Medicine and Health Sciences Commons^™

Integrating Stakeholder Feedback Into The Design Of A Peer-Delivered Primary Care Wellness Program: A Rapid Qualitative Study, Emily M. Johnson, Kyle Possemato, Matthew Chinman, Gala True, Jacob Hedges, Brittany N. Hampton, E. Jennifer Edelman, Stephen A. Maisto

School of Medicine Faculty Publications

Background: Individuals seen in Primary Care with behavioral health concerns who decline behavioral health treatment may benefit from the support of peers (consumers in recovery from behavioral health concerns employed to support other consumers). Whole Health STEPS is a new intervention for Veterans in Primary Care with behavioral health concerns which combines essential elements of peers’ role and the Whole Health model using a stepped-care design. We incorporated stakeholder feedback in the Whole Health STEPS design to improve fit with Veterans, peers, and primary care settings. Methods: We conducted semi-structured qualitative interviews with VA staff using questions derived from the …

Covid‑19‑Related Risk, Resilience, And Mental Health Among Mexican American Mothers Across The First Year Of The Pandemic, Amy L. Non, Elizabeth S. Clausing, Sandraluz Lara‑Cinisomo, Kimberly L. D’Anna Hernandez

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Background Latina mothers have been especially affected by the pandemic and historically exhibit high rates of depression and anxiety. However, few longitudinal studies have assessed the effect of the pandemic on this vulnerable population. We hypothesized that COVID-19-related stressors would associate with psychological distress among Latina mothers across the first year of the pandemic.

Methods We investigated COVID-19-related impact, stigma, and fears across two critical time points and changes in these measures in relation to changes in maternal anxiety and depression among mothers of Mexican descent living in Southern California (n=152). Surveys were administered within 5–16 weeks of …

Traumatic Stress-Induced Increases In Anxiety-Like Behavior And Alcohol Self-Administration Are Mediated By Central Amygdala Crf1 Neurons That Project To The Lateral Hypothalamus, Marcus M. Weera, Daniel A. Webster, Rosetta S. Shackett, Federica Benvenuti, Jason W. Middleton, Nicholas W. Gilpin

School of Graduate Studies Faculty Publications

Avoidance stress coping, defined as persistent internal and/or external avoidance of stress-related stimuli, is a key feature of anxiety- and stress-related disorders, and contributes to increases in alcohol misuse after stress exposure. Previous work using a rat model of predator odor stress avoidance identified corticotropin-releasing factor (CRF) signaling via CRF type-1 receptors (CRF1) in the central amygdala (CeA), as well as CeA projections to the lateral hypothalamus (LH) as key mediators of conditioned avoidance of stress-paired contexts and/or increased alcohol drinking after stress. Here, we report that CRF1-expressing CeA cells that project to the LH are preferentially activated in male …

Virtual Delivery Of Stress Management And Resiliency Training (Smart) During The Covid-19 Pandemic To Hematology/Oncology Fellows: A Pilot Study, Colt Williams, Sherry Chesak, Deirdre R. Pachman, Ross Dierkhising, Laura Rhee, Konstantinos Leventakos

Journal of Wellness

Introduction: Medical trainees experience a high degree of stress that predisposes them to burnout. This pilot study tested a scalable approach to deliver a validated resilience program (Stress Management and Resiliency Training (SMART)) among Hematology/Oncology fellows at an academic medical center.

Methods: This was a mixed-methods, prospective, single-arm clinical trial involving Hematology/Oncology fellows at Mayo Clinic in Rochester, MN, USA. Four one-hour training sessions were conducted virtually with 26 fellows. Stress, burnout, and emotional resilience were measured at baseline, three months, and six months post-intervention using the Perceived Stress Scale (PSS-10), Maslach Burnout Inventory (MBI-HSS), and Connor-Davidson Resilience …

Reduced Grey Matter Volume In Adolescents With Conduct Disorder: A Region‑Of‑Interest Analysis Using Multivariate Generalized Linear Modeling, Ru Zhang, R. James R. Blair, Karina S. Blair, Matthew Dobbertin, Jordan E. Pierce, Johannah Bashford‑Largo, Ahria J. Dominguez, Melissa Hatch, Sahil Bajaj

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Background Conduct disorder (CD) involves a group of behavioral and emotional problems that usually begins during childhood or adolescence. Structural brain alterations have been observed in CD, including the amygdala, insula, ventrolateral and medial prefrontal cortex, anterior cingulate cortex, and fusiform gyrus. The current study developed a multivariate generalized linear model (GLM) to differentiate adolescents with CD from typically developing (TD) adolescents in terms of grey matter volume (GMV).

