Medicine and Health Sciences Commons^™

From The National To The Local: Issues Of Trust And A Model For Community-Academic-Engagement, Olufunmilayo Chinekezi, Lauri Andress, Etsemaye P Agonafer, Susan Massick, Sarah Piepenbrink, Karey M Sutton, Philip M Alberti, Desiree De La Torre, Shannon Guillot-Wright, Marshala Lee

Faculty, Staff and Student Publications

Inequities in health and health care in the United States have persisted for decades, and the impacts on equity from the COVID-19 pandemic were no exception. In addition to the disproportionate burden of the disease across various populations, the pandemic posed several challenges, which exacerbated these existing inequities. This has undoubtedly contributed to deeply rooted public mistrust in medical research and healthcare delivery, particularly among historically and structurally oppressed populations. In the summer of 2020, given the series of social injustices posed by the pandemic and highly publicized incidents of police brutality, notably the murder of George Floyd, the Association …

The Predictive Value Of Coronary Microvascular Dysfunction For Left Ventricular Reverse Remodelling In Dilated Cardiomyopathy, Ao Kan, Yinping Leng, Shuhao Li, Fang Lin, Qimin Fang, Xinwei Tao, Mengyao Hu, Lianggeng Gong

Faculty, Staff and Student Publications

AIMS: to evaluate the degree of coronary microvascular dysfunction (CMD) in dilated cardiomyopathy (DCM) patients by cardiac magnetic resonance (CMR) first-pass perfusion parameters and to examine the correlation between myocardial perfusion and left ventricle reverse remodelling (LVRR).

METHODS: In this study, 94 DCM patients and 35 healthy controls matched for age and sex were included. Myocardial perfusion parameters, including upslope, time to maximum signal intensity (Time

RESULTS: With a median follow-up period of 12 months [interquartile range (IQR), 8-13], 41 DCM patients (44%) achieved LVRR. Compared with healthy controls, DCM patients presented CMD with reduced upslope, SI

CONCLUSIONS: CMD could …

A Case Of Successful Treatment Of Recurrent Urinary Tract Infection By Extended-Spectrum Β-Lactamase Producing, Naomi Bier, Blake Hanson, Zhi-Dong Jiang, Herbert L Dupont, Cesar A Arias, William R Miller

Faculty, Staff and Student Publications

Recurrent urinary tract infections (UTIs) are a challenging clinical entity that can be frustrating for patient and physician alike. Repeated rounds of antibiotics can select for multidrug-resistant organisms, further complicating care. We describe the successful use of fecal microbiota transplantation (FMT) for the treatment of recurrent extended-spectrum β-lactamase (ESBL)-producing

Subendocardial And Transmural Myocardial Ischemia: Clinical Characteristics, Prevalence, And Outcomes With And Without Revascularization, K Lance Gould, Tung Nguyen, Richard Kirkeeide, Amanda E Roby, Linh Bui, Danai Kitkungvan, Monica B Patel, Mohammad Madjid, Mary Haynie, Dejian Lai, Ruosha Li, Jagat Narula, Nils P Johnson

Faculty, Staff and Student Publications

BACKGROUND: Subendocardial ischemia is commonly diagnosed but not quantified by imaging.

OBJECTIVES: This study sought to define size and severity of subendocardial and transmural stress perfusion deficits, clinical associations, and outcomes.

METHODS: Regional rest-stress perfusion in mL/min/g, coronary flow reserve, coronary flow capacity (CFC), relative stress flow, subendocardial stress-to-rest ratio and stress subendocardial-to-subepicardial ratio as percentage of left ventricle were measured by positron emission tomography (PET) with rubidium Rb 82 and dipyridamole stress in serial 6,331 diagnostic PETs with prospective 10-year follow-up for major adverse cardiac events with and without revascularization.

RESULTS: Of 6,331 diagnostic PETs, 1,316 (20.7%) had severely …

Corrigendum: Editorial: Period Poverty, Lea Sacca, Christine Margaret Markham, Jhumka Gupta, Melissa Peskin

Faculty, Staff and Student Publications

This corrects the article "Editorial: Period poverty" in volume 5, 1140981.

