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Testing Claims Of Efficacy And Mechanism Of Action For Emotion Focused Couples Therapy: A Dyadic Case Study Using Time-Series Design, Albert Jun-Wei Wong

Doctoral Dissertations

The overall purpose of this study was to test claims regarding both the efficacy and mechanism of change for Emotion Focused Couple Therapy (EFT). Although a number of treatment outcome studies have been conducted on EFT, the vast majority of these studies emanate from the research laboratories associated with the two founders of EFT. Additionally, most EFT research has examined treatment outcome rather than mechanisms of change. This study used a time-series single-case experimental design approach to examine both the efficacy and the mechanisms of change in EFT for couple distress. I systematically tracked the symptoms of couple distress across …

Absorption And Utilization Of Choline And Vitamin B12 In Lactating Dairy Cows Using Different Delivery Methods, Virginia Maria Artegoitia Etcheverry

Doctoral Dissertations

Choline and vitamin B12 are essential nutrients for growth and performances of production animals. However, both nutrients are extensively degraded during digestion in the rumen. This thesis comprised three experiments. First, four cows equipped with a rumen cannula and catheters in the portal vein and a mesenteric artery received a post-ruminal bolus of: 1) cyanocobalamin (CN-CBL) alone (0.1 g) [gram], 2) CN-CBL (0.1 g) + casein (10 g) or 3) CN-CBL (0.1 g) + whey proteins (10 g). After the bolus, blood samples were taken until 24 h [hour] post-bolus. The intestinal absorption of CN-CBL was greater when the vitamin …

The Green Staff Of Asclepius: Envisioning Sustainable Medicine, Jason Lee Fishel

Doctoral Dissertations

To make society sustainable our institutions must also become sustainable. As an institution, health care contributes to environmental degradation. While unsurprising, contributions to environmental degradation increase risk factors for disease and illness, effectively frustrating the goals of medicine. To find ways to make health care sustainable I begin by reviewing the literature on sustainability from within environmental ethics and two previous attempts at envisioning sustainable health care in order to learn what to include in a vision of sustainable health care. Then I examine problems specific to making medicine sustainable by investigating how sustainability might affect the principles of medicine. …

Effect Of Small Interfering Rnas On In Vitro Replication And Gene Expression Of Feline Coronavirus, Eman Ahmed Mohamed Anis

Doctoral Dissertations

Feline corononavirus (FCoV) infection is ubiquitous in domestic cat populations worldwide and is usually associated with subclinical or mild enteritis. However, in some cats infection may result in the development of a fatal progressive disease called feline infectious peritonitis (FIP). FIP is considered to be the major cause of infectious-related death in pet cats. Currently, there is no protective vaccine or curative treatment to this highly fatal disease. In this study, we evaluated the ability of small interfering RNAs (siRNAs) to inhibit the in vitro viral replication and gene expression of FCoV as a potential treatment for FIP.

Five synthetic …

Living With Hypertension: Experiences Of Black Men Related To Their Perceptions Of The Clinical Encounter At Diagnosis, Glenda Mccartney Feild

Doctoral Dissertations

Introduction: In the U.S., hypertension (HTN) is the most common primary diagnosis and HTN related illnesses are the number one cause of death. Being a member of the Black population increases the risk for developing HTN. Black males are reported to develop HTN earlier in life and have a high incidence of undiagnosed, untreated, and uncontrolled HTN. Sociocultural and gender barriers influence this population’s perceptions of medical experiences, which affects their participation in health-promoting behaviors such as eating a healthy diet, engaging in regular physical activity, avoiding tobacco, limiting alcohol consumption, and decreasing stress.

Purpose: The purpose of this study …

"I Saved The Iguana": A Mixed Methods Study Examining Responder Mental Health After Major Disasters And Humanitarian Relief Events, Suzanne Marie Boswell

Doctoral Dissertations

The purpose of this mixed methods study was twofold. The first was to use Hobfoll’s (1989) Conservation of Resources theory to predict psychological stress based on responders’ perceptions of resource adequacy. The second was to use qualitative interviewing to gain a more comprehensive understanding of the disaster/humanitarian responder experience.

