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Theses/Dissertations

Walden Dissertations and Doctoral Studies

2016

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Full-Text Articles in Life Sciences

Incidence And Factors Associated With Nonalcoholic Fatty Liver Disease Among Patients With Rheumatoid Arthritis, Ani K. John Jan 2016

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 ...


The Association Of Cancer Development In Patients With Systemic Lupus Erythematosus, Rose Michelle Coley Jan 2016

The Association Of Cancer Development In Patients With Systemic Lupus Erythematosus, Rose Michelle Coley

Walden Dissertations and Doctoral Studies

The Association of Cancer Development in Patients with Systemic Lupus Erythematosus by

Rose Michelle Coley

MPH, Walden University, 2011

BS, University of Mount Olive, 2008

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Public Health

Walden University

March 2016

Both cancer and autoimmune diseases have been associated with numerous factors that may independently lead to the development of either disease. When these factors overlap the difficulty in assessing association is compounded. The numerous factors that are thought to cause systemic lupus erythematosus (SLE), which leads to the development of cancer, makes the study ...


The Relationship Between Nutrient Intake And Social Emotional Functioning In Preschool Children, Tracy L. Daniel Jan 2016

The Relationship Between Nutrient Intake And Social Emotional Functioning In Preschool Children, Tracy L. Daniel

Walden Dissertations and Doctoral Studies

Mental health disorders are rising in children and being referred to as an epidemic. Numerous studies have shown micronutrient deficiencies and poor diet quality are suspected of playing a contributory role in the escalation of certain disorders. However, there is no research in young children focusing specifically on social emotional disorders and possible links to nutrition. Conventional treatment for social emotional disorders in children typically involves medication. Parents are increasingly turning to complementary and alternative medicine to treat their children with a method that is individualized and holistic. The biopsychosocial model provided the theoretical framework for this correlational study that ...


Academic Success For The 21st Century Learner: Intrapersonal Intelligence And Resilience, Juanita Lynn Parker Jan 2016

Academic Success For The 21st Century Learner: Intrapersonal Intelligence And Resilience, Juanita Lynn Parker

Walden Dissertations and Doctoral Studies

Internal and personal strengths are associated with positive academic outcomes in the higher educational setting and are particularly relevant to the 21st century learner in the modern complex and global society. There is limited research addressing the connection between intrapersonal intelligence, resilience, and academic success. This information is important to better assist students in developing qualities that foster academic success and sustainability. The purpose of this study was to investigate the correlations between intrapersonal intelligence, as measured by the Multiple Intelligences Development Assessment Scales (MIDAS); resilience, as measured by the Connor-Davidson Resilience Scale (CD-RISC); and academic success, as measured by ...


Influence Of Overweight, Obesity, Social Support, And Self-Efficacy On Breastfeeding Outcomes Among African-American Women, Elizabeth Hoo Jan 2016

Influence Of Overweight, Obesity, Social Support, And Self-Efficacy On Breastfeeding Outcomes Among African-American Women, Elizabeth Hoo

Walden Dissertations and Doctoral Studies

Breastfeeding reduces morbidity and mortality among mothers and children, yet African-American women breastfeed at lower rates than women of other racial and ethnic groups do. Higher rates of overweight, obesity, and low socioeconomic status may be contributing factors in this population; however, limited research exists regarding the roles of maternal overweight and obesity on breastfeeding outcomes. The purpose of this study was to examine whether social support and self-efficacy positively influence breastfeeding outcomes among overweight and obese African American women. Self-efficacy and social support theories provided the theoretical framework for the study. Research questions examined whether (a) maternal overweight and ...


Time To Diagnosis Of Second Primary Cancers Among Patients With Breast Cancer, Edward Okezie Irobi Jan 2016

Time To Diagnosis Of Second Primary Cancers Among Patients With Breast Cancer, Edward Okezie Irobi

Walden Dissertations and Doctoral Studies

Many breast cancer diagnoses and second cancers are associated with BRCA gene mutations. Early detection of cancer is necessary to improve health outcomes, particularly with second cancers. Little is known about the influence of risk factors on time to diagnosis of second primary cancers after diagnosis with BRCA-related breast cancer. The purpose of this cohort study was to examine the risk of diagnosis of second primary cancers among women diagnosed with breast cancer after adjusting for BRCA status, age, and ethnicity. The study was guided by the empirical evidence supporting the mechanism of action in the mutation of BRCA leading ...


