Digital Commons Network^™

Association Between Obesity And Depression And Anxiety Disorders: Results From The 2008 National Health Interview Survey, Monica Gaidhane

Theses and Dissertations

Introduction: Obesity is one of the most important medical problems in the U.S. and is considered to be an epidemic with over 30% of the population being obese. Obesity is associated with increased risk of hypertension, diabetes, cardiovascular diseases, certain cancers and a shorter life expectancy. Recent studies have shown that higher BMI levels are also significantly associated with several lifetime mental disorders such as major depressive disorder, anxiety disorders as well as panic attacks and panic disorders. Purpose: The purpose of this study was to quantify the extent to which higher BMI increased the likelihood of Depression, Anxiety Disorder …

Client Perceptions And Working Alliance: Predictors Of Outcome?, Theresa Do

Theses and Dissertations

BACKGROUND In recent years, there has been a push to measure and monitor the quality of health care and the delivery of effective services. Substance use disorders are debilitating and in order to better understand this facet of substance abuse, it is important for organizations and providers to assess the quality of services, client satisfaction, and the relationships that exist between clients and treatment providers. PURPOSE The purpose of the study was to (1) assess the extent of the relationship between measures of client perceptions of satisfaction and treatment outcomes and (2) to assess the relationship between measures of therapeutic …

Reaching Resilience: A Multiple Case Study Of The Experience Of Resilience And Protective Factors In Adult Children Of Divorce, Denis' A. Thomas

Doctoral Dissertations

The purpose of this qualitative case study was to describe the experiences of resilience following parental divorce for university freshmen. Five participants were interviewed using a multiple case study methodology and Richardson’s (2002) resilience model as the theoretical framework. It examined how the three needs of Self-Determination theory (autonomy, relatedness, and competence) and the three categories of protective factors (individual, family, and community) contributed to resilience. Data were collected through demographic surveys, divorce artwork, resilience artwork, and interview transcriptions. General themes, typological self-determination need themes, and typological protective factor themes were developed for each individual and across cases. The findings …

The Impact Of Met-Expectation Of Organizational Justice On Attitudinal And Behavioral Outcomes Of Intercollegiate Athletics Coaches, Seungmo Kim

Doctoral Dissertations

The purposes of this study were to examine coaches’ perceptions of distributive, procedural, and interactional justice regarding current resource distribution systems in intercollegiate athletics in terms of sport types (high profile sports vs. low profile sports) and gender of players (male participant sports vs. female participant sports) and the impacts of direct or indirect organizational justice on coaches’ attitudinal (job satisfaction and affective organizational commitment toward organization and supervisor) and behavioral (organizational citizenship behavior for organization and supervisor) outcomes through the mediating effects of met expectations, outcome satisfaction, and social exchange relationships (perceived organizational support and leader-member exchange) via a …

Comparing Perceptions Of The Nursing Profession Among Associate And Baccalaureate Nursing Students And Registered Nurses, Sherry R. Lovan

Nursing Faculty Publications

The inconsistencies between the perception of the profession of nursing and the reality of practice can lead to problems in student attrition or result in disillusionment with a career in nursing after a new graduate enters practice. With the nursing shortage reaching critical levels, it is important to examine possible discrepancies that exist and address strategies to reduce them.

For this study, a quantitative design was selected to explore how the perception of the nursing profession compared among first-semester associate degree nursing students, first-semester baccalaureate nursing students, and registered nurses. A convenience sample N = 238 included 69 ADN students, …

Impact Of Parent’S Hiv Status On Their Uninfected Child—A Comparative Analysis Of The Child’S Healthcare Utilization, Access And Health Outcomes, Arijit Ganguli

Theses and Dissertations (ETD)

With the advent of effective antiretroviral medication and increased expectancy of life span among HIV-infected individuals has lead to an increase in the at-risk population of uninfected children living with their HIV-infected parent(s). The purpose of this study was to investigate the impact of parent’s HIV status on their child’s access to healthcare resources, healthcare utilization and health outcomes.

