Medicine and Health Sciences Commons^™

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 …

Nigerian Pensioners’ Knowledge, Attitudes, And Beliefs About Type 2 Diabetes, Nnawuihe Ugochukwu Nwosu

Walden Dissertations and Doctoral Studies

AbstractDiabetes is one of the leading killer diseases globally, and it is on the rise, especially in developing countries like Nigeria. The high prevalence of undiagnosed Type 2 diabetes in developing African countries has been attributed to a lack of knowledge and awareness about the disease, unbelief in modern healthcare efficacy, and limited healthcare services access. The purpose of this study was to explore the knowledge, attitudes, and beliefs about Type 2 diabetes among pensioners in Nigeria. A qualitative phenomenological research design was used for the study. The constructs of the health belief model formed the study’s theoretical framework. Data …

Managers’ Challenges Complying With Environmental Regulations In Ghana’S Mining Sector, Augustin Tandoh

Walden Dissertations and Doctoral Studies

Even though Ghana’s mining industry has been and continues to be of remarkable benefit to the national economy, environmental pollution continues to plague the industry. The purpose of the qualitative case study was to obtain the perceptions of 9 nongovernmental organization (NGO) stakeholders of the challenges faced by managers in the Ghanaian mining industry tasked with complying with Ghana Environmental Protection Agency (GEPA) regulations. Freeman’s stakeholder theory was the theoretical framework of the study. Data were collected from semistructured interviews with a purposive sample of Ghanaian and international NGO representatives who sought to work with, or even shame and pressure, …

A Study Of Public Awareness About The Threat Of Earthquakes, Mike Allen

Walden Dissertations and Doctoral Studies

Noticeably absent from the existing literature was a correlation study which would have gauged individual awareness for earthquakes. The literature search provided one quantifiable narrative that correlated college education with awareness about earthquakes; the study found that college graduates scored higher points on the awareness test for earthquakes than their counterparts who had no college education. The research question for this study examined the possible correlations between personal characteristics and awareness about earthquakes. A survey was developed and used to find hypothesized correlations between public awareness and a number of variables such as age, gender, education, income, and professional leadership. …

Why African American Men Diagnosed With Chronic Obstructive Pulmonary Disease Continue To Smoke, Vashonda Laniece Allen

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this research was to explore why some African American men diagnosed with chronic obstructive pulmonary disease (COPD) continue smoking following their diagnosis. The theory of planned behavior (TPB) guided the development of this research. The research questions were developed to understand the attitudes, behavioral intentions, subjective norms, social norms, perceived power, and perceived behavioral control that influence their continuing or quitting smoking based on the TPB model. The study’s research method was qualitative. A pilot study, using the same criteria as the main study, confirmed the reliability of the interview guide. Participants were informed about the study …

Understanding Female Somali Noncollege Graduate Immigrant’S Experiences With Cervical Cancer Screening Services, Rachel Anyu Anyu-Lainjo

Walden Dissertations and Doctoral Studies

AbstractHealthcare disparities exist in cervical cancer screening worldwide particularly in women of East African descent compared to non-African women. Previous research has investigated the reasons for low participation in cervical cancer screening among Blacks, minorities, and immigrant populations. Limited research has focused on immigrant women in the United States of America, specifically immigrants from Somalia who currently live in St. Cloud, Minnesota. The purpose of this qualitative study was to understand the perception of Somali immigrant women ages 25 - 45 years who have not earned a college degree and their lived experiences with cervical cancer screening. Two conceptual frameworks …

Educational Intervention To Increase Telemedicine Knowledge In Nurses, Jean Sylvestre Ayissi Essono

Walden Dissertations and Doctoral Studies

Limited access to healthcare services is a factor that can reduce quality of care, and it is more pronounced in rural settings. One plausible solution to this concern is telemedicine, the use of electronic information and telecommunication technologies to provide care when an individual and provider are not in the same location. Although telemedicine has been suggested as a solution to the access to care concern, it is not widely integrated into the nursing practice. Using Nightingale’s holistic theory of caring, the purpose of this DNP project was to determine if an educational study geared towards telemedicine increased knowledge and …

