Medicine and Health Sciences Commons^™

Internal Population Displacement And Vaccination Completion, Malnutrition, And Respiratory Infections Among Children In The Central African Republic, Francois Xavier Batalingaya

Walden Dissertations and Doctoral Studies

Forced displacement in fragile and conflict-affected countries has the potential to disrupt access to basic primary healthcare services such as immunization. The purpose of this study was to assess the association between internal population displacement and vaccination completion, malnutrition, and acute respiratory infections (ARIs) while controlling for maternal characteristics of wealth index, education level, and residence status in the Central African Republic. The socioecological model underpinned this cross-sectional study that used a secondary dataset collected in 2018 – 2019 and maintained by UNICEF. Descriptive statistics and logistic regression tests were used to analyze the data. The findings of this study …

Association Between Dietary Phytoestrogen Intake And Xenoestrogen Exposure And Estrogen-Dependent Cancers, Pisita Bolsue

Walden Dissertations and Doctoral Studies

The role of circulating estrogens and the impact of lifetime exposure to multiple sources of exogenous estrogens as factors in carcinogenesis were not well understood. Research showed conflicting results when dietary phytoestrogen (PE) intake and xenoestrogen (XE) exposure occurred independently and when co-exposed. The purpose of this quantitative cross-sectional study was to investigate the association between dietary PE intake and XE exposure and the development of estrogen-dependent cancers in an epidemiological context. The advanced model of the epidemiology triangle was the theoretical framework for the current study in which binary logistic regression was employed on secondary data from the 2003–2006 …

Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice

Walden Dissertations and Doctoral Studies

Health-related quality of life (HRQoL) is a theoretical concept that intertwines physical, mental, emotional, and social functioning, with a focus on the impact that health status has on quality of life. Although sociodemographic factors are associated with lower HRQoL, how these factors influence HRQoL in military veterans is less understood. The study’s purpose was to examine the relationships between sociodemographic characteristics (gender, military pay grade, military branch, and geographic location) and perceived HRQoL measured by the SF-8 survey among veterans living in a metropolitan community in the Mid-Atlantic region of the United States. A cross-sectional recruitment study design yielded 90 …

Relationship Between Childhood Trauma, ,Adverse Childhood Experiences, And Self-Management Of Type 1 And Type 2 Diabetes, Deserie J. Otoole

Walden Dissertations and Doctoral Studies

AbstractPoorly controlled diabetes is the result of lack of self-care, which contributes to complications, ill quality in life, the rise in health care costs, and early death. The purpose of this quantitative, nonexperimental study was to examine the extent to which diabetes type (Type 1 and Type 2), childhood trauma, and adverse childhood experiences predict diabetes self-management (glucose management, dietary control, physical activity, health care use, total self-management). Contemporary trauma theory suggests that early childhood trauma results in negative health-related consequences in adulthood. Standard multiple regression analyses showed that (a) higher levels of physical neglect and emotional abuse predicted poorer …

Providing Diabetes Education To Improve Staff Nurses' Knowledge, Marcia A. Patterson

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a chronic metabolic disease that affects over 34.2 million or 10.5% of the U.S. population and ranks as the seventh leading cause of death. Tennessee's diabetes prevalence rate is ranked 45th overall in the nation, with 14.9% of the population affected, and in the local area for this project, the rate is greater than 15%, creating a public health concern. Despite its prevalence, there is still a wide gap in knowledge among nurses on diabetes management. The practice-focused question for this project addressed whether a staff education program would improve nurses' knowledge regarding diabetes. The significant gap …

Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy

Walden Dissertations and Doctoral Studies

Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with …

The Relationship Between Chlamydia, Gonorrhea, Syphilis And Race, Gender, And Age, Johnny James Mcgrew

Walden Dissertations and Doctoral Studies

The purpose of this quantitative correlational design using secondary data from Colorado Department of Public Health and Environment was to examine the relationship between different types of sexually transmitted infections (STIs), specifically, chlamydia, gonorrhea, and syphilis, and race, gender, and age in the United States. This study is significant because it could assist medical personnel to focus on more personally-based STI treatments. This study could also lead to a call for more research regarding sexual health programs across the nation, individuals’ willingness to share personal information regarding STIs, and how sexual health programs could increase testing for STIs. The study …

Experiences Of New Graduate Nurses Who Transitioned To Practice Using Virtual Conferencing Software, Sara Moran

