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2022

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Articles 21991 - 22020 of 23775

Full-Text Articles in Medicine and Health Sciences

Using Integrated Staff Education To Increase Medication Adherence In A Mentally Ill Population, Tiffany Dawn Burke-Lott Jan 2022

Using Integrated Staff Education To Increase Medication Adherence In A Mentally Ill Population, Tiffany Dawn Burke-Lott

Walden Dissertations and Doctoral Studies

Failure to adhere to medication regimens is a serious problem that affects both the patient and the health care system. Psychiatric patients have the lowest rates of adherence, as low as 24%. The evidence shows that nonadherence to medication is a global challenge in the field of mental illness and is linked with a poor prognosis. Patients who are nonadherent to medications experience exacerbations of their mental illness, which can lead to rehospitalization, poor psychosocial outcomes, relapse of symptoms, reduced effectiveness of subsequent treatment, wastage of limited health care resources, increased substance abuse, poor quality of life, and increased risk …

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Lgbtq Patient Funding And Satisfaction On Patient Volume And Hospital Revenue, Kourtney Denise Carter Jan 2022

Lgbtq Patient Funding And Satisfaction On Patient Volume And Hospital Revenue, Kourtney Denise Carter

Walden Dissertations and Doctoral Studies

AbstractHistorically, the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community has reported low patient satisfaction for health care. The purpose of this quantitative study was to examine the statistical relationship between patient satisfaction among LGBTQ patients (independent variable) and patient volume and hospital revenue (dependent variables) in the U.S. state of Georgia. The study was grounded on Andersen's model of healthcare utilization. Two research questions guided this study related to the statistical relationship between hospital revenue and patient satisfaction within health systems and the statistical relationship between patient satisfaction and patient volume. The study included 567 members of the LGBTQ …

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Strategies Physicians Apply To Value-Based Patient Care For Quality Reimbursement, Sadia Chaudhry-Zutshi Jan 2022

Strategies Physicians Apply To Value-Based Patient Care For Quality Reimbursement, Sadia Chaudhry-Zutshi

Walden Dissertations and Doctoral Studies

Low-quality value-based patient care negatively impacts physicians’ ability to maintain private solo practices. Physicians who lack strategies to apply value-based patient care may lose their ability to stay in a private solo practice. Grounded in the complex adaptive system theory, the purpose of this qualitative multiple case study was to explore strategies used by private solo physicians that provided value-based patient care. Participants were four physicians in solo private practice who successfully applied value-based patient care to maintain their private solo practice. Data were collected from semistructured interviews and organizational documents and analyzed using thematic analysis. Three themes emerged: (a) …

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Perceptions Of Hypertensive Adults With Low Health Literacy About Self-Management Of Hypertension, Ngozi Scholar Chukwuemeka Jan 2022

Perceptions Of Hypertensive Adults With Low Health Literacy About Self-Management Of Hypertension, Ngozi Scholar Chukwuemeka

Walden Dissertations and Doctoral Studies

AbstractHypertension (HTN) is one of the most significant risk factors for morbidity and mortality worldwide and is responsible for the annual deaths of approximately 9 million people globally. A major problem with HTN self-management (SM) is low health literacy (HL), which is associated with poor health outcomes and self-care. The purpose of this explanatory sequential, mixed method study, guided by Pender’s health promotion model, was to explore the perceptions of adults with HTN and low HL about the SM of their HTN. A total of 32 adults with HTN were screened using the Newest Vital Sign health literacy screening tool. …

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Nonpharmacological Pain Control Following Hip And Knee Replacements In Older Adults, Adraine Cox Jan 2022

Nonpharmacological Pain Control Following Hip And Knee Replacements In Older Adults, Adraine Cox

Walden Dissertations and Doctoral Studies

Abstract Over prescribing opioids after hip and knee replacements in older adults is closely linked to the opioid epidemic. Despite being a public health concern associated with increased mortality rates, opioids are the most frequently used method for controlling postoperative pain. Therefore is important to know whether nonpharmacological pain control methods may effectively reduce the burden of opioid addiction, thus reducing the risk of opioid-related fatalities. The purpose of this study was to determine whether a systematic review of the literature provided evidence supporting nonpharmacological methods of pain control following hip and knee replacements in older adults compared to use …