An Educational Program For Nursing Home Nurses On Sepsis In Older Adults, Wendy Belden

Walden Dissertations and Doctoral Studies

Elderly nursing home patients’ high rates of hospitalization due to sepsis impact their morbidity and mortality and significantly cost the U.S. healthcare system. Skilled nursing facility (SNF) nurses who have the knowledge to assess older adults for signs and symptoms of sepsis and communicate findings to providers are instrumental in providing improved care for patients. The purpose of this doctoral project was to provide a group evidence-based educational intervention on sepsis care of older adults geared toward nurses working in SNFs. The practice-focused question asked whether an educational intervention focused on the signs and symptoms of sepsis in the elderly …

Sociodemographic Factors, Socioeconomic Factors, And Teenage Pregnancy Outcomes In Guyana, Karen Roslyn Cummings

Walden Dissertations and Doctoral Studies

Teenage pregnancy, a global phenomenon is associated with adverse pregnancy outcomes, owing to the mother’s individual factors, location, education attainment, and service accessibility. Globally, 16 million babies are born to teenage mothers annually. In Guyana, there is a paucity of information on factors associated with teenage pregnancy rate which stands at 74 per 1,000, and its outcomes. Archived data from the 2014 UNICEF Multiple Indicator Cluster Survey 5 (MICS5) was used to identify and examine relationships between the sociodemographic, socio-economic factors, and teenage pregnancy outcomes in Guyana. This quantitative cross-sectional review approach guided by the Bronfenbrenner theoretical framework analyzed data …

Improving Nursing Knowledge On Antibiotic Therapy To Prevent Pneumonia Readmissions, Muskuda Deen

Walden Dissertations and Doctoral Studies

Lack of education on the appropriate use of antibiotic therapy can lead to an increase in early readmissions for patients with community-acquired pneumonia (CAP). The purpose of this project was to educate medical-surgical nurses at an inpatient hospital in the southern region of the United States on the appropriate use of antibiotic therapy to decrease early CAP readmissions. The project practice question was whether the infection control clinical practice guidelines would increase the medical-surgical nurses’ knowledge on the appropriate use of antibiotic therapy to decrease the 30-day readmission rates for patients diagnosed with CAP. The staff education development was guided …

Staff Education On The Use Of The Lace Index In Clinical Settings, Carrole Dorcent

Walden Dissertations and Doctoral Studies

As of 2008, the Centers for Medicare and Medicaid Services has instituted monetary penalties for institutions with excess readmissions. As a result of these initiatives, hospitals are investing resources and efforts to educate their staff to use tools aimed at reducing readmission rates. The LACE index tool is one metric used to identify patients at high risk for readmission. The practice-focused question addressed in this project was whether the use of a teaching module is effective at improving clinical staff knowledge on the LACE index. The purpose of the project was to develop a teaching module to educate advanced practice …

Subclinical Stress On Obesity Among Obese African American Women, Dr. Nosakhare Osasu Idehen

Walden Dissertations and Doctoral Studies

AbstractObesity is a complex disease linked to genetics, health behaviors, upstream social determinants of health, and psychosocial stress. Obesity-related chronic diseases and opportunity cost significantly impact individuals and communities. Current prevention policies focus on diet and exercise without demonstrating the benefits of stress coping strategies in obesity management. Subclinical racial minority and gender stress heighten hypervigilance, psychological overload, poor stress coping strategies, inflammation, and obesity. Subclinical stress varies with race and gender, and it is higher in African American (AA) women. The purpose of this qualitative study was to explore the lived experience of subclinical racial minority and gender stress …

Hpv Vaccination Rates Among Males In Minority Populations, Andrew Lemke

Walden Dissertations and Doctoral Studies

Ethnic minorities are less likely to be vaccinated in comparison to White individuals. As a result, Blacks have one of the highest rates of human papillomavirus (HPV)-related complications. The purpose of the quantitative study was to identify significant factors predicting initiation of HPV vaccination in Black male adolescents. The study was based on the constructs of Ajzen’s theory of planned behavior and used a cross-sectional design that involved weighted data from the 2018 National Immunization Survey (n=395,067) conducted by the Centers for Disease Control and Prevention. The research questions were based on how factors such as fear, family involvement, sexual …

