Medicine and Health Sciences Commons^™

Retention Of Foster Parents For At-Risk Youth In Tennessee, Marvin Amos

Walden Dissertations and Doctoral Studies

Federal legislation with the Family First Prevention Service Act (FFPSA) of 2017 required Tennessee to increase foster parent retention strategies. Tennessee does not have enough available foster homes for adolescents. The purpose of this generic qualitative study was to explore foster parent retention in Tennessee and to inform policymakers on how to adapt policy to increase the retention. The theoretical foundation for this study was based on the policy feedback theory, to identify the policy scope in Tennessee, and the two-factor theory, to guide the data analysis in the context of employee satisfaction and retention measures. Purposive sampling techniques were …

Structural Empowerment Of Nurse Leaders In New York State During The Covid-19 Pandemic, Tracey Braithwaite

Walden Dissertations and Doctoral Studies

The current phenomenological study explored the lived experience of Acting Chief Nursing Officers, Chief Nursing Officers, Chief Nursing Executives (henceforth CNOs) at hospitals in New York State who were charged with responding to executive orders while maintaining quality of patient care despite staffing constraints, inadequate supplies, or lack of additional support for the duties associated with their role. Their experience of structural empowerment in relation to the COVID-19 pandemic was also studied. The theoretical framework was Kanter’s theory of structural empowerment that addressed organizational behavior in the context of employee empowerment. The research question addressed how the CNOs perceived their …

Trauma-Informed Behavioral Health Leadership And Employee Engagement At A Child Advocacy Center, Andrew Krantz

Walden Dissertations and Doctoral Studies

Employee engagement is essential for an organization to meet its mission and vision. When employees are not engaged, there are higher levels of turnover, secondary traumatic stress, and burnout. Furthermore, when employees are not engaged, there is a decrease in the quality of patient care. Behavioral health leaders can positively impact employee engagement by engaging in trauma-informed behavioral health leadership. This qualitative case study reviews the impact of trauma-informed behavioral health leadership on employee engagement at a large Child Advocacy Center in the northeastern United States who was struggling with low levels of employee engagement and high levels of turnover …

Admission Timing, Age, Sex, Pain, And Disability As Outcome Predictors Of Short-Term Pain Programs, Nanesha Courtney

Walden Dissertations and Doctoral Studies

Researchers have found that age, sex, education level, and pretreatment pain levels may be significant predictors of patient outcomes; however, it remained unknown whether the timing of treatment predicts pain and disability after a multidisciplinary short-term intensive pain treatment program. The purpose of this quantitative nonexperimental study was to use archival data to examine whether the timing of entry into a multidisciplinary short-term intensive pain treatment program predicted pain and functioning levels at posttreatment. Glasser’s choice theory was used to examine whether the combined effect of pretreatment pain, occupational disability level, age, sex, education level, and time of entrance predicted …

The Experiences Of Middle-Aged Women In An Online Weight-Loss Community, Holly Fields

Walden Dissertations and Doctoral Studies

The obesity epidemic continues to be a public health crisis in the United States. The number of obese middle-aged women has risen dramatically over the past few decades. Despite multiple levels of support available, not all women are receiving the support they need to reduce overweight/obesity, as evidenced by the continuing rise in obesity. Using a qualitative phenomenological approach, this study examined middle-aged women's views on exercising, eating healthily, and social support in online weight-loss communities. For this study, the health belief model (HBM) and social learning theory (SLT) were used as conceptual frameworks to understand a person's behavioral intentions …

Experiences Of Women Faculty Using Meditative Practices Through Workplace Health Promotion In Ontario, Kelly Lynn Henley

Walden Dissertations and Doctoral Studies

Workplace stress is pervasive and changes to the postsecondary teaching and learning environment have contributed to stress among women faculty and adversely impacted their personal well-being. The purpose of this qualitative study was to understand how the constructs in the health belief model (HBM) play a role in the use of worksite wellness initiatives to manage stress and promote wellness among women postsecondary faculty in Ontario. The research questions were designed based on the HBM to examine the participants’ perceptions of severity and susceptibility to workplace stress, perceived benefits and barriers to participation, motivation to participate, and self-efficacy. Women faculty …

The Lived Experience Of Lung Cancer Patients With Psychological Health And Physical Activity, Donna Leeann Homkes

Walden Dissertations and Doctoral Studies

AbstractPhysical activity (PA) is recognized as a treatment protocol for lung cancer patients that improves physical impairments and reduces symptoms of psychological stress. This qualitative interpretive phenomenological analysis (IPA) study was conducted to explore the lived experience of lung cancer patients and how PA is influenced by anxiety, depression, and fatigue. This study was guided by Bandura’s self-efficacy theory and Engel’s biopsychosocial model. In-depth semi structured interviews were conducted with seven lung cancer participants over Zoom and in person. The data were analyzed using manual hand coding. The analysis revealed themes in patients’ experiences about how PA participation is influenced …