Walden Dissertations and Doctoral Studies

Orientation is a pivotal moment for new graduate nurses as they transition into the acute care setting. The COVID-19 pandemic changed in-person orientation to virtual orientation, but little is known about the experiences of new graduate nurses who attended the virtual orientation process. The purpose of this qualitative interpretive descriptive study, guided by Duchscher’s theory and the technology adaptation model 2, was to understand the experiences of new graduate nurses who transitioned to practice utilizing video-based conference software for nursing orientation. Twelve new graduate nurses were interviewed using virtual conferencing software. Data were analyzed using interpretive description and then were …

Pancreatic Cancer: Quantitative Study Investigating The Regional Risk Factors In North Carolina, Holly Marie Myers

Walden Dissertations and Doctoral Studies

Pancreatic cancer is the fourth-leading cause of cancer-related deaths in the United States, killing more than 90% of individuals diagnosed within 5 years. Due to the lack of signs and symptoms, 82% of all pancreatic cancer cases are diagnosed in terminal stages. As such, the most powerful method to reducing the morbidity and mortality of pancreatic cancer is to further investigate the risk factors. According to the theoretical framework of the ecosocial theory, long-term exposure to exposures to unfavorable socioecological and environmental factors serve as a “web of causation” for adverse health outcomes. Using data from the North Carolina Department …

Staff Education Of Diabetic Foot Care In An Ambulatory Setting, Riza Grace Nielsen

Walden Dissertations and Doctoral Studies

One of the most important factors affecting the quality of diabetes care is the association between a patient’s knowledge and their practices. The practice gap in this primary care clinic was a lack of standardized diabetic foot care. The purpose of this DNP project was to provide nursing staff with an evidence- based, culturally congruent diabetic footcare curriculum that could help decrease inconsistencies in care. The practice-focused question for this project addressed whether an educational program for nursing staff on diabetic footcare would increase their knowledge and translate this knowledge into practice to prevent diabetic foot infections and its complications. …

A Staff Education Project On The Administration Of Clinical Practice Guidelines For The Treatment Of Obesity And Overweight Children And Adolescents, Emilia Ochiabuto Okoye

Walden Dissertations and Doctoral Studies

AbstractObesity among children and adolescents has reached epidemic proportions in the United States (U.S). Nurses in pediatric settings have a critical role to play in assessing and managing childhood obesity. The partner site for this project has a childhood obesity rate of 35% compared to the national average of 19%. However, the nursing staff lacked adequate knowledge, competence, and confidence in assessing and managing childhood obesity in line with the recommended guidelines. The problem was addressed by implementing the Clinical Practice Guideline for the Treatment of Obesity and Overweight Children and Adolescents via an education program. The program’s content was …

Cardiomems Staff Education To Improve Use Of Pulmonary Artery Sensor Data In An Emergency Department, Betty Sue Reynolds

Walden Dissertations and Doctoral Studies

Assessing volume status in patients with congestive heart failure (CHF) remains a difficult task. Newer technology, such as CardioMEMS, allows providers to download pulmonary artery pressure measurements from an implanted sensor. In a large rural emergency department (ED), lack of staff education on CardioMEMS made the device useless when a patient presented to the ED. The purpose of this project was to develop a staff education in-service to address the gap in practice. The theory used to guide development of an effective curricular program and instruction method was Knowles’ theory of andragogy. Application of the analysis, design, development, implementation, and …

Education To Increase Nurse Knowledge And Compliance With Social Determinants Of Health Screening, Bonnie Rieger

Walden Dissertations and Doctoral Studies

To provide holistic care and ensure positive patient health outcomes, the social determinants of health (SDOH) must be addressed. Research demonstrates that while medical care is a contributor to wellness, the SDOH serve an influential role in patient health outcomes. There is limited literature describing how to best educate practicing nurses about SDOH concepts. The purpose of this DNP project was to provide an educational intervention to increase inpatient staff nursing knowledge of the SDOH. Sources of evidence used to create the education module included scholarly literature describing the SDOH concepts and their application to patient, community, and population health. …

Black/African American Men’S Lived Experiences Of Workplace Colorism Bullying, Dr. Benjamin K. Spady Ph.D

Walden Dissertations and Doctoral Studies

Bullying in the U.S. workplace is an ongoing issue that transcends industry boundaries due to perpetrators’ ineffectiveness in viewing all coworkers as equals. The purpose of this qualitative interpretative phenomenological analysis study was to explore the lived experiences of Black/African American men who endure workplace colorism bullying. Critical race theory provided the conceptual framework, which labeled racism as an omnipresent systemic force. Semistructured interview data were collected from six Black/African American men who resided in the United States and who were bullied in the workplace within the past 20 years. Data were coded via open coding to discover themes. The …