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The Association Of Suicidality With Video Gaming And Physical Inactivity Among U.S. Adolescents, Mary Colleen Cyrus Jan 2022

The Association Of Suicidality With Video Gaming And Physical Inactivity Among U.S. Adolescents, Mary Colleen Cyrus

Walden Dissertations and Doctoral Studies

Suicide represents a leading cause of death in U.S. young people, and the rate is increasing. Although young people are spending more time each day playing video or computer games, there is limited research on the association, if any, between playing video games and suicidality. The purpose of this study was to identify whether there is a statistically significant association between video gaming, physical inactivity, and suicidality (suicidal ideation, planning, and attempts). Age, race, gender, and being bullied electronically and in school were assessed as potential confounding variables. The interpersonal theory of suicidal behavior and the social-ecological theory served as …

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Alternative Diet Practices As Predictors For Vaccine Confidence, Nancy Dolin Jan 2022

Alternative Diet Practices As Predictors For Vaccine Confidence, Nancy Dolin

Walden Dissertations and Doctoral Studies

Perceived risks and side effects have left some with a lack of confidence in the safety and efficacy of vaccines. This may lead to not adhering to the recommended vaccination schedule and result in outbreaks that have the potential to harm those who are unable to get vaccinated due to age or infirmity. It is vital to seek and address the characteristics that may predict one’s confidence in vaccines. The aim of this study was to identify whether an individual’s alternative diet behavior may be able to predict their confidence in the measles, mumps, and rubella (MMR) vaccine. The theoretical …

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The Outcome Of Stroke Education And Management On Cerebrovascular Accident Patients In Bermuda, Antoinette Simone Dyer Jan 2022

The Outcome Of Stroke Education And Management On Cerebrovascular Accident Patients In Bermuda, Antoinette Simone Dyer

Walden Dissertations and Doctoral Studies

AbstractIncidence of cardiovascular accident (CVA), also referred to as a stroke, has increased in Bermuda. Understanding key contributing factors is necessary to reduce incidences that are associated with this disease process. This dissertation examined the outcome of stroke education and management on CVA patients in Bermuda. The health belief model, incorporating a reflection of the public health framework, guided the analysis of a quantitative dataset obtained through Bermuda Hospitals Board’s Neurology Department. A cross-sectional study design was used to sample 253 stroke patients over a 2-year period (2019 -2021). The Wilcox test was employed to compare two groups – stroke …

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Length Of Stay In A Homeless Shelter And Mitigating Homelessness, Uwemedimo S. Etteyit Jan 2022

Length Of Stay In A Homeless Shelter And Mitigating Homelessness, Uwemedimo S. Etteyit

Walden Dissertations and Doctoral Studies

AbstractHomelessness is a major public health issue in the United States. Every night, thousands of people have no residence to call their own. Most homeless persons turn to homeless shelters for help. Despite the homeless shelters, the problem of homelessness persists. This study examined the concept that the length of time spent at a homeless shelter is related to the homeless persons mitigating their homelessness through home placement, jobs, and healthcare access. Homelessness was examined using the socioecological model with its attendant levels of influence. On the intrapersonal level, socioeconomic status, education, old age, veteran status, and disability were factors. …

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Clinical Practice Guideline For Post Discharge Primary Care Follow-Up Program For Copd, Stephanie Frimpong-Badu Jan 2022

Clinical Practice Guideline For Post Discharge Primary Care Follow-Up Program For Copd, Stephanie Frimpong-Badu

Walden Dissertations and Doctoral Studies

AbstractApproximately 15.7 million individuals throughout the United States have been diagnosed with chronic obstructive lung disease (COPD), with 700,000 individuals hospitalized annually in the United States. An estimated one in five patients are readmitted within 30 days, raising the costs above $15 billion annually. The gap in practice was a lack of adequate clinical practice guidelines associated with discharge to primary care in this acute care facility. The purpose of this project was to use the expertise of the multidisciplinary team of pulmonologists, acute care nurse practitioners, respiratory therapists, and pharmacists to develop a clinical practice guideline using evidence-based literature …

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Staff Education To Improve Safe Use Of Antipsychotic Medication In An Outpatient Clinic, Marinette Nyangono Garrison Jan 2022

Staff Education To Improve Safe Use Of Antipsychotic Medication In An Outpatient Clinic, Marinette Nyangono Garrison