Recruitment And Retention Of Health Care Workers In Rural Areas, Robbie Marie Julian

Walden Dissertations and Doctoral Studies

Health care worker shortage is a global problem and is challenging for human resources managers. Human resource managers need more strategies to recruit and retain healthcare workers in rural areas to decrease healthcare worker shortages, unemployment rates, patient morbidity, and mortality rates. Grounded by Maslow’s hierarchy of needs theory, the purpose of this qualitative multiple case study was to explore strategies human resource managers use to recruit and retain healthcare workers in rural areas. The participants were three managers from Southern Louisiana rural area medical facilities with at least 5 years of experience developing and implementing successful recruitment and retention …

Association Between Knowledge Of Human Papillomavirus, Related Cancers, And Barriers To Information, Joycelyn Larbie

Walden Dissertations and Doctoral Studies

Globally, over 250,000 women die every year from cervical cancer and human papillomavirus (HPV). The purpose of this quantitative study was to discover the relation between sociodemographic factors of age, educational attainment, socioeconomic status, personal belief, and knowledge about HPV and related cancers. A cross-sectional design was used to determine statistical relationships. Secondary de-identified data from the Health Information National Trends Survey 2018 was accessed from the National Center Institute and was employed in the study. The study used a simple random technique to select a sample of 3,504 women. Logistic regression was used to estimate the odds of knowing …

Challenges In Discharge Planning For Adults Transitioning From An Inpatient Psychiatric Level Of Care Experiencing Homelessness, Deanna` R. Mccaskill

Walden Dissertations and Doctoral Studies

Mental illness and the homeless population are a growing concern in the United States. Homeless individuals utilize emergency rooms and acute inpatient stays more than those with housing. Social workers play a vital role in discharge planning, starting on the first day of admission. This action research study explored the challenges of social workers developing discharge plans for adults transitioning from an inpatient psychiatric level of care experiencing homeless. The theoretical framework implemented in this study was systems theory. Data were collected from 12 purposively selected master’s level social workers in the format of individual and focus group interviews. Eight …

Development Of A Standardized Novice Neonatal Nurse Orientation Program, Joanne Rau Pasinski

Walden Dissertations and Doctoral Studies

Abstract Neonatal intensive care units (NICUs) are fast-paced units requiring skilled nurses to care for a unique patient population. Orientation of new nurses to the NICU can be challenging for both the orientee and the preceptor. Offering an evidence-based practice orientation program by an accredited organization that is specific to NICU can be a valuable tool for both the preceptor and the orientee as well as enhance nurse, patient, and organizational outcomes. The project question explored if use of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) 15-module nursing orientation program for RNs in a NICU increased their …

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 …

Lived Experience Of Women Veterans Navigating The Veteran Healthcare System, Candance Willett

Walden Dissertations and Doctoral Studies

Many women veterans who navigate the Veterans Affairs (VA) healthcare system across the United States have felt that their voices have not been heard regarding their input and lived experiences concerning inclusion to the quality-of-care delivery for their health needs. The purpose of this study was to explore the lived experiences of women veterans who were currently facing or had previously faced difficulty navigating the VA healthcare system. The framework used for this qualitative study was interpretive phenomenological analysis. The qualitative method used was hermeneutics which was designed by Edmund Husserl and Martin Heidegger. Semi structured interviews were of 12 …

Comparison Of Cultural Self-Efficacy Between Urban And Rural Nurse Educators, Denise Rene Morris

Walden Dissertations and Doctoral Studies

Integration of an inclusive educational environment requires nursing faculty to embrace a transformational change in academics. The cultural interactions of an educator teaching in an urban district may differ from the relations experienced by a rural nurse educator. The purpose of this quantitative study, guided by Bandura’s social cognitive theory, was to determine whether there is a difference between the cultural self-efficacy scores of nurse faculty teaching in a rural location compared to those in an urban location as well as whether the demographics of age, ethnic background, and years in the nursing profession predict cultural self-efficacy scores. Nursing faculty …

Effect Of Family Engagement On The Behavioral Health Of Mentally Ill Offenders, Jessica Rae Horn

Walden Dissertations and Doctoral Studies

In the United States, 40% of incarcerated individuals have been diagnosed with a mental health disorder, but they often lack the support system needed to navigate their incarceration. This study addressed ways to understand how family engagement opportunities can improve the behavioral health of mentally ill offenders. Specifically, five research questions were used to explore the degree to which the practice of family engagement was understood as a method for providing support to mentally ill incarcerated individuals. The study followed the Baldrige Framework of Excellence to identify current organizational leadership and management issues that can help reach its goals, improve …

