Medicine and Health Sciences Commons^™

Relationship Of Mindfulness To Worldview Defense When Mortality Is Salient, Blake Ausmus

Walden Dissertations and Doctoral Studies

Humans value self-preservation, and therefore that which is perceived to threaten survival should cause stress. However, humans have also developed the understanding of their own mortality, meaning that they cognitively understand that death is inevitable. The conflict arising from these opposing constructs holds the potential to cause anxiety. Interestingly, this anxiety is not easily observed in most. Terror management theory posits that there are buffer systems in place that help to keep death anxiety at bay so that humans are able to continue to function in their daily lives. These buffers include becoming more stringent to one’s worldviews and less …

Improving Nurses' Knowledge On The Assessment And Documentation Practices In The Pediatric Settings Of A Jamaican Hospital, Binol Rajesh Balachandar

Walden Dissertations and Doctoral Studies

AbstractThere have been anecdotal reports from the on-site Quality Assurance team, administrators, and educators that a theory-practice gap exists in pediatric nursing practice settings relating to the specific assessment and documentation. A deidentified chart review confirmed the reported practice gaps in 80% of the patient records. Therefore, in collaboration with the in-service unit, this staff education project and the educational interventions were implemented, and the knowledge improvement was appraised using a pre and posteducation survey. Mozirow’s reflective learning theory formed the basis for staff education, utilizing adult learning principles. Twenty-five consenting nurses completed the preeducation survey (N = 25); however, …

Influence Of Cyberbullying On Suicidal Behaviors, David Dellerman

Walden Dissertations and Doctoral Studies

Secondary data was used to examine the prevalence of suicidal behaviors and the association between cyberbullying by high school-aged students (Grades 9–12) both heterosexual and sexual minority youth (SMY) and suicidal behaviors experienced by high school-aged students (Grades 9–12) in the United States using data from the 2017 CDC’s Youth Risk Behavior Surveillance System (YRBSS). The YRBSS used in this research was the newest and most comprehensive data. The YRBSS is a national school-based survey, that is used to monitor health-related behaviors including violence, sexual behaviors (heterosexual and SMY students), intentional and unintentional injuries that contribute to suicide behaviors. Results …

American Urologists’ Concerns With Nonclinical Activities Moderating Burnout, Nichele Lynn Greer

Walden Dissertations and Doctoral Studies

As burnout continues to increase in the healthcare field and specifically in the specialty of urology, gaining knowledge of certain risk factors associated with burnout can potentially help prevent further increases. Intervention programs may also be developed as a result of understanding these relationships. The purpose of this quantitative correlational analysis was to determine whether hours worked on nonclinical activities moderated the relationship between age and burnout as well as gender and burnout in American urologists. The theoretical foundations utilized in this research were the jobs demands resources model, which suggested that burnout occurs as a result of job demands …

Website Accessibility Strategies, Gary W. Hrezo

Walden Dissertations and Doctoral Studies

Most websites cannot be readily used by people with disabilities, despite the internet being an essential component for people to be part of a community. Applying web accessibility strategies means that people with disabilities can better interact with the web. Grounded in Davis’s technology acceptance model, the purpose of this qualitative multiple case study was to examine strategies used by web designers to make websites accessible for people with disabilities. The participants were experienced web developers from organizations in Florida with websites that have a Web Content Accessibility Guidelines Level 2 of three levels, i.e., AA- rating. The data collection …

An Educational Program For Standardization Of Care For The Acute Opioid Withdrawal, Jessica Ann Larson

Walden Dissertations and Doctoral Studies

Opioid addiction is a widespread chronic disease affecting millions of Americans each year, resulting in medical, social, financial, and societal detriments. Patients experiencing opioid withdrawal benefit from a standardized and evidence-based approach to care. The purpose of this doctoral nursing project was to provide inpatient nursing education for a standardized clinical practice approach to optimize patient outcomes. The research question examined the impact of an educational program for nurses presenting a new standardized opioid withdrawal clinical practice guideline inclusive of assessment, nursing interventions, a symptom triggered order set, and follow up plan of care in terms of knowledge gained and …

Prediabetes, Implementation Of Ada Practice Guidelines And Provider Perspective, Kimberlee May Manguiat-Lang