Methylmercury Exposure Via Canned Tuna Fish Consumption And Breast Cancer, Jennifer Bodenrader Jan 2016

Methylmercury Exposure Via Canned Tuna Fish Consumption And Breast Cancer, Jennifer Bodenrader

Walden Dissertations and Doctoral Studies

Widespread consumption of canned tuna fish since the 1950s may explain some of the increase in breast cancer prevalence in the United States and Europe. Although canned tuna is the primary source of human exposure to methylmercury, its role as an estrogen activating metalloestrogen has been overlooked in the etiology and incidence of breast cancer. Carcinogenic theory asserts that increased exposure to estrogen elevates the risk of breast cancer. The purpose of this population-based, case control study was to examine the association between canned tuna consumption, total blood mercury, and breast cancer in the NHANES 2003-2006 surveys. A multivariable logistic ...


Acculturation, Inflammation, And Depression Among Hispanic Adults In The United States, Kristin Marie Marano Jan 2016

Acculturation, Inflammation, And Depression Among Hispanic Adults In The United States, Kristin Marie Marano

Walden Dissertations and Doctoral Studies

Disparities exist in the recognition and treatment of depression among Hispanics in the United States, creating a social, ethical, economic, and public health burden. This study was designed to generate an improved understanding of the causes of and/or contributors to depression within this population. It was specifically designed to 1) assess the prevalence and severity of depression among Hispanic adults in the United States relative to adults of other race/ethnicities in the United States; 2) clarify the inconsistent results in the literature concerning the relationship between acculturation and depression among Hispanic adults in the United States; and 3 ...


Sustainability Strategies For Value-Added Agricultural Producers In California's San Joaquin Valley, Sharon L. Starcher Jan 2016

Sustainability Strategies For Value-Added Agricultural Producers In California's San Joaquin Valley, Sharon L. Starcher

Walden Dissertations and Doctoral Studies

Economic and climate changes, combined with changing government regulations, are altering the strategic business model for small farm operators and necessitating their reliance on multiple income sources to maintain financial viability. The purpose of this multiple case study was to explore the strategies of 3 small farming businesses in California's San Joaquin Valley that successfully implemented value-added products which contributed to their financial sustainability. Data from semistructured interviews and relevant documents were analyzed through the lens of system theory, utilizing in vivo coding to identify patterns and themes. Three high-level themes emerged: knowledge, marketing, and networking. The theme of ...


Transcriptome Analysis Of Vaccine Responses To Francisella Tularensis Or Venezuelan Equine Encephalitis Virus, Rebecca Ann Erwin-Cohen Jan 2016

Transcriptome Analysis Of Vaccine Responses To Francisella Tularensis Or Venezuelan Equine Encephalitis Virus, Rebecca Ann Erwin-Cohen

Walden Dissertations and Doctoral Studies

The lack of vaccines for emerging and re-emerging diseases highlights technical gaps and indicates a need for innovative approaches to produce new vaccines. Vaccines may be improved by knowledge of host responses to vaccination, disease pathogenesis, and the effect of age and genetics on vaccine outcome. This study's purpose was to quantitatively assess the molecular epidemiology of Francisella tularensis (Ft) and Venezuelan Equine Encephalitis Virus (VEEV). Study results support the Epidemiology Nexus model which holds that association of changes in gene expression to vaccination facilitate understanding the mechanisms of immune development and link public health and disease epidemiology. My ...


