Medicine and Health Sciences Commons^™

Ampk In The Ventromedial Nucleus Of The Hypothalamus: A Key Regulator For Thermogenesis, Hailan Liu, Yong Xu, Fang Hu

Children’s Nutrition Research Center Staff Publications

Obesity has become a global health issue, but effective therapies remain very limited. Adaptive thermogenesis promotes weight loss by dissipating energy in the form of heat, thereby representing a promising target to counteract obesity. Notably, the regulation of thermogenesis is tightly orchestrated by complex neuronal networks, especially those in the hypothalamus. Recent evidence highlights the importance of adenosine monophosphate-activated protein kinase (AMPK) within the ventromedial nucleus of the hypothalamus (VMH) in modulating thermogenesis. Various molecules, such as GLP-1, leptin, estradiol, and thyroid hormones, have been reported to act on the VMH to inhibit AMPK, which subsequently increases thermogenesis through the …

Development Of A Rapid And Efficient Protoplast Isolation And Transfection Method For Chickpea (Cicer Arietinum), Ninghui Cheng, Paul A Nakata

Children’s Nutrition Research Center Staff Publications

Chickpea (Cicer arietinum L.) is the second most important grain legume worldwide. Recent advances in the sequencing of the chickpea genome has provided a new and valuable resource to aid efforts in gene discovery and crop trait improvement. Technical difficulties in stable chickpea transgenics and the lack of a transient expression system for rapid analysis of gene expression and function; however, has limited the usefulness of this genomic resource. As a step toward alleviating this limitation, we report here the development of a simple and efficient transient gene expression protocol. Using leaves from chickpea seedlings, we have established a …

Classify Multicategory Outcome In Patients With Lung Adenocarcinoma Using Clinical, Transcriptomic And Clinico-Transcriptomic Data: Machine Learning Versus Multinomial Models, Fei Deng, Lanlan Shen, He Wang, Lanjing Zhang

Children’s Nutrition Research Center Staff Publications

Classification of multicategory survival-outcome is important for precision oncology. Machine learning (ML) algorithms have been used to accurately classify multi-category survival-outcome of some cancer-types, but not yet that of lung adenocarcinoma. Therefore, we compared the performances of 3 ML models (random forests, support vector machine [SVM], multilayer perceptron) and multinomial logistic regression (Mlogit) models for classifying 4-category survival-outcome of lung adenocarcinoma using the TCGA. Mlogit model overall performed similar to SVM and multilayer perceptron models (micro-average area under curve=0.82), while random forests model was inferior. Surprisingly, transcriptomic data alone and clinico-transcriptomic data appeared sufficient to accurately classify the 4-category survival-outcome …

Automated Phonetic Transcription Grading Tool (Aptgt), Marisha Speights Atkins, Dallin J. Bailey, Cheryl D. Seals, Guorui Li, Robertson Bassy, Yang Cao, Sicheng Li, Bennett Abigail

Faculty Publications

The Automated Phonetic Transcription Grading Tool (APTgt) is an online Learning Management System (LMS) that facilitates the comparison of phonetic transcriptions for instruction and clinical training purposes. It uses an embedded IPA graphical keyboard for transcription input. A custom edit distance algorithm aligns transcriptions in an intuitive way and then calculates differences quantitatively. This allows for objective scoring of transcriptions of even severely impaired productions, which may be difficult to score via traditional comparison methods. APTgt also includes support for comparing narrow phonetic transcriptions with diacritics. Contact the Technologies for Speech Language Pathology Research Lab at [email protected] for registration information.

Telehealth Efforts To Reduce Hospital Readmissions Of Congestive Heart Failure Patients, Sirfornia L. Deasfernandes

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a chronic condition that affects millions of individuals in the United States. There is no cure for CHF, but medical interventions can help treat the symptoms and improve health outcomes. The purpose of this quantitative study was to determine if telehealth services help to reduce the readmission status of patients diagnosed with CHF. The theoretical framework used in this study was the individual and family self-management theory to help focus on self-management behaviors that contribute to improving the patients' health outcomes. The research questions were focused on addressing CHF patients receiving telehealth services and whether …

The Effects Of A Plant-Based Diet On Inflammation Of Patients With Cardiac Disease, Rachel L. Butcher