Walden Dissertations and Doctoral Studies

AbstractPrediabetes occurs before the development of diabetes in some people. Practitioners who educate people about prediabetes are not consistently using the latest evidence-based practice guidelines. The purpose of this mixed-method study was to fill a gap in the literature by providing evidence of the provider practices, attitudes and barriers when implementing American Diabetes Association (ADA) practice guidelines for the prediabetic patient. The Theory of Planned Behavior applies to evidence-based practice and the implementation of evidence-based practice guidelines. Research questions for this study focused on determining rate of compliance with ADA clinical practice guidelines from health care professionals to include providers …

Exploring Moral Distress, Ethical Climate, And Psychological Empowerment Among New Registered Nurses, Luz Bruel Mauro

Walden Dissertations and Doctoral Studies

Moral distress in nursing has been an issue for decades and has consequences on nurses’ physical, emotional, and psychological well-being. Nurses in different settings experience a high intensity and frequency of moral distress particularly in intensive care units (ICU), but few studies have examined the moral distress of non-ICU nurses. The purpose of this 3-manuscript dissertation was to assess the frequency and level of moral distress, ethical climate, and psychological empowerment among new registered nurses (NRNs) who work in non-ICU settings. The conceptual framework of Jameson's moral distress guided this study. Twenty-three NRNs with fewer than 3 years of experience …

Exploring Implementation Strategies Of Iot Technology In Organizations: Technology, Organization, And Environment, Khanhhung Hoang Pham

Walden Dissertations and Doctoral Studies

AbstractAfter organizations successfully adopt the internet of things (IoT) technology, many corporate information technology (IT) leaders face challenges during the implementation phase. Corporate IT leaders' potential failures in implementing IoT devices may impede organizations from integrating IoT solutions and promoting business benefits. Grounded in technology-organization-environment (TOE) theory, the purpose of this qualitative, pragmatic inquiry study was to explore strategies that corporate IT leaders use to implement IoT technology in their organizations. The participants were six corporate healthcare IT leaders who successfully used implementation strategies for implementing IoT solutions for their organizations. Data were collected using semistructured interviews and industry security …

The Correlation Between Acl Injury & Concussion, Brandon Michael Phillips

Theses and Dissertations--Kinesiology and Health Promotion

Concussion (also known as mild traumatic brain injury) is a neurological injury that occurs after a blow to the head or neck area and can have affects to movement based on the severity of the injury. Mild traumatic brain injury has possible linkage to an increased risk of anterior cruciate ligament (ACL) injury. The purpose of this thesis was to assess the impact of prior concussion on lower extremity mechanics that are associated with risk of ACL injury. A total of 11 individuals with prior history of concussion and 11 healthy individuals without prior history of concussion (56.5 months since …

Etiology Of Firefighter Injuries: A Health Care Practitioner Perspective, Alyssa Quinn Eastman

Theses and Dissertations--Kinesiology and Health Promotion

BACKGROUND: Structural firefighting involves the performance of rigorous occupational tasks in unpredictable, dynamic, and hot environments which increases firefighters’ risk of injury. Specifically, the National Fire Protection Association reported that musculoskeletal injuries account for 56% of non-fireground and 41% of fireground injuries. Furthermore, physical training is the most common cause of injury, accounting for one-third of all injuries and resulting in 41% of post-injury absences from work. There is limited research identifying occupational and exercise injury risk factors among firefighters. However, experienced health care practitioners working with fire departments may provide critical insight into potential mechanisms of these common injuries. …

Estrogen Regulation Of Daily Metabolic Rhythms In Female Mice, Oluwabukola Omotola

Theses and Dissertations--Biology

Circadian rhythms are approximately 24-hour cycles of behavior, physiology, and gene expression. In mammals, these circadian rhythms are generated by clocks located in nearly every tissue in the body. The function of circadian clocks is to synchronize physiology and behavior with environmental cycles such as the light-dark cycle. After menopause, when circulating levels of estrogens are very low, women are more susceptible to obesity comorbidities such as metabolic syndrome and cardiovascular disease, suggesting that estrogens regulate these processes. Estrogens could protect females from metabolic dysfunction by regulating circadian rhythms. Consumption of diets that are high in fat contribute to obesity. …

Investigating The Effects Of In-Vivo Therapeutics Hypoxia Treatment Paradigms In Neurite Outgrowth Patterns, Jae Hyun Yoo