Evaluation Of Recovery Level And Surgical Site Infection For Hip Replacement Surgeries, Misha Foster

Walden Dissertations and Doctoral Studies

Surgical site infection (SSI) is one of the most common healthcare associated infections and is a major cause of morbidity and mortality. Existing studies have focused primarily on perioperative intervention strategies to reduce infection risks following total joint replacement (TJA) procedures. However, postoperative (post-op) SSI risk factors may account for a significant percentage of hospital readmissions due to infections at the surgical site. Therefore, the purpose of this study was to examine the association between post-op recovery level and SSI among patients who underwent primary hip arthroplasty procedures. Using the social ecological model, which conceptualizes health broadly and focuses on …

Oncology Nurses’ Experiences Dealing With And Managing Compassion Fatigue While Caring For Terminally Ill Patients, Stacey-Ann Mary Whyte

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) is a significant cause of nurse burnout (BO). Oncology nurses are particularly susceptible to CF because of the continual contact with terminally ill patients and recurrent experiences with patients’ death. A search of existing literature found no published studies that explicitly focused on interviewing oncology nurses to gain their expression of their lived experiences with CF while caring for terminally ill patients. This phenomenological qualitative study explored oncology nurses’ experiences dealing with and managing CF when caring for terminally ill patients. Figley’s compassion fatigue theory grounded this study. The research questions focused on the lived experiences of …

On The Potential Therapeutic Roles Of Taurine In Autism Spectrum Disorder, Alberto Rubio-Casillas, Elrashdy M. Redwan, Vladimir N. Uversky

Molecular Medicine Faculty Publications

Contemporary research has found that people with autism spectrum disorder (ASD) exhibit aberrant immunological function, with a shift toward increased cytokine production and unusual cell function. Microglia and astroglia were found to be significantly activated in immuno-cytochemical studies, and cytokine analysis revealed that the macrophage chemoattractant protein-1 (MCP-1), interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), and transforming growth factor β-1 (TGFB-1), all generated in the neuroglia, constituted the most predominant cytokines in the brain. Taurine (2-aminoethanesulfonic acid) is a promising therapeutic molecule able to increase the activity of antioxidant enzymes and ATPase, which may be protective against aluminum-induced neurotoxicity. …

Biomolecular Condensates: Insights Into Early And Late Steps Of The Hiv-1 Replication Cycle, Francesca Di Nunzio, Vladimir N. Uversky, Andrew J. Mouland

Molecular Medicine Faculty Publications

A rapidly evolving understanding of phase separation in the biological and physical sciences has led to the redefining of virus-engineered replication compartments in many viruses with RNA genomes. Condensation of viral, host and genomic and subgenomic RNAs can take place to evade the innate immunity response and to help viral replication. Divergent viruses prompt liquid–liquid phase separation (LLPS) to invade the host cell. During HIV replication there are several steps involving LLPS. In this review, we characterize the ability of individual viral and host partners that assemble into biomolecular condensates (BMCs). Of note, bioinformatic analyses predict models of phase separation …

Period Poverty And Life Strains: Efforts Made To Erase Stigma And To Expand Access To Menstrual Hygiene Products, Jennifer L. Brinkley, Nicole Niebuhr

Indiana Journal of Law and Social Equality

No abstract provided.

Does Environmental Testing Of C. Difficile Predict Whether A Patient Is Positive With C. Difficile?, David Caccese

Public Health Theses

Clostridioides difficile is a major public health threat and frequent cause of healthcare-associated infections. Hospitals have struggled to control C. difficile due in part to the challenge of identifying asymptomatic C. difficile carriers and because of C. difficile’s ability to survive on environmental surfaces for long periods. Asymptomatic carriers and environmental surfaces can contribute to C. difficile transmission. Screening of all patients for C. difficile upon hospital admission is not feasible and asymptomatic patients may not be accepting of surveillance testing. Thus, this study examines whether sampling the patient’s room environment once they have been admitted can indicate a patient …

Factorial Validation Analysis Of The Children’S Eating Behavior Questionnaires And Association With Weight Status: The Ola Tuputupua’E Cohort Study, Wenya Tian

Public Health Theses

Background: Childhood obesity is a pressing issue requiring a reliable tool for assessing health-related eating behaviors. The Child Eating Behavior Questionnaire (CEBQ) is a parent-reporting measure designed to assess multiple dimensions of children's eating behavior. This study aimed to assess CEBQ factor structure with data collected from Ola Tuputupua's Cohort and analyze the association between children's eating behavior and weight.

Methods: The confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted. Multinominal logistic regression analyses were conducted to examine associations between the CEBQ subscales with children's weight (healthy weight/overweight/obesity) as the dependent variable.