Methods The whole‐brain structural MRI data were collected from 96 adolescents with CD (mean age = 16.188 ± 1.259 years; mean IQ = 104.292 ± 8.107 ; 63 males) and 90 …

Momentary Shame & Executive Function: Negative Self-Attribution As A Precursor To Performance Error, Mary M. Bryan

Master's Theses & Other Graduate Student Works

Individuals who experience momentary shame experiences may attribute a sense of wrongdoing to their identity. Witnessing one's violation of social mores may promote withdrawal, rumination, and/or aggression, which may restrict cognitive processes that affect typical executive function. In particular, task initiation, inhibition, and cognitive flexibility were selected when measuring levels of executive dysfunction. 10 participants were asked to complete shame and executive function pre-screeners, a shame- or neutral-affective writing task, and a real-time executive function measure. Results suggest that those who self-reported higher levels of shame proneness and underwent a shame-affective stimulus may have displayed improved inhibition and cognitive flexibility. …

The Design And Impact Of A Clinic-Based Community Program On Food Insecurity, Healthy Eating Behaviors, And Mood, Tiffany Wesley Ardoin, Elizabeth Perry, Chelsea Morgan, Jared Hymowitz, Donald Mercante

School of Medicine Faculty Publications

Food insecurity is a national issue that disproportionately impacts Louisiana citizens, contributing to the state’s poor health outcomes. We know that the Supplemental Nutrition Assistance Program (SNAP) and food pantries improve access to food, but we have limited data on what interventions improve food insecurity. The Geaux Get Healthy Clinical Program at Our Lady of the Lake (GGHOLOL) is a clinic-based community program that leverages community partnerships and a clinical setting to provide education and access to resources for individuals with food insecurity. This prospective study examines the impact of GGHOLOL on food insecurity as a pre-post survey evaluation over …

Specialized Late Cingulo-Opercular Network Activation Elucidates The Mechanisms Underlying Decisions About Ambiguity, Jordan E. Pierce, Nathan M. Petro, Elizabeth Clancy, Caterina Gratton, Steven E. Petersen, Maital Neta

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Cortical task control networks, including the cingulo-opercular (CO) network play a key role in decision-making across a variety of functional domains. In particular, the CO network functions in a performance reporting capacity that supports successful task performance, especially in response to errors and ambiguity. In two studies testing the contribution of the CO network to ambiguity processing, we presented a valence bias task in which masked clearly and ambiguously valenced emotional expressions were slowly revealed over several seconds. This slow reveal task design provides a window into the decision-making mechanisms as they unfold over the course of a trial. In …

Fornix Volumetric Increase During Aging Associates To Microglia Activation Leading To Defective Cognitive Performance, Marcela Cárdenas Tueme, Luis Ángel Trujillo-Villarreal, Victor Ramírez-Amaya, Eduardo Garza-Villarreal, Alberto Camacho-Morales, Diana Reséndez-Pérez

Research Symposium

Background: Ageing displays a low-grade pro-inflammatory profile in blood and brain. It has been documented proinflammatory cytokines accumulation leading to neuroinflammation during aging. Aged brains integrate pro inflammatory cytokines accumulation, active microglia and volumetric changes which correlates with defective cognitive performance and neurodegeneration.