This was a cross-sectional study in which the information on the children of HIV seropositive parent(s) was collected through a face-to-face interview of the HIV-infected parents having children currently residing with them. The comparative group comprising of children of HIV seronegative …

Preferences And Willingness To Pay For Osteoarthritis Treatments Among The Medicare Population, Meghan Alexis Hufstader

Theses and Dissertations (ETD)

The design of this study is a non-random cross sectional survey to determine Medicare beneficiaries’ preferences and willingness to pay for osteoarthritis (OA) treatments. The population of interest in this study is the Medicare eligible (over age 65) population in Memphis, TN, and surrounding cities. Data were collected at Senior Centers and one internal medicine practice. The sample size was 181.

Choice-based conjoint analysis technique was utilized. The preferences and willingness to pay were determined using choice-based conjoint analysis, advanced design module with a dual-response none option. Choice-based conjoint analysis uses computer guided surveys to elicit patient preference for a …

Dimensions Of Loss From Mental Illness, Amy E. Z. Baker, Nicholas Procter, Tony Gibbons

The Journal of Sociology & Social Welfare

This review explores the nature, scope and consequences of loss resulting from mental illness. Losses are described within four key themes: self and identity, work and employment opportunities, relationships, and future-oriented losses. In reflecting upon review findings, several assumptions about loss are illuminated. Findings are situated within the cornerstones of recent mental health reform, specifically a recovery-oriented approach and social inclusion. Particular attention is directed towards notions of risk and responsibility and tensions in realizing the impact of loss within an individualized recovery framework. Implications and recommendations for policy and practice are highlighted.

Common Genetic Variation And The Control Of Hiv-1 In Humans, Jacques Fellay, Dongliang Ge, Kevin V. Shianna, Sara Colombo, Bruno Ledergerber, Elizabeth T. Cirulli, Thomas J. Urban, Kunlin Zhang, Curtis Gumbs, Jason P. Smith, Antonella Castagna, Alessandro Cozzi-Lepri, Andrea De Luca, Philippa Easterbrook, Huldrych F. Gunthard, Simon Mallal, Cristina Mussini, Judith Dalmau, Javier Martinez-Picado, Jose M. Miro, Niels Obel, Steven M. Wolinsky, Jeremy J. Martinson, Roger Detels, Joseph Margolick, Lisa Jacobson, Patrick Descombes, Stylianos E. Antonarakis, Jacques S. Beckmann, Stephen J. O'Brien, Norman L. Letvin, Andrew J. Mcmichael, Barton F. Haynes, Mary Carrington, Sheng Feng, Amalio Telenti, David B. Goldstein, Niaid Center For Hiv/Aids Vaccine Immunology (Chavi)

Biology Faculty Articles

To extend the understanding of host genetic determinants of HIV-1 control, we performed a genome-wide association study in a cohort of 2,554 infected Caucasian subjects. The study was powered to detect common genetic variants explaining down to 1.3% of the variability in viral load at set point. We provide overwhelming confirmation of three associations previously reported in a genome-wide study and show further independent effects of both common and rare variants in the Major Histocompatibility Complex region (MHC). We also examined the polymorphisms reported in previous candidate gene studies and fail to support a role for any variant outside of …

Influences On Job Retention Among Homeless Persons With Substance Abuse Or Psychiatric Disabilities, Russell K. Schutt, Norman C. Hursh

The Journal of Sociology & Social Welfare

Job retention is an important psychosocial rehabilitation goal, but one that is not often achieved. We investigate facilitators of and barriers to employment retention among homeless individuals with psychiatric and substance abuse diagnoses who were re-interviewed eight or more years after participating in a traditional vocational rehabilitation program. Most program graduates who maintained employment had secured social support from a variety of sources; personal motivation was also a critical element in job retention and compensated in some cases for an absence of social support. Both the availability of social support contacts and personal motivation influenced likelihood of maintaining sobriety. Physical …

