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Pertussis Resurgence In Europe: Incidence And Epidemiologic Cycles In Immunization Required And Non-Required Countries, Sheryl Ann Duquet Jan 2020

Pertussis Resurgence In Europe: Incidence And Epidemiologic Cycles In Immunization Required And Non-Required Countries, Sheryl Ann Duquet

Walden Dissertations and Doctoral Studies

Although pertussis vaccines have been available for over 7 decades, countries are experiencing a pertussis resurgence. This study sought to establish a relationship between the European pertussis immunization schedule designs (with and without the inclusion of adolescent boosters) and the immunization requirement (recommended or required), which potentially influences immunity waning, and thus the incidence rate and epidemiologic cycles of pertussis. The theoretical foundation for this study was the theory of herd immunity. A quantitative research method was used, supported by a secondary data source. The statistical analysis included the use of linear regression to evaluate the relationship between the requirement ...


Microcystins And Liver Disease Mortality, Insights From An Ecological Study, Rajesh Tirpaul Melaram Jan 2020

Microcystins And Liver Disease Mortality, Insights From An Ecological Study, Rajesh Tirpaul Melaram

Walden Dissertations and Doctoral Studies

Microcystins (MCs) are toxic secondary metabolites produced by freshwater cyanobacteria. Algal bloom subsidence can stimulate MC release, which can impair liver function if orally exposed to in large doses. The purpose of this retrospective, U.S. ecological study was to determine if MC exposure represented an environmental risk factor for liver disease mortality using a socioecological approach. A longitudinal ecological substudy investigated the association between average total MCs in Lake Washington and Lake Manatee and age-adjusted chronic liver disease (CLD)/cirrhosis death rates in Brevard County and Manatee County, Florida (FL). A prediction model of total MCs was deduced by ...


Associations Between Income, Acculturation, Country Of Origin, And Type Ii Diabetes Among African Immigrants To Ontario, Canada, Girma Aman Goshe Jan 2019

Associations Between Income, Acculturation, Country Of Origin, And Type Ii Diabetes Among African Immigrants To Ontario, Canada, Girma Aman Goshe

Walden Dissertations and Doctoral Studies

Diabetes has become a longstanding public health challenge around the world. Over the last 3 decades, the number of people with Type II diabetes (T2DM) has grown to an epidemic level in Canada. Prior research indicated African immigrants residing in Ontario, Canada experienced a 2-4 times higher prevalence of T2DM than Canadian-born individuals. The social determinants of health theoretical framework guided this study assessing the relationship of the risk factors with T2DM. A quantitative, cross-sectional design was employed using the 2007-2014 Canadian Community Health Survey data. The random sample included 1,526 African immigrants residing in Ontario, Canada. Descriptive, bivariate ...


Vitamin D Receptor Gene Polymorphisms Knowledge And Breast Cancer In Texas, Ejike Roland Egwuekwe Jan 2019

Vitamin D Receptor Gene Polymorphisms Knowledge And Breast Cancer In Texas, Ejike Roland Egwuekwe

Walden Dissertations and Doctoral Studies

Breast cancer is a world health problem and is a leading cause of cancer-related death among women in the United States. However, breast cancer risks were reported to be reduced through exposure to Vitamin D through its Receptors identified as the p53 target gene. The purpose of this study was to assess the associations between VDR gene polymorphisms knowledge/awareness and decisions to reduce breast cancer risks and likelihood of mammogram screening among women in Texas. Data from survey were used. Roy adaptation model was the theoretical framework that guided this quasi- experimental, quantitative research. The dependent variables were decisions ...


Predictors Of Nutritional Status Among U.S. Adults, Erum Syed Jan 2019

Predictors Of Nutritional Status Among U.S. Adults, Erum Syed

Walden Dissertations and Doctoral Studies

The purpose of this study was to more fully understand the reasons underlying poor nutritional status among adults in the United States (US) and to provide research findings that can be used to develop programs and policies to help improve nutritional status in the US. The National Health and Nutrition Examination Survey (NHANES) dataset and the correlational quantitative study design were used to explore the associations between food security, household smoking, and demographics and nutritional status. The social ecologic theory, specifically the social ecology of health as it relates to interventions, was used as the study's theoretical framework. The ...