Walden Dissertations and Doctoral Studies

AbstractThe use of antipsychotic medications is growing in an outpatient clinic despite the increased risk of mortality and morbidity such as falls, fractures, stroke in adults, neurological adverse effects, weight gain, and cardio-metabolic abnormalities in pediatric populations. The purpose of this project was to develop an educational program to enhance clinic staff knowledge about pharmacologic and nonpharmacologic means to manage patients’ care and improve outcomes. The conceptual framework for the project was Knowles’s adult learning theory supported by the Kirkpatrick model of training evaluation. The practice-focused question asked whether an educational program would increase staff knowledge related to the safe …

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Assessing Violence And Mental Health With The 2019 Nevada Youth Risk Behavioral Survey, Samantha Graham Jan 2022

Assessing Violence And Mental Health With The 2019 Nevada Youth Risk Behavioral Survey, Samantha Graham

Walden Dissertations and Doctoral Studies

The effects from childhood trauma can interfere in all aspects of a child’s life, including their education. School delivery systems need to be trained to identify these risks and how to reduce further risks of re-traumatization by applying trauma-informed practices. This study addressed the impact of adverse childhood experiences (ACEs) on mental health and behavioral issues. The study was guided by Bandura’s social cognitive theory and the socioecological model. The correlation between ACEs and mental health as well as ACEs and physical violence were examined based on data from the 2019 Nevada Youth Risk Behavioral Survey, which was a high …

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Hysterectomy And Self-Esteem Among African American Women, Gibson T. Green Jan 2022

Hysterectomy And Self-Esteem Among African American Women, Gibson T. Green

Walden Dissertations and Doctoral Studies

AbstractOver 600,000 hysterectomies are performed each year in the United States. Studies have shown that African American women are disproportionately impacted by hysterectomy and that most African American women treated with hysterectomy are young and of childbearing age. As a result, some African American women’s spouses have negative perceptions about the surgery. The purpose of this study was to examine the impact of hysterectomy on self-esteem or satisfaction among African American women and feelings of partner rejection after a hysterectomy. Sociometer theory (the study of self-esteem) was used to examine an association between hysterectomy and self-esteem or satisfaction. The study …

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The Impact Of Staff Sexual Misconduct On U.S. Federal Prison Inmates’ Mental And Physical Health, Wanwisa Grover Jan 2022

The Impact Of Staff Sexual Misconduct On U.S. Federal Prison Inmates’ Mental And Physical Health, Wanwisa Grover

Walden Dissertations and Doctoral Studies

Prison staff sexual misconduct is an ongoing issue in the United States, but little is known about how inmates’ perceptions of staff sexual misconduct influence their mental and physical health. The purpose of this quantitative research study was to examine the relationship between staff sexual misconduct with federal prison inmates and prisoner mental health and rates of injury, and why inmates are not reporting sexual misconduct encounters. Ecological theory provided the theoretical foundation. The three research questions were designed to examine the relationships between nonconsensual sexual misconduct of prison inmates with prison staff and (a) serious mental health illnesses and …

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Health-Related Quality Of Life For Veterans Transitioned Into Civilian Life, Vicki Ann Guerra Jan 2022

Health-Related Quality Of Life For Veterans Transitioned Into Civilian Life, Vicki Ann Guerra

Walden Dissertations and Doctoral Studies

Texas veterans transitioning to civilian life have experienced health issues after discharge. There are processes to follow before seeking treatment or diagnosis for any health issue prior to military discharge. Given the gaps in the literature on veteran health, quality of life and transition to civilian life, scholars lack understanding of the transitional events that take place. Veteran health issues are impacted by medical appointment wait-times, day to day life events, and this can lead to decreased quality of life. The purpose of this mixed-methods study (N=36) was to evaluate veterans’ health related quality of life who had transitioned from …

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Crisis Intervention Team Training On Autism Among Female Cit-Trained Police Officers, Julie Hall Jan 2022

Crisis Intervention Team Training On Autism Among Female Cit-Trained Police Officers, Julie Hall

