Incidence Of And Risk Factors For Thromboembolic Events In Elderly Medicare Patients With Kidney Cancer,
2016
Walden University
Incidence Of And Risk Factors For Thromboembolic Events In Elderly Medicare Patients With Kidney Cancer, Monica Kobayashi
Walden Dissertations and Doctoral Studies
The incidence of venous and arterial thromboembolic events (VTEs/ATEs) varies greatly by cancer type and age, with increased risk in the elderly. Very little research has been reported specific to elderly kidney cancer patients. Retrospective cohort analyses of Medicare patients, 11,463 with and 11,463 without kidney cancer, between 2003 and 2010 were conducted to compare incidence rates of VTEs/ATEs in cancer patients with matched noncancer patients and to assess independent risk factors for VTEs in cancer patients. The advanced epidemiology triangle was the theoretical framework used to interpret the association between incident events and other factors. Using Cox proportional hazard …
Socioeconomic Status Mobility And Lifetime Exposure To Discrimination On Cardiovascular Disease Events,
2016
Walden University
Socioeconomic Status Mobility And Lifetime Exposure To Discrimination On Cardiovascular Disease Events, Nkenge H. Jones-Jack
Walden Dissertations and Doctoral Studies
Blacks in the United States have the highest rates of hypertension in the world, and their cardiovascular disease mortality rates are higher than for any other population group as a result of traditional risk factors such as obesity and stronger family history. However, additional underlying factors, such as social determinants of health (e.g., socioeconomic status [SES]) and macrosocial factors (e.g., racism), also correlate with adverse health outcomes. This study investigated whether the interaction between SES mobility over the lifecourse and lifetime racial discrimination influenced the extent to which hypertension contributed to the cardiovascular disease health disparities observed among Blacks in …
Impact Of Pneumococcal Conjugate Vaccine Thirteen Valent On The Reduction Of Invasive Pneumococcal Disease,
2016
Walden University
Impact Of Pneumococcal Conjugate Vaccine Thirteen Valent On The Reduction Of Invasive Pneumococcal Disease, Aissata Coulibaly
Walden Dissertations and Doctoral Studies
Many children under the age of 5 die each year of invasive pneumococcal disease. Childhood vaccination against this disease reduces morbidity and mortality. Despite the introduction of a pneumococcal conjugate vaccine (PCV13) in a central African country in 2011, all provinces have not yet been vaccinated. The purpose of this quantitative quasi-experimental study was to determine whether there was an association between the introduction of PCV13 and new cases of pneumococcal disease in 2 provinces in central Africa. The sample size for the study was 380. The theoretical framework for this study was the epidemic model supported by the concept …
Comparing African- And U.S.-Born Blacks At Stage Of Diagnosis And Treatment For Nonsmall Cell Lung Cancer,
2016
Walden University
Comparing African- And U.S.-Born Blacks At Stage Of Diagnosis And Treatment For Nonsmall Cell Lung Cancer, Relindis K. Fofung
Walden Dissertations and Doctoral Studies
Lung cancer is a disease with a high mortality rate for the U.S. Black population. There had been considerable research done on different population demographics, necessary to achieve the Healthy People 2020 overarching goals to eliminate health disparities, gain health equity and maintain quality health. Yet, the African-born Black (AFBB) population has been understudied for nonsmall cell lung cancer (NSCLC). This study sought to determine whether within race differences in stage at diagnosis and treatment of NSCLC exists between AFBB and American-born Blacks (AMBB) populations in the United States. The study data is secondary data collected as part of the …
The Role Of Socio-Demographics Factors In Voluntary Counselling And Testing Uptake In South-Africa.,
2016
Walden University
The Role Of Socio-Demographics Factors In Voluntary Counselling And Testing Uptake In South-Africa., Felix Ikechi Woke
Walden Dissertations and Doctoral Studies
Many researchers have alluded to the inequity in distribution of HIV preventive services in South Africa (SA). Other researchers have demonstrated that socio-demographic factors are main determinants of distribution of preventive services like voluntary counseling and testing (VCT) in SA. VCT is a primary HIV prevention tool through which infected persons enter the treatment, care, and support programs; identifying the impact of socio-demographic determinants (SDDs) on VCT uptake in SA could help direct VCT services to areas and individuals that need them most. The research question in this study examined what and how SDDs impact the uptake of VCT in …