Honors Undergraduate Theses

Cardiac disease is the primary cause of death in the United States of America (CDC, 2017). Despite ongoing efforts and investments to improve cardiac health in the United States, most of the population will suffer from cardiovascular diseases. There is a multitude of research supporting that diet can contribute to cardiac disease, but it is less known that diet can greatly contribute to regulation and reversal of cardiovascular disease processes (Huang et al., 2012; Satija et al., 2017; Kim et al., 2019). Existing research supports the efficacy of plant-based diets to manage and reverse certain cardiac diseases (Tuso et al., …

Hospital Footwear As A Vector For Organism Transmission, David J. Frederick

Honors Undergraduate Theses

In the United States healthcare system, nearly one in 31 patients contract a nosocomial infection. Footwear worn in these hospital settings are a factor that should be considered when determining contributing agents and methods for organism transmission. The purpose of this review is to synthesize the current research on hospital footwear as a vector for organism transmission. Eight studies were included in this review to examine the impact of wearable interventions on footwear-related contamination in the hospital setting and organism transfer as it relates to footwear and hospital environments. The link between the organism load and diversity on hospital worn …

Millennial Attitudes Toward Telehealth: An Integrative Literature Review, Hannah Gwyneth Y. Tabora

Honors Undergraduate Theses

Purpose: The primary purpose of this research was to explore individuals born in the millennial generation’s likelihood of using telehealth and virtual office visits as a replacement for face to face provider interactions. The secondary purpose was to examine the feasibility and access of treatable conditions and ailments in a virtual environment.

Methods: A literature review exploring millennials and telehealth was performed using various databases with search terms combined to include: ‘millennials*’, ‘telehealth*’, ‘telemed*’, ‘finance*’, ‘primary care*’, ‘healthcare*’, ‘health knowledge*’, ‘literacy*’, ‘education*’, ‘misinformation*’. The data was conformed into tables that synthesized the relationship between the millennial generation and their access …

Trophic Enteral Feeds In Mechanically Ventilated Adult Patients With Acute Respiratory Distress Syndrome/Acute Lung Injury And Associated Clinical Outcomes, Kiersten Ann Tidwell

Honors Undergraduate Theses

Enteral nutrition (EN) is often delayed in critically ill patients despite strong evidence to support that early enteral nutrition feeding is beneficial in this population. Adverse outcomes in critically ill patients in which nutrition is delayed include a longer length of stay and time on the ventilator, and a higher incidence of pneumonia and hospital mortality. The purpose of this literature review was to evaluate the current evidence regarding trophic enteral feeds in mechanically ventilated adult patients with acute respiratory distress syndrome (ARDS)/acute lung injury (ALI) and associated clinical outcomes. A retrospective literature review was performed to identify articles published …

Application Of The Andersen Health System Utilization Framework In The Investigation Of The Use Of Traditional Medicine In Kumasi, Ghana, Pascal Felix

College of Graduate Studies: Theses & Dissertations

There is a gap in theoretically-based-research on the use of Traditional Medicine (TM) in Low and Middle-Income Countries (LMIC). The Andersen Health System Utilization (AHU) framework was used to explore the factors associated with TM use among chronically ill patients seeking care from the Komfo Anokye Teaching Hospital (KATH), Ghana, West Africa. Two research questions allowed a focused application of the AHU model. The first research question sought to identify the need, predisposing, and enabling factors associated with TM use. The second research question sought to examine the relationship between TM and perceived health status. Multinomial logistic regression and instrumental …

Assessing Public Health Workforce Informatics Competencies: A Study Of Three Health Departments In Metro Atlanta, Olatanwa Adewale

College of Graduate Studies: Theses & Dissertations

Background: There is a need for the public health workforce to be current and versatile in technology usage. Public health leveraging technology usage in service delivery has the potential to improve efficiency and bring it to the forefront in the provision of healthcare services. The purpose of this study was to assess public health workforce informatics competencies in select Atlanta health districts and determine the correlates of public health informatics proficiency.

Methods: A 10-item instrument adapted from the recommendations of a Working Group document by the Centers for Disease Control and Prevention and the 2015 Informatics Capacity and …

Deployment And Travel Medicine Knowledge, Attitudes, Practices, And Outcomes Study (Kapos): Malaria Chemoprophylaxis Prescription Patterns In The Military Health System, Patrick W. Hickey, Indrani Mitra, Jamie Fraser, David Brett-Major, Mark S. Riddle, David R. Tribble