Diabetes Mellitus Type 2: A Quality Improvement And Patient Safety Initiative, Remeliza Navarrete Tukay Jan 2016

Diabetes Mellitus Type 2: A Quality Improvement And Patient Safety Initiative, Remeliza Navarrete Tukay

Walden Dissertations and Doctoral Studies

The purpose of the quality improvement (QI) project was to examine the relationship between amended nursing education concerning diabetes mellitus (DM) Type 2 self-care management incorporating Tune in, Explore, Assist, Communicate, and Honor (TEACH) and Motivational Interviewing (MI) strategies and techniques and the Glycosylated hemoglobin (HgbA1C) of veteran patients with uncontrolled diabetes. The target sample included the 2 licensed practical nurses and 2 registered nurses assigned to 2 primary care teams, and the 10 purposively sampled patients with uncontrolled DM Type 2 from each team. The nurses' competencies were measured through descriptive comparison before and after nursing education implementation using ...


Risk Factors Associated With Severe Acute Respiratory Infections Cases, Ryan Gatdula Ortiguerra Jan 2016

Risk Factors Associated With Severe Acute Respiratory Infections Cases, Ryan Gatdula Ortiguerra

Walden Dissertations and Doctoral Studies

The close proximity of the United States to the Mexican border poses a concern for communicable diseases because of the high flow of population movement. The purpose of this retrospective, quantitative study was to identify risks associated with respiratory diseases using an analysis of archived data from the Severe Acute Respiratory Illness (SARI) surveillance program. Based on the epidemiologic triangle theory, demographic and etiologic factors were analyzed to examine any associations with SARI in this population. Between 2010 and 2012, 798 subjects enrolled in this program, with 336 (42.1%) testing positive for respiratory pathogens. Chi square analysis determined that ...


Adventist Affiliation And Type 2 Diabetes Pre- And Post-Complete Health Improvement Program (Chip), Janie Unruh Jan 2016

Adventist Affiliation And Type 2 Diabetes Pre- And Post-Complete Health Improvement Program (Chip), Janie Unruh

Walden Dissertations and Doctoral Studies

Adventists following a plant-based diet have half the prevalence and incidence of type 2 diabetes than nonvegetarian Adventists. This study used a quantitative, correlational study design to assess if there was a significant difference in type 2 diabetes prevalence rate between Adventists and non-Adventists preprogram, and if there were significant differences in biometrics between Adventists and non-Adventists with diabetes pre- and post-Complete Health Improvement Program (CHIP). This study incorporated the social ecological model for its conceptual framework and examined pre- and postprogram changes among Adventists (n=210; 20.1%) and non-Adventists (n=836; 79.9%) with type 2 diabetes. It ...


Promoting Diabetes Self-Managment Eduaction And Training In Out-Patient Clinics, Inemesit Godwin Udo Jan 2016

Promoting Diabetes Self-Managment Eduaction And Training In Out-Patient Clinics, Inemesit Godwin Udo

Walden Dissertations and Doctoral Studies

Abstract

Type 2 diabetes mellitus (T2DM) is a long term metabolic disorder characterized by high blood sugar, insulin resistance, and relative lack of insulin. T2DM is a leading cause of cardiovascular disease, blindness, kidney failure, lower-limb amputation, and other complications that are costly to patients and the U.S. health care system. Lack of knowledge and underdeveloped skills for self-management of diabetes continues to be the biggest problem for patients with T2DM. Using a team approach and Rosswurm and Larrabee's (1999) conceptual model as a framework, the purpose of this doctorate of nursing practice quality improvement project was to ...


Exploring Factors Influencing Information Technology Portfolio Selection Process In Government-Funded Bioinformatics Projects, Braulio J. Cabral Jan 2016

Exploring Factors Influencing Information Technology Portfolio Selection Process In Government-Funded Bioinformatics Projects, Braulio J. Cabral

Walden Dissertations and Doctoral Studies

In 2012, the National Cancer Institute's (NCI) Board of Scientific Advisors (BSA) conducted a review of the Center for Biomedical Informatics and Information Technology's (CBIIT) bioinformatics program. The BSA suggested that the lack of a formal project selection process made it difficult to determine the alignment of projects with the mission of the organization. The problem addressed by this study was that CBIIT did not have an in-depth understanding of the project selection process and the factors influencing the process. The purpose of this study was to understand the project selection process at CBIIT. The research methodology was ...