The Impact Of Social Determinants On Tuberculosis Incidence Trends In New Jersey,
2016
Walden University
The Impact Of Social Determinants On Tuberculosis Incidence Trends In New Jersey, Thomas Larry Brown
Walden Dissertations and Doctoral Studies
Social determinants have impacted disease states. The purpose of this study was to determine the influence of social determinants on the incidence of tuberculosis over a 20-year period for the state of New Jersey to determine interventions that can be developed for the state. The epidemiological triad (host-agent-environment) served as the theoretical foundation for this study. A quantitative series of cross sectional analyses were performed using secondary data from a New Jersey Department of Health database on population tuberculosis incidence for the state. Categorical data analyses were used to describe the data. According to study results, certain social determinants; such …
Factors Associated With Late Stage Diagnosis Of Cervical Cancer In The United States,
2016
Walden University
Factors Associated With Late Stage Diagnosis Of Cervical Cancer In The United States, Marianne S. Pelletier
Walden Dissertations and Doctoral Studies
Cervical cancer represents a significant public health problem in the United States. According to the Centers for Disease Control and Prevention, the prognosis is related to stage at diagnosis, with the 5-year survival rate being 91.2% for early stage disease and only 17.0% for those with late stage disease. There is a gap in the literature examining the association of insurance status with late stage cervical cancer diagnosis across a large segment of the United States population. There is also a gap in the literature examining women residing in the United States with late stage cervical cancer diagnosis and identifying …
Comparison Of Neovascular Age-Related Macular Degeneration Populations In The United States,
2016
Walden University
Comparison Of Neovascular Age-Related Macular Degeneration Populations In The United States, Susan Lynette Coultas
Walden Dissertations and Doctoral Studies
Age-related macular degeneration (AMD) is one of the leading causes of blindness in the United States in people who are 50 and older. The safety and efficacy of aflibercept for the treatment of late stage neovascular AMD (NAMD) has been demonstrated by clinical trials among several populations; however, it is unclear whether all NAMD patients respond in the same manner as was studied in the clinical trials. The purpose of this study was to examine if populations of patients treated with aflibercept for the treatment of NAMD were significantly different from one another in terms of health characteristics, treatment regimens, …
Association Between Haart And Metabolic Syndrome Components Among Hiv-Positive Adults In Southeastern Nigeria,
2016
Walden University
Association Between Haart And Metabolic Syndrome Components Among Hiv-Positive Adults In Southeastern Nigeria, Bridget Okiemute Amechi
Walden Dissertations and Doctoral Studies
Highly active antiretroviral therapy (HAART) contributes to metabolic disorders and the growing prevalence of metabolic syndrome (MetS) in human immunodeficiency virus (HIV)-infected patients. Hypertension, obesity, and hyperglycemia (components of MetS) are risk factors for cardiovascular disease. Studies have shown that HIV patients on HAART have a 2-fold risk of dying from MetS. There are no such studies in Umuahia; hence the need for this study to fill this gap. Using a sample size of 192 medical records of HIV-infected patients in Federal Medical Centre, Umuahia, and applying metabolic syndrome theory, this study examined the relationships among types of HAART regimen, …
Understanding Caregivers' Perceptions Of Childhood Immunization,
2016
Walden University
Understanding Caregivers' Perceptions Of Childhood Immunization, Oliver Anyabolu
Walden Dissertations and Doctoral Studies
Low immunization in Nigeria is associated with high prevalence of childhood diseases. The purpose of this qualitative phenomenological study was to describe caregivers' perceptions of routine immunization of their children ages 24 to 36 months. Caregivers' attitudes, cultural beliefs, and knowledge regarding immunization were examined. The health belief model was used to guide study. Interviews were conducted with 5 caregivers of fully immunized and 5 caregivers of partially and nonimmunized children. Digital recordings were analyzed using NVivo 10 to identify themes and subthemes. Attitudes of caregivers with fully immunized children included both perceived barriers (distance to health center, lack of …
Community And Patient-Centered Medical Home In The Care Of Chronically Ill Patients,
2016
Walden University