Journal Articles: Epidemiology

The Deployment and Travel Medicine Knowledge, Attitudes, Practices, and Outcomes Study (KAPOS) examines the integrated relationship between provider and patient inputs and health outcomes associated with travel and deployments. This study describes malaria chemoprophylaxis prescribing patterns by medical providers within the U.S. Department of Defense's Military Health System and its network of civilian healthcare providers during a 5-year period. Chemoprophylaxis varied by practice setting, beneficiary status, and providers' travel medicine expertise. Whereas both civilian and military facilities prescribe an increasing proportion of atovaquone-proguanil, doxycycline remains the most prevalent antimalarial at military facility based practices. Civilian providers dispense higher rates of …

Educating Nurses About Poststroke Depression And Using The Phq-2/9, Mary Mcmullen

Walden Dissertations and Doctoral Studies

Stroke has affected more than 7 million people and up to 33% of those patients reporting depression. The lack of screening for depression for patients post stroke can delay treatment for depression and hinder or lengthen recovery. The purpose of this project was to develop a nursing staff education program on using the Patient Health Questionnaire (PHQ) tools (PHQ-2 and PHQ-9) at the bedside to detect signs and symptoms of depression and identify nurse-driven interventions. Using the Johns Hopkins nursing evidence-based practice model and Orem's self-care model for guidance, an interdisciplinary team was assembled to collaborate on the development. A …

Examining Icu Nurses' Knowledge Of Ventilator-Associated Events And Ventilator-Associated Pneumonia, Dorothy J. Sanders-Thompson

Walden Dissertations and Doctoral Studies

Ventilator-associated events (VAEs) are patients' complications of respiratory conditions including ventilator-associated pneumonia (VAP). Research shows that VAP is the most common hospital-acquired infection among ventilated patients and a leading source of mortality. With greater risk for complications among ventilated- supported patients, nurses working in the ICU must keep abreast of new knowledge and update expertise to develop technical and clinical skills in daily practice. The purpose of this project was to assess whether an educational intervention would increase the ICU nurses' level of knowledge of the evidence-based intervention. Knowles' adult learning theory was chosen for this project. A paired-samples t-test …

Effects Of Transformational Leadership On Direct Home Healthcare Employee Turnover, Lisa K. Johnson

Walden Dissertations and Doctoral Studies

Ineffective leadership and excessive direct home healthcare workers’ intent to resign may decrease home healthcare worker satisfaction, increase workplace accidents, and hinder the quality of patient home healthcare. Home healthcare leaders have a problem of retaining direct home healthcare workers and can benefit from comprehending the factors that enhance leadership and mitigate the turnover of home healthcare workers. Grounded in transformational leadership theory, the purpose of this quantitative correlational study was to examine the relationship between the perception of transformational leadership behaviors and direct care intent to resign. The population consisted of direct home healthcare workers who reported to frontline …

Lived Experiences Of African American Nursing Students In An Associate Degree Nursing Program, Monique Renee Merritt

Walden Dissertations and Doctoral Studies

Despite recognition of the barriers that African American nursing students encounter while pursuing nursing education, leaders of U.S. nursing programs continue to struggle to retain these students and promote their degree completion. Poor retention and lack of completion contributes to the unequal representation of African American nurses in the U.S. healthcare workforce compared to the overall population. The purpose of this qualitative study was to examine the experiences that helped to promote African American nursing students’ success or served as barriers to successful completion of an Associate Degree Nursing program. Tinto’s integration model was used as the theoretical framework. Semistructured …

Adult Attachment For African American Women Who Have Mothers With Borderline Personality Disorder, Elizabeth Uchechi Onyeali

Walden Dissertations and Doctoral Studies

The effects that borderline personality disorder (BPD) can have on the loved ones of those who suffer from the mental illness is significant and can be deleterious and enduring. Maternal BPD can adversely impact mother-daughter relationships by fostering abnormal connections and insecure attachment bonds. This is particularly the case for African American mothers, of whom research suggests that the early attachment bond between them and their daughters significantly shapes how their daughters behave, perceive themselves, and relate to others. The purpose of this qualitative transcendental phenomenological study was to explore how the experiences of being raised by a mother diagnosed …

Strategies Used In Ehealth Systems Adoption, Joshua Adams

Walden Dissertations and Doctoral Studies

Failure to adopt an interoperable eHealth system limits the accurate communication exchange of pertinent health-care-related data for diagnosis and treatment. Patient data are located in disparate health information systems, and the adoption of an interoperable eHealth system is complex and requires strategic planning by senior health care IT leaders. Grounded in DeLone and McLean’s information system success model, the purpose of this qualitative case study was to explore strategies used by some senior information technology (IT) health care leaders in the successful adoption of an eHealth system. The participants were 8 senior health care IT leaders in the eastern United …