Theses and Dissertations--Medical Sciences

Spinal cord injury, specifically in the cervical C3-C4 region of the cervical spine, contributes to impaired breathing and a diminished quality of life. Therefore it is important to find effective and safe therapeutics to restore breathing function. Indeed, there are a myriad of research being performed in addition to valuable collaboration amongst different institutions. As such, inspired by a previous experiment, we decided to test our hypothesis that an enriching environment consisting of different hypoxic environments - sustained and intermittent hypoxia alongside normoxia - would result in neurite outgrowth. Moreover, we hypothesized that sustained hypoxia would result in the greatest …

Mammalian Target Of Rapamycin Cell Signaling Pathway In Phosphatase And Tensin Homolog Induced Kinase 1 Knockout Rat Model Of Familial Parkinson's Disease, Martha Helena Mortell

Theses and Dissertations--Medical Sciences

More than 10 million people are living with Parkinson’s disease (PD), one million of which are people in the United States. PD is the second most common age-related neurodegenerative disorder, after Alzheimer’s disease, and is characterized by the accumulation of a-synuclein aggregates and the degeneration of dopaminergic neurons. The loss of endogenous dopamine in PD brain accounts for the motor decline presented clinically in PD patients. Etiological factors of PD include oxidative damage and inflammation, although the detailed mechanisms remain unknown. Risk factors for PD include gender, age, environmental factors, and gene mutations.

The current thesis research employed phosphatase and …

Trem2: Gene Expression And Role In Alzheimer’S Disease, Henry Snider

Theses and Dissertations--Medical Sciences

Genetic mutations in the TREM2 gene are highly correlated with risk of Alzheimer’s disease, but alternative splicing patterns of TREM2 transcripts have not been fully described. Characterization of TREM2 alternative splicing will be of significant use to the scientific community as the field of Alzheimer’s disease research progresses. The goal of this study was to fully describe splicing patterns in TREM2, as different splicing isoforms of genes can alter express and/or function of the final protein. Human blood and anterior cingulate cortex brain tissue from 61 individual donors was processed and used for PCR and quantitative PCR as well as …

Apoe Genotype And Sex Modulate Ketogenic Diet Enhancements To Metabolism And Gut Microbiome In Young Mice, Andrew T. Yackzan

Theses and Dissertations--Medical Sciences

The apolipoprotein ε (APOE) allele in humans has been associated with risk for development of Alzheimer’s disease (AD). There are predominately three variations of the allele – ε2 (E2), ε3 (E3), and ε4 (E4) – with E4 contributing the greatest risk of AD development. Recent research has unveiled evidence of neurometabolic and neurovascular deficits in E4 carriers present decades before the onset of dementia; it is believed these chronic defects play a major role in the development of AD, thus making them a potential target for preventative intervention. The purpose of this study was to examine the effect of a …

Classification And Effect Of Correctors On Sitosterolemia-Associated Mutants In Abcg8, Brittney Poole

Theses and Dissertations--Medical Sciences

Objective: To classify mutants of ABCG8 identified in subjects with clinically confirmed Sitosterolemia, a rare form of Familial Hypercholesterolemia distinguished by the accumulation of phytosterols in plasma and tissues and determine the effects of correctors and/or regulators of proteostasis on maturation of the ABCG5/ABCG8 sterol transporter.

Methods: Disease-causing missense mutants within the cytosolic domain of ABCG8 were generated through site-directed mutagenesis. Normal and mutant proteins were expressed in human hepatocytes. Cellular proteins were prepared, and maturation was assessed by SDS-PAGE and immunoblotting. Formation of the higher molecular weight, mature form of glycoproteins was used as a bioassay for trafficking the …

Evaluating The Microbiome To Boost Recovery From Stroke: The Embrs Study, Tyler Hammond

Theses and Dissertations--Neuroscience

Accumulating evidence suggests that gut microbes modulate brain plasticity via the bidirectional gut-brain axis and may play a role in stroke rehabilitation. A severely imbalanced microbial community has been shown to occur following stroke, causing a systemic flood of neuro- and immunomodulatory substances due to increased gut permeability and decreased gut motility. Here we measure post-stroke increased gut dysbiosis and how it correlates with gut permeability and subsequent cognitive impairment.