Methods: Mice from 2-,12- and 20-months-old of age were submitted to different memory tests: Y-maze, Barnes maze, object location test and object location test. Afterwards, we performed structural MRI to evaluate macrostructural changes related to memory and learning regions. Following this, we also evaluated in peripheral blood and in brain tissue the presence of pro-inflammatory cytokines …

Acute Ethanol Modulates Synaptic Inhibition In The Basolateral Amygdala Via Rapid Nlrp3 Inflammasome Activation And Regulates Anxiety-Like Behavior In Rats, Soumyabrata Munshi, Lucas Albrechet-Souza, Raoni Conceição Dos-Santos, Claire E. Stelly, Maria E. Secci, Nicholas W. Gilpin, Jeffrey G. Tasker

School of Graduate Studies Faculty Publications

Chronic alcohol exposure leads to a neuroinflammatory response involving activation of the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome and pro-inflammatory cytokine production. Acute ethanol (EtOH) exposure activates GABAergic synapses in the central and basolateral amygdala (BLA) ex vivo, but whether this rapid modulation of synaptic inhibition is due to an acute inflammatory response and alters anxiety-like behavior in male and female animals is not known. Here, we tested the hypotheses that acute EtOH facilitates inhibitory synaptic transmission in the BLA by activating the NLRP3 inflammasome-dependent acute inflammatory response, that the alcohol-induced increase in inhibition is cell type- and …

The Difficulty In The Diagnosis And Management Of Antidepressant Discontinuation Syndrome, Sidney Charm D. Reyes

School of Medicine Publications and Presentations

Background: Antidepressant discontinuation syndrome (ADS) is a condition that occurs in about 20% of patients following the abrupt reduction/stoppage of any antidepressant medication that has been taken continuously for at least one month.

Case Presentation: We present a 36-year-old Hispanic woman who initially presented for evaluation of flu-like symptoms (subjective fever, rhinorrhea) and worsening body aches, trouble sleeping, and headaches for the past three days. She also reported recent exposure to a sick co-worker. Rapid flu, strep, and COVID tests came back negative. Pt was diagnosed with a viral URI and was discharged with counseling on supportive treatment. The patient …

Exploring The Effects Of Christian Worldviews On Heart Rate, Stress, And Adjustment After Loss In Bereaved Individuals, Emma Radini Ratnavel

Honors Scholar Theses

The objective of this study is to investigate the correlation between Christian values, perceptions of God, and physiological stress, assessed through heart rate, among individuals who are experiencing grief due to the loss of a loved one. Previous studies have analyzed various physiological effects on the body. There are very few studies that examine the correlation between Christian values and heart rate in bereaved participants. To explore these topics further, this study analyzes 59 undergraduate students who have recently lost a loved one, identify as a Christian, and are at least 18 years old. The participants' perceptions of God and …

Assessing Blood Oxygen Level–Dependent Signal Variability As A Biomarker Of Brain Injury In Sport-Related Concussion, Evan D. Anderson, Tanveer Talukdar, Grace Goodwin, Valentina Di Pietro, Kamal M. Yakoub, Christopher E. Zwilling, David Davies, Antonio Belli, Aron K. Barbey

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Mild traumatic brain injury is a complex neurological disorder of significant concern among athletes who play contact sports. Athletes who sustain sport-related concussion typically undergo physical examination and neurocognitive evaluation to determine injury severity and return-to-play status. However, traumatic disruption to neurometabolic processes can occur with minimal detectable anatomic pathology or neurocognitive alteration, increasing the risk that athletes may be cleared for return-to-play during a vulnerable period and receive a repetitive injury. This underscores the need for sensitive functional neuroimaging methods to detect altered cerebral physiology in concussed athletes. The present study compared the efficacy of Immediate Post-concussion Assessment and …

Sex Differences In Mood And Anxiety-Related Outcomes In Response To Adolescent Nicotine Exposure, Tsun Hay Jason Ng

Electronic Thesis and Dissertation Repository

Nicotine dependence is causally linked to increased risk of mood/anxiety disorders in later life. Females are reported to experience a higher prevalence of anxiety/depressive disorders and challenges in smoking cessation therapies, suggesting a potential sex-specific response to nicotine exposure and mood/anxiety disorder risk. However, pre-clinical evidence of sex-specific responses to adolescent nicotine exposure is unclear. Thus, to determine any sex differences in anxiety/depressive-related outcomes, adolescent male and female Sprague Dawley rats received nicotine (0.4 mg/kg; 3x daily) or saline injections for 10 consecutive days, followed by behavioural testing, in-vivo electrophysiology and Western Blot analyses. Our results revealed that adolescent nicotine …

