Digital Commons Network^™

Effects Of A Collaborative Care For Depression Intervention On Health Service Utilization And Depression Severity, Girlyn Arganza Cachaper

Health Services Research Dissertations

Depression is the leading cause of disability worldwide, disproportionately affecting the Medicaid population. Collaborative care programs for depression are transforming primary care to increase access and coordinate physical and behavioral health services. Understanding the relationships between components of collaborative care programs, characteristics of participants, and their effect on outcomes can maximize program effectiveness. A pilot collaborative care for depression program within a Medicaid managed care organization was evaluated using administrative claims and case management data. Participants (n=444) included adults with prior Medicaid coverage and a comparison group identified using one-to-one propensity score-matching. Multivariate logistic regression models estimated the odds of …

The Relationship Between Obesity And Periodontal Disease, Jean Conover

Dental Hygiene Master's Papers and Projects

Obesity has been targeted as the sixth most significant risk factor worldwide that is known to contribute to both oral and other associated systemic diseases.² According to the Centers for Disease Control and Prevention (CDC), the prevalence of obesity among adults in the U.S. is 40% and 18.5% in youth with prevalence higher among middle aged adults (42.8%) than younger adults (35.7%).³ As of 2016, nearly two billion people worldwide were either overweight or obese.¹ Research indicates accumulated excessive fat from being overweight or obese contributes to serious health impairments.⁴ World-wide obesity is associated with increased …

A Social-Ecological Framework Of Theory, Assessment, And Prevention Of Suicide, Robert J. Cramer, Nester D, Kapusta

Community & Environmental Health Faculty Publications

The juxtaposition of increasing suicide rates with continued calls for suicide prevention efforts begs for new approaches. Grounded in the Centers for Disease Control and Prevention (CDC) framework for tackling health issues, this personal views work integrates relevant suicide risk/protective factor, assessment, and intervention/prevention literatures. Based on these components of suicide risk, we articulate a Social-Ecological Suicide Prevention Model (SESPM) which provides an integration of general and population-specific risk and protective factors. We also use this multi-level perspective to provide a structured approach to understanding current theories and intervention/prevention efforts concerning suicide. Following similar multi-level prevention efforts in interpersonal violence …

Healthcare Outcomes And Resource Utilization Associated With Neonatal Hypoglycemia: Analysis Of Data From The Hcup Kid’S Inpatient Database, Brook T. Alemu

Health Services Research Dissertations

Neonatal hypoglycemia is the most common metabolic abnormality in infants and is associated with neurological damage and death. The risk of developing hypoglycemia among infants born from diabetic mothers is even higher. Although much work has been performed addressing issues for treatment and care, research related to neonatal hypoglycemia has been focused on the clinical or individual level risk factors. Contextual risk factors such as hospital characteristics, neighborhood economic status, and regional variations were not considered in earlier studies. Additionally, although healthcare resources utilization of hypoglycemia has been adequately addressed in the adult population, this topic has not been studied …

A Web-Based Interprofessional Education Program For School Nurses And Athletic Trainers: A Pilot Study, Lauren Ashley Welsch

Health Services Research Dissertations

Background: Interprofessional education (IPE) programs have been shown effective in improving interprofessional collaborative practice (ICP) through increased communication and teamwork amongst healthcare professionals with the ultimate goal of improving patient safety and outcomes. However, their use and subsequent outcomes have not been reported amongst athletic trainers (ATs) and school nurses (SNs) in secondary school healthcare. The purpose of this study is to develop, implement and evaluate an IPE program designed to meet the needs of this unique healthcare setting. In addition, qualitative analysis will further describe the communication between ATs and SNs. Methods: A mixed method exploratory design was employed. …

Effects Of A Unilateral Strength And Plyometric Training Program For Division I Soccer Players, Eric Potter

Human Movement Studies & Special Education Theses & Dissertations

The current thesis examined the effects of a unilateral strength and plyometric program on power (bilateral and unilateral vertical jumps), speed (20 meter sprint), and agility (Agility T- Test) in collegiate soccer players compared to a traditional bilateral-based training program. Due to the fact that a majority of the research on performance variables in athletes is done using bilateral lifting and plyometric programs, yet most movements in field sports such as sprinting and changing direction are unilateral-based, this specific topic could have value for enhanced performance for athletic populations. The participants included 34 male and female Division-I soccer players who …

The Effect Of Magnification Loupes On Dental Hygienists' Posture While Exploring, Emily Ludwig, Gayle B. Mccombs, Susan L. Tolle, Daniel M. Russell

Dental Hygiene Faculty Publications

Purpose: The purpose of this study was to determine the effects of dental magnification loupes on posture during instrumentation.