The Role Of Glucose Level On The Performance Of The Framingham Risk Score, Uohna June Thiessen Jan 2019

The Role Of Glucose Level On The Performance Of The Framingham Risk Score, Uohna June Thiessen

Walden Dissertations and Doctoral Studies

Cardiovascular diseases (CVD) are responsible for more deaths than any other disease, continue to threaten the quality of life for many, and is a major burden to the health care system. The Framingham Heart Study (FHS) identified the major CVD risk factors that became essential to effective CVD screening strategies and the Framingham Risk Score (FRS), is used to assess CVD risk. Based on the concepts of the health behavior model and CVD as a cardiometabolic disorder, multivariate logistic regression analysis was used to evaluate the association between fasting blood glucose (FBG) levels and a CHD event, and to determine ...


Nurse Practitioner Attitudes, Perceptions And Knowledge About Antimicrobial Stewardship, Evelyn C. Fabian Jan 2019

Nurse Practitioner Attitudes, Perceptions And Knowledge About Antimicrobial Stewardship, Evelyn C. Fabian

Walden Dissertations and Doctoral Studies

Resistance to antibiotics has increased dramatically in the United States, with serious associated medical, social, and economic consequences. The purpose of this project was to assess nurse practitioners' attitudes, perceptions, and knowledge about antimicrobial stewardship and knowledge in the management of anaerobic infections as well as resistant gram-negative bacteremia. Data were collected using a web-based survey in a hospital facility. The practice question explored whether nurse practitioners' attitudes, perceptions, and knowledge about antimicrobial stewardship significantly increased after an education program on antimicrobial stewardship. The project was framed by Knowles's adult learning theory. A 16-item survey was administered before and ...


Evidence-Based Practice Self-Study Education Program For Staff Nurses On Genomics, Nancy L. Norman-Marzella Jan 2019

Evidence-Based Practice Self-Study Education Program For Staff Nurses On Genomics, Nancy L. Norman-Marzella

Walden Dissertations and Doctoral Studies

Nurses routinely obtain genomic data when collecting family health histories. However, they report low confidence in their knowledge and understanding of genomics and the genetically engineered medications prescribed for their patients. The purpose of this project was the development and implementation of an evidence-based online education program about genetics and genomics to increase the nurses' understanding and ability to provide competent care for their patients receiving treatments based on the science of genomics. Knowles's principles of adult learning theory guided the development and delivery of the online education project to 12 medical-surgical registered nurses employed in a hospital in ...


Immunoglobulin Therapy And Primary Immunodeficient Patients' Health-Related Quality Of Life And Well-Being, Niedre Heckman Jan 2018

Immunoglobulin Therapy And Primary Immunodeficient Patients' Health-Related Quality Of Life And Well-Being, Niedre Heckman

Walden Dissertations and Doctoral Studies

Individuals born with primary immune deficiency diseases (PIDD) have a dysfunctional immune system, and many are treated by lifelong injections of immunoglobulin therapy. Studies have shown that these patients have low health-related quality of life (HRQOL) and well-being (WB) and that these outcomes might be improved by the availability of therapy innovated according to preferences for fewer needle sticks or a shorter infusion time. Regulators at the U.S. Food and Drug Administration (FDA) have approved therapies innovated per these preferences. However, there is limited data demonstrating how these innovations impact HRQOL and WB. Using the biopsychosocial model, the purpose ...


Single Men's Experiences Of Coping With Financial Stress, Heath Downes Jan 2018

Single Men's Experiences Of Coping With Financial Stress, Heath Downes

Walden Dissertations and Doctoral Studies

Experiencing financial hardship is stressful and can lead to the development of psychological symptoms, including depression and anxiety. Although researchers have examined the broad categories of coping strategies that people employ when faced with financial hardship, little is known about the experiences of single men who were able to navigate stressful times without developing anxiety or anxiety-like symptoms. The purpose of this phenomenological study was to explore the successful coping experiences of single men with financial hardship (e.g., loss of job, home, finances). Bonanno's theory of resilience provided the framework for the study. Data were collected from interviews ...