A Pilot Study Of An Automated Voice Response System And Nursing Intervention To Monitor Adherence To Oral Chemotherapy Agents, Veronica Decker, Sandra L. Spoelstra, Emily Miezo, Renee Bremer, Mei You, Charles W. Given, Barbara A. Given

Peer Reviewed Articles

This study was designed to develop and test a system to monitor adherence with non-hormonal oral chemotherapeutic agents using an automated voice response (AVR) system plus nursing intervention. Participants received the Symptom Management Toolkit then participated in an interview for symptom severity, satisfaction, and beliefs about oral agents. Patients received weekly AVR calls, which assessed adherence to oral agents and severity of 15 symptoms. Patients who reported adherence of < 100% of prescribed oral agents or symptoms of 4 or greater (0-10 scale) for three consecutive weeks, were called by a nurse for assistance with symptom management and adherence to oral chemotherapy medications. Following the 8 weekly AVR calls, patients participated in a follow up interview and medical record review. Subjects were 30 oncology patients who were ambulatory and treated at two cancer centers in Midwest USA. The results indicate 23.3% non adherence rate to oral chemotherapy medications due to symptoms and forgetting to take the medication. An association between symptom management and adherence was found. Symptom severity and beliefs about medications were not significantly different between adherent and non adherent patients. This pilot study demonstrated the ability to accrue patients for a longitudinal trial and informed intervention design, while providing guidance for future interventions and research studies.

This study was designed to develop and test a system to monitor adherence with nonhormonal oral chemotherapeutic agents using an automated voice response (AVR) system plus nursing intervention. Participants were patients …

Fuzzy Logic In Neurosurgery: Predicting Poor Outcomes After Lumbar Disk Surgery In 501 Consecutive Patients, Muhammad Shahzad Shamim, Ather Enam, Uvais Qidwai

Section of Neurosurgery

Background: Despite a lot of research into Patient selection, a significant number of Patients fail to benefit from surgery for symptomatic lumbar disk herniation. We have used Fuzzy Logic-based fuzzy inference system (FIS) for identifying Patients unlikely to improve after disk surgery and explored FIS as a tool for surgical outcome prediction.
Methods: Data of 501 Patients were retrospectively reviewed for 54 independent variables. Sixteen variables were short-listed based on heuristics and were further classified into memberships with degrees of membership within each. A set of 11 rules was formed, and the rule base used individual membership degrees and their …

Etiology, Functional Status And Short Term Outcome Of Patients With Pituitary Lesions. An Experience From A Developing Country, Osama Ishtiaq, Mansoor Ul Haq, Azra Rizwan, Mohammad Qamar Masood, Saeed Mehar, Abdul Jabbar

Section of Diabetes, Endocrinology and Metabolism

OBJECTIVE: To describe the etiology, functional status and short term outcome of patients with pituitary lesions (PL).

METHODS: Brain or pituitary MRI reports of 3753 patients were analyzed for PL over the period of 2000 to 2007, done at the Aga Khan University Hospital (AKUH), Karachi, Pakistan. MRIs with reported PL and all those ordered by Endocrinologists with or without pituitary abnormalities, were included in the analysis. This made a total of 338 (9%) MRI reports. PL were defined as pituitary tumors, cysts, haemorrhage, hypoplasia; and empty sella. Patients with these PL, were analyzed for symptoms, hormonal profile and short …

Selected Barriers And Incentives For Participation In A University Wellness Program, Trever J. Ball

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Evidence supporting the benefits of worksite health promotion (WHP) programs is extensive. Research shows these programs can improve the health of participants, lower health care costs, and improve the bottom line of employers. Although the evidence of these benefits is vast, reported participation in WHP is not optimal. Little published data exists on employees' perceived incentives and barriers for participation in WHP.