Methods: A convenience sample of 27 right-handed dental hygienists, with no prior history of injuries or disabilities of the head, neck, or trunk region, enrolled in the study. Baseline posture calibration was taken and tri-axial accelerometers were placed on four locations of the head and trunk (occipital region of head; cervical vertebrae C5; thoracic vertebrae T5; lumbar vertebrae L1) to measure acceleration and the orientation of the body to gravity. Participants were randomly assigned to wear self-supplied magnification loupes during either …

Impact Of Inpatient Care In Emergency Department On Outcomes: A Quasi-Experimental Cohort Study, Aisha Lateef, Soo-Hoon Lee, Dale Andrew Fisher, Wei-Ping Goh, Hui Fen Han, Uma Chandra Segara, Tiong Beng Sim, Malcolm Mahadehvan, Khean Teik Goh, Noel Cheah, Aymeric Yt Lim, Phillip H. Phan, Reshma A. Merchant

Management Faculty Publications

BACKGROUND: Hospitals around the world are faced with the issue of boarders in emergency department (ED), patients marked for admission but with no available inpatient bed. Boarder status is known to be associated with delayed inpatient care and suboptimal outcomes. A new care delivery system was developed in our institution where boarders received full inpatient care from a designated medical team, acute medical team (AMT), while still residing at ED. The current study examines the impact of this AMT intervention on patient outcomes.

METHODS: We conducted a retrospective quasi-experimental cohort study to analyze outcomes between the AMT intervention and conventional …

Alcohol And Substance Use Knowledge, Attitudes, Subjective Norms, Self-Efficacy, Perceived Behavioral Control, And Behavioral Intentions Among Omani College Students, Muna S. Bait Ajzoon

Health Services Research Dissertations

Alcohol and/or substance use among college students is a serious public health issue. In Oman, studies addressing college student’s alcohol and/or substance use are limited. The purpose of this study was to identify knowledge, attitudes, subjective norms, self-efficacy, and perceived behavioral control associated with alcohol and/or substance usage patterns among Omani college students (OCSs); identify behavioral intentions for alcohol and/or substance use among OCSs; and facilitate the development of culturally relevant evidenced-based interventions for Omani young people by communicating study findings to policymakers and healthcare program leaders.

A cross-sectional design used an online survey completed by college students from Oman …

Unmet Needs And Service Utilization By Informal Caregivers, Ryan Marie Diduk-Smith

Health Services Research Dissertations

The number of Americans expected to live into their 80’s and 90’s is growing at an increased rate in the United States, and the numbers of those aging adults with multiple chronic conditions also continues to grow. It is estimated that by 2050, there will be 89 million adults over the age of 65 years living in the United States. For a variety of reasons, including policy, personal, and financial reasons, many aging adults are choosing to “age in place” or to remain in the community. With the increase in the numbers of aging adults in the community, the ability …

Measuring Outcomes In Competence And Confidence In Clinical Skills Through The Use Of Standardized Patients, Jennifer W. Cuchna

Health Services Research Dissertations

Limited literature is available concerning the use of standardized patients (SPs) in physical therapy education related to outcomes which are assessed. The purpose of our study was to investigate the effects SP implementation had on first year, doctor of physical therapy (DPT) student’s communication and patient interviewing skills and their confidence in those skills.

Our study utilized a comparison group, repeated measures design with the collection of four survey instruments at pre-test and two posttest time points. The instruments for our study measured general self-efficacy (GSE), task-specific self-efficacy (Self-Perceived Communication Competence (SPCC) and Froehlich Communication Competence (FroCom) and confidence (Standardized …

The Relationship Of Early Class Start Times On Sleepiness And Driving Behaviors In An Emerging Adult Population, Jessica L. Fry

Psychology Theses & Dissertations

Teenage driver sleepiness is a recent concern for preventing motor vehicle fatalities. Early school start times limit the amount of sleep teenage high school students acquire during the week and have been related to increased crash risk. The current study extends this finding to teenage and emerging adult college students. The author examined the link between sleepiness and teenage driving behaviors, including the relationship between school start times and sleepiness. In all, 536 participants were recruited to participate in an online survey assessing driving and sleep behaviors. Correlations and path analysis found that sleepiness fully mediated the relationship between early …

Predictive Value Of Adhd Symptomatology On Motives And Outcomes Of Stimulant Misuse, Alexander Laszlo Peterkin

