Medicine and Health Sciences Commons^™

Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza

Walden Dissertations and Doctoral Studies

Patients with heart failure (HF) have recurrent symptoms that lead to frequent hospital readmissions. Moreover, HF is one of the leading causes of 30-day hospital readmissions. Evidence shows that patients with a high level of HF self-care have decreased readmissions. HF self-care education is commonly delivered by the nurse at hospital discharge, and the patient’s transition to self-care is a critical point in the continuum of care. However, nurses must be knowledgeable of patient self-care in HF to effectively convey this information to the patient upon discharge. Therefore, this staff education project question asked whether nursing knowledge of HF patient …

Tetanus Immunity Among Adults In The Democratic Republic Of The Congo, Sue K. Gerber

Walden Dissertations and Doctoral Studies

Although tetanus is not a contagious disease, it can be deadly for people who are exposed and do

not have protective immunity against tetanus, which can be acquired only through vaccination.

Most studies on adult tetanus protective immunity are from high-income countries; limited

studies occur in Africa, and none has been reported from the Democratic Republic of the Congo

(DRC). This study sought to determine protective immunity against tetanus among adults in

DRC in relation to their age, sex, place of residence, and for women, antenatal care. The primary

purpose of this observational cross-sectional study using a nested serosurvey within …

Development Of A Clinical-Academic-Community Collaboration To Improve Health Literacy, Daniela B. Friedman Ph.D., Michelle A. Arent, Brooks Yelton Ma, Lmsw, Mayank Sakhuja, Venice E. Haynes, Samuel Noblet, Heather M. Brandt Ph.D., Ches, William D. Isenhower, Abraham Wandersman, Diana Zona, Cyndi New, Delores Fedrick, Jonathan Scaccia, Larisa Bruner

Faculty Publications

Limited health literacy is associated with poor patient health outcomes and increased hospitalization rates. Patient-provider communication plays an important role in patient health literacy and the understanding of medical terminology. This study demonstrates how a collaboration between clinical, academic, and community partners was instrumental in the design and implementation of a clinic readiness assessment and a clinic-based pilot intervention to encourage patient-provider communication and improve patient health literacy. A state hospital association, academic research team, and community adult literacy center director collaborated to develop a 60-item clinic readiness assessment and an evidence-informed pilot intervention. The clinic readiness assessment captured clinics’ …

Bnasnpdb: An Interactive Web Portal For The Efficient Retrieval And Analysis Of Snps Among 1,007 Rapeseed Accessions, Tao Yan, Qian Wang, Antony Maodzeka, Dezhi Wu, Lixi Jiang

Publications

The rapid development of high-throughput sequencing technology and the decrease in sequencing costs provide valuable resources and great opportunities for researchers to investigate genomic variations across hundreds or even thousands of accessions in the post-genomic era. The management and exploration of these large-scale genomic variations heavily rely on programming and command-line environments, which are challenging and time-consuming for most experimental biologists and plant breeders. Here, we present BnaSNPDB, an interactive web portal with a user-friendly interface that provides multiple analysis modules for retrieving, analyzing, and visualizing single nucleotide polymorphisms among 1,007 accessions of worldwide rapeseed germplasm. It is compatible, extendable, …

Critically Appraised Topic: Hippotherapy Intervention For School Age Children With Autism Spectrum Disorders, Jedekiah May, Delanie Vitosh, Karleen Vonkrosigk

Critically Appraised Topics

The prevalence of autism spectrum disorders (ASD) has risen nearly 600 percent in the past two decades, with estimates suggesting that 1 in 68 children worldwide have a clinical diagnosis (Centers for Disease Control and Prevention [CDC], 2014). Children with ASD experience resultant challenges in occupational functioning due to impairments in communication, social interaction, and sensory processing. Sensory modulation issues can cause negative impacts on physical and social functioning. Modulation allows filtering of irrelevant stimuli and maintenance of an optimal level of arousal that facilitates attention to environmental demands with longer engagement in tasks (Llambias, Magill-Evans, Smith, & Warren, 2016). …

The Gut-Brain Axis: Treating Depression Through Microbiome Alterations, Alexandria Bachman-Williams