Influences Of Nutritional Food Label Understanding In African-American Women With Obesity, Cynthia Jean Hickman Jan 2016

Influences Of Nutritional Food Label Understanding In African-American Women With Obesity, Cynthia Jean Hickman

Walden Dissertations and Doctoral Studies

Nutritional food label understanding (NFLU) in African American Women (AAW) is a philosophy that addresses obesity. Public health efforts have implemented nutritional and caloric information to packaged and restaurant foods to improve nutrient and calorie literacy. Research suggest NFLU might have a minimal effect on reducing obesity. However, it is not known how obese AAW born during the baby-boom era (51 to 64 years of age) perceive NFLU in relation to their dietary behaviors. The purpose of this phenomenological study was to understand the lived experience of obese AAW regarding NFLU from a cognitive and behavioral perspective. Twelve, AAW answered ...


Public Health Leaders' Perceptions Of And Attitudes Concerning Eating Disorders, Karin L. Lightfoot Jan 2016

Public Health Leaders' Perceptions Of And Attitudes Concerning Eating Disorders, Karin L. Lightfoot

Walden Dissertations and Doctoral Studies

Eating disorders are associated with high mortality rates. Most eating disorder prevention research is conducted within the fields of psychology and psychiatry, not in public health. This gap in public health research can lead to insufficient attention to the root causes of eating disorders and minimal upstream prevention efforts. The purpose of this phenomenological study was to identify public health leaders' perceptions of and attitudes concerning eating disorders as a public health issue. Objectification theory was used to describe how societal expectations have created an environment in which people's self-worth is based on their outward physical appearance. Ecological theory ...


Providing Optimal Nutrition In Critical Care, Jo Anne Foley Jan 2016

Providing Optimal Nutrition In Critical Care, Jo Anne Foley

Walden Dissertations and Doctoral Studies

Malnutrition among hospitalized patients is prevalent and associated with adverse outcomes. At the health care facility for which this quality improvement (QI) initiative was developed, patients were not consistently fed within the nationally recommended 48 hours. The purpose of this project was to facilitate the early initiation of enteral feedings to prevent malnutrition in a vulnerable patient group by development of an evidence-based enteral feeding policy, algorithm, and nursing education module. The find, organize, clarify, understand, select, plan, do, check, and act model provided a systematic approach for development of the project. Validation of the QI initiative was through the ...


Short Term Memory Of Magnetic Resonance Imaging Technologists, Samuel Maldonado Jan 2016

Short Term Memory Of Magnetic Resonance Imaging Technologists, Samuel Maldonado

Walden Dissertations and Doctoral Studies

This study examined the short term memory (STM) difference of magnetic resonance imaging (MRI) technologists versus non-MRI technologists. Human and animal studies have indicated that residual magnetic fields have caused changes within the cerebral structure. Research on residual magnetic fields and their effect on STM is still at its infancy. A quasi-experimental design was used to determine if any significant difference existed between the STM of MRI technologists (n = x) and a control population sample (n = x). The STM of both groups was assessed with the use of the Rivermead Behavioural Memory Test-Third Edition. Solicitation of the participants was from ...


Evaluating The Impact Of Policies On Production Efficiency Of Nigeria's Rice Economy, Samuel Chukwueyem Rapu Jan 2016

Evaluating The Impact Of Policies On Production Efficiency Of Nigeria's Rice Economy, Samuel Chukwueyem Rapu

Walden Dissertations and Doctoral Studies

Nigeria, like all other rice consuming nations, has experienced a surge in domestic demand for rice since 1970. However, local rice production has not been sufficient to meet local demand, leading to this demand continually being filled by imports. The Federal Government of Nigeria has initiated subsidies programs intended to improve Nigerian rice farmers' technical and cost efficiency levels. This quantitative study evaluated the impact of these policies on the technical and cost efficiency levels of paddy rice farm households in Nigeria. Farrell's (1957) efficiency theory and production theory served as the theoretical frameworks. Data were collected from a ...