Utilisation Of The Simplified Pulmonary Embolism Severity Index In Prognostication Of Pulmonary Embolism – A Retrospective Study In A Regional Hospital In Hong Kong, Ka-Hung Lau, Chi-Suen Chiu, Liang Chow, Ngai-Yin Chan

Journal of the Hong Kong College of Cardiology

Pulmonary embolism is the most severe form of venous thromboembolism that can result in significant morbidity and mortality, especially if left untreated. Guidelines suggested the use of clinical scoring systems to stratify patients’ risk of mortality, which helps to guide subsequent management strategy. Simplified pulmonary embolism severity index is a well-validated prognostic score that predicts the risk of short term mortality of pulmonary embolism and studies showed that low-risk patients could be safely managed as outpatients. However, local studies on the use of prognostic scores including simplified pulmonary embolism severity index in management of pulmonary embolism are lacking.

The Clinical Outcomes Of Covid-19 Infection With Pre-Existing Heart Failure – A Scientific Review, Ka-Yi Chan, Hiu-Ching Chan, Calvin Ka-Lam Leung, Qing-Wen Ren, Kai-Hang Yiu

Journal of the Hong Kong College of Cardiology

The COVID-19 pandemic has caused major impact to our world in various aspects. Healthy individuals infected with COVID-19 often develop different complications, even more so for patients with medical comorbidities. Various reports and studies have suggested cardiovascular disease as one of the major comorbidities in patients with COVID, and COVID infection could be life threatening in patients with pre-existing heart diseases, such as heart failure. In view of such, we aim to review on the subset of COVID patients who have pre-existing heart failure, in terms of in-hospital mortality, delivery of in-patient care and in-hospital complications. In conclusion, heart failure …

Effect Of Breastfeeding Support Initiative On Knowledge, Breast Engorgement, And Newborn Feeding Behavior Among Post-Cesarean Mothers, Smitha M V Dr, Priyadarshini T, Sandhya Kashyap, Jyoti Sambharwal, Angel Joy, Ashitha Korothan, Premlata Sabarni, Sabarni Banerjee

Manipal Journal of Nursing and Health Sciences

Effect of Breastfeeding Support Initiative on knowledge, Breast engorgement, and Newborn feeding behavior among post-cesarean mothers

ABSTRACT:

Background:

Delayed breastfeeding, improper breastfeeding techniques such as difficulties in holding the baby, posture, and sucking, and poor knowledge and skills on breastfeeding leads to breast engorgement and poor feeding. The breastfeeding support initiative is a unique program encouraging lactation to improve breastfeeding and prevent complications

Objectives:

To determine the effect of the breastfeeding support initiative on the knowledge of breastfeeding, breast engorgement, and newborn feeding behavior among post-cesarean mothers.

Methods:

We conducted a Quasi-experimental study among 60 post-cesarean mothers at a selected …

Risk Factors Associated With The Development Of Type Ii Diabetes-Related Complications, Jessica Danielle Lucas Williams

Walden Dissertations and Doctoral Studies

By 2040, it is estimated that 642 million people ages 20 to 79 will have Type II diabetes, thereby making it a heavily studied topic among scholars. As more people are diagnosed with Type II diabetes each year, the literature is slowly shifting to long-term complications. However, the many risk and protective factors that exist have created gaps in the literature. The purpose of this study was to determine the relationship between participation in diabetes self-management classes, mental health, physical health, BMI, smoking status, exercise, and possible diabetes complications (diabetes-related retinopathy and diabetes-related kidney disease). The gap in the literature …

Moderators Of Peripheral Neuropathy On Overall And Cardiovascular Mortality In People Without Diabetes, Adeoye Muideen Adenekan

Walden Dissertations and Doctoral Studies

Peripheral neuropathy (PN), a group of common heterogeneous disorders with varied etiologies, is associated with substantial morbidity and mortality. PN presents both as a diagnostic and therapeutic challenge to physicians and other healthcare providers. Socioeconomic moderators of PN in adults without diabetes in the United States have not been well studied. The consequences of PN can be devastating and include foot ulcers, amputations, a general decline in the quality of life, and death. The overall prevalence of PN in the United States is 13.5% in adults with diabetes and 11.6% in adults without diabetes. Clearly, these statistics indicate a public …

Educating Nurses On Failure To Rescue Due To Treatment Delay, Ganiyu Olasheni Adewale

Walden Dissertations and Doctoral Studies

Studies have found a shortfall in nurses' skills in caring for patients with a significant risk of failure to rescue in an acute care setting. The practice gap the healthcare facility was experiencing today was a gap in relation to failure to rescue with an increased rate of sentinel cases. There was a knowledge deficit among critical care nurses. The importance of educating nursing staff is to increase their knowledge and help decrease the occurrence of failure to rescue in an acute care setting. The practice-focused question for this education project asked if educating nursing staff with a medical-surgical competency …