Individual Understanding Of The Risks Associated With Polypharmacy, Michelle Patricia Mchenry Jan 2018

Individual Understanding Of The Risks Associated With Polypharmacy, Michelle Patricia Mchenry

Walden Dissertations and Doctoral Studies

With many individuals experiencing multimorbidity, individuals are being prescribed more medications. Although there are benefits to taking medications to manage symptoms and treat disease processes, there are also risks to taking multiple medications. The purpose of this phenomenological study was to explore participants' understanding of the risks associated with practicing polypharmacy. Game theory, credibility theory, and belief bias were the conceptual frameworks used to explain how individuals experienced their care and being prescribed 5 or more medications. Eight participants residing in subsidized housing in a small Midwest city, who were taking 5 or more medications volunteered to take part in ...


Teaching Heart Failure Patients A Low-Sodium Diet, Karen Faye Wright Jan 2018

Teaching Heart Failure Patients A Low-Sodium Diet, Karen Faye Wright

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a progressive medical condition affecting more than 7 million people in the United States (US) with 700,000 new cases reported annually. More than half of those treated for CHF are readmitted at least once a year. The problem addressed by this quality improvement initiative was lack of adherence to low sodium diet (LSD) among CHF patients, knowledge and skill deficit, and excessive 30-day CHF readmissions. The health belief model and the self-care deficit theory guide nurses in acquiring the skills needed to teach LSD. Twelve months of data were selected from 93 CHF readmissions ...


Education Models For Teaching Adults About Modifying Dietary Carbohydrate And Controlling Weight, Vincient Cleamons Jan 2018

Education Models For Teaching Adults About Modifying Dietary Carbohydrate And Controlling Weight, Vincient Cleamons

Walden Dissertations and Doctoral Studies

The prevalence of diabetes and other pathophysiological conditions has been correlated with the incidence of obesity. A large portion of an adult community in the northwestern United States suffers from excessive weight that has been linked to premature mortality rates and certain forms of diabetes. Excess calories from carbohydrate have been shown to increase weight. Therefore, diets that are modified in carbohydrate and calories may help mitigate weight and obesity comorbidities. This qualitative, single case study's purpose was to explore the methods health care professionals use for teaching adults about controlling weight. Altheide and Johnson's analytic realism theory ...


Understanding Feeding Style And Young Children's Consumption Of Food, Mary W. Bean Jan 2018

Understanding Feeding Style And Young Children's Consumption Of Food, Mary W. Bean

Walden Dissertations and Doctoral Studies

Due to increased rates of childhood obesity since 2010, researchers have examined family environmental factors and family influences on children's consumption of healthy foods. While previous research has examined how factors such as food presentation and the food intake of other family members can predict a child's body mass index, there has been little research examining whether parent factors predict the amount of healthy foods children eat. This quantitative survey study examined whether certain parent factors, specifically parents' attitudes about food, parents' feeding styles, and parents' attachment styles, predicted the amount of fruits and vegetables children ate. Understanding ...


Waterborne Disease Reduction Using Evidence-Based Microbiology Verification In Lower Nyakach, Kenya, Richard R. Blodgett Jan 2018

Waterborne Disease Reduction Using Evidence-Based Microbiology Verification In Lower Nyakach, Kenya, Richard R. Blodgett

Walden Dissertations and Doctoral Studies

Waterborne diseases continue to plague the poorest people in low-income countries and are estimated to cause 4,600,000 acute incidents of diarrhea resulting in over 2,000 deaths daily. A major challenge is performing microbiology tests to monitor drinking water quality. Friends of the Old (FOTO) implemented a novel strategy using evidence-based microbiology to educate communities about the relationship between contaminated water and disease. Two commercially available tests for E.coli, adapted for fieldwork, provided easily interpreted results of contamination that correlate with WHO's disease risk categories. Simple and effective household water treatment options 'solar pasteurization and/or ...


Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner Jan 2018

Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner

Walden Dissertations and Doctoral Studies

Insulin resistance is an increasing public health issue with the current literature, suggesting reduced sensitivity of insulin leads to adult onset diabetes and associated downstream pathologies that reduce life expectancy. The main objectives of this study were to evaluate the ability of the Oral Glucose Insulin Secretion Test (OGIST) to identify insulin resistance and examine differences in the insulin sensitivity based on gender, age, and ethnicity. This study was supported by the insulin resistance theory which focuses on the reduced ability of insulin to bind to the cellular insulin receptor, reducing the sensitivity of insulin. The OGIST lab results of ...


Association Of Dietary Intake With Suicidal Ideation Or Suicide Attempts In Adolescents, Zenobia J. Bryant Jan 2018

Association Of Dietary Intake With Suicidal Ideation Or Suicide Attempts In Adolescents, Zenobia J. Bryant

Walden Dissertations and Doctoral Studies

Suicide is among the leading cause of adolescent deaths worldwide and thus a significant public health concern. Risk factors for suicidal behavior include drinking alcohol, smoking, and engaging in risky sexual behaviors. One area of concern is dietary patterns and their association with depressive symptoms and suicidal ideation. Bandura's social cognitive theory emphasizes the assumption that one can perform specific actions to bring about desired outcomes. The primary research questions for this quantitative, retrospective, cross-sectional study concerned whether there is a statistically significant interaction between fruit and vegetable intake and suicidal ideation or suicide attempts. Data from 71,776 ...


Meeting The Nutritional Needs Of Very Low Income Diabetic Patients, Mary Hossley Jan 2018

Meeting The Nutritional Needs Of Very Low Income Diabetic Patients, Mary Hossley

Walden Dissertations and Doctoral Studies

Adult Type II diabetes is an increasing public health problem, particularly among very low-income minority populations. The purpose of this study was to create a nutritional guide for a diabetic specific meal plan with an accompanying food pantry nutrition packet for very low-income Type II diabetic patients at a rural Mississippi Free Clinic. The practice-focused question is: Will a nurse-prepared nutritional guide with supplemental food packets improve the glucose control in low income diabetic patients? The gap in practice is that there has been no structured nutrition education guide and no food pantry support plan for Type II adult diabetics ...


Using Parent-Identified Strengths Of Autistic Children To Advance Strength-Based Intervention, Angelique Francesca Trigueros Jan 2018

Using Parent-Identified Strengths Of Autistic Children To Advance Strength-Based Intervention, Angelique Francesca Trigueros

Walden Dissertations and Doctoral Studies

Questions remain about the range of abilities autistic children possess and what constitutes effective treatment. Strength-based intervention contrasts with traditional autistic intervention approaches that focus on children's deficits. Studies on strength-based intervention approaches have not revealed how children's strengths are identified and have not used the insights of parents for this purpose. Neurodiversity serves as the conceptual framework because the tenets of neurodiversity align with those of strength-based approaches and hold that autism is a variation of the human condition rather than a disability. The purpose of this qualitative interpretive phenomenological study was to explore how the parent-identified ...


The Impact Of Lemongrass, Oregano, And Thyme Essential Oils On Candida Albicans' Virulence Factors, Jennifer Marie Eddins Jan 2018

The Impact Of Lemongrass, Oregano, And Thyme Essential Oils On Candida Albicans' Virulence Factors, Jennifer Marie Eddins

Walden Dissertations and Doctoral Studies

Increased systemic infections and growing resistance of Candida species in immunosuppressed people have prompted research for additional treatment options. The purpose of this quantitative study was to investigate the potential of lemongrass, oregano, and thyme essential oils tested individually, combined, and combined with the antifungal agents fluconazole and caspofungin to kill Candida albicans isolates in a controlled laboratory setting. This study was grounded on the theoretical concepts of the epidemiologic triangle model. The experimental data collected were used to investigate risk factors related to age, gender, race, and comorbidities. Kill rates of lemongrass, oregano, and thyme essential oils individually and ...


Clostridium Difficile Infection (Cdi): Use Of Preventive Bundle To Decrease Cdi Incidences, Lisa Feliciano Jan 2018

Clostridium Difficile Infection (Cdi): Use Of Preventive Bundle To Decrease Cdi Incidences, Lisa Feliciano

Walden Dissertations and Doctoral Studies

The challenge of combating Clostridium difficile infections (CDI) is a major problem within many health care organizations as CDI adds to the cost of care and is an uncomfortable and sometimes fatal complication of hospitalization for the patient. The practice-focused question for this doctoral project was targeted at patients in hospital settings on a medical surgical floor and asked if clostridium difficile preventive bundles reduce the incidence of CDI compared with nonstandardized preventative methods. Using the plan-do-study-act framework, the purpose of this DNP project was to use a clostridium difficile bundle approach to study the effects of clostridium difficile incidence ...


A Phenomenological Investigation Of Adult Daughters Of Childhood Paternal Abandonment, Mary Spencer Jan 2018

A Phenomenological Investigation Of Adult Daughters Of Childhood Paternal Abandonment, Mary Spencer

Walden Dissertations and Doctoral Studies

A father's abandonment of his minor daughter can leave an indelible impression on her psyche -- one that can forever affect her intimate romantic relationships. The purpose of this qualitative phenomenological study was to explore where women who were abandoned by their fathers prior to the age of 18 are today as adults in terms of their intimate romantic relationships and how they develop and engage in these relationships. The research questions examined how a daughter being abandoned by her father prior to the age of 18 relates to where she is today in her adult intimate romantic relationships and ...


Implementing A Healthy Diet In The Intellectual Disability Residential Community, Stephanie Michelle Shelton Jan 2018

Implementing A Healthy Diet In The Intellectual Disability Residential Community, Stephanie Michelle Shelton

Walden Dissertations and Doctoral Studies

The problem addressed in this study was how staff working in a residential agency for individuals with an intellectual disability (IID) make decisions about how to implement a healthy diet. The purpose of this study was to identify the influences on decisions made by staff on the meals they provided to their clients with an IID. The theory of planned was used to study the influences of attitude, subjective norms, and perceived behavior control on the meals provided for IID. The key research question explored how staff members make decisions. A qualitative case study design was used. The 12 participants ...


Roles Of Community Pharmacists In Improving Oral Health Awareness In Plateau State, Northern Nigeria, Olaniyi O. Taiwo Jan 2017

Roles Of Community Pharmacists In Improving Oral Health Awareness In Plateau State, Northern Nigeria, Olaniyi O. Taiwo

Walden Dissertations and Doctoral Studies

There is poor oral health awareness in Nigeria. This is mainly attributed to limited access to correct information on oral health as well as a lack of oral health care providers. The impact of the poor oral health awareness is worse in Northern Nigeria due to the uneven distribution of oral health care workers and training facilities. The purpose of this cross-sectional study was to describe the roles of community pharmacists (CPs) in Plateau State, Nigeria as sources of oral health information. Theoretical framework for this study was the theory of planned behavior (TPB). Background knowledge and practices of oral ...


Assessing For Awareness And Knowledge Regarding Diabetes In Pre-Diabetes Obese Patients, Remona Lysa Brown Jan 2017

Assessing For Awareness And Knowledge Regarding Diabetes In Pre-Diabetes Obese Patients, Remona Lysa Brown

Walden Dissertations and Doctoral Studies

Over the past few decades, there has been an increase in prevalence of diabetes in the United States. Prevention of diabetes and improving patients' knowledge and awareness of diabetes are crucial for healthcare providers. Using the Health Belief Model (HBM) as a theoretical foundation, the student used the National Diabetes Prevention Program (NDPP) from the Centers for Disease Control and Prevention (CDC), to improve awareness and knowledge of diabetes among obese individuals with prediabetes. The key research question of this project was to determine whether the patients' diabetes knowledge and awareness improved after the NDPP program. A convenience sample of ...


Culturally Competent Nutrition Counseling And Health Outcomes Of Patients On Emergency Dialysis, Edlyn Geraldine Bustamante Jan 2017

Culturally Competent Nutrition Counseling And Health Outcomes Of Patients On Emergency Dialysis, Edlyn Geraldine Bustamante

Walden Dissertations and Doctoral Studies

Undocumented end stage renal disease (ESRD) patients in the United States only have access to emergency dialysis. To compensate for the lack of regular dialysis these patients must follow strict renal dietary restrictions. However, nutrition counseling by a dietitian is not part of the renal management of patients on emergency dialysis. The purpose of this quantitative quasi-experimental treatment-control study was to assess how the application of nutritional counseling that is both culturally and linguistically competent affects dialysis frequency and biochemical lab values such as serum potassium, phosphorus, and vitamin D of patients in emergency dialysis. The study was grounded on ...


Breast Cancer, Mana'olana/Hope, And The Experience Of Native Hawaiian Women, Karla Marie Calumet Jan 2017

Breast Cancer, Mana'olana/Hope, And The Experience Of Native Hawaiian Women, Karla Marie Calumet

Walden Dissertations and Doctoral Studies

Breast cancer is one of the leading causes of morbidity and mortality among women. A diagnosis of cancer is a stressful event that requires an individual to adapt to new stressors. The purpose of this qualitative study was to better understand the perceptions of mana'olana/hope and living with breast cancer among Native Hawaiian women. The conceptual framework of this phenomenological study was positive psychology. Data collection included in-depth interviews with 5 Native Hawaiian women who had been diagnosed with breast cancer. Data coding and analysis resulted in identification of 8 themes.

The themes included: (a) mana'olana /hope ...


Paths To Tier 1 Genomics Implementation: A Survey Of Chronic Disease Directors, Amy Ponte Jan 2017

Paths To Tier 1 Genomics Implementation: A Survey Of Chronic Disease Directors, Amy Ponte

Walden Dissertations and Doctoral Studies

Although evidence is currently available for population-based genetic screening and testing of individuals and their family members for certain hereditary chronic disease conditions (Tier 1), few states have integrated these genomic applications into chronic disease prevention programs. State and territorial chronic disease directors (CDDs) could provide the leadership needed to deliver these applications in more states. The purpose of this study was to determine whether an association exists between current chronic disease genomics funding or specific state genomic activities and the level of knowledge and interests in genomics by these directors. Rogers's diffusion of innovations (DIT) theory was used ...


Development Of An Educational Program To Obtain And Maintain Healthy Weights Among 4th And 5th Grade Students, Stephanie Dean Black Jan 2017

Development Of An Educational Program To Obtain And Maintain Healthy Weights Among 4th And 5th Grade Students, Stephanie Dean Black

Walden Dissertations and Doctoral Studies

Development of an Educational Program to Obtain and Maintain Healthy Weights Among 4th and 5th Grade Students

By

Stephanie D. Black

MSN, University of Phoenix, 2008

BSN, Southwest Baptist University, 2006

ASN, Southwest Baptist University, 2003

Capstone Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

October 2017

Obesity is prevalent in schoolchildren and increases risk of chronic diseases throughout the lifespan. Strategies are needed to address this growing health problem. Education in elementary schools targeting the topics of nutritional choices and prevention of obesity, particularly in 4th-5th grade population, is ...


Using Multi-Theory Model To Predict Low Salt Intake - Nigerian Adults With Hypertension, Christine Adekemi Dokun-Mowete Jan 2017

Using Multi-Theory Model To Predict Low Salt Intake - Nigerian Adults With Hypertension, Christine Adekemi Dokun-Mowete

Walden Dissertations and Doctoral Studies

Hypertension is a chronic non-communicable disease and a major risk factor for cardiovascular diseases, renal malfunction, disability, and premature death. One of the public health recommendations for the management of hypertension is the reduction of sodium/salt intake. There is need to develop and implement new evidence-based theoretical interventions to initiate and sustain behavior change in health education and promotion. Therefore, the quantitative cross-sectional method and design was used to investigate the adequacy of multi-theory model (MTM) constructs for the initiation and the sustenance of low sodium/salt intake behavior in hypertensive Nigerian adults. In addition, the impact of the ...