An Educational Program For Providers On Asthma Management For Pediatric Clients, Ngozi Anyatonwu

Walden Dissertations and Doctoral Studies

Asthma, a chronic inflammatory respiratory disease, is the third-ranking cause of hospitalization among children under the age of 15. Of the 25 million Americans living with asthma, 6.2 million are children under the age of 18. In 2018, more than 11.4 million people with asthma, including more than 3 million children reported having one or more asthma exacerbations. The burden of pediatric asthma accounts for more than 13.8 million missed school days among children ages 5 to 17 years, $3 billion in losses due to missed work, $29 billion due to asthma-related mortality and $50.3 billion in medical costs. Asthma …

Predictors Of Colorectal Cancer Screening Among Maryland Adults, Aged 50–75 Years, Pamela Manwi Asangong

Walden Dissertations and Doctoral Studies

Screening plays an essential role in reducing colorectal cancer (CRC) incidence and mortality rates, yet CRC screening use remains low in Maryland and lower in some age and racial/ethnic groups with limited resources to participate in CRC screening programs. The purpose of this quantitative, cross-sectional study is to investigate whether age group, sex, race/ethnicity, education level, income level, health insurance coverage, and access to health care professional can predict an individual, 50–75 years of age, in Maryland to take action to fully meet the United States Preventive Services Task Force CRC screening test recommendation within the recommended time interval. The …

Impact Of Mentoring On First Year Nursing Student Anxiety, Heather Ann Clesi

Walden Dissertations and Doctoral Studies

First-year nursing students (FYNS) experience anxiety that can decrease academic achievement and result in attrition from the nursing program (NP). Research has not evaluated the impact of faculty mentoring (FM) offered by the NP on FYNS anxiety level and academic achievement in didactic courses. This study, guided by Neuman’s system model, used a descriptive cross-sectional design. An online survey link was distributed to FYNS in a southwestern state via NP directors and social media. FYNS were asked if their NP offered FM and were sorted into groups based on their response. Responses were received from 321 participants with 75 meeting …

Association Of Social Support And Depressive Symptoms Among African Americans, Jacketta Renee Cobbs

Walden Dissertations and Doctoral Studies

Depression affects over 120 million individuals worldwide; in the United States, depression is a leading cause of disability for individuals’ ages 15-44 years. Social support can affect both physical and depressive symptoms; therefore, most patients with heart failure (HF) need support from family and/or friends to effectively manage their health condition. This indicates family and/or friends are expected to be the core support system for long term care of those with HF. The purpose of this study was to determine whether social support contributes to depressive symptoms among African Americans with HF. The research questions examined the experience of different …

Clinical Practice Guideline Development To Diagnose And Treat Adolescents With Obesity, Barbara Hunter Hudgens

Walden Dissertations and Doctoral Studies

Adolescent obesity is a worldwide multifaceted epidemic. This disease affects the medical, physical, psychosocial, and family aspects of adolescent life. Identification, diagnosis, and referrals to providers that can initiate early interventions that improve weight status have been recommended as critical steps in curtailing childhood obesity. This evidence-based clinical practice guideline (CPG) was developed for the healthcare providers at a rural clinic in Southwest Arkansas to provide consistency in the identification, diagnosis, and referral of adolescents. The health belief model (HBM) and the trans-theoretical model (TTM) were used to consider adolescents’ individual characteristics and beliefs as well as their readiness to …

Acknowledging And Addressing Adolescent Depression, Johnsie Burke Hughes

Walden Dissertations and Doctoral Studies

A family practice was found to inconsistently screen adolescents for depression even with the necessary Patient Health Questionnaire (PHQ) screening tools being readily available in their electronic medical record. The development of a practice guideline that offers a systematic approach to screening using the PHQ2 and the PHQ9 will potentially result in an increased guidance and provider willingness to screen for adolescent depression in the family practice setting. The purpose of this DNP project was to determine if an algorithmic practice guideline would increase provider willingness to assess for adolescent depression and identify any barriers to the use of the …

Relationship Between Pm2.5 Levels And Cancer Incidences In Interior Alaska, Sandra G. Lewis