The study is significant given the expanding role of nurses within disaster/humanitarian response organizations. Furthermore, psychological stress results in increased turnover of human resources in these organizations. This turnover is detrimental to humanitarian systems that already lack adequate coverage and sufficiency because funding and human/material resources grow at a slower pace …

Dissociation And Sexual Trauma: The Moderating Role Of Somatization, Amineh Abbas

Doctoral Dissertations

This study examined various types of trauma, with an emphasis on sexual trauma across the lifespan, in a clinical sample of male and female adult outpatients assessed for trauma, somatization, and dissociation. Two hundred forty-five adult outpatients at the University of Tennessee Psychological Clinic were administered the Dissociative Experiences Scale (DES), the Traumatic Experiences Checklist (TEC), and Symptom Checklist-90-Revised (SCL-90-R), as part of the routine intake procedure. Of those individuals, 200 patients completed the questionnaires correctly and were included in the final study sample. The experience of sexual trauma indeed accounted for additional variance in somatization scores over and above …

Belief In The Efficacy Of Psychotherapy (Bep): Psychometric Scale Development And Examination Of Theoretical Correlates, Erin Gray Volpe

Doctoral Dissertations

This study develops a psychometric scale measuring the extent to which an individual expects psychotherapy to be effective: The Belief in the Efficacy of Psychotherapy (BEP). Based in the research that describes expectations for therapy as process expectations or outcome expectations, the BEP scale is developed to measure outcome expectations for therapy exclusively (i.e., is psychotherapy helpful?). Current expectancy measures vastly underrepresent outcome expectations in particular, and BEP will be the first to focus solely on outcome expectations. Additionally, the proposed BEP scale measures the general cultural belief system (i.e., non-patients) and their beliefs about psychotherapy and therapists specifically, …

The Effects Of A Brief Mindfulness Intervention On Lab-Based Aggression, Amanda Eliza Seavey

Doctoral Dissertations

Aggression and violence are severe and prevalent problems associated with numerous negative health consequences and increased health care costs. Prevalence rates vary with the highest rates being among young adult populations. Some research indicates that aggression perpetration is an attempt at controlling negative affect. Therefore, many have posited that emotion regulation may be an amenable risk factor for violence and aggression, and interventions such as mindfulness-based therapies designed to enhance emotion regulation and distress tolerance may be helpful. Previous research has found positive effects on psychological well-being using even brief mindfulness interventions. Thus, the current study aimed to investigate how …

Exploring Perceptions Of Staff Registered Nurse Preceptors For Undergraduate, Pre-Licensure Nursing Students, Katherine C. Hall

Doctoral Dissertations

Staff nurses are increasingly called upon to accept more responsibilities and roles in addition to provider of patient care, including that of preceptor. Aside from dealing with demands of high acuity patients, working long hours with inadequate staffing, and carrying heavy workloads, nurses may view teaching and supervising students as an additional burden, time-consuming, and not part of their role. The purpose of this dissertation was to explore staff nurse experiences as preceptors to undergraduate, pre-licensure nursing students. Emphasis was placed on exploring RN’s perceptions of the role, specifically the preparation for, support in, and understanding of what the role …

Hospital Competitive Strategies And Performance Outcomes, Wei Wu

Doctoral Dissertations

Hospitals are under increasing pressure to improve performance and healthcare outcomes. The existing literature does not point to a clear conclusion on whether competition can help address the performance challenges of hospitals which lead to improvements in clinical outcomes. Prior research on the effects of hospital competitive strategies usually focuses on one strategy or one type of outcome at a time. As such, there is a dearth of systematical studies on different hospital competitive strategies and their consequent performance outcomes.

The main objective of this dissertation is to examine several hospital competitive strategies and quantitatively validate the implications of each …

Peace Under Pressure: Portraits Of Christian Leadership In College Basketball Coaches, Charles Henry Wilson Jr.