Walden Dissertations and Doctoral Studies

The problem addressed in this qualitative case study was the lack of documentation that supports the perceptions and experiences of crisis intervention team (CIT) trained female police officers related to their encounters with persons with mental illness (PwMI) with autism. Using Giles’s communicative accommodation theory (CAT), the purpose of this study examined the perceptions of CIT-trained female police officers of PwMI with autism during encounters. Giles’s CAT was aligned closest with the teachings of CIT training. Seven participants provided data which comprised of completed questionnaires and transcribed interviews. The method of analysis used was a combination of inductive coding and …

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Nurse Manager’S Leadership And Communication Skills And A Registered Nurse’S Organizational Citizenship Behavior, Satisfaction, And Intent To Leave, Emmitte J. Hall Jan 2022

Nurse Manager’S Leadership And Communication Skills And A Registered Nurse’S Organizational Citizenship Behavior, Satisfaction, And Intent To Leave, Emmitte J. Hall

Walden Dissertations and Doctoral Studies

The Veteran’s Health Administration (VHA) is the largest employer of registered nurses in the United States. The American Association of Colleges of Nursing predicts there will be a nursing shortage through the year 2030 and replacing and training each nurse is expensive and negatively impacts patient care. A review of the literature showed organizations with high levels of organizational citizenship behavior (OCB) had high levels of job satisfaction, which reduces turnover, but there was no research on the existence and impact of OCB in a federal health care facility, specifically the VHA. The purpose of this quantitative, correlational research was …

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Using Social Perspectives On Vaccination To Build Public Trust In Pro-Vaccine Communication, Lindsay Hale Jan 2022

Using Social Perspectives On Vaccination To Build Public Trust In Pro-Vaccine Communication, Lindsay Hale

Walden Dissertations and Doctoral Studies

United States public health guidelines for mandating vaccination of school age children for preventable diseases is increasingly ineffective. Little is known, however, about what sociocultural factors influence parents’ and legal guardians’ decisions to adhere to, hesitate against, or refuse to abide by immunization public health guidelines. The purpose of this qualitative study was to discover and better understand sociocultural factors that contribute to or detract from parents and legal guardians’ adherence to recommended vaccination schedules. The theoretical framework for this study was Coleman’s Rational Choice Theory. Research questions involved sociocultural factors and reference groups that influence parents and legal guardians’ …

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Educating Staff Nurses On E-Cigarette And Vaping Associated Lung Injury, Dana Janette Imaoka Jan 2022

Educating Staff Nurses On E-Cigarette And Vaping Associated Lung Injury, Dana Janette Imaoka

Walden Dissertations and Doctoral Studies

AbstractVaping product use has gained popularity since the first device was marketed in the early 2000s. Use among the adolescent and teen populations has grown steadily to the point of becoming an epidemic. As the largest group of healthcare professionals, nurses have the most contact with patients in healthcare settings and are in the position of providing care and education to them. The purpose of this doctoral project was to increase knowledge of vaping product use as well as the growing number of e-cigarette- and vaping-associated lung injuries (EVALI) in the United States. A gap was identified in nurses’ knowledge …

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Marijuana Legalization And Depression Effects On Marijuana Use In African American Late Adolescents, Anthony Olusegun Iroko Jan 2022

Marijuana Legalization And Depression Effects On Marijuana Use In African American Late Adolescents, Anthony Olusegun Iroko

Walden Dissertations and Doctoral Studies

State medical marijuana legalization (MML) may contribute to increased cannabis use among older adolescents, especially African American youth and adolescents with depression. This quantitative cross-sectional correlational study, which utilized Smart’s availability-proneness theory of drug use as a guiding framework, had a two-fold purpose: to determine if state MML status and self-reported depression were significantly related to past-month marijuana use and to assess if state MML status significantly moderated between depression and past-month marijuana use. The study utilized data from 1,391 African American late adolescents (aged 16-20) who participated in the 2018 National Survey on Drug Use and Health. Binary logistic …

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Investigation Of Cdk8 Inhibitor Q-12 Effects On Cdk8 And Cdk8 Substrates In Triple Negative Breast Cancer Cell Line Mda-Mb-468, Shengxi Li Jan 2022

Investigation Of Cdk8 Inhibitor Q-12 Effects On Cdk8 And Cdk8 Substrates In Triple Negative Breast Cancer Cell Line Mda-Mb-468, Shengxi Li