Marijuana Cultivation Laws And Admissions For Cannabis Use Disorder In Us Substance Abuse Treatment Facilities, Nada Al-Rubaiee

Walden Dissertations and Doctoral Studies

With approximately 4.4 million Americans addicted to cannabis, it is considered a dominant non-medical drug that is common in the US. The purpose of this study was to investigate the possible contribution of the state laws that allow the cultivation of marijuana to Marijuana Medical (MM) program cardholders on cannabis addiction. This study was conducted to address the issue of the increase in demand for cannabis-related admissions that contribute to an upsurge in the unmet treatment needs. The study is founded on the Ecological Models proposed by Urie. The key research question explored the association between state laws that allow …

Preventing Nosocomial Infections In West Central Africa Through Nurse Education, Frida Ashu

Walden Dissertations and Doctoral Studies

AbstractNosocomial infections are acquired after being hospitalized. Lack of nurses’ education pertaining to nosocomial infections increase the risk of infections. Nurses working in the target facility in West Central Africa were not knowledgeable about current evidence-based infection control practices. The purpose of this project was to educate nurses on how to reduce the rate of nosocomial infections. The analysis, design, develop, implement, and evaluate model was used to guide the development of this project. Three experts evaluated the education program for content validity and usability. The program was presented as a PowerPoint to 40 health care workers via Zoom. The …

The Perceived Impact Of Childbirth Related Ptsd And Maternal Bonding, Sheila Baez

Walden Dissertations and Doctoral Studies

AbstractChildbirth has been increasingly viewed as a potentially traumatic event and process impacting both mother and infant. Previous research on childbirth has concentrated on the development of postpartum depression and its impact; research on posttraumatic stress disorder (PTSD) after childbirth has been limited. However, the results of this research study suggested that the development of childbirth-related PTSD may be a far more common phenomenon than previously suggested. Bowlby’s attachment theory and Ainsworth’s further development and expansion of the theory served as a framework which investigated the experiences of 10 biological females, aged 21 and over previously diagnosed with PTSD after …

Thirty-Second Mindful Body Scan Meditation For Bedside Nurses, Shruti Balwalli-Udyawer

Walden Dissertations and Doctoral Studies

Compassion fatigue, or secondary traumatic stress, is a state of physical and mental exhaustion caused by an inability to cope with the everyday environment that reduces the ability of the nurse to provide high-quality health care to a patient. The purpose of this staff education project, guided by Selye’s general adaption syndrome , was a 6-week, 30-second mindfulness exercise program to promote stress reduction for cardiac step-down and medical-surgical nurses. In this quantitative, pre- and posttest study, the Perceived Stress Scale was completed by a sample of 24 nurses who met the inclusion criteria. The practice focused whether educating nurses …

Increasing Knowledge Of Emergency Department Nurses On Recognizing Aggressive Patient Behavior, Kandee Barnes

Walden Dissertations and Doctoral Studies

Emergency department (ED) nurses are exposed daily to workplace violence putting them at risk for injury from aggressive patients. A gap in practice was identified in an urban ED in a state in the Southeastern United States. ED nurses at this site do not have the knowledge to recognize and reduce aggressive patient behavior. The guiding practice-focused question addressed whether educating ED nursing staff on recognizing aggressive patient behavior would increase knowledge. To address the gap, an educational session was developed based on a comprehensive literature search, with the assistance of an expert panel and using the analyze, design, develop, …

A Comparison By Ethnicity Of Usage Of Medication, Intubation Use, And Mortality Rates Of Covid-19 Patients In An Urban Hospital, Howard Rubin Baruch

Walden Dissertations and Doctoral Studies

Evidence from an urban hospital initially revealed that ethnicity had no bearing on treatment modalities or mortality among patients admitted and diagnosed with COVID-19 symptoms from January 1, 2020 to January 1, 2021. The purpose of this study was focused on answering three principal research questions concerning evidence at one hospital of differences in medication used, whether intubation was used, and mortality by ethnicity for those treated for COVID-19 while controlling for age, gender, and co-morbidities. The health belief model served as the theoretical framework. Data was collected from 1188 patient charts, and binary logistic regression was used to test …