Strategies For Catalyzing Clinicians’ Support Of Telemedicine Programs In Rural Communities, Jonathan Liwag

Walden Dissertations and Doctoral Studies

Clinicians’ failure to accept contemporary technology has been a critical barrier to telemedicine program adoption. Staff technical challenges and resistance to change can affect technology return on investment, which concerns telemedicine program leaders. Grounded in Davis’s technology acceptance model, the purpose of this qualitative, descriptive single case study was to explore strategies used by program leaders in the Marianas Islands who successfully gained clinicians’ acceptance of contemporary technology. The participants were 5 program leaders recommended by their institution because of their leadership role and telemedicine technologies experience. Data were collected from 4 face-to-face and 1 audio teleconference interview with the …

The Relationship Between Leadership Style, Job Satisfaction, Nurse Retention, And Patient Care Outcomes: A Systematic Review, Richard Lazarus Nwaorgu

Walden Dissertations and Doctoral Studies

Poor nurse retention, job dissatisfaction, and reduced patient health outcomes are pervasive issues at the healthcare institution of this project. Institutional data reflects a continual decline in retention and job satisfaction rates, which in 2018 showed a 20% drop in retention and a 25% drop in job satisfaction. The institution’s annual survey identified perceptions about leadership styles that gave rise to negative nursing behaviors and the negative impact on patient care outcomes. The purpose of this systematic review project (SRP) was to identify the relationship between nursing leadership styles, job satisfaction, nurse retention, and patient care outcomes within a hospital …

Ambivalence Over Emotion Expression And The Effects Of Religious Coping In African American Christians, Anya Loraine Dobbs

Walden Dissertations and Doctoral Studies

African Americans are 10% more likely than non-Hispanic Whites to report having serious mental health issues from psychological stressors. Mental health concerns, such as depression and anxiety, that arise from psychological stressors, are more than likely to go untreated in African Americans. African Americans are more likely to turn to religion- their church, their pastors, and fellow parishioners to address these concerns. Religion and religious coping has influenced African Americans’ attitudes regarding help-seeking and mental health treatment, with the “Black Church” historically being a source of many things, including mental health care. Pargament’s theory of religious coping served as a …

Effective Postdischarge Communication From Nursing Staff To Mental Health Patients, Paula Renee Garrison

Walden Dissertations and Doctoral Studies

AbstractMental health patients have a history of decreased follow-up appointments, poor diet, and medication noncompliance after discharge from inpatient facilities in addition to multiple co-morbidities, making a return to the community difficult. The practice problem was an increase in hospital readmissions of mental health patients within 30 days postdischarge due to inadequate post-discharge education and follow-up communication. Using Rodgers’s recovery on mental health theory and Revan’s action learning theory, a staff education program was developed to educate 10 nursing staff and two social workers on how to effectively implement postdischarge communication at 3 days and 30 days after discharge from …

Evaluation Of A Division I Mid-Major University’S Student-Athlete Mental Health Program, Heather M. Swanson

University of the Pacific Theses and Dissertations

The following executive summary provides high level findings of a student-athlete mental health program (SAMHP) at a National Collegiate Athletic Association Division I mid-major university. Various elements of the SAMHP were evaluated to create a well-rounded understanding of the program to determine sustainability, goals, and stakeholder expectations. Findings from this study provided insight on stakeholder needs, program successes, and implications for program improvements.

Determining Optimal Resistance Loads During Exercise In Male And Female College Students, Alexia Amo

University of the Pacific Theses and Dissertations

Exercise is a crucial component in obtaining proper health and fitness objectives in young adulthood. Determination of an optimal resistance load for men and women may aid in physiological function and reduce the likelihood of injury. We tested 32 physically active men (n=14) and women (n=18) between ages 18-25 on Proteus Motion, USA. Proteus applies continuous three-dimensional magnetic resistance loads during exercise. Testing consisted of 2 repetitions of horizontal and vertical push and pull exercises comparing performance of the dominant and non-dominant arm. Each exercise was performed with a resistance of 7lb, 14lb, 21lb, and 28lb for a total of …

Translationally-Transformed Coupled-Cluster Theory For Periodic Systems, Boris Daniel Gutierrez-Cortes

University of the Pacific Theses and Dissertations

There are a lot of interesting problems in surface chemistry where quantum chemistry could give great insight, like reaction mechanisms in heterogeneous catalysis, the effect of surface functionalization on semiconductors, or the influence of defects on the reactivity of crystal surfaces.