Walden Dissertations and Doctoral Studies

Exposure to high levels of ambient air particulates < 2.5 microns in diameter (PM2.5) in the Fairbanks North Star Borough (FNSB) and the resulting impact on cancer incidence is the focus of this study. Climate, geography, and culture influence PM2.5 levels, particularly during the long cold season. While this study considers lung cancer incidences from PM2.5 exposure, the primary focus of the study is the incidences of all other types of cancers from exposure to PM2.5, because of the limited research done on this topic. This quantitative, retrospective, cohort study considered the incidences of new cancer diagnoses in the population during a 10-year period (January 1, 2008-December 31, 2017). The 2 FNSB Zip Codes, designated “hot spots,” frequently see spikes in PM2.5 during the long cold season. These areas are densely populated and contain the EPA-regulated air quality monitors. Cancer diagnoses in the hot spot Zip Codes were compared to cancer diagnoses in outlying Zip Codes (non-hot spots) that experience less PM2.5 and are more consistently within the EPA air quality guidelines. EPA monitors are not yet located in the non-hot spots. Cancer patient data were obtained from the Fairbanks Memorial Hospital Cancer Center. The results demonstrated that a strong association was found between PM2.5 exposure and non-lung cancers (OR = 1.37; RR = 1.36; p < 0.001); and between PM2.5 exposure and lung cancer (OR = 1.87; RR = 1.88; p < 0.001). These findings may be used to promote an increased awareness among FNSB residents of the potential impact on cancer diagnoses from inhaling high levels of PM2.5, so residents may change their behavior in favor of alternatives to biomass burning to improve air quality.

Job Satisfaction And Turnover Among Millennial Nurses In Public Hospitals, Gwen Mancuso

Walden Dissertations and Doctoral Studies

This study addressed turnover of millennial generation behavioral health nurses (MGBHNs). Because retention strategies mitigate the consequences of turnover, the purpose of this quantitative, correlational study was to examine job satisfaction (JS) and anticipated turnover (AT) intention among MGBHNs employed in U.S. public hospitals. Research questions were focused on determining what, if any, correlation exists between AT and JS. The theoretical frameworks were Herzberg’s theory and person in environment theory. A multiple linear regression and 5 Spearman’s rho correlation analyses were used to analyze data from a convenience sample of 65 MGBHNs to understand the relationship between the independent variables …

Medication Reconciliation In An Outpatient Clinical Setting, Tilena Martin

Walden Dissertations and Doctoral Studies

Medication reconciliation is a fundamental step in the delivery of safe care, because if it is not done correctly, it can set the stage for medication errors. Medication reconciliation has been shown to alleviate safety issues that lead to mortality, falls, and adverse drug reactions. The project question examined how in-service training can improve the knowledge of nurse practitioners and medical assistants about medication reconciliation. The project was guided by Knowles’ theory of adult learning and Rosswurm and Larrabee’s health belief model. A 1-hour educational module was prepared, and all participants completed the training prior to a discussion period. Sources …

The Hospital Consumer Assessment Of Healthcare Providers And Systems And Readmissions, Sheri Matson

Walden Dissertations and Doctoral Studies

Patient perception of care has become a main priority in the delivery of high-quality health care. The creation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey provided a nationally standardized method of evaluating patient perception to be incorporated in the reimbursement process defined by the Centers for Medicare and Medicaid Services (CMS). The purpose of this study was to examine the relationship between HCAHPS scores and readmission rates in 2 states in the South Atlantic region of the United States. Using social construction theory, this quantitative study utilized multiple regression analysis to analyze HCAHPS scores (independent …

Readmissions Of Heart Failure Patients: The Caregiver’S Perception, Jill Pansini

Walden Dissertations and Doctoral Studies

Heart failure patients account for 27% of readmissions within 30 days of discharge, which is an indicator of poor quality of care. Additionally, heart failure patients report that they do not receive adequate discharge planning, pointing to a need for improved discharge planning and practitioner follow-up. As the severity of heart failure increases, caregivers may be the key to decreasing readmissions. The purpose of this qualitative, hermeneutic phenomenological study was to explore the lived experiences and challenges faced by caregivers of heart failure patients ages 65 and over readmitted within 30 days of discharge. The transitional care model guided the …

Interprofessional Teams As A Strategy To Address Physician Shortages In North Dakota, Judy Ann Solberg

Walden Dissertations and Doctoral Studies

North Dakota health care and political leaders are facing pressure to revise health care delivery in the state. A chronic shortage of health care providers, retention issues, an aging population, and a recent population burst, as well as an abnormally high rate of physician retirement, have made health care access problematic for residents of the rural state. The purpose of this study was to explore and understand the main inhibitors and facilitators of employing interprofessional teams as a strategy to address rural physician shortages in North Dakota. Bandura’s social cognitive theory provided the framework for this phenomenological study of issues …