Individuals’ Lived Experiences With Pharmaceutical Patient Assistant Programs, Marcia Clarke-Burke

Walden Dissertations and Doctoral Studies

AbstractPharmaceutical patient assistance programs (PAPs) were introduced as an alternative to address patients’ inability to obtain necessary prescription drugs. However, individuals were not fully exploring the beneficial nature of PAPs due to a poor understanding of the programs. Additional research is needed to understand how PAPs impact patients’ outcomes and costs of care. Grounded in Andersen and Newman’s model of health care utilization, this qualitative research was guided by the hermeneutic phenomenological research design. Data were collected during interviews with 11 participants located in various states regarding their participation in PAPs and their lived experiences in using PAPs. Collected data …

An Educational Intervention For Perioperative Nurses On Venous Thromboembolism Prophylaxis, Joann Mcghee-Evans

Walden Dissertations and Doctoral Studies

AbstractResearch has demonstrated that enhancing a nurse’s knowledge and awareness may result in positive patient, provider, and organizational outcomes. In a local organization, there had been a 25% increase of postoperative venous thromboembolisms (VTEs) within the last 12 months. The purpose of this doctor of nursing practice (DNP) project was to determine whether an educational intervention focused on VTE and the standards of care for VTE prevention increased knowledge and awareness among perioperative nurses working in the local organization. Benner’s novice to expert theory and King’s goal attainment theory provided the framework for the DNP project. Thirty-eight nurses were invited …

Reducing Same-Day Procedure Cancellations At An Interventional Spine And Pain Management Center, Adriene Smith

Walden Dissertations and Doctoral Studies

AbstractReducing Same-Day Procedure Cancellations at an Interventional Spine and Pain Management Center by Adriene Smith

Walden UniversityOctober 2023   Abstract The practice problem at a local interventional spine and pain management center was that the nurses lacked sufficient knowledge of the facility’s preoperative screening tool. The problem resulted in inadequate patient preparation for surgical procedures that led to a 33% same-day surgery cancellation rate. A staff education project was conducted to educate the nurses on how to properly use the facility’s preoperative screening tool and assess their knowledge of common blood thinner medications included in the preoperative screening process. Failure to …

Restoration Of Normal Blood Flow In Atherosclerotic Arteries Promotes Plaque Stabilization, Morgan A. Schake, Ian S. Mccue, Evan T. Curtis, Thomas J. Ripperda, Samuel Harvey, Bryan T. Hackfort, Anna Fitzwater, Yiannis S. Chatzizisis, Forrest M. Kievit, Ryan M. Pedrigi

Journal Articles: Cellular & Integrative Physiology

Blood flow is a key regulator of atherosclerosis. Disturbed blood flow promotes atherosclerotic plaque development, whereas normal blood flow protects against plaque development. We hypothesized that normal blood flow is also therapeutic, if it were able to be restored within atherosclerotic arteries. Apolipoprotein E-deficient (ApoE^−/−) mice were initially instrumented with a blood flow-modifying cuff to induce plaque development and then five weeks later the cuff was removed to allow restoration of normal blood flow. Plaques in decuffed mice exhibited compositional changes that indicated increased stability compared to plaques in mice with the cuff maintained. The therapeutic benefit of …

Longitudinal Assessment Of Multimorbidity Medication Patterns Among Smokers In The Copdgene Cohort, Yisha Li, Sarah J. Schmiege, Heather Anderson, Nicole E. Richmond, Kendra A. Young, John E. Hokanson, Stephen I. Rennard, Tessa L. Crume, Erin Austin, Katherine A. Pratte, Rebecca Conway, Gregory L. Kinney

Journal Articles: Pulmonary & Critical Care Med

Background and objectives: Chronic obstructive pulmonary disease (COPD) is usually comorbid with other chronic diseases. We aimed to assess the multimorbidity medication patterns and explore if the patterns are similar for phase 1 (P1) and 5-year follow-up phase 2 (P2) in the COPDGene cohort. Materials and Methods: A total of 5564 out of 10,198 smokers from the COPDGene cohort who completed 2 visits, P1 and P2 visits, with complete medication use history were included in the study. We conducted latent class analysis (LCA) among the 27 categories of chronic disease medications, excluding COPD treatments and cancer medications at P1 and …