Psychology Theses & Dissertations

ADHD stimulant misuse is defined as taking a stimulant used to treat ADHD either without having a prescription for that stimulant or in a manner that deviates from the prescription’s instructions. This has been a growing trend among undergraduate students over recent years. Prior research has found that misusers are likely to have severe symptoms of ADHD, misuse for primarily academic reasons, and display problems associated with substance abuse. The current study aimed to determine the predictive value of ADHD symptomatology on frequency of ADHD stimulant misuse, mediated by academic motives for misuse and substance abuse problems. The survey for …

Breaking The Silence: A Phenomenological Exploration Of Secondary Traumatic Stress In U.S. College Student Affairs Professionals, Robert Jason Lynch

Educational Leadership & Workforce Development Theses & Dissertations

Breaking the Silence: A Phenomenological Exploration of Secondary Traumatic Stress in U.S. College Student Affairs Professionals is a qualitative-intensive mixed methods study using phenomenology and art-based research techniques to uncover the essence of secondary traumatic stress in U.S. college student affairs professionals. Researchers in the fields of psychology, counseling, social work and other helping professions suggest that repeated exposure to individuals experiencing trauma, or hearing repeated details of an individual’s trauma, have negative outcomes on professional helpers. Coined secondary traumatic stress, this phenomenon may be defined as “the stress resulting from helping or wanting to help a traumatized or suffering …

Protective Factors Against Peer And Social Media Sex Messages: The Moderating Role Of Parental Influences On African American Emerging Adult Students' Sexual Behaviors, Jacqueline Eunice Haywood

Psychology Theses & Dissertations

The most recent research on risky sexual behaviors is primarily based on adolescent, predominately White, or multiple race (e.g., African American and White) samples. There is a paucity of literature focused exclusively on African Americans, particularly African American emerging adults between the ages of 18 and 25. Given the increased risk for sexually transmitted infections (STIs) for college aged African Americans, it is important to understand factors that may decrease engaging in risky sexual behaviors that are specific to this group. The current study examined the roles of parental warmth and communication about sex as protective factors. Participants (n = …

Sexual Orientation Differences In Treatment Expectation, Alliance, And Outcome Among Patients At Risk For Suicide In A Public Psychiatric Hospital, Martin Plöderl, Sabine Kunrath, Robert J. Cramer, Jen Wang, Larissa Hauer, Clemens Fartacek

Community & Environmental Health Faculty Publications

BACKGROUND: Sexual minority (SM) individuals (gay, lesbian, bisexual, or otherwise nonheterosexual) are at increased risk for mental disorders and suicide and adequate mental healthcare may be life-saving. However, SM patients experience barriers in mental healthcare that have been attributed to the lack of SM-specific competencies and heterosexist attitudes and behaviors on the part of mental health professionals. Such barriers could have a negative impact on common treatment factors such as treatment expectancy or therapeutic alliance, culminating in poorer treatment outcomes for SM versus heterosexual patients. Actual empirical data from general psychiatric settings is lacking, however. Thus, comparing the treatment outcome …

Factors Influencing Distribution Of Prosthetic Devices In Iran: An Economic Analysis, Sarah Tensen

Virginias Collegiate Honors Council Conference

An estimated 177,622 Iranians have suffered an injury resulting in amputation. Prosthetic devices in Iran are scarce due to wealth disparity, wars, and lack of vital resources. Without prosthetic devices, amputees face unemployment, homelessness, a lowered self-esteem and cannot fully participate in society. I examined economic factors influencing the distribution of prosthetic devices and reviewed articles that focus on healthcare costs, distributions and services, relationships between Iran and other countries, etiology of amputation to find a solution for the prosthetic distribution issues. I concluded issues resulted from high costs, unequal distributions of wealth and resources, unsafe conditions, and a deficit …

Sleep Disorders And Kidney Transplant Outcomes: Findings From An 18-Year (1997-2015) Historical Cohort Study, Margaret M. Lubas

Health Services Research Dissertations

A historic cohort study of kidney transplant recipients with a failed graft was conducted to examine the associations between sleep disorders and kidney transplant outcomes. Adult kidney transplant recipients who were transplanted and failed or died with a functioning graft during the designated study time period (January 1, 1997 to September 1, 2015, inclusive) were included (n=299). The primary independent variables, any sleep disorder and any sleep-disordered breathing disorders, were defined through a diagnosis in a subject’s medical record. Transplant outcomes included: death with a functioning graft, graft survival time, and patient survival time after graft failure.