Screening For Depression In Immigrants In Their Host Country, Hortense Bissila

Walden Dissertations and Doctoral Studies

AbstractThe initial need for care for depression is greater for immigrants, who encounter linguistic, cultural, structural, and attitudinal hurdles to mental health care that render them more susceptible to increased levels of depressive symptoms compared to populations of hosting country. The aim of this Doctor of Nursing Practice project was to educate frontliners in the community on how to assess for depression in immigrants in culturally congruent ways. This project addresses gap in mental health care practice that needs urgent redress in promoting self-cultural competence and raising awareness to assess for depression on immigrants. To meet the aims of the …

Personal Hardiness As An Unexamined Component Of The Healthy Volunteer Effect, Angelique E. Blann

Walden Dissertations and Doctoral Studies

Clinical trials are the standard for approving medicines for public use. To conduct trials, researchers depend on a declining number of volunteers. The healthy volunteer effect, a phenomenon in which participants demonstrate better outcomes than their peers, limits the generalizability of trial outcomes. The healthy volunteer effect does not fully explain the outcome difference between volunteers and nonvolunteers. The purpose of this cross-sectional quantitative study was to examine personal hardiness as an unexplored component of the healthy volunteer effect and determine whether personal hardiness is associated with willingness to participate. Hardiness was a personality construct that represented resilience to stress. …

Neighborhood Factors, Cardiovascular Illness, Mental Health, And Aging In The United States, Brenda Billings

Walden Dissertations and Doctoral Studies

The inability to age in place among people 65 years old and older is a public health problem in the United States. However, it is unknown what neighborhood factors (i.e., trust, safety, shared values) impact the communities that are struggling to support individuals looking to stay in their homes as they age. The purpose of this quantitative correlational study was to examine the relationship between neighborhood factors (i.e., trust, safety, and shared values), cardiovascular illness (i.e., heart attack and stroke), mental health (i.e., depression), and aging in place, controlling for sex, age, marital status, educational level, employment status, and race. …

Comparison Of Rural Associate Degree Nursing Students’ Clinical Judgment After Curriculum Change, Karen Bowen

Walden Dissertations and Doctoral Studies

New graduate nurses often lack adequate clinical judgment skills to practice competent nursing care, which may result in increased risk of committing practice errors that threaten patient safety. To mitigate errors in patient safety, industry leaders have called for nursing program improvements in preparation of nursing students’ clinical judgement as they transition to professional practice. Guided by Tanner’s clinical judgment theory, the rural state nursing programs in this study implemented a concept-based curriculum to promote clinical judgment which includes thinking skills, priority setting, and management of care. The purpose of this three-part, quantitative, nonexperimental study was to compare the development …

Association Between Covid-19 Health Knowledge, Self-Efficacy And Preventive Behaviors Among Nursing Students, Josephine Miane Britanico

Walden Dissertations and Doctoral Studies

Abstract Nursing students possess valuable public health knowledge to prevent the spread of COVID-19 infection. They can provide health education to the public with reliable information and adequate resources. To better understand the role nursing students can take in prevention efforts, the purpose of this quantitative correlational study was to examine the association between COVID-19 health knowledge, self-efficacy, and preventive behavior among undergraduate nursing students. The health belief model was the theoretical framework that guided this study. The primary research questions assessed (a) if there was a statistically significant association between COVID-19 health knowledge and preventive behavior among nursing students, …

Educator Preparedness In The Use Of Simulation In Nursing Education, Marcelene E. Hart

Walden Dissertations and Doctoral Studies

AbstractNurse educators lack preparation when using simulation as a teaching modality in educating nurses and nursing students within their clinical environment. The purpose of this basic qualitative study was to understand nurse educators’ perceptions of the challenges in preparing for simulation-based training experiences for nurses and nursing students. Vygotsky’s constructivist theory was used as the conceptual framework for the study to emphasize students’ innate ability to learn using active and hands-on processes through simulation experiences. Questions were developed to explore the challenges nurse educators encounter when preparing for simulation activities. Survey questionnaire invitations were sent through email to hundreds of …

Exploration Of Nurses' Knowledge About Healthcare For Transgender Patients, Elizabeth Kempt