The purpose of this study was to determine perceived barriers and incentives for participation in an existing WHP program at a large land-grant university. Opinions of eligible WHP participants were collected using a web-based questionnaire (n = …

A Comprehensive Program Description And Recommendations For The Del Rosa Youth Program, Martin C. Hodnett

Loma Linda University Electronic Theses, Dissertations & Projects

Amid budget cuts, economic recession, and difficulties many Americans face, more families are looking for ways to access needed services and goods from nongovernmental sources. Churches and faith based organizations, such as the Del Rosa Seventh-day Adventist (SDA) Church, have been bridging the gap for families seeking assistance, particularly in the area of youth services. The Del Rosa Youth Program, an outreach program sponsored by Del Rosa SDA Church, provides mentoring and religious programming for at-risk youth. In an effort to assist them in becoming more competitive for funding, the current project has reviewed the relevant literature and provided recommendations …

Cognitive Processes And Race Differences: Possible Factors Contributing To Ptsd, Christina Fay

Graduate Theses

Past research suggest differences in racial group’s perceived experiences in traumatic situations and different ways of coping can affect individual levels of posttraumatic stress disorder (PTSD) symptoms. The author examined how race, methods of coping and risk/resilience factors interact with PTSD symptomology. A total of 28 Black, Hispanic and Non Hispanic Caucasian Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans were assessed for PTSD symptoms, methods of coping and risk/resilience factors related to deployment. Findings indicate no significant differences for minorities and non Hispanic Caucasians on level of PTSD symptoms. Findings indicate significant differences between minorities and non Hispanic Caucasians on …

Carotid Artery Disease In Patients Undergoing Elective Coronary Artery Bypass Surgery, Waseem Akhtar, Ayan Sabih, Arif Ali, Mubashir Aslam, Nadeem Ahmad

Department of Radiology

OBJECTIVE: To determine frequency of carotid artery disease in patients undergoing elective coronary artery bypass grafting (CABG) using Doppler sonography.STUDY DESIGN: Observational study.

PLACE AND DURATION OF STUDY: Radiology Department, The Aga Khan University Hospital, Karachi, from January 2005 to September 2008.

METHODOLOGY: Patients with known cardiovascular disease waiting for CABG surgery were enrolled for carotid artery Doppler sonography. A predefined data entry form was used for data collection. Coronary angiography findings, carotid artery findings and other associated factors were noted from medical and radiological records. Frequency and pattern of carotid artery disease along with associated risk factors were evaluated. …

Comparison Of Cephalometric Norms Of Esthetically Pleasing Faces, Attiya Jawaid Shaikh, Arif R Alvi

Section of Dental-Oral Maxillofacial Surgery

OBJECTIVE: To establish cephalometric norms of a sample of aesthetically pleasing Pakistani faces and to analyze differences and similarities with accepted standards for Caucasians.

STUDY DESIGN: Analytical cross sectional study.

PLACE AND DURATION OF STUDY: Carried out at Alvi Dental Hospital, Karachi, from August 2007 to February 2008.

METHODOLOGY: Cephalometric tracings were analyzed on a sample of 40 (20 males and 20 females) Pakistani young adults, aged 18-25 years, with full complement of permanent teeth, no previous orthodontic treatment and pleasing profile. To check the reliability of the measurements, 20 randomly selected cephalograms were retraced. None of the measurements showed …

Association Of Various Reproductive Rights, Domestic Violence And Marital Rape With Depression Among Pakistani Women, Faridah A. Ali, Syed M. Israr, Badar S. Ali, Naveed Z. Janjua

Community Health Sciences

Background: Depression among women is common in developing countries. Gender inequality can contribute to women's risk for depression. Lack of reproductive and sexual rights is an important marker of gender inequality and women do not have the freedom to express their reproductive and sexual needs in many parts of the world. Therefore we designed this study to determine the association of depression with lack of various reproductive rights and domestic violence among married women in Karachi, Pakistan. Methods: A case-control study with 152 cases and 152 controls, which included women 15-48 years, recruited from two teaching hospitals from 1(st) June …