Academic Motivation Decreases Across Adolescence For Youth With And Without Attention-Deficit/Hyperactivity Disorder: Effects Of Motivation On Academic Success, Zoe Smith, Marcus Flax, Stephen P. Becker, Joshua Langberg

Psychology: Faculty Publications and Other Works

This longitudinal study examined growth trajectories of academic motivation in youth with and without attention-deficit/hyperactivity disorder (ADHD) across the important developmental transition from middle school to high school, and associations with academic success. Consistent with self-determination theory (SDT) of motivation, trajectories of amotivation, extrinsic motivation, and intrinsic motivation were modeled.

Identification Of Structural Brain Alterations In Adolescents With Depressive Symptomatology, J. Bashford‑Largo, R. James R. Blair, Karina S. Blair, Matthew Dobbertin, Ahria Dominguez, Melissa Hatch, Sahil Bajaj

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Introduction: Depressive symptoms can emerge as early as childhood and may lead to adverse situations in adulthood. Studies have examined structural brain alternations in individuals with depressive symptoms, but findings remain inconclusive. Furthermore, previous studies have focused on adults or used a categorical approach to assess depression. The current study looks to identify grey matter volumes (GMV) that predict depressive symptomatology across a clinically concerning sample of adolescents.

Methods: Structural MRI data were collected from 338 clinically concerning adolescents (mean age = 15.30 SD=2.07; mean IQ = 101.01 SD=12.43; 132 F). Depression symptoms were indexed via the Mood …

Predicting Suicide Attempt History: Self-Report And Objective Measures Of Pain, Boriana Lassiter

<strong> Theses and Dissertations </strong>

The aim of this study was to replicate a factor analysis of the Painful and Provocative Events Scale (PPES), to test whether commonly used self-report measures associated with the Interpersonal Theory of (IPTS) would predict suicide attempt status and suicidal history, and to test whether physical pain sensitivity would differentiate suicide attempers, ideators, and those with no suicidal history (controls). Factor analysis of the PPES yielded a 5-factor solution consisting of Rare and Illegal Activities, Abuse Experience, Dangerous Sports, Medical Trauma, and Body Modification. Only Abuse Experience predicted suicide attempt status and overall suicidal history. Abuse Experience, the Psychache Scale, …

Using Behavior Sequence Analysis To Study Teams During Long- Duration Isolation And Confinement, Andres Käosaar, Dr. Nathan Smith, Dr. David A. Keatley, Pranav Ambhorkar, Dr. Moritz Von Looz, Konstantinos Konstantinidis

Journal of Human Performance in Extreme Environments

With a renewed impetus and appetite for human space exploration, both government-funded agencies and private companies are focusing on longer and farther crewed missions into the solar system. Such space missions rely on highly interdependent teams living and working together in isolated, confined, and extreme (ICE) environments. Understanding the behavioral patterns of teams in ICE environments is, thus, paramount for the future success of such missions. Due to the complexity of studying ICE teams, several researchers have called for methodological innovations to advance knowledge in this area. In the current research, a proof-of-concept methodological approach is introduced that provides a …

Cerebral Hyperemia Is Not A Sole Modulator Of Postexercise Executive Function Benefit: Evidence From Hypercapnia And Passive Exercise, Mustafa Shirzad

Electronic Thesis and Dissertation Repository

A single bout of exercise improves executive function (EF); however, the physiological mechanism(s) contributing to this benefit are unclear. One candidate mechanism for the benefit is an exercised-mediated increase in cerebral blood flow (CBF) that improves neural efficiency. In my thesis, I conducted two experiments to assess the relationship between an increase in CBF and EF. In Experiment 1, I examined passive exercise, and in Experiment 2, I examined a 2.5% hypercapnic environment given that both interventions increase CBF independent of the metabolic demands of volitional muscle activity. Experiment 1 indicated that passive exercise increased CBF and was associated with …

Previous Health Care Experiences’ Influence On Health Care Perceptions Among Residents In Six Homeless Shelters In Seattle, Washington, July–October 2021, Ashley A. Meehan, Sarah N. Cox, Nicholas B. Thuo, Julia H. Rogers, Amy C. Link, Miguel A. Martinez, Natalie K. Lo, Brian J. Manns, Melissa A. Rolfes, Eric J. Chow, Helen Y. Chu, Emily Mosites, Morhaf Al Achkar

Journal of Patient-Centered Research and Reviews

Purpose: The study purpose was to learn and describe 1) where homeless shelter residents receive health care, 2) what contributes to positive or negative health care experiences among shelter residents, and 3) shelter resident perceptions toward health care.

