Medicine and Health Sciences Commons^™

Facilitating And Enhancing Biomedical Knowledge Translation: An In Silico Approach To Patient-Centered Pharmacogenomic Outcomes Research, Kourosh Ravvaz

Theses and Dissertations

Current research paradigms such as traditional randomized control trials mostly rely on relatively narrow efficacy data which results in high internal validity and low external validity. Given this fact and the need to address many complex real-world healthcare questions in short periods of time, alternative research designs and approaches should be considered in translational research. In silico modeling studies, along with longitudinal observational studies, are considered as appropriate feasible means to address the slow pace of translational research. Taking into consideration this fact, there is a need for an approach that tests newly discovered genetic tests, via an in silico …

Family Connections: The Impact Of Self-Disclosure, Solidarity, And Stereotyping On Relational Satisfaction In Grandparent-Adult Grandchild Dyads, Deanne Priddis

Theses and Dissertations

As life expectancy increases, the length of time in both the grandparent and adult grandchild role increase. The grandparent-adult grandchild relationship is integral to the health and preservation of the family system. The sample for this quantitative study included 62 grandparent-adult grandchild dyads, 124 individuals. Findings indicate that both the grandparents and the adult grandchildren experienced meaning and burden in the grandparent-adult grandchild relationship. The six different types of solidarity (affectual, consensual, structural, associational, functional, and normative) had varying associations with relational satisfaction for the grandparents and adult grandchildren. Although there are several self-disclosures in a close grandparent-adult grandchild relationship, …

"I Know I Can't Be The Only Lesbian Out There:" An Inductive Thematic Analysis Of A Virtual Community Of Lesbian Breast Cancer Survivors, Rachael Lynn Wandrey

Theses and Dissertations

Sexual minority women are at a significantly greater risk for developing breast cancer (BC) than heterosexual women. Little is known about the unique BC experiences of lesbian women. The present thesis describes the findings of an inductive thematic analysis of messages posted to a large lesbian-specific discussion forum found on breastcancer.org. Fifteen themes were identified, including privileging sensation over appearance, experiencing heterosexism in medical contexts, believing others perceive a lack of distress over breast loss because of patient’s lesbian sexual orientation, feeling pressure from surgeons to get reconstructive surgery, and viewing the BC journey as a sexual-identity disclosure crisis. In …

Mentally Disordered Or Culturally Displaced? How The Ptsd Label Transforms Personhood In Us Military Veterans, Katinka Hooyer

Theses and Dissertations

Medical experts claim that Posttraumatic Stress Disorder among United States military service personnel, who served in Iraq and Afghanistan has contributed to an “epidemic of suicide” in the U.S. However, veterans, military commanders, and mental health providers argue that feelings of grief, guilt, mistrust, rage, and alienation are actually normal moral reactions to the abnormal situations that war creates. Furthermore, they argue that these normal reactions are currently transformed into a psychiatric diagnosis that promises clinical solution – a cure. Recent epidemiologic studies suggest that evidence-based clinical treatments are ineffective for a majority of veterans with PTSD and that the …

Predicting Postraumatic Stress Disorder In Single-Incident Trauma Survivors With An Acute Injury, Joshua C. Hunt

Theses and Dissertations

The objective of this study was to create a brief and easily administered screen that can be used by hospital staff to identify those at risk for the later development of PTSD. Utilizing previous research examining pretrauma, peritrauma, and posttrauma risk factors for the development of PTSD among single-incident trauma survivors with an acute injury, an item pool was created and reviewed by experts in the field. This item pool along with a previously created screen were given to patients admitted to two level 1 trauma centers in the U.S. A follow-up was conducted at one month in which participants …

Text Mining Of Patient Demographics And Diagnoses From Psychiatric Assessments, Eric James Klosterman

Theses and Dissertations

Automatic extraction of patient demographics and psychiatric diagnoses from clinical notes allows for the collection of patient data on a large scale. This data could be used for a variety of research purposes including outcomes studies or developing clinical trials. However, current research has not yet discussed the automatic extraction of demographics and psychiatric diagnoses in detail. The aim of this study is to apply text mining to extract patient demographics - age, gender, marital status, education level, and admission diagnoses from the psychiatric assessments at a mental health hospital and also assign codes to each category. Gender is coded …

College Student Lay Health Information Mediary Behavior: An Examination Of Ehealth Literacy And Unrequested Health Advice, Andrew William