University of the Pacific Theses and Dissertations

Cyclin-dependent kinases (CDKs) and cyclins (Cyclins) are the core molecules in the regulation mechanism of the entire cell cycle. Cell cycle dysregulation is a common feature of human cancers, and inhibitors of cyclin-dependent kinases (CDKs) play a crucial role in cell cycle control and are one of the most promising areas of cancer therapy. We aspired to use our cyclin-dependent kinase 8 (CDK8) inhibitor, Q-12, as a probe for biomarker discovery for CDK8 inhibitor sensitive tumor types. Q-12 shows potent inhibition of cell viability and induction of apoptosis process in some triple-negative breast cancer (TNBC) and colorectal cancer cell lines …

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Optimization Of The Structure Of Ttr Ligands For Half-Life Extension (Tlhe), Guanming Jiang Jan 2022

Optimization Of The Structure Of Ttr Ligands For Half-Life Extension (Tlhe), Guanming Jiang

University of the Pacific Theses and Dissertations

Many potential therapeutic agents face challenges for their clinical development due to short circulation half-life. As a result, prolonging the half-life of therapeutic drugs in circulation while preserving their hydrophilicity and small size will be a key step toward more effective and safe pharmacological molecules. Our lab developed a new approach for enhancing the safety and efficacy of therapeutic agents. By endowing therapeutic agents with a hydrophilic small molecule (a derivative of the clinical candidate, AG10) which reversibly binds to the serum protein transthyretin (TTR), the half-life of the therapeutic agent should be extended by binding to the TTR in …

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Expression Of Mouse Full-Length Aryl Hydrocarbon Receptor And Human Aryl Hydrocarbon Receptor Ligand Binding Domain In Pichia Pastoris, Yiyuan Wang Jan 2022

Expression Of Mouse Full-Length Aryl Hydrocarbon Receptor And Human Aryl Hydrocarbon Receptor Ligand Binding Domain In Pichia Pastoris, Yiyuan Wang

University of the Pacific Theses and Dissertations

Aryl hydrocarbon receptor (AHR) is a ligand-activated transcription factor that regulates biological responses to planar aromatic hydrocarbon. AHR activates gene transcription by binding to its corresponding enhancer with its partner-aryl hydrocarbon receptor nuclear translocator (ARNT). In addition, this receptor has been shown to regulate xenobiotic-metabolizing enzymes such as cytochrome P450. AHR exists widely in body tissues and affects bioactivation of carcinogenic compounds, T cell differentiation, fatty acid synthesis, cell proliferation, hematopoietic stem cell differentiation, respiratory reactivity, and insulin sensitivity. Although the precise mechanism illustrating the endogenous AHR function remains unclear, there has been intense interest in exploring AHR as a …

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Optimizing The Human Aryl Hydrocarbon Receptor (Hahr) Expression In Pichia Pastoris, Junyu Qian Jan 2022

Optimizing The Human Aryl Hydrocarbon Receptor (Hahr) Expression In Pichia Pastoris, Junyu Qian

University of the Pacific Theses and Dissertations

The aryl hydrocarbon receptor (AHR) is a transcription factor which heterodimerizes with the aryl hydrocarbon receptor nuclear translocator (Arnt) to regulate downstream gene transcription. For the purpose of studying the crystal structure of human aryl hydrocarbon receptor (hAHR), it is essential to obtain abundant amount of pure recombinant protein.Basing on the benefits of using P. pastoris system to produce recombinant protein, including appropriate folding, secretion of interest proteins to the external environment of the cell, and easier purification process of protein due to the its limited production of endogenous secretory proteins [1], our lab chose P. pastoris yeast as the …

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Peripherally Restricted Delivery System Provides Insights On The Role Of Cns In Precipitating Opioid-Induced Constipation, Dengpan Liang Jan 2022

Peripherally Restricted Delivery System Provides Insights On The Role Of Cns In Precipitating Opioid-Induced Constipation, Dengpan Liang

University of the Pacific Theses and Dissertations

A serious opioid crisis is affecting public health and economics, eroding people’s quality of life. 80% of patients who receive opioids suffer from adverse effects such as Opioid-induced constipation (OIC). However, there is no efficient medicine for these adverse effects. Notably, mainstream theory supports that analgesia effects are mainly controlled by CNS while OIC is predominately controlled by peripheral. In addition, the sites of action of opioid was based on the assumption that mu-opioid receptor antagonists (PAMORAs), did not cross the blood-brain barrier (BBB). Unfortunately, the BBB crossing of PAMORAs mislead the understanding of the role of the central nervous …