Physician Assistant Scholarly Project Posters

• The purpose of this study is to explore the role of gut microbiome alterations in the treatment of anxiety and depression. • There are multiple pathological pathways that lead to the development of anxiety and depression. • Research shows a link between pathologic bacteria and low grade inflammation. This causes a disruption of neurotransmitters that are current targets of pharmacological treatment of depression and anxiety. • Transfer of “pathogenic” bacteria caused increased symptoms of anxiety and depression. • Treatment with probiotics and “protective” bacteria showed decreased BDI scores and improved symptoms. • Studies were small but show need for …

The Effects Of Initiating Metformin, To Prevent Or Delay Type Ii Diabetes, In Patients With Prediabetes, Kelsey K. Abraham, Jeanie Mchugo

Physician Assistant Scholarly Project Posters

The purpose of this literature review is to explore metformin’s role in the treatment of patients with prediabetes within the primary care setting. The efficacy of metformin versus lifestyle modifications will be compared as well as metformin, as adjunctive therapy, to lifestyle modifications. Along with efficacy, a systematic analysis will examine the three above mentioned therapies regarding diabetes risk reduction. Lastly, this review will examine the safety and tolerability of metformin, specifically in patients with prediabetes. The data presented shows evidence that lifestyle modifications are first line treatment for prediabetes while metformin use should be reserved for those who fail …

Use Of Marijuana In Those With Anxiety And Depression, Heather Flaa

Physician Assistant Scholarly Project Posters

The purpose of this research and literature review was to compare the use of marijuana to SSRIs in reducing anxiety and depression symptoms.

• This literature review searched databases Cochrane, PubMed, Clinical Key, PsycINFO, and DynaMed Plus from the year 1990 and on. Keywords: cannabis, marijuana, anxiety, generalized anxiety disorder, depression, and selective serotonin reuptake inhibitors.

• Many meta-analyses show SSRIs continue to be first line treatment in those with anxiety and depression in reducing symptoms.

• Patients with marijuana use showed an increased odds ratio of developing anxiety and depression or increasing symptoms in several studies.

• No studies …

Comparison Of Anterior Cruciate Ligament Graft Materials And Risk Of Rupture/Reinjury In Young Athletes, Matt Hockert

Physician Assistant Scholarly Project Posters

The anterior cruciate ligament tear is a standard surgical injury seen with young athletes competing at elite, amateur, and recreational capacities. The purpose of this literature review is to determine the rehabilitation guidelines and risks associated with anterior cruciate ligament reconstruction, as well as determining the role of rehabilitation in graft rupture. This literature review also serves to determine if graft choice for surgical repair plays a role in an increased risk of rupture or reinjury. This literature review used various online databases, including Dynamed, Cochran, and PubMed, with the utilization of MeSH terms listed below in “keywords” in order …

Cannabis Effectiveness On The Motor Symptoms Of Parkinson’S Disease, Austin Fridrich

Physician Assistant Scholarly Project Posters

Fueled by news media reports, cannabis use has been ever growing in popularity for the treatment of both motor and non-motor symptoms of Parkinson’s disease (PD). The purpose of this literature review is to evaluate the safety and efficacy of using cannabis to treat the motor symptoms and levodopa-induced dyskinesia of PD. In this literature review electronic databases were searched and included PubMed, CINAHL, Embase, DynaMedPlus, Cochrane Library, Academic Search Premier, and Clinical Key. A variety of keywords and mesh terms, as listed below, were used to define a set of literature. There were 16 studies chosen for review that …

Catheter Ablation Of The Accessory Pathway In The Asymptomatic Patient With Wolff-Parkinson-White, Erin B. Mondry

Physician Assistant Scholarly Project Posters

The purpose of this research and literature review was to analyze the safety and efficacy associated with invasive catheter ablation of the accessory pathway, in comparison to risk of sudden cardiac death and malignant arrythmias in non-ablated, asymptomatic individuals with Wolff-Parkinson-White (WPW). In this review, five databases were searched including CINAHL, Clinical Key, PubMed, Cochrane Library, and Dynamed Plus. Both keyword and mesh terms were used to define a set of the literature discussing Wolff-Parkinson-White, ventricular preexcitation, radiofrequency catheter ablation, and sudden cardiac death. Works chosen for review were published from 2009 to 2019, and included surveys, case control studies, …

Mat Effectiveness For Oxycodone Vs Heroin In Opioid Use Disorders, Casey Myklebust