Walden Dissertations and Doctoral Studies

AbstractThe transgender population is growing, and along with the population growth, the healthcare needs for gender transitioning of both medical and surgical procedures. Registered nurses (RNs) who care for hospitalized transgender patients are required to be knowledgeable about their care, yet little is known about what nurses know about the healthcare of the transgender patient. The purpose of this basic qualitative study, guided by Benner’s novice to expert theory, was to explore the knowledge and perceptions of RNs regarding healthcare of transgender persons undergoing transition to the opposite gender. Social media and snowball sampling were used to recruit 10 RNs …

Perceptions Of Women Of Color Improving Patient Outcomes Through Hospital Leadership Advancement, Benita A. Mclarin

Walden Dissertations and Doctoral Studies

Women of color have been underrepresented in hospital leadership positions and face challenges in advancing their careers. The benefit to hospitals providing women of color with training and support to move into leadership positions may be improved patient outcomes. Grounded in the interactional model of cultural diversity framework, the purpose of this basic qualitative study was to explore the perceptions of women of color advancing in leadership roles in hospitals and their impact on patient outcomes. The study participants included 16 women of color in leadership positions from hospitals in a western U.S. state. Data were collected through semi structured …

Consideration Of Mindfulness Intervention For Hispanic Adolescents In A School Setting, Kierra Mcshine Gregory

Walden Dissertations and Doctoral Studies

Hispanic adolescents’ accessibility to treatment options for depression is met with limitations associated with financial barriers and cultural misalignment. This research study aimed to bring to light an alternative psychotherapy treatment through the foundations of mindfulness interventions. The goal was to understand the experience of Hispanic adolescents when engaging in mindfulness in a school setting. The purpose of this study was to gather information about the experiences of Hispanic adolescents using mindfulness to support mental health practitioners, school counselors, and behavioral interventionists to provide treatment options that are accessible and meet the needs of this culture group. This explanatory case …

Academic Performance And E-Cigarette Use Among Teenagers, Jeremy Tan Rondael

Walden Dissertations and Doctoral Studies

Early e-cigarette use by youth has the capacity to create an early addiction to nicotine, increasing the risk of life-long dependency and the possible development of multiple cardiovascular and pulmonary diseases. Reinforced by the socioecological model, the purpose of this study was to determine if academic performance is associated with e-cigarette use among teenagers and young people and if the presence of adverse childhood events (e.g., cyberbullying in school and/or the presence of homelessness) mediated this association. This study included all respondents (N = 1,401) from the state of Nevada who answered the 2019 National Youth Risk Behavior Survey. Binary …

Transitional Care For The End Stage Renal Disease Patient, Elaine Vitto

Walden Dissertations and Doctoral Studies

AbstractThe prevalence rates for end stage renal disease (ESRD) have continued to rise by approximately 20,000 cases per year, and the number of patients with kidney failure requiring dialysis in the United States had reached 554,038 at the end of 2018. Transition of care for patients between acute care facilities and other care facilities such as dialysis centers remains challenging for providers. Lack of clear communication between providers, poor patient understanding of post-hospital self-care, and gaps in healthcare scheduling contribute to a high rate of adverse events. This facility did not have a detailed clinical guideline for ESRD communication between …

Evaluation Of The Implementation Of Primary Prevention Guidelines For The Treatment Of Hypertension, Aramide Alayande

Walden Dissertations and Doctoral Studies

AbstractHypertension is a chronic disease that is associated with increased risk of cardiovascular mortality. This Doctor of Nursing Practice project was a quality improvement initiative that addressed the gap in practice that the nurse practitioners (NPs) were not consistently following the American College of Cardiology (ACC) and American Heart Association (AHA) recommended guidelines for the treatment of hypertension. The purpose of the project was to evaluate whether the NPs were consistently using the guidelines to treat patients with hypertension after an educational intervention. The project used a before-after approach to evaluate the consistency of using the guidelines in treatment of …

Marijuana Cultivation Laws And Admissions For Cannabis Use Disorder In Us Substance Abuse Treatment Facilities, Nada Al-Rubaiee

Walden Dissertations and Doctoral Studies

With approximately 4.4 million Americans addicted to cannabis, it is considered a dominant non-medical drug that is common in the US. The purpose of this study was to investigate the possible contribution of the state laws that allow the cultivation of marijuana to Marijuana Medical (MM) program cardholders on cannabis addiction. This study was conducted to address the issue of the increase in demand for cannabis-related admissions that contribute to an upsurge in the unmet treatment needs. The study is founded on the Ecological Models proposed by Urie. The key research question explored the association between state laws that allow …