Plane wave based methods applied to crystals cannot handle problems that are localized in nature like surface defects and adsorbates. On the other hand, molecular electronic structure techniques, which describe these effects and the locality of the electronic correlation well, are too computationally expensive to use on these systems.

In this work, we introduce translationally-transformed coupled-cluster (TT-CC) theory, a …

Investigating The Specificity Of Coiled-Coil Recognition, Melina Huey

University of the Pacific Theses and Dissertations

The bZIP transcription factors make up a family of long α-helical proteins that dimerize based on a pattern of hydrophobic residues and bind to DNA through a region of basic residues. Because binding specificity is a particular topic of interest, the dimerization interaction is attractive as a possible candidate to better understand protein quaternary structure. Use of the Knob-Socket (KS) model for determination of packing structure provides a novel approach to analyze protein-protein interactions. A KS analysis of the protein-protein interface provides unique insight into the specificity of the classical leucine zipper pseudo-7mer repeat. From an analysis of the KS …

In Vitro Comparative Study Of The Binding Affinity And Targeted-Drug Delivery Efficiency Of Egfr-Targeting Peptides, Jingda Wang

University of the Pacific Theses and Dissertations

Peptides have been used as targeting ligands in targeted drug delivery. Conjugating peptides to cytotoxicity agents via a linker to build peptide-drug conjugate (PDC) is a promising targeting strategy. The binding affinity of the peptide ligand and the receptor plays a crucial role in the PDC targeted drug delivery. Although the ligand binding which can be used in targeted drug delivery has been established conceptually, the quantitative or semi-quantitative contribution of binding affinity in targeting efficiency has not been fully explored. The optimal range of binding affinity of the peptide for targeted delivery remains unknown. Therefore, there is a lack …

Development Of Linked-Domain Protein Inhibitors Of The E2-Conjugating Enzyme Ube2d, Anneroos E. Nederstigt

University of the Pacific Theses and Dissertations

In most eukaryotic organisms, the ubiquitination pathway is one of the most important and versatile signaling systems in use. It is integral to processes such as protein degradation and homeostasis, DNA repair cell cycle regulation, signaling and regulation, epigenetics, and many more. Ubiquitin (Ub) is a short polypeptide of 8.6 kDa, 76 residues that functions as a reversible post-translation modification (PTM). It furthermore contains 7 different lysine residues (K6, K11, K27, K29, K33, K48, K63), all of which can form isopeptide linkages with one another to link individual Ub moieties to form unique polyUb chains onto substrates. The type of …

Bayesian-Derived Vancomycin Auc24h Threshold For Nephrotoxicity In Special Populations, Dan Ho

University of the Pacific Theses and Dissertations

A Bayesian-derived 24-hour area under the concentration-time curve over minimum inhibitory concentration from broth microdilution (AUC24h/MICBMD) ratio of 400 to 600 is recommended as the new monitoring parameter for vancomycin to optimize efficacy and minimize nephrotoxicity. The AUC24h threshold of 600 mg*h/L for nephrotoxicity was extrapolated from studies that assessed the general population. It is unclear if this upper threshold is consistent or varies when used in special populations such as critically ill patients, obese patients, patients with preexisting renal disease, and patients on concomitant nephrotoxins.The purpose of this study is to investigate the generalizability of the proposed vancomycin AUC24h …

Harnessing Transthyretin To Enhance The In Vivo Half-Life Of Human Interleukin-2 (Il-2), Fang Liu

University of the Pacific Theses and Dissertations

Protein therapeutics are available as cytokines, clotting factors, enzymes, hormones, growth factors, antibodies et al. They have been shown to be effective in treating a variety of important human diseases. Since human insulin was approved as the first recombinant protein therapeutic, this field has experienced rapid growth. One of the biggest challenges for protein therapeutics in clinical application is their short half-life. Except for monoclonal antibodies, which have serum half-life for weeks, most of the protein therapeutics have half-lives ranging from minutes to hours. Kidney filtration, proteasome degradation and liver metabolism are the main factors that attribute to their short …