We recruited 12 participants with acute stroke, 12 healthy control participants, and 18 participants who had risk factors for stroke, but had not had a stroke. We measured the gut …

Evaluating The Role Of Mmp9 In Hyperhomocysteinemia Induced Cerebrovascular Pathology, Alexandria Linton

Theses and Dissertations--Neuroscience

Vascular contributions to cognitive impairment and dementia (VCID) is one of the leading causes of dementia, along with Alzheimer’s disease (AD), and often manifests as a comorbidity of AD. Elevated plasma homocysteine, known as hyperhomocysteinemia (HHcy), is a risk factor for VCID; however, the mechanism underlying the connection between HHcy and development of VCID pathology remains elusive. Understanding this mechanism would reveal novel therapeutic targets with the potential to be disease modifying, which are a critical need for a disease that lacks any approved treatment. Previous studies from our lab have strongly associated neuroinflammation and blood brain barrier (BBB) dysregulation …

Interleukin-1 Receptor 1 Signaling In Mild Tbi: Do Endothelial Cells Play A Major Role?, Colleen N. Bodnar

Theses and Dissertations--Neuroscience

Across the world, over 69 million people sustain a traumatic brain injury (TBI) per year making TBI a major health concern worldwide. Of all the TBIs that occur each year, it is suggested that up to 90 percent are mild in nature. Even a mild TBI causes both physical damages to the cells of the brain and activation of a variety of biochemical cascades. Inflammation is an extremely common pathology seen in the brains of TBI survivors of all severities. Chronic inflammation can cause detrimental effects within the brain including neurodegeneration. A major pro-inflammatory cytokine, interleukin-1 (IL-1), is upregulated within …

Establishment And Verification Of A Sars Cov2 Antibody Detection Assay Comparing Venous And Mitra Samples, Stephen C. Mayer

Theses and Dissertations--Medical Sciences

During the COVID-19 pandemic in 2020, the need for highly-specific, wide-spread, and rapid serological testing surged. In this study, we showed very strong positive correlation between venous blood collection and Mitra home sampling kits for the detection of anti- spike IgGs using an in-house ELISA protocol (based on a protocol from Mt. Sinai). This study demonstrates the utility of using at-home, patient-centric testing to enhance the sero-surveillance methods currently in place for viral tracking and monitoring.

Parental Barriers Toward Seeking Mental Healthcare For Saudi Children At Risk Of Adhd, Amani Kappi

Theses and Dissertations--Nursing

Attention deficit hyperactivity disorder (ADHD) is a mental health disorder commonly diagnosed in childhood. Underdiagnosis and undertreatment of ADHD can lead to the development of other mental illnesses and disruptions in social functioning in adulthood. Therefore, parents can play a crucial role in proactively seeking mental healthcare for children who are at risk for or who have a clear diagnosis of ADHD. Studies in the United Kingdom and the United States highlight many barriers that prevent parents from seeking mental healthcare for their children, such as negative attitudes towards the mental healthcare system and stigma towards mental illnesses.

Cultural differences …

Describing And Predicting Preprocedural Anxiety In Patients Scheduled For Advanced Gastrointestinal Endoscopy During The Covid-19 Pandemic, Dawn Profit

Theses and Dissertations--Nursing

Advanced gastrointestinal endoscopy includes a group of specialized procedures and interventions that are being performed more frequently with little attention given to a patient’s preprocedural anxiety issues. Preprocedural anxiety is an anticipated problem with any surgery or invasive procedure and if sustained or experienced excessively, is associated with negative clinical factors and complications.

In the beginning of 2020, the United States was met with a global pandemic caused by the coronavirus SARS-CoV-2, termed COVID-19. There were recommendations to decrease medical procedural case volume in order to slow the spread of the virus, protect staff and patients from getting the virus, …

Development And Psychometric Testing Of An Instrument To Identify Factors That Predict Intentions Related To Post-Mortem Organ Donation Among Saudi Arabian Nurses, Salman Alreshidi

Theses and Dissertations--Nursing

Organ donation shortage is a major international concern. Global data on organ donation and transplantation activities from the World Health Organization indicate that in 2019 organs were available for less than 10% of transplantations needed. In Saudi Arabia alone, the organ donation shortage accounts for 28.8% of deaths annually. Nearly 31% of donated organs are from donors outside of the country because many eligible donors in Saudi Arabia do not donate.