The Burden Of Stroke And Transient Ischemic Attack In Pakistan: A Community-Based Prevalence Study, Ayeesha Kamran Kamal, Ahmed Itrat, Muhammed Murtaza, Maria Khan, Asif Rasheed, Amin Ali, Amna Akber, Zainab Akber, Naved Iqbal, Sana Shoukat, Farzin Majeed, Danish Saleheen

Section of Neurology

Background: The burden of cerebrovascular disease in developing countries is rising sharply. The prevalence of established risk factors of stroke is exceptionally high in Pakistan. However, there is limited data on the burden of stroke and transient ischemic attack (TIA) in South Asia. We report the first such study conducted in an urban slum of Karachi, Pakistan. Methods:Individuals 35 years of age or older were invited for participation in this investigation through simple random sampling. A structured face-to-face interview was conducted using a pretested stroke symptom questionnaire in each participant to screen for past stroke or TIA followed by …

Reading & Writing Health: Nurses' Experience Of Patients' Health Literacy, Susan Herrgott

Regis University Student Publications (comprehensive collection)

The ability to read, understand, and act appropriately on healthcare information directly affects an individual's ability to access services and successfully communicate with healthcare providers. This ability is called health literacy and it includes the skills patients need to communicate with providers, read medical information, adhere to treatments, and decide when and how to seek medical care. Most of the research around health literacy has focused on patients’ experiences. In order to fully understand the problem, though, the experience of providers needs to be understood, too. The purpose of this study was to gain insight into nurses’ experience of patient …

Social Service Needs And Perceptions Of Low-Income Latinos In Metro Denver, Marissa M. Kaesemeyer

Regis University Student Publications (comprehensive collection)

The Latino population has the highest uninsured rates among all racial and ethnic groups in the United States. Latinos are likely to be poor, and have difficulties accessing social services. The purpose of this study is to understand what social services Latinos need, as well as Latino perceptions regarding access to social services. In order to provide better social services and ultimately maintain good health, it is important for social service organizations to understand their clients' needs and perceptions. The research question is "What are the social service needs of low-income Latinos and how do they perceive access to these …

The Relationship Between Residency And Socio-Demographics To Academic Performance In Ncaa Division I Freshman Athletes, Eric Matthew Snyder

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Numerous studies have been completed on the academic ability of student athletes. Since the mid 1980s, the NCAA has emphasized the importance of academics and mandated more stringent requirements to be able to participate in intercollegiate athletics. These initial-eligibility standards have been successful in increasing overall graduation rates of student-athletes, but there remain a number of concerns. The purpose of the study was to determine if an NCAA D-I freshman student athlete's place of residency on campus, as opposed to off campus, while attending college during his/her freshman year had a statistically significant relationship to achievement as it relates to …

A Descriptive Review Of Health Care Providers Perspective On Stigmatization Of Hiv/Aids Patients: United States And South Africa, Ana I. Fonseca

Honors Projects

Compares the issue of social stigma affecting people with HIV/AIDS in the United State and in South Africa. Posits that stigma is more of an interpersonal problem in the United States, while it is a huge barrier to access to care in South Africa. Data was compiled through personal conversations and experiences in South Africa during June 2009, interviews with health professional and community members in Rhode Island during the fall of 2009, and reading of the professional literature.

Resting State Default-Mode Network Connectivity In Early Depression Using A Seed Region-Of-Interest Analysis: Decreased Connectivity With Caudate Nucleus., Robyn Bluhm, Peter Williamson, Ruth Lanius, Jean Theberge, Maria Densmore, Robert Bartha, Richard Neufeld, Elizabeth Osuch

Department of Medicine Publications

AIM: Reports on resting brain activity in healthy controls have described a default-mode network (DMN) and important differences in DMN connectivity have emerged for several psychiatric conditions. No study to date, however, has investigated resting-state DMN in relatively early depression before years of medication treatment. The objective of the present study was, therefore, to investigate the DMN in patients seeking help from specialized mental health services for the first time for symptoms of depression.