Physician Assistant Scholarly Project Posters

Opioid use disorder is a major epidemic in the United States. • Rural areas suffer the most with limited resources available for treatments options. • A limited number of providers participate in MAT programs due to a negative stigma. • Project Echo was developed to spread awareness and information about MAT to educate providers and healthcare facilities about the needs of opioid use disorder patients that are not being met. • Buprenorphine, naltrexone, and methadone are the FDA approved medications to assist in MAT. • Medication assisted treatment is a long-term commitment to successfully maintain sobriety. • Medication alone is …

Hpv Vaccine In Adolescents: How To Increase Uptake, Natasha Richsesin

Physician Assistant Scholarly Project Posters

The human papillomavirus (HPV) is a sexually transmitted virus that affects both males and females of all ages. An HPV vaccine was created to help protect against harmful infections caused by the virus.

• This literature review focuses on the relationship between the HPV vaccine and its low uptake from untoward events, misinformation surrounding the vaccine, and different education methods. PubMed, Clinical Key, and Cochrane electronic databases are used for the literature review. A comprehensive literature review was conducted, and articles utilized were based on the age of the population being 11 to 29 years old, the HPV vaccine’s involvement …

Methamphetamine: Potential Risk Factor For Neurodegenerative Conditions, Katelyn Sarlette

Physician Assistant Scholarly Project Posters

Methamphetamine use is a relevant problems in many communities. While it has many adverse health effects, it may also contribute to the development of the neurodegenerative conditions such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), and Parkinson’s disease (PD).

• A literature review was conducted using PubMed, EMBASE, Clinical Key, and DynaMed. Literature found included high quality systematic reviews, randomized controlled trials, and meta-analysis.

• Literature supports that METH use has several major neurotoxic effects resulting in physical and cognitive deficits. There is minimal available evidence evaluating METH use as a risk factor for ALS although, they do share …

Low-Dose Naltrexone For Treatment In Crohn’S Disease And Fibromyalgia, Hannah R. Tkach

Physician Assistant Scholarly Project Posters

The United States has experienced a dramatic increase in opioid abuse and overdoses, leading to a national epidemic. Contributing to this epidemic is the use of opioid therapy for complex chronic inflammatory and neuropathic conditions that remain difficult to treat. Many traditional treatments are ineffective or have intolerable side effects, forcing providers to utilize opioid therapy as a last resort. Recently, there is increased interest in the use of partial opioid antagonist naltrexone to treat Crohn’s disease and fibromyalgia. Previous research suggests the potential for naltrexone to provide analgesic effects when administered in low doses via its unique interaction with …

The Effects Of A Clinical Coaching Education On Clinical Faculty’S Coaching Behaviors, Kara L. Kaldawi

Walden Dissertations and Doctoral Studies

New graduates’ readiness to provide safe nursing care is a goal of nursing programs and employers. However, new graduate nurses do not always have the skills to make decisions in the clinical setting during a patient situation, which can result in poor patient outcomes. But clinical coaching is a faculty teaching framework that promotes the development of clinical reasoning through the deliberate practice of questioning and feedback after a patient situation. Thus, the purpose of this study was to determine whether participation in a clinical coaching education program improved the coaching behaviors of clinical nurse educators. Knowles’ theory of adult …

The Impact Of Mental Health First Aid Training On Law Enforcement Officer Mental Health Literacy, Cindy J. Blankenship

Walden Dissertations and Doctoral Studies

An increasing number of juvenile offenders with untreated mental health issues are entering the justice system. Lack of adequate training of criminal justice personnel enhances the possibility of this population being arrested which is creating an overwhelming problem for stakeholders. This study sought to determine if the implementation of Mental Health First Aid (MHFA) Training impacted law enforcement officers’ (LEOs’) mental health literacy. This mixed-methods study used a quasi-experimental, one-group, pretest-posttest design, with a qualitative survey. Participants consisted of a sample of 28 LEOs from a rural Southeastern United States law enforcement agency. Study findings indicated that MHFA training increased …

Reduce Postpartum Complications By Improving Postpartum Care Appointment Attendance, Shayla Tennille Buckler