While post-mortem organ donation has the potential to increase available organs for transplantation, in many countries, including Saudi Arabia, hesitancy among candidate donors and their family members can present …

Assessing Patient Engagement With An Mhealth Application For Improving Heart Failure-Related Self-Care In Real-World Settings, Ifeanyi Madujibeya

Theses and Dissertations--Nursing

Consumer-facing mobile health applications (mHealth apps) are being increasingly integrated into routine heart failure (HF)-related self-care. However, there is a dearth of research on patient engagement with mHealth apps in real-world settings and the effect of such engagement on HF outcomes, making it challenging to inform decision-making regarding the use of mHealth apps in real-world settings.

The specific aims of this dissertation were to; 1) examine current evidence on measures of engagement with mHealth interventions in patients with HF; 2) examine the patterns of patient engagement with a consumer-facing mHealth app and the predictors of engagement in real-world settings;3) identify …

Building Tools For Improved Modulation Of The Human Gabaa Receptor, A Central Nervous System Target For The Treatment Of Anxiety, Garrett Edward Zinck

Theses and Dissertations--Pharmacy

In the U.S., anxiety is recognized as an increasing range of mentally and physically debilitating psychiatric health disorders with significant economic repercussions. Over the last 20 years, several novel anti-anxiety therapies have entered the drug development pipeline, but none have made it to market.

The work in this dissertation focused on structurally modifying valerenic acid (VA), a structurally unique carboxylated sesquiterpene acid found in Valeriana officinalis. VA is putatively reported to have allosteric modulatory activity of the human GABA_A receptor, a ligand-gated ion channel responsible for attenuating neurotransmissions. Structural modeling of VA’s GABA_A receptor interaction suggests that …

Analysis Of Potential Facilitators To Use Of Hiv Pre-Exposure Prophylaxis (Prep) In A Young Transgender Population, Noah Dixon

Theses and Dissertations--Pharmacy

Pre-exposure prophylaxis for HIV prevention (PrEP) is heavily under-utilized in transgender youth, a population which experiences high risk factors for contracting HIV and exhibits unique barriers to care. This retrospective study used a secondary data analysis of survey results from transgender youth between 16-and 24-years-old to analyze various exposures for association with PrEP use. It was hypothesized that medical gender affirming therapy, mental health care treatment, and HIV programming would be independently associated with increased use of PrEP in transgender youth. It was found that only HIV prevention services and programming related to HIV or gender identity were associated with …

Studies Toward The Development Of An Improved Countermeasure For Synthetic Opioid Overdose, Sidnee L. Hedrick

Theses and Dissertations--Pharmacy

One of the most prominent opioid analgesics in the United States is the high potency agonist fentanyl. It is used in the treatment of acute and chronic pain and as an anesthetic adjuvant. When used inappropriately, however, ingestion of just a few milligrams of fentanyl or other synthetic opioid can cause opioid-induced respiratory depression (OIRD), often leading to death. Currently, the treatment of choice for OIRD is the opioid receptor antagonist naloxone. Recent reports, however, suggest that higher doses or repeated dosing of naloxone (due to recurrence of respiratory depression) may be required to fully reverse fentanyl-induced respiratory depression, rendering …

Investigating The Physical Stability Of Amorphous Pharmaceutical Formulations, Travis W. Jarrells

Theses and Dissertations--Pharmacy

Amorphous formulations, including amorphous solid dispersions (ASDs), consisting of the active pharmaceutical ingredient (API) intimately mixed in a polymeric matrix, are an attractive formulation approach to improve drug delivery, dissolution, and solubility. However, an amorphous API in an ASD is in a higher energy state compared to the crystalline drug and results in most ASDs being inherently unstable. The polymer helps to stabilize the amorphous drug against crystallization such that the resulting homogenous mixture maintains its solubility advantage relative to the crystalline form. One challenge of ASDs is that the presence of impurities including crystals or residual solvent, variations in …

Response Of Dopaminergic System To Cocaine Exposure, Recovery After Cocaine Abstinence, And Impact Of A Long-Acting Cocaine Hydrolase, Jing Deng

Theses and Dissertations--Pharmacy

Cocaine produces its physiological effects by targeting multiple proteins in the central nervous system, particularly by binding with dopamine transporter (DAT) to block the normal dopamine (DA) recycling process. This process along with the pleasure feeling would wear off shortly after the abstinence from the drug. However, chronic cocaine use is associated with neuroadaptations in the dopaminergic system, including increases in the density of DAT on plasma membrane of dopaminergic neurons. Given the critical role of DAT in neurotransmission, various studies have been carried out on animal models to learn its structure, function, and distribution. Long-standing evidence supports that DAT …