Methods: Semi-structured interviews (SSIs) utilizing purposive sampling and focus group discussions (FGDs) utilizing convenience sampling were conducted at 6 homeless shelters in Seattle-King County, Washington, during July–October 2021. All residents (age ≥ 18) were eligible to participate. SSIs were conducted with 25 residents, and 8 FGDs were held. Thematic analysis was conducted using Dedoose.

Results: Participants received health care …

Incorporating Poi As A Therapeutic Modality For Preschool Aged Children In The Care Clinic, Danielle Zirkle

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Self-Care Practices In Doctoral Nursing Students And Effects On Educational Experience, Megan Lutman

Dissertations

Problem: Doctoral nursing students are often faced with stressors on top of their schooling, one of which is continuing to work while pursuing their education. This in combination with normal life stressors can be challenging. The purpose of this project was to survey doctoral nursing students on what their current self-care practices.

Methods: An exploratory needs assessment project was created to gather data from Doctor of Nursing practice (DNP) and Doctor of Philosophy (PhD) nursing students in an urban, mid-sized, Midwestern, public university to identify current self-care practices, barriers to self-care, preference of self-care practices, and the impact these …

Acute Agitation Intervention Tool For Reduction Of Polypharmacy, Brooks J. Propst

Dissertations

Introduction: Patients with behavioral health diagnoses are among the highest risk for
aggression. For pediatric patients with behavioral health needs, urgent treatment is
needed for aggressive behavior, due to the potential unwanted outcomes. The purpose of this Quality Improvement (QI) pilot project was to implement an Acute Agitation Intervention Tool that uses the Broset Violence Checklist (BVC) to guide
pharmacological intervention for mild and moderate to severe agitation in pediatric
patients with behavioral health needs ages 8 to 18 to decrease the number of medications that patients are getting per agitation event over a 12-week period.

Methods: This QI included …

Specialized Late Cingulo-Opercular Network Activation Elucidates The Mechanisms Underlying Decisions About Ambiguity, Jordan E. Pierce, Nathan M. Petro, Elizabeth Clancy, Caterina Gratton, Steven E. Petersen, Maital Neta

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Cortical task control networks, including the cingulo-opercular (CO) network play a key role in decision-making across a variety of functional domains. In particular, the CO network functions in a performance reporting capacity that supports successful task performance, especially in response to errors and ambiguity. In two studies testing the contribution of the CO network to ambiguity processing, we presented a valence bias task in which masked clearly and ambiguously valenced emotional expressions were slowly revealed over several seconds. This slow reveal task design provides a window into the decision-making mechanisms as they unfold over the course of a trial. In …

Effects Of Sex And Estrous Cycle On Intravenous Oxycodone Self-Administration And The Reinstatement Of Oxycodone-Seeking Behavior In Rats, Nicole M. Hinds, Ireneusz D. Wojtas, Corinne A. Gallagher, Claire M. Corbett, Daniel F. Manvich

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

The increasing misuse of both prescription and illicit opioids has culminated in a national healthcare crisis in the United States. Oxycodone is among the most widely prescribed and misused opioid pain relievers and has been associated with a high risk for transition to compulsive opioid use. Here, we sought to examine potential sex differences and estrous cycle-dependent effects on the reinforcing efficacy of oxycodone, as well as on stress-induced or cue-induced oxycodone-seeking behavior, using intravenous (IV) oxycodone self-administration and reinstatement procedures. In experiment 1, adult male and female Long-Evans rats were trained to self-administer 0.03 mg/kg/inf oxycodone according to a …