Chi-square statistics were …

The Relationship Between Trauma Exposure And College Student Adjustment: Factors Of Resilience As A Mediator, Amber Leih Jolley

Counseling & Human Services Theses & Dissertations

Adjustment to college is an important developmental task for students entering institutions of higher education. More than half of students who enter college report exposure to a potentially traumatic event (PTE), with many students reporting multiple event exposure (Banyard & Cantor, 2004). Many students adjust well to college despite experiencing PTEs, suggesting that certain factors may mitigate the effects of exposure. This study utilized archival data to explore the relationship between the type of PTE, accumulation of PTEs, underlying factors of resilience, and adjustment to college in a national sample of treatment-seeking college students. The data were analyzed using hierarchical …

Personality, Motivation, And Internet Gaming Disorder: Understanding The Addiction, Kristy L. Carlisle

Counseling & Human Services Theses & Dissertations

This dissertation examined the relationships among personality traits, motivation for play, and Internet gaming disorder in a diverse sample of Internet gamers, using a group correlational design and path analysis. The researcher sampled participants who self-identify as Internet gamers by posting invitations to participate in the study on Internet forums, as well as by accessing the gaming population at Pokémon Go hotspots. The study used valid and reliable instruments: The Ten-Item Internet Gaming Disorder Test (IGD-10), the abbreviated form of the Big Five Inventory (BFI-10), and the Motivation to Play Online Games Questionnaire (MPOGQ). Data analysis included descriptive statistics related …

Understanding The Experiences Of Women With Anorexia Nervosa Who Complete An Exposure Therapy Protocol In A Naturalistic Setting, Gina B. Polychronopoulos

Counseling & Human Services Theses & Dissertations

Anorexia Nervosa (AN) is a serious mental health concern in the United States, with the highest mortality rate of all mental disorders. Females comprise the vast majority of people with AN, although the number of males with the condition is rising. Anorexia Nervosa has a high relapse rate and is often enduring, which makes it challenging to treat successfully; therefore, the mental health profession is in need of innovative therapeutic approaches. Exposure therapy has a growing evidence base for the treatment of eating disorders, including AN; however, there are very few studies that explore body image/mirror exposure specifically in patients …

The Role Of Self-Care And Hardiness In Moderating Burnout In Mental Health Counselors, Traci Danielle Richards

Counseling & Human Services Theses & Dissertations

This study explored the relationship between self-care, hardiness, and burnout in a sample of mental health counselors using a hierarchical multiple regression. Additionally, the relationship between hardiness, identity characteristics, and job factors was explored using a Pearson’s correlation and MANOVA. The study used valid and reliable instruments: the Maslach Burnout Inventory (MBI) to assess burnout and the Dispositional Resilience Scale (DRS) to assess hardiness. Results of a hierarchical multiple regression indicated that hardiness accounts for more of the variance in predicting burnout than self-care. Significant predictors of burnout include age, job satisfaction, self-care frequency, and hardiness. Data collected for this …

Establishing The Psychometric Properties Of The Understanding Mental Health Scale: A Dissertation Study, Michael Thomas Kalkbrenner

Counseling & Human Services Theses & Dissertations

The purpose of this dissertation study was to validate the Understanding Mental Health Scale (UMHS). The UMHS is a 50-item questionnaire that was designed to measure college students’ awareness of mental health issues. To test the psychometric properties of the UHMS, a principal axis factor (PAF) analysis with an oblique rotation was conducted using an existing data set of 350 college students. Results revealed a two-factor structure underlying college students’ understanding of mental health issues. The factors were named risk-factor awareness (familiarity with warning signs of mental health issues) and resource awareness (knowledge of resources for mental health issues). A …

Exploring The Relationship Between Depression And Resilience In Survivors Of Childhood Trauma, Marquis A. Norton

Counseling & Human Services Theses & Dissertations

Although experiences of trauma are common, reactions vary due to a host of biopsychosocial and cultural factors that influence the individual reaction to the trauma (Nakai et al., 2015). One such factor is resiliency, the capability to adapt in adverse environmental circumstances (Basim & Cetin, 2011). This study used hierarchical multiple regression to examine the relationships between childhood trauma, recent experiences of depression, and resilience in adult university students. This study also examined the possible moderating effects on depression by resilience. Participants completed the Childhood Trauma Questionnaire, Connor-Davidson Resilience scale, and PROMIS Depression survey. Small significant relationships were found for …

An Exploratory Factor Analysis Examining Experiences And Perceptions Of Campus Safety For International Students, Sonia H. Ramrakhiani