Molecular Characterization Of Streptococcus Pneumoniae Causing Disease Among Children In Nigeria During The Introduction Of Pcv10 (Gsk), Stephanie W. Lo, Paulina A. Hawkins, Binta Jibir, Fatimah Hassan-Hanga, Mahmoud Gambo, Rasaq Olaosebikan, Grace Olanipekun, Huda Munir, Nicholas Kocmich, Amy J. Rezac-Elgohary, Safiya Gambo, Danstan Bagenda, Paul D. Fey, Robert F. Breiman, Lesley Mcgee, Stephen D. Bentley, Stephen K. Obaro, Community Acquired Pneumonia And Invasive Bacterial Disease Capibd Consortium

Journal Articles: Anesthesiology

Streptococcus pneumoniae (pneumococcus) is a leading vaccine-preventable cause of childhood invasive disease. Nigeria has the second highest pneumococcal disease burden globally, with an estimated ~49 000 child deaths caused by pneumococcal infections each year. Ten-valent pneumococcal conjugate vaccine (GSK; PCV10) was introduced in December 2014 in a phased approach. However, few studies have characterized the disease-causing pneumococci from Nigeria. This study assessed the prevalence of serotypes, antibiotic susceptibility and genomic lineages using whole genome sequencing and identified lineages that could potentially escape PCV10 (GSK). We also investigated the potential differences in pneumococcal lineage features between children with and …

Identification Of Ywhah As A Novel Brain-Derived Extracellular Vesicle Marker Post Long-Term Midazolam Exposure During Early Development, Nghi M. Nguyen, Daniel Meyer, Luke Meyer, Subhash Chand, Jagadesan Sankarasubramanian, Maireen Miravite, Chittibabu Guda, Sowmya V. Yelamanchili, Gurudutt Pendyala

Journal Articles: Anesthesiology

Recently, the long-term use of sedative agents in the neonatal intensive care unit (NICU) has raised concerns about neurodevelopmental outcomes in exposed neonates. Midazolam (MDZ), a common neonatal sedative in the NICU, has been suggested to increase learning disturbances and cognitive impairment in children. However, molecular mechanisms contributing to such outcomes with long-term MDZ use during the early stages of life remain unclear. In this study, we for the first time elucidate the role of brain-derived extracellular vesicles (BDEVs), including mining the BDEV proteome post long-term MDZ exposure during early development. Employing our previously established rodent model system that mimics …

Evaluation Of A Math And Medication Administration Proficiency Program In A Pre-Licensure Nursing Program, Dianne J. Hoekstra

Graduate Research Theses & Dissertations

Calculation of the correct dosages is a key factor for safe patient medication administration. For decades nurse educators have aimed to improve the knowledge and skills of the pre-licensure nursing students for medication administration. In a midwestern pre-licensure nursing school, a program was implemented using a curriculum wide approach for the teaching, remediation, and assessment of the math skills required for safe medication administration; known as the Math and Medication Administration Proficiency (MMAP) program. This dissertation evaluates the MMAP program using a logic model and mixed methods approach. Results indicated improvement in the pre-licensure nursing students’ success with the testing …

Exploring Barriers And Promoters Of Crc Screening Use Among Agricultural Operators: A Pilot Study Of An Application Of Concept Mapping, Cheryl Beseler, Jungyoon Kim, Roma Subramanian, Susan Harris, Karen Funkenbusch, Aaron Yoder, Tamara Robinson, Jason M. Foster, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

INTRODUCTION: The purpose of the study was to identify barriers and facilitators of colorectal cancer (CRC) screening use among agricultural operators in Nebraska, US.

METHODS: The concept mapping approach was used to engage participants and enhance the generation of ideas and opinions regarding CRC screening. Two focus groups (seven women and seven men) were conducted.

RESULTS: Among women, the cost domain was most agreed upon as important, followed by experiencing symptoms, awareness, and family. Among men, the important concepts related to CRC screening were family and friend support, feeling too young to get CRC, family or personal history of CRC, …

Effectiveness And Safety Of Bictegravir/Emtricitabine/Tenofovir Alafenamide In Patients With Hiv-1 Infection And Ongoing Substance Use Disorder: The Base Study, Joshua P. Havens, Sara Bares, Elizabeth Lyden, Anthony T. Podany, Kimberly Scarsi, Nada A. Fadul, Susan Swindells

Journal Articles: Infectious Diseases

BACKGROUND: People with human immunodeficiency virus (HIV) and substance use disorder (PWH/SUD) are at higher risk of nonadherence to antiretroviral therapy. Bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) exhibits high rates of efficacy with a favorable adverse event profile. The BASE study (NCT03998176) is a phase 4, single-arm study evaluating the effectiveness and safety of B/F/TAF among PWH/SUD.