Doctoral Dissertations

NCAA Division I college basketball coaching is a high-stakes, high-reward profession. This study is based on three premises: (a) there is increasing pressure on college basketball coaches to win immediately and win consistently; (b) coaches are expected to maintain their integrity; (c) the pressure to win immediately and win consistently can influence some coaches to compromise their integrity. Given that context, the purpose of this study was to investigate and illuminate the lived experience of Christian head men’s and women’s basketball coaches at public, NCAA Division I institutions. This study was guided by two guiding research questions: (a) What is …

Communication, Control, And Time: The Lived Experience Of Uncertainty In Adolescent Pregnancy, Elizabeth Dortch Dalton

Doctoral Dissertations

This study qualitatively examined the lived experience of uncertainty among pregnant adolescents. Utilizing a phenomenological approach, long interviews were conducted with 10 pregnant adolescent women between the ages of 15-18 years. Interviews were transcribed and analyzed using the process of phenomenological explication. Data, emergent themes, memos, and a detailed audit trail were maintained using the qualitative data analysis package Nvivo 10 for Mac (beta version). Findings can be summarized with eight themes that underlie the essence of uncertainty in adolescent pregnancy: suspicion and denial, disclosure and reactions, controlling the flow of information, relational renegotiation, the emerging reality of pregnancy, information …

Intimacy Uncertainty And Identity In Gay Male Couples Dealing With A Serodiscordant Hiv Status, Scott Allen Eldredge

Doctoral Dissertations

When individuals are diagnosed with a chronic illness, their lives instantly change. Daily routines are interrupted and attendance to the symptoms and side effects of illness and medication becomes a daily chore. However, the patient is not the only one that feels the disruptive effects of illness and the partner of the chronically ill patient must also contend with the daily effects of an illness that they themselves do not have. In the case of HIV, the infectious nature of the disease, along with the stigma associated with the disease, serve to be additional sources of stress in an already-stressful …

Development Of The Biostatistics And Clinical Epidemiology Skills Assessment For Medical Residents, Patrick Brian Barlow

Doctoral Dissertations

This study developed the Biostatics and Clinical Epidemiology Skills (BACES) assessment, and established its preliminary item characteristics and validity evidence. Unlike previous instruments, the BACES assessment was developed and tested using an item response theory (IRT) approach to measurement to create a new, adaptive biostatistics and clinical epidemiology knowledge assessment for graduate medical professionals. Thirty multiple-choice questions were written to focus on interpreting relevant examples of clinical epidemiology and statistical methods. A four person expert panel reviewed these items for content validity. After this review, the BACES assessment was administered to 147 medical residents across three academic medical centers. Results …

Associations Of Total Activity Counts And Physical Activity Intensity Levels With The Metabolic Syndrome: A Structural Equation Modeling Approach, Dana Lizbeth Wolff

Doctoral Dissertations

To clarify the protective benefits of physical activity (PA), epidemiologists and public health researchers continue to seek improved methods of assessing PA. In particular, accelerometers have gained acceptance with researchers as they provide reliable estimates of PA and can record both the amount and intensity of ambulatory movement. However, there is concern that accelerometer data reduction techniques may not provide quantitatively accurate measurements of time spent in various PA intensity categories. One way to circumvent these inaccuracies is to use the accelerometer-derived total activity counts (TAC), which is a more direct expression of what the monitor records.

In order to …

Discovery Of The Meanings, Expressions, And Practices Related To Malaria Care Among The Maasai, Cecily Weller Strang

Doctoral Dissertations

Each year, malaria invades and infects 300 million persons, kills up to 1 million, and 90% of deaths are among children in Sub-Saharan Africa. Malaria illness and deaths cost Africa $12 billion in lost productivity. Eighty percent of all malaria cases occur in 17 African countries; one is Kenya, where one group suffers incessantly from malaria, the Maasai. Their pastoral, indigenous lifestyle places the Maasai men, women, and children daily at malaria risk. Although malaria is preventable and treatable, high mortality and morbidity occurrence continues. Global interest in malaria care includes prevention, treatment, and eradication. The current use of generic …

Effect Of A Leucine/Pyridoxine Nutraceutical On Energy Metabolism And Satiety In Lean And Obese Dogs, Maryanne Murphy

Doctoral Dissertations

Obesity is the most common nutritional disorder of pet dogs (prevalence of 23–59%). This 29-week study investigated a nutraceutical containing 1 g leucine and 13 mg pyridoxine designed to maintain lean muscle mass while decreasing adiposity when compared with positive and negative controls. After determining individual maintenance calorie requirements over 3 – 4 weeks, thirty-six healthy adult Beagles were divided into obesification, weight gain prevention, or maintain ideal body weight arms.

Obesity was induced and during a weight loss phase, excess calories were removed, and obesification dogs were given nutraceutical with CAD (ObN), placebo with CAD (ObP), or a therapeutic …