Community And Patient-Centered Medical Home In The Care Of Chronically Ill Patients, Victor A. Carrillo
Walden Dissertations and Doctoral Studies
Large portions of the US population live in poor inner-city communities. Health needs assessment data have shown that these communities have disproportionately high rates of chronic illnesses. The patient-centered medical home (PCMH) model was developed to address the gaps that exist in the primary care system, and emphasizes a redesign of primary care that is patient centered, utilizes multiple levels of healthcare professionals, information technology, and care coordination. However, little evidence exists on the value of this model which may explain why it has not gained wide acceptance by primary care providers. Therefore, this study was designed to examine the …
Risk Factors And Outcomes For Bloodstream Infections Among Patients With Skin Infections,
2016
Walden University
Risk Factors And Outcomes For Bloodstream Infections Among Patients With Skin Infections, Michael Rybak Rybak
Walden Dissertations and Doctoral Studies
Acute bacterial skin and skin structure infections (ABSSSI) are common infections within the local community, and they result in higher morbidity and health care costs. While risk factors for skin and soft tissue infections have been previously evaluated, risk factors associated with secondary bloodstream infections (BSI) has not been investigated, especially in an intercity patient population with limited health care resources. In this case control investigation, 392 patients consisting of 196 cases (ABSSSI + BSI) and 196 controls (ABSSSI) were investigated to determine risk for BSI. Both sociodemographic and underlying conditions were evaluated. According to bivariate analysis of cases and …
Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes,
2016
Walden University
Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, Kathy Bianco
Walden Dissertations and Doctoral Studies
Alzheimer's disease (AD) is the 6th leading cause of death in older Americans. Currently there is no cure for AD, and even though the specific cause is unknown, diabetes mellitus type 2 (DM2) is regarded as a risk factor. Hispanics have a higher incidence of DM2 and possibly AD. I chose a life course theoretical model for this quantitative cross-sectional study to illuminate the variables most pertinent to a pathway from good health to poor health. The variables chosen were hypertension (HTN), obesity, smoking, stroke, dyslipidemia, and lower educational attainment. The research questions were used to examine biologic, metabolic, sociologic, …
Impact Of Medicare And Medicaid Beneficiaries With Selected Conditions On Emergency Department Utilization,
2016
Walden University
Impact Of Medicare And Medicaid Beneficiaries With Selected Conditions On Emergency Department Utilization, John K. Amoh
Walden Dissertations and Doctoral Studies
Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF) are conditions that represent significant and ongoing medical costs, including frequent emergency department (ED) visits, hospitalizations, work absences, and disability. This retrospective cross-sectional study, examined the effects of the frequent ED visits due to COPD and CHF on the beneficiaries of Medicare and Medicaid in Maryland. The goal was to identify the factors that led these patients to visit the ED, the impact of these visits on Medicare utilization and costs across Maryland, and preventative intervention strategies to control this population's costs of care. Secondary data were analyzed from 2010-2012 …
Hospital Preparedness: Effects Of Designated Preparedness Coordinators On Hospital Preparedness For Special Hazard Classes,
2016
Walden University
Hospital Preparedness: Effects Of Designated Preparedness Coordinators On Hospital Preparedness For Special Hazard Classes, Rodney Sinelair Jones
Walden Dissertations and Doctoral Studies
Since 9/11, little statistical rigor has been placed on identifying the correlates of hospital preparedness. This quantitative study explores the research question: Is there a correlation between the employment of a designated hospital preparedness coordinator and the reported level of preparedness for: (a) general preparedness; (b) chemical, biological, radiological, and nuclear (CBRN) events; (c) pandemic disease outbreaks; (d) mass casualty events; and (e) internal infrastructure failure, as assessed by an online survey. Alternative analysis was conducted to assess the relationship between access to resources and the 5 dependent variables. Using complexity theory as the theoretical framework, point biserial correlation and …
Incidence And Factors Associated With Nonalcoholic Fatty Liver Disease Among Patients With Rheumatoid Arthritis,
2016
Walden University