Development Of Miriplatin-Loaded Nanoparticles Against Non-Small Cell Lung Cancer, Zhongyue Yuan

University of the Pacific Theses and Dissertations

Lung cancer claims the highest mortality and the second-most estimated new cases among all oncological diseases [1]. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all newly diagnosed lung cancers [2]. Approximately 40% of newly diagnosed lung cancer patients are stage IV. For stage IIIB/IV NSCLC, cytotoxic combination chemotherapy is standard first-line chemotherapy. A regimen of platinum (cisplatin or carboplatin) plus paclitaxel, gemcitabine, docetaxel, vinorelbine, irinotecan, or pemetrexed is the recommended clinical treatment [3].

Cisplatin is the first-generation platinum-based anti-cancer drug. Although cisplatin is much more effective than other platinum drugs at the same dosage [4], accumulating reports …

Impact Of 17-Beta Estradiol And Moderate-Intensity Exercise On Mesenteric Arterial Function Of Uc Davis Type-2 Diabetes Mellitus Rats, Md Rahatullah Razan

University of the Pacific Theses and Dissertations

The studies in this dissertation were designed to investigate the impacts of estrogen (17-β estradiol/E2) and moderate-intensity exercise (MIE) on the mesenteric arterial (MA) function of the University of California Davis type-2 diabetes mellitus (UCD-T2DM) Rat model. Our recent report suggests that diabetes impairs MA vasorelaxation in both sexes of the UCD-T2DM model. Particularly, we reported that MA from prediabetic male rats showed a greater impairment compared to that in prediabetic females. However, when females become diabetic, they exhibit a greater vascular dysfunction than males. Therefore, the aim of the first study was to investigate whether female sex hormone, specifically …

The Effects Of Adding Motivational Interviewing To A Behavioral Coaching Intervention To Increase Physical Activity, Ryley Acrea

University of the Pacific Theses and Dissertations

Most people do not meet the physical activity guidelines set forth by the Center for Disease Control (CDC) and World Health Organization (WHO). Sufficient physical activity plays an important role in preventing chronic illnesses, such as Type 2 diabetes, which are a burden on the health care system. Health coaching (a client-centered approach to improve health outcomes) holds promise as a preventive strategy to change health behavior and limit office visits, thereby reducing the burden of illnesses caused by physical inactivity. One component of health coaching that warrants more research is motivational interviewing. The current study used a multiple baseline …

Knowledge Sharing Among Veterinary And Medical Health Professionals On Zoonotic Diseases Control: A Social Exchange Theory Perspective, Lydia Endaben Lakan, Sarah Dauda Yani

Library Philosophy and Practice (e-journal)

Two constructs of social exchange theory explain the perception of veterinary and medical health professionals about knowledge sharing on zoonotic disease control. Two research questions were raised as follows: What is the perception of veterinary and medical health professionals about knowledge sharing in managing zoonotic diseases? How do the constructs of social exchange theory explain the perception of veterinary and medical health professionals about knowledge sharing in managing zoonotic disease? A qualitative method using a case study research design was used for the study. Purposive sampling technique was used to select participants for the study. Data were collected …

Characterizing The Role Of Necroptosis Of Airway Epithelial Cells In The Immune Response To Respiratory Pathogens, Ashleigh Nichole Riegler

All ETDs from UAB

Necroptosis, a programmed form of lytic cell death, is initiated by various viral and bacterial pathogens through irreparable ion dysregulation and energy depletion. This cellular damage results in the activation of the cellular kinases RIPK1 and RIPK3, consecutively, and the activation and membrane targeting of MLKL, the latter responsible for lysis. Here we have demonstrated that necroptosis of airway epithelial cells is key in the development of the adaptive immune response to asymptomatic colonization by Streptococcus pneumoniae (Spn). Briefly, necroptotic deficient animals or wildtype animals colonized with Spn lacking the necroptosis-triggering pneumolysin toxin, failed to recruit CD11c+ leukocytes to the …