Exploring Millennial Retention Strategies And Methods In The Workplace, Alphonso Simmons Jan 2016

Exploring Millennial Retention Strategies And Methods In The Workplace, Alphonso Simmons

Walden Dissertations and Doctoral Studies

Many U.S. organizations fail to retain Millennials for longer than 3 years. The purpose of this case study was to explore the strategies and methods leaders have used to retain Millennial employees within a small business in the Washington, DC, metropolitan area. The leaders of this small business have retained their Millennial employees for the last 3 years. The conceptual frameworks for the study were Bass's transformational leadership theory and von Bertalanffy's general systems theory. Data were collected from semistructured interviews with 4 participant leaders with a successful record of retaining Millennials. In addition, company documents including ...


Emotional Intelligence, Job Satisfaction, And Burnout For Dietitians, Cara Perdue Jan 2016

Emotional Intelligence, Job Satisfaction, And Burnout For Dietitians, Cara Perdue

Walden Dissertations and Doctoral Studies

There are low retention rates of dietitians and this impacts quality of care. Emotional intelligence (EI) may be the missing component to improve retention, due to EI increasing job satisfaction and decreasing burnout for other health providers. The purpose of this study was to examine the relationship between EI, job satisfaction, and burnout for dietitians. The theoretical framework utilized was the 4-branch model of EI. Method of inquiry was convenience, quantitative non-experimental design. Registered dietitians (N = 84,173) living in the United States were contacted via e-mail. Approximately 9.5% of dietitians (n = 8,038) completed the Wong and Law ...


A Plan For The Implementation And Evaluation Of Diet Education In Type 2 Diabetes, Soy Ramsumeer Jan 2016

A Plan For The Implementation And Evaluation Of Diet Education In Type 2 Diabetes, Soy Ramsumeer

Walden Dissertations and Doctoral Studies

Abstract

Type 2 Diabetes Mellitus (T2DM) is the seventh leading cause of death in the United States with a projected increase of 552 million people worldwide who will be affected with this illness by 2030. The need to address this issue is vital to prevent complications and reduce healthcare spending. The DNP project is aimed at planning and designing a nutritional education program tailored toward specific ethnic groups in order to increase knowledge in making healthy food choices. This project is intended to educate Registered Nurses (RNs) on nutrition so that they can offer dietary knowledge to T2DM patients. Additional ...


Medical Community Distrust And The Influenza Vaccination Rates Of Black Americans, Kenyatte Irby Winston Jan 2016

Medical Community Distrust And The Influenza Vaccination Rates Of Black Americans, Kenyatte Irby Winston

Walden Dissertations and Doctoral Studies

Black Americans experience influenza vaccination rates that are lower than the rates of other ethnic groups. Low influenza vaccination rates among the Black community are associated with higher influenza infection rates, influenza-related hospitalizations, and higher influenza mortality rates. There is a belief within the Black American community that the medical establishment does not have the Black American patient in its best interest, leading to feelings of distrust. The purpose of this study was to determine if the distrust of the medical community is a relevant factor in the low influenza vaccination rates of Black Americans aged 18 and older in ...


Oral Nutritional Supplement Use In Relation To Length Of Stay In Heart Failure Patients At A Regional Medical Center, Ellen Burkhardt Babb Jan 2016

Oral Nutritional Supplement Use In Relation To Length Of Stay In Heart Failure Patients At A Regional Medical Center, Ellen Burkhardt Babb

Walden Dissertations and Doctoral Studies

Improving the nutritional status of hospitalized patients has been shown to reduce length of stay (LOS), hospital costs, readmission rates, complication rates, and mortality. Provision of nutrient-rich, liquid, oral nutrition supplements (ONS) is one approach to improving nutritional status. ONS use has been associated with improved outcomes among patients with diagnoses of orthopedic injuries and pressure ulcers, mainly using prospective designs among elderly and/or malnourished patients. Less information is available for other diagnoses, and no analysis of the effects of ONS could be found that considered the epidemiological triad of person, place, and time. This study used a quantitative ...