Results: The original eight-factor CEBQ …

The Antitrust Alternative: Promoting Public Health Through Competition, Michael Cederblom

Indiana Journal of Law and Social Equality

No abstract provided.

Comparing American Retail Pharmacies To Italian And Greek Retail Pharmacies, Shea C. Dolan

Undergraduate Theses, Professional Papers, and Capstone Artifacts

No abstract provided.

For Women Of Missoula: Menstruation And Refugees, Bella M. Spencer

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Stigmatization, lack of accessible menstrual products, and an overall misconstrued sense of menstruation impact menstruators at a disproportionate rate. When delving into the literature, we found that refugee women not only faced stigmas and a lack of access to menstrual products and education, but also ran into cultural barriers and differing attitudes on menstruation. To address this issue, we formulated the idea of a menstrual drive. Instead of focusing on refugee menstruators as a whole, our focus will be the refugee population in Missoula, MT. We recognize that the stigmatization of menstruation is an ongoing global issue that affects many …

Combatting Bacterial Infections: The Efficacy Of Poly-Gamma-Glutamic Acid On The Prevention Of Nasopharyngeal Infections Among Individuals With Cleft Lip And Palate, Florence Pun

Scripps Senior Theses

Cleft lip and palate (CLP) is a medical condition where children are born with an unfused lip and palate. While surgery is required to fuse the lip and palate, there are other conditions that children with CLP face after surgeries, such as otitis media (OM), speech impediments, and difficulty breathing. Particularly, OM occurs frequently in individuals with CLP because the tensor veli palatini muscles cannot open the Eustachian tube frequently and ventilate the middle ear properly, even after surgery. This thesis is a research proposal to evaluate whether γ-PGA can be used in nasal washes to safely prevent nasopharyngeal infections …

Campylobacter Vaccination Reduces Diarrheal Disease And Infant Growth Stunting Among Rhesus Macaques, Sara M. Hendrickson, Archana Thomas, Hans-Peter Raué, Kamm Prongay, Andrew J. Haertel, Nicholas S. Rhoades, Jacob F. Slifka, Lina Gao, Benjamin K. Quintel, Ian J. Amanna, Ilhem Messaoudi, Mark K. Slifka

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Campylobacter-associated enteric disease is estimated to be responsible for more than 160 million cases of gastroenteritis each year and is linked to growth stunting of infants living under conditions of poor sanitation and hygiene. Here, we examine naturally occurring Campylobacter-associated diarrhea among rhesus macaques as a model to determine if vaccination could reduce severe diarrheal disease and infant growth stunting. Compared to unvaccinated controls, there are no Campylobacter diarrhea-associated deaths observed among vaccinated infant macaques and all-cause diarrhea-associated infant mortality is decreased by 76% (P = 0.03). By 9 months of age, there is a 1.3 cm increase in dorsal …

Chronic Alcohol Consumption Dysregulates Innate Immune Response To Sars-Cov-2 In The Lung, Sloan A. Lewis, Isaac R. Cinco, Brianna M. Doratt, Madison B. Blanton, Cherise Hoagland, Natali Newman, Michael Davies, Kathleen A. Grant, Ilhem Messaoudi

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Background Alcohol consumption is widespread with over half of the individuals over 18 years of age in the U.S. reporting alcohol use in the last 30 days. Moreover, 9 million Americans engaged in binge or chronic heavy drinking (CHD) in 2019. CHD negatively impacts pathogen clearance and tissue repair, including in the respiratory tract, thereby increasing susceptibility to infection. Although, it has been hypothesized that chronic alcohol consumption negatively impacts COVID-19 outcomes; the interplay between chronic alcohol use and SARS-CoV-2 infection outcomes has yet to be elucidated.

Methods In this study we employed luminex, scRNA sequencing, and flow cytometry to …

Monoclonal Antibody Therapy Of Breastfeeding Patient Infected With Sars-Cov-2: A Case Report, Nicole E. Marshall, Madison B. Blanton, Brianna M. Doratt, Delphine C. Malherbe, Monica Rincon, Ilhem Messaoudi

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Introduction: Although safety data demonstrated the efficacy and effectiveness of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination for all individuals over 6 months of age, including pregnant and breastfeeding individuals, optimal treatment courses for symptomatic pregnant and lactating individuals infected with SARS-CoV-2 remain to be defined. Case Description: A coronavirus disease 2019 (COVID-19)-vaccinated breastfeeding woman received anti-SARS-CoV-2 monoclonal antibody treatment casirivimab–imdevimab 5 days after diagnosis of a symptomatic breakthrough SARS-CoV-2 infection. Results and Conclusions: The patient did not present with obvious defects in innate or adaptive cellular subsets, but compared with controls had minimal maternal antibody response to recommended …