METHODS: Fourteen depressed subjects and 15 matched controls were scanned using 4-T functional magnetic resonance imaging while resting with eyes closed. All but one subject was …

Direct Healthcare Costs Of Hip, Vertebral, And Non-Hip, Non-Vertebral Fractures., Nianwen Shi, Kathleen Foley, Gregory Lenhart, Enkhe Badamgarav

College of Population Health Faculty Papers

Limited data exist regarding the cost of non-hip, non-vertebral (NHNV) fractures. Although NHNV fractures may be less expensive than hip and vertebral fractures, they have a higher incidence rate. The objective of this study was to quantify first-year healthcare costs of hip, vertebral, and NHNV fractures. This was a claims-based retrospective analysis using a case-control design among patients with commercial insurance and Medicare employer-based supplemental coverage. Patients were > or =50 years old with a closed hip, vertebral, or NHNV fracture between 7/1/2001 and 12/31/2004, and continuous enrollment 6 months prior to and 12 months after the index fracture. Adjusted mean …

Stepped Care For Smoking Cessation: A Cost-Effectiveness Analysis And Simulation Of Future Outcomes, Brandi E. Franklin

Theses and Dissertations (ETD)

It has been well established that smoking is the leading avoidable cause of premature morbidity and mortality in the United States and abroad. Smoking is attributable to over 400,000 annual deaths, and $193 billion in healthcare costs and lost productivity. Despite the apparent dangers and tremendous costs of tobacco use and dependence, smokers find difficulty quitting. Recently, stepped care has been proposed as a viable intensive approach for achieving long-term cessation. This research sought to evaluate cost-effectiveness of stepped care in a diverse population of smokers and analyze future health outcomes of smoking cessation.

Cost-effectiveness analysis was conducted from an …

Use Of Emoticons For Assessing Emotion And Mood States In Web-Based Interventions, Jennifer Chua So

Loma Linda University Electronic Theses, Dissertations & Projects

In the rapidly growing field of online psychotherapeutic interventions, an increasing number of clinicians are seeking to extend therapeutic interventions into cyberspace. However, because communication with clients in this medium is often devoid of auditory and visual feedback, these clinicians are not able to rely on their clinical observations. It then becomes incumbent to develop a psychometrically and theoretically sound means of assessing emotion and mood states that can be easily utilized in this forum. Utilizing cross-culturally and empirically supported models of emotion structure shown to be influential in the self-report data, the Positive Affect and Negative Affect factors, this …

Function And Pain In Community-Dwelling, Adult Mid-Southerners With Limb Loss, Cecile B. Evans

Theses and Dissertations (ETD)

Background: Limb loss affects about 1 in 190 people in the US. Risk factors for limb loss include diabetes, obesity, smoking, minority race, and poverty, which are all common in the Mid-South population. Function is impaired by limb loss, and pain associated with limb loss may further impair function.

Purpose: Describe the function, pain, health status, and demographics of community-dwelling, adult Mid-Southerners with limb loss. Estimate the relationship between function and pain, health status, and demographics of community-dwelling, adult Mid-Southerners with limb loss. Estimate the joint influences on function by pain, health status, and demographics of community-dwelling, adult Mid-Southerners with …

Parenting Styles Of Division I Men And Women Hockey Players In The Wcha, Jeffrey Giesen

Culminating Projects in Kinesiology

The purpose of this study was to identify the perceived parenting styles of athletes in the Western Collegiate Hockey Association (WCHA). Four parenting styles were identified in previous studies, authoritarian, authoritative, permissive and neglecting.

Fifteen teams and over 250 athletes were surveyed. Permission was obtained from the head coach of each of the men's and women's team. The survey was sent to a full time staff person for each team that the researcher had contacted to assure the surveys would be completed. The survey was given during each team's spring training and then returned in a pre-paid envelop.

Descriptive statistics …