METHODS: Viremic (HIV RNA >1000 copies/mL) PWH/SUD initiated B/F/TAF once daily for 48 weeks (W). The primary endpoint was proportion of participants with HIV RNA/mL at W24. Secondary endpoints were proportion of participants with HIV-1 RNA/mL at W48, safety, B/F/TAF adherence (dried blood spot [DBS] concentrations …

A Facile Strategy For The Fabrication Of Cell-Laden Porous Alginate Hydrogels Based On Two-Phase Aqueous Emulsions, Wen Xue, Donghee Lee, Yunfan Kong, Mitchell A. Kuss, Ying Huang, Taesung Kim, Soonkyu Chung, Andrew T. Dudley, Seung-Hyun Ro, Bin Duan

Journal Articles: Genetics, Cell Biology & Anatomy

Porous alginate (Alg) hydrogels possess many advantages as cell carriers. However, current pore generation methods require either complex or harsh fabrication processes, toxic components, or extra purification steps, limiting the feasibility and affecting the cellular survival and function. In this study, a simple and cell-friendly approach to generate highly porous cell-laden Alg hydrogels based on two-phase aqueous emulsions is reported. The pre-gel solutions, which contain two immiscible aqueous phases of Alg and caseinate (Cas), are cross-linked by calcium ions. The porous structure of the hydrogel construct is formed by subsequently removing the Cas phase from the ion-cross-linked Alg hydrogel. Those …

Rescue Of Auditory Function By A Single Administration Of Aav-Tmprss3 Gene Therapy In Aged Mice Of Human Recessive Deafness Dfnb8, Wan Du, Volkan Ergin, Corena Loeb, Mingqian Huang, Stewart Silver, Ariel Miura Armstrong, Zaohua Huang, Channabasavaiah B. Gurumurthy, Hinrich Staecker, Xuezhong Liu, Zheng-Yi Chen

Journal Articles: Genetics, Cell Biology & Anatomy

Patients with mutations in the TMPRSS3 gene suffer from recessive deafness DFNB8/DFNB10. For these patients, cochlear implantation is the only treatment option. Poor cochlear implantation outcomes are seen in some patients. To develop biological treatment for TMPRSS3 patients, we generated a knockin mouse model with a frequent human DFNB8 TMPRSS3 mutation. The Tmprss3^A306T/A306T homozygous mice display delayed onset progressive hearing loss similar to human DFNB8 patients. Using AAV2 as a vector to carry a human TMPRSS3 gene, AAV2-hTMPRSS3 injection in the adult knockin mouse inner ear results in TMPRSS3 expression in the hair cells and the spiral ganglion neurons. …

Advances In Antimicrobial Peptide Discovery Via Machine Learning And Delivery Via Nanotechnology, Alexa Sowers, Guangshun Wang, Malcolm Xing, Bingyun Li

Journal Articles: Pathology and Microbiology

Antimicrobial peptides (AMPs) have been investigated for their potential use as an alternative to antibiotics due to the increased demand for new antimicrobial agents. AMPs, widely found in nature and obtained from microorganisms, have a broad range of antimicrobial protection, allowing them to be applied in the treatment of infections caused by various pathogenic microorganisms. Since these peptides are primarily cationic, they prefer anionic bacterial membranes due to electrostatic interactions. However, the applications of AMPs are currently limited owing to their hemolytic activity, poor bioavailability, degradation from proteolytic enzymes, and high-cost production. To overcome these limitations, nanotechnology has been used …

Nursing News & Views - January 2023, Joanne Miller Rn

Nursing Newsletters

No abstract provided.

Metformin Lactic Acidosis, Joshua Santoli, Hossein Tohidi, Jamie Lee Aldakkour

West Florida Division GME Research Day 2023

No abstract provided.

Fever Of Unknown Origin Secondary To Staphylococcus Epidermidis Infective Endocarditis In A Patient With Aicardi Syndrome, Kimberly Sanchez Lopez, Elvis Caraballo Antonio, Gabriel Barciela Perez, Melanio J. Rodriguez, Yeissen Godinez

East Florida Division GME Research Day 2023

INTRODUCTION Aicardi syndrome is a rare neurodevelopmental disorder predominantly affecting females and characterized by agenesis of the corpus callosum, infantile spasms, and distinctive chorioretinal lacunae. We present the case of a 24-year-old female with a known history of Aicardi syndrome who presented with fever of unknown origin, ultimately attributed to Staphylococcus Epidermidis infective endocarditis involving a native valve.

CASE DESCRIPTION A 24-year-old female with a history significant for Aicardi syndrome and epilepsy presented to the emergency department for fever during the past week; her primary care physician sent her for outpatient blood work a few days prior, including blood culture, …