Walden Dissertations and Doctoral Studies

This evidence-based project (EBP) was developed to increase postpartum appointment attendance to improve maternal outcomes for postpartum women. The practice problem was that the postpartum women who received prenatal care failed to return for postpartum care at a community clinic in north east Texas. The practice-focused question explored whether an educational intervention with the nursing staff would increase postpartum appointment attendance. The framework used was Pender’s Health Promotion Model. The preintervention data were retrieved from an electronic medical record (EMR) generated report that provided the number of postpartum appointments attended 30 days before the intervention. The nursing staff received a …

Meat Intake And Prostate Cancer In African American Men, Uchenna Njoku

Walden Dissertations and Doctoral Studies

African American men have more prostate cancer and are more than twice as likely to die of the disease as Caucasian men, and the reasons for this racial disparity have not been clarified. Identifying lifestyle and dietary risk factors of prostate cancer is an important public health issue. Studies on the association between meat intake and prostate cancer risk have produced inconsistent results. The purpose of this cross-sectional quantitative study was to determine whether there is an association between total meat intake and total prostate cancer risk among African American men when controlling for age, income, educational level, physical activity, …

Behavioral, Demographic, And Clinical Determinants Of Hiv Serostatus In Zambian Women, Debebe Masresha Gebreyohannes

Walden Dissertations and Doctoral Studies

The rate of human immunodeficiency virus (HIV) infection shows a diminishing trend at the global level while it shows increasing in intensity of mortality, morbidity, and burden in Sub-Saharan Africa. The intertwined behavioral, demographic, and clinical determinants fueled the incidence of infections in Zambian women. The purpose of this study was to determine the association between demographic, behavioral, and clinical determinants with HIV serostatus in Zambian women. With the conceptual framework of the World Health Organization’s Commission for Social Determinants of Health (CSDH) and quantitative method of MANOVA, this study examined Zambian Demographic Health Survey data for Zambian women of …

Impact Of Education On Hiv Testing Among African American Women In The United States, Florence Matimbah Mbangowah

Walden Dissertations and Doctoral Studies

Improved and increased human immunodeficiency virus (HIV) testing among African American women in the United States could facilitate early detection of the virus. The purpose of this cross-sectional quantitative study was to determine if there was a significant association between HIV testing participation and education level (i.e., high school, college, post-college level) based on access to healthcare after accounting for insurance, income, employment, marital status, English language proficiency, and vision quality. The integrated theory of health behavior change, the theoretical framework used for this research, proposes that changes in health behavior can be improved by various factors such as fostering …

Care Management And Readmission Among Elderly African American Patients With Chronic Illnesses, Vivien Lyn Salmon

Walden Dissertations and Doctoral Studies

More than 70 million Americans aged 50 years and older suffer from at least 1 or more chronic condition and use the emergency department frequently. By 2025, chronic illness will affect an estimated 164 million Americans or nearly 49% of the population. The rapid rise in chronic illness is due to a combination of an aging population, longer life expectancies, and poor lifestyle choices. This quantitative study provided a statistical analysis on the impact of care management on readmissions among African Americans between the ages of 65 and 80, with diabetes, hypertension, asthma, or multiple chronic conditions. Logistic regression was …

Methods To Increase The Rate Of Childhood Vaccinating, Mary Beth Tillman

Walden Dissertations and Doctoral Studies

Vaccinations such as polio, diphtheria, varicella, and meningitis help to protect a child from life-threatening illnesses which have previously been contained by routine vaccinations. However, misinformation, negative press, and other contributing factors, have influenced caregivers to refuse to vaccinate their children placing the children at risk for contracting the disease. The Centers for Disease Control and Prevention recommends regular vaccinations for children beginning as newborns, yet the vaccination rate remains below acceptable levels. This project was developed to provide an educational program guided by Orem’s self-care theory and intended to increase nurses’ knowledge of vaccination and ultimately vaccination rates. A …

Reducing Congestive Heart Failure Hospital Readmission Through A Practice Guideline, Michelle Hamric

Walden Dissertations and Doctoral Studies

Patients with congestive heart failure (CHF) are at increased risk for hospital readmission within 30 days of discharge. The gap in practice involves the coordination of care for patients with CHF in the transition from hospital to home. Patients with CHF are at increased risk for hospital readmission due to barriers involving self-care, communication, and coordination of care. The purpose of this project was to implement a clinical practice guideline (CPG) that used a predictive tool and clinical pathway for coordination of care for CHF patients at increased risk for hospital readmission within 30 days. The DNP project involved using …