Incidence And Factors Associated With Nonalcoholic Fatty Liver Disease Among Patients With Rheumatoid Arthritis, Ani K. John
Walden Dissertations and Doctoral Studies
Nonalcoholic fatty liver disease (NAFLD) has become one of the most common hepatic diseases worldwide, making the diagnosis and management of NAFLD an emerging public health issue. Theories associated with NAFLD surmise that inflammation may be the root cause, along with the complex interplay of other chronic conditions such as obesity, metabolic syndrome, diabetes, dyslipidemia, and cardiovascular disease (CVD). It is unknown if other inflammatory conditions such as rheumatoid arthritis (RA), along with the use of methotrexate (MTX), might confer increased risk for NAFLD. Longitudinal data collected from a retrospective cohort of 17,481 adult RA patients in the United States …
Chiropractic Student Infection Control Practices And Methicillin-Resistant Staphylococcus Aureus Skin Infections,
2016
Walden University
Chiropractic Student Infection Control Practices And Methicillin-Resistant Staphylococcus Aureus Skin Infections, Jonathon Todd Egan
Walden Dissertations and Doctoral Studies
Chiropractic training involves many hours of skin contact, and chiropractors have manual contact with millions of patients annually, but chiropractic has only had professional clinical hygiene guidance since 2010. Methicillin-resistant Staphylococcus aureus (MRSA) is the most common cause of cultured skin and soft tissue infection (SSTI) in the United States. Using the epidemiologic triad of person, place, and time as a framework, this quantitative, cross-sectional study obtained the first assessment of MRSA SSTI incidence among chiropractic students and its association with infection control behaviors (hand and table hygiene, sharing gowns, and sharing lotion) and initiation of patient care. The study …
Associations Between Healthcare Facility Types And Healthcare-Associated Infections,
2016
Walden University
Associations Between Healthcare Facility Types And Healthcare-Associated Infections, Aretha D. Miller
Walden Dissertations and Doctoral Studies
Healthcare-Associated Infections (HAIs) continue to be an epidemiological issue burdening patients and public health systems worldwide. The purpose of this study was to determine if specific healthcare facility types (Acute Care Hospitals, Long Term Acute Care Hospitals, and Inpatient Rehabilitation Facilities) were associated with particular categories of HAIs: Ventilator-Associated Pneumonias (VAPs), Central Line-Associated Bloodstream Infections (CLABSIs), and Catheter-Associated Urinary Tract Infections (CAUTIs). The theoretical framework for this study was the environmental determinants of infectious disease framework. A single research question focused on whether an association existed among the specified health care facility types and HAIs. Three independent categorical variables were …
Asthma Determinants, Health Care Utilization, And Control Among Women In Puerto Rico,
2016
Walden University
Asthma Determinants, Health Care Utilization, And Control Among Women In Puerto Rico, Maria Calixta Ortiz-Rivera
Walden Dissertations and Doctoral Studies
Active asthma and asthma-related health care utilization are higher among adult females than they are among adult males in Puerto Rico. The purpose of this study was to examine the determinants of the risk of active asthma and associated health care utilization and asthma control among women in Puerto Rico. Guided by the Andersen behavioral model, the study included data from the Asthma Call-Back Survey (ACBS) during 2011 and 2012 in Puerto Rico. The associations between active asthma and behavioral, demographic, and environmental factors were assessed using logistic regression. The relationship between asthma-related health care utilization and predisposing, enabling, and …
Use Of Maternal Health Services And Pregnancy Outcomes In Nigeria,
2016
Walden University
Use Of Maternal Health Services And Pregnancy Outcomes In Nigeria, Abubakar Sadiq Umar
Walden Dissertations and Doctoral Studies
Maternal health services (MHS) provide primary, secondary, and tertiary levels of prevention to achieve better pregnancy outcomes. However, use of prenatal and natal services among Nigerian women has been ranked among the lowest in the world and, consequently, the country is among the 10 countries with the highest maternal mortality ratio. Moreover, nationwide community-based studies on the use of maternal health services in Nigeria are limited. To address this gap, this quantitative, cross-sectional study analyzed the 2008 Nigerian Demographic and Health Survey (NDHS) data to identify whether Nigerian women's biological, cultural, and socioeconomic characteristics are associated with their use of …