Unmet Needs And Coping Strategies Of Older Underserved Veterans During The Covid-19 Pandemic, Trenton M. Haltom, Joyce Tiong, Tracy L. Evans, Nipa Kamdar, Gala True, Mark E. Kunik

School of Medicine Faculty Publications

Introduction: The COVID-19 pandemic has had profound impacts on people with diabetes, a group with high morbidity and mortality. Factors like race, age, income, Veteran-status, and limited or interrupted resources early in the COVID-19 pandemic compounded risks for negative health outcomes. Our objective was to characterize the experiences and needs of under-resourced Veterans with type 2 diabetes during the COVID-19 pandemic. Methods: We conducted semi-structured qualitative interviews (March through September 2021) with U.S. military Veterans with diabetes. Transcripts were analyzed using a team-based, iterative process of summarizing and coding to identify key themes. Participants included Veterans (n = 25) who …

A Public Health Educational Campaign For Sudden Unexpected Infant Death (Suid) Intervention, Elia G. Peralta Landeros

Master's Projects and Capstones

Purpose: The rate of infant mortality serves as a crucial indicator of the overall health of society (CDC, 2022). The five leading causes of infant mortality are birth defects, preterm birth, sudden infant death syndrome, injuries, and maternal pregnancy complications. The prevalence of infant mortality varies across states, with eastern states and minority-ethnicity infants having higher prevalence. This thesis proposes utilizing the Safe to Sleep framework to introduce Giving Breath, a public health education campaign that introduced breastfeeding as an intervention to Sudden Unexpected Infant Death (SUID).

Methods:

1. Analyze current and new policies' impact on women's rights to breastfeed …

The Impact Of Community Of Inquiry And Self-Efficacy On Student Attitudes In Sustained Remote Health Professions Learning Environments, Amanda K. Burbage, Yuane Jia, Thuha Hoang

School of Allied Health Professions Faculty Publications

Background: Sustained remote learning environments, like those experienced in late 2020 due to the COVID-19 pandemic, share characteristics with online courses but were not intentionally designed to delivered virtually. The purpose of this study was to investigate the impact of Community of Inquiry, a widely used online learning environment framework, and self-efficacy on perceived student attitudes within sustained remote learning environments. Methods: An interinstitutional team of health professions education researchers collected survey data from 205 students representing a wide range of health professions in five U.S. institutions. Latent mediation models under structural equation modeling framework were used to examine whether …

Lifelong Fitness In Ambulatory Children And Adolescents With Cerebral Palsy I: Key Ingredients For Bone And Muscle Health, Noelle G. Moreau, Kathleen M. Friel, Robyn K. Fuchs, Sudarshan Dayanidhi, Theresa Sukal-Moulton, Marybeth Grant-Beuttler, Mark D. Peterson, Richard D. Stevenson, Susan V. Duff

School of Allied Health Professions Faculty Publications

Physical activity of a sufficient amount and intensity is essential to health and the prevention of a sedentary lifestyle in all children as they transition into adolescence and adulthood. While fostering a fit lifestyle in all children can be challenging, it may be even more so for those with cerebral palsy (CP). Evidence suggests that bone and muscle health can improve with targeted exercise programs for children with CP. Yet, it is not clear how musculoskeletal improvements are sustained into adulthood. In this perspective, we introduce key ingredients and guidelines to promote bone and muscle health in ambulatory children with …

Arnold-Chiari Malformation-I Borderline Personality Disorder, Aric Huber, Matthew Driben, Eduardo Espiridion

Transformative Medicine (T-Med)

Introduction:
Arnold-Chiari Malformation I (AM-I) is a congenital anomaly that manifests with cerebellar dysfunction. There is a displacement of cerebellar tonsils into the foramen magnum. Several mood disorders, personality disorders, and intellectual disabilities are associated with AM-I. Borderline personality disorder (BPD) is characterized by symptoms of mood lability, impulsivity, extreme efforts of abandonment, splitting and dysfunctional relationships.

Case Description:
The patient is an early aged adult with a past medical history of AM-I, hypothyroidism, Wolff-Parkinson-White syndrome, and diabetes mellitus type II. The patient was admitted to the hospital after ingesting foreign bodies. He/she presented with mood lability, sad mood, anhedonia, …