Counseling & Human Services Theses & Dissertations

Although international students make up a significant percentage of the college population and contribute to higher education institutions in multiple ways, a lack of attention is paid to their safety needs. This dissertation examined the experiences and perceptions of campus safety among international college/university students in the United States. The researcher sampled participants from different institutions around the country, who self-identified as international students. A researcher-developed 53-item Likert scale questionnaire, International Students’ Safety Questionnaire (ISSQ), was administered to the sample. Findings from the exploratory factor analysis (EFA) provided evidence for the four-factor solution for the 26-item ISSQ accounting for 48.65% …

Ticks Elicit Variable Fibrinogenolytic Activities Upon Feeding On Hosts With Different Immune Backgrounds, Ashish Vora, Vikas Taank, John F. Anderson, Durland Fish, Daniel E. Sonenshine, John D. Catravas, Hameeda Sultana, Girish Neelakanta

Biological Sciences Faculty Publications

Ticks secrete several anti-hemostatic factors in their saliva to suppress the host innate and acquired immune defenses against infestations. Using Ixodes scapularis ticks and age-matched mice purchased from two independent commercial vendors with two different immune backgrounds as a model, we show that ticks fed on immunodeficient animals demonstrate decreased fibrinogenolytic activity in comparison to ticks fed on immunocompetent animals. Reduced levels of D-dimer (fibrin degradation product) were evident in ticks fed on immunodeficient animals in comparison to ticks fed on immunocompetent animals. Increased engorgement weights were noted for ticks fed on immunodeficient animals in comparison to ticks fed on …

The Role Of Neighborhood Characteristics In Late Stage Melanoma Diagnosis Among Hispanic Men In California, Texas, And Florida, 1996-2012, Valerie M. Harvey, Clinton W. Enos, Jarvis T. Chen, Hadiza Galadima, Karl Eschbach

Community & Environmental Health Faculty Publications

Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD) and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late …

Impact Of Disease On The Survival Of Three Commercially Fished Species, John M. Hoenig, Maya L. Groner, Matthew W. Smith, Wolfgang K. Vogelbein, David M. Taylor, Donald F. Landers Jr., John T. Swenarton, David T. Gauthier

Biological Sciences Faculty Publications

Recent increases in emergent infectious diseases have raised concerns about the sustainability of some marine species. The complexity and expense of studying diseases in marine systems often dictate that conservation and management decisions are made without quantitative data on population-level impacts of disease. Mark-recapture is a powerful, underutilized, tool for calculating impacts of disease on population size and structure, even in the absence of etiological information. We applied logistic regression models to mark-recapture data to obtain estimates of disease-associated mortality rates in three commercially important marine species: snow crab (Chionoecetes opilio) in Newfoundland, Canada, that experience sporadic epizootics …

Epidemiology Of Knee Sprains In Youth, High School, And Collegiate American Football Players, Daniel R. Clifton, James A. Onate, Eric Schussler, Aristarque Djoko, Thomas P. Dompier, Zachary Y. Kerr

Rehabilitation Sciences Faculty Publications

Context: Assessment of health-related quality of life (HRQOL) after injury is important. Differences in HRQOL between nonathletes and athletes and between injured and uninjured athletes have been demonstrated; however, the evidence has not been synthesized.

Objective: To answer the following questions: (1) Does HRQOL differ among adolescent and collegiate athletes and nonathletes? (2) Does HRQOL differ between injured adolescent and collegiate athletes or between athletes with a history of injury and uninjured athletes or those without a history of injury?

Data Sources: We systematically searched CINAHL, MEDLINE, SPORTDiscus, and PubMed. A hand search of references was also conducted. Study Selection: …

Somatosensory Deficits In Post-Acl Reconstruction Patients: A Case-Control Study, Johanna M. Hoch, William O. Perkins, Jonathan R. Hartman, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Introduction: Diminished cutaneous detection thresholds have been identified in patients with multiple orthopedic conditions, and these phenomena may occur in postanterior cruciate ligament reconstructed (ACLR) patients. The purpose of this study was to determine if differences in lower extremity cutaneous detection thresholds exist in post-ACLR patients when compared with healthy controls. Methods: Fifteen individuals who were post-ACLR and 15 individuals who had no history of knee injury participated. Light touch cutaneous detection thresholds were assessed at 4 locations on the foot and ankle (first metatarsal, fifth metatarsal, medial malleolus, and lateral malleolus). Nonparametric statistics examined group differences between the …