no significance found between professional exclusion from EOL care discussions and the abilities of RTs to collaborate with intensive care unit (ICU) team members within the shared decision-making model as it relates to providing care in the ICU. There …

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