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The Interrelationship Between Treatment, Ethnicity, And Structured Exercise In Clinical Populations, Amanda M. F. Lopez Jan 2022

The Interrelationship Between Treatment, Ethnicity, And Structured Exercise In Clinical Populations, Amanda M. F. Lopez

University of the Pacific Theses and Dissertations

Cancer is the second leading cause of death, with about approximately 1.9 million Americans being diagnosed each year. Yet, it has high survival rates with the help of advancing treatments like radiation therapy. Cancer patients and survivors are contingent on experiencing a decline in physical functioning, quality of life, and physiological parameters. Treatment is effective and can prolong life expectancy but can be deleterious to a patient’s health. Parallel with cancer's impact on Americans is cardiovascular disease. Cardiovascular disease is responsible for 1 in 4 deaths. The development of cardiovascular disease is not spread accordantly among all ethnicities. Hispanics are …

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Thermodynamic Mechanisms Of Helix Stabilization In A Model Peptide And Protein, Ryan Murray Jan 2022

Thermodynamic Mechanisms Of Helix Stabilization In A Model Peptide And Protein, Ryan Murray

University of the Pacific Theses and Dissertations

Biologics are large, complex therapeutic agents generally produced from living organisms. One group of biologics is peptide/protein based. Biological agents offer unique advantages over traditional therapeutics including longer half-lives, higher specificity, greater efficacy, and reduced off-target effects. However, protein/peptide based drugs suffer from both delivery and stability issues. The higher order of protein structures (secondary, tertiary, etc.) derive ~80% of their conformational stability from paltry hydrophobic effects, with net stabilization of 5-15 kcal/mole observed for many proteins. Loss of conformational stability can lead to increased aggregation, precipitation, and degradation; and reduced activity and side effects. To increase stability and improve …

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Aac Camp As A Pre- And Post- Service Training Model, Joanne Kim Jan 2022

Aac Camp As A Pre- And Post- Service Training Model, Joanne Kim

University of the Pacific Theses and Dissertations

The purpose of this study was to determine the effectiveness of participation in an AAC-based day camp as a pre-service training opportunity for students of speech-language pathology and a post-training opportunity for practicing speech-language pathologists (SLPs). Following the conclusion for the most recent iteration of the AAC Academy hosted by the Diagnostic Center of Central California, students and SLPs who volunteered within the past ten years were recruited via email to participate in semi-structured interviews. Upon thematic analysis of the interview transcripts, the following themes were conceptualized: (1) Many volunteers had some interest, if not experience, with AAC prior to …

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Spouses Of First Responders: A Narrative Inquiry Of Survival, Recovery And Healing, Jennifer D. Geiger Jan 2022

Spouses Of First Responders: A Narrative Inquiry Of Survival, Recovery And Healing, Jennifer D. Geiger

University of the Pacific Theses and Dissertations

The nature of the work of emergency responders (i.e., firefighters, law enforcement, paramedics, and dispatch) includes high stress and direct experiences of traumatic situations. The experience of posttraumatic stress is common. The spouse or significant other is often the first person to see a change in their responder and the person most likely to be sought out for support from the responder, yet there is little support for the spouses or significant others of emergency workers. The purpose of this qualitative study using in-depth interviews and narrative inquiry was to learn about participants’ experiences at the 6-day residential treatment (retreat) …

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Exploring Sport, Exercise, And Performance Psychology Practitioners’ Attitudes On Attire, Claire Harding Jan 2022

Exploring Sport, Exercise, And Performance Psychology Practitioners’ Attitudes On Attire, Claire Harding

College of Graduate Studies: Theses & Dissertations

Research has revealed that attire has an influence on one’s self-perceptions, self and socially prescribed adjective traits and behavior (Adam & Galinsky, 2012; Lubker et. al, 2008; Peluchette & Karl, 2007). The present study aims to explore the influence of attire on perceptions, attitudes, and experiences of SEPP (Sport, Exercise, and Performance Psychology) practitioners during their applied work. Specifically, these factors were investigated through various demographic lenses such as gender, experience level, and age in order to describe the population. SEPP graduate students (n = 49) and early career professionals (n = 82) were asked to participate in a questionnaire, …

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