Sociopolitical Determinants Of Parental Acceptance Of Childhood Vaccination In Abuja, Nigeria, Lawrence Madu Ohammah

Walden Dissertations and Doctoral Studies

Despite the efficacy of vaccines, some parents still reject vaccination of their children, resulting in low vaccination coverage, a greater burden of vaccine-preventable diseases, and high infant mortality. The purpose of this study was to investigate the sociopolitical determinants of vaccination status among children, aged 0-24 months, and identify the factors that drive vaccine hesitancy. The social ecological model served as the theoretical framework. The study research design was a quantitative cross-sectional survey. An interviewer-administered questionnaire was used to collect primary data from parents and caregivers in 384 randomly selected households from 48 settlements in the Abuja Municipal Area Council. …

Hiv Positive African American Women’S Lived Experiences And Clinical Outcomes, Christie Olejemeh

Walden Dissertations and Doctoral Studies

African American (AA) women are disproportionately affected by HIV/AIDS. The infection rate for AA women continues to increase, and literature lacks information specifically on education for AA women regarding viral suppression at diagnosis. The purpose of the study was to understand the lived experiences of AA women living with HIV in the District of Columbia, particularly how they acquired knowledge of viral suppression. To understand their experiences with antiretroviral medications, viral suppression, discrimination, and stigma, this qualitative study applied a hermeneutic phenomenological approach. The theories of resilience and empowerment were applied. Ten HIV positive AA women living in the District …

Preparing Clinical Faculty To Teach And Reinforce Hourly Rounding, Lisa Bailey

Walden Dissertations and Doctoral Studies

A gap exists in the knowledge of clinical faculty teaching prelicensure students about hourly rounding. The purpose of this project was to develop an educational program to prepare clinical faculty teaching student nurses to conduct hourly rounding. Hourly rounding trained faculty ensure safe practice by students and adherence to hospital policies. Hourly rounding includes the 4 Ps, which entails the assessment of “potty”, pain, position, and possession/periphery. Models and theories used to inform the project included the American Academy of Pediatrics’ 10-step process for developing training courses, Knowles’ theory of adult learning, Kirkpatrick's evaluation model, and the Accreditation Commission for …

Guidelines For Chronic Back Pain: An Education Module For Health Providers, Ron Pascual

Walden Dissertations and Doctoral Studies

Effective chronic back pain management and patient self-care guidelines are necessary for healthcare providers treating patients with complaints of low back pain (LBP). The purpose of this doctoral project was to provide an evidence-based educational program aimed at improving the knowledge and skills of healthcare professionals regarding the Center for Disease Control (CDC) and American Chronic Pain Association (ACPA) guidelines, emphasizing alternative pain management treatments. The staff education project was supported by the biomedical pain model and chronic care model. A panel of 3 experts including the clinic’s board-certified anesthesiologist and pain management specialist, clinical manager, and leading medical director …

Exploring Health Literacy In The Acute Care Setting In A Rural Border Region, Shiloh Williams

Walden Dissertations and Doctoral Studies

Health literacy is important to ensuring patients have the necessary knowledge and skills needed to actively participate as a member of their own healthcare team. Patients with low health literacy are at increased risk for poor outcomes and limited participation in decisions affecting their health or treatment plan. Using the Social Ecological Model (SEM) as a framework, the purpose of this study was to determine the relationship between medical-surgical registered nurses, medical-surgical patients and the registered nurse’s (RN) assessment of their patient’s health literacy of those who live in a rural-border region. The study’s sample consisted of 84 pairs of …

Managing Occupational Stress Among Nigerian Police Officers Deployed To Borno State, Nigeria, Babatunde Salmon Alabi

Walden Dissertations and Doctoral Studies

The police officers in Borno State, Nigeria, lack adequate training to manage the occupational stress when deployed to perform their civic duties of protection of lives and properties. Using the theory of psychological stress and coping, the purpose of this general qualitative study was to explore strategies that police officers deployed to Borno State of Nigeria used in managing occupational stress when discharging their duties. The research question was written to address the strategies required by police officers deployed to Borno State, Nigeria, in managing occupational stress when discharging their duties. Using semistructured interviews, 15 participants were selected who had …