Evaluation Of Active And Passive Neonatal Tetanus Surveillance Systems In Katsina State, Nigeria, Shafique Sani Nass Jan 2016

Evaluation Of Active And Passive Neonatal Tetanus Surveillance Systems In Katsina State, Nigeria, Shafique Sani Nass

Walden Dissertations and Doctoral Studies

The incidence and mortality rates of neonatal tetanus (NNT) remain underreported in Nigeria. This cross-sectional study was guided by the Mosley and Chen's model for the elements of child survival in developing countries. The goals of the study were twofold: (a) to compare the NNT prevalence and the mortality rates from the existing surveillance system and active surveillance of health facility records in 7 selected health facilities from 2010 to 2014 in Katsina state, Nigeria and (b) to assess the associations between selected NNT risk factors, number of maternal tetanus toxoid injections, frequency of antenatal visits, place of delivery ...


Initiating Nicotine Cessation In A Community Mental Health Center, Rosalind R. Keith Jan 2016

Initiating Nicotine Cessation In A Community Mental Health Center, Rosalind R. Keith

Walden Dissertations and Doctoral Studies

Individuals suffering from mental illness are often adversely affected by tobacco use. Historically, clinicians are reluctant and inadequately prepared to recognize and treat comorbid nicotine addiction in the chronic mentally ill (CMI) client. As evidenced by a review of the literature, healthcare providers are missing opportunities for nicotine cessation treatment. There is a lack of educational preparation amongst clinicians to treat nicotine addition and a concern that treatment of nicotine addiction can negatively impact existing psychiatric disorders. The purpose of this project was to create an educational plan for nicotine cessation for CMI clients at a community health center. The ...


Equine Assisted Activities And Therapies: The Measuring Of Equine Temperament, Thecla M. Helmbrecht Howard Jan 2016

Equine Assisted Activities And Therapies: The Measuring Of Equine Temperament, Thecla M. Helmbrecht Howard

Walden Dissertations and Doctoral Studies

The field of equine assisted activities and therapies (EAAT) is growing in popularity as an alternative healing approach. However, there is a paucity of peer-reviewed research on the horses who serve as equal partners in EAAT. The purpose of this quantitative study was to discover the impact of equine-facilitated therapeutic activities on the temperament of horses, and to determine how to select a better human-to-horse therapeutic match when providing EAAT services. The theoretical framework for this research drew from Romanes' theory of animal intelligence, which predicts that temperament would change as a result of prolonged participation in specific work (EAAT ...


Barriers To Exclusive Breastfeeding Among Mothers During The First Four Weeks Postpartum, Jessy V. Thomas Jan 2016

Barriers To Exclusive Breastfeeding Among Mothers During The First Four Weeks Postpartum, Jessy V. Thomas

Walden Dissertations and Doctoral Studies

According to the World Health Organization, breastfeeding is natural and the most effective way of nourishment to feed infants and young children to ensure child health and survival. Currently, the World Health Organization, the American Academy of Pediatrics, and other health organizations recommend exclusive breastfeeding during the first 6 months of life. Although exclusive breastfeeding has been shown to reduce the occurrence of adverse health outcomes to the infant and mother, the duration of exclusive breastfeeding remains relatively low in the United States. The theory of planned behavior was used as a theoretical framework for this study. The purpose of ...


Equine Facilitated Psychotherapy For Veteran Survivors With Full Or Partial Ptsd, Mark Aaron Mayfield Jan 2016

Equine Facilitated Psychotherapy For Veteran Survivors With Full Or Partial Ptsd, Mark Aaron Mayfield

Walden Dissertations and Doctoral Studies

Symptom severity among veteran survivors with partial or full posttraumatic stress disorder (PTSD) continues to increase, with approximately 40% of U.S. veterans reporting significant symptomology 10 years after initial onset of the condition. Veteran survivors often struggle to find therapeutic interventions that meet their specific needs and have a difficult time maintaining a therapy that is both equitable and evidenced based. Grounded in the Rogerian, client-centered theory, the purpose of this qualitative collective exploratory case study was to explore the effects of equine-facilitated psychotherapy with 3 veteran survivors with partial or full PTSD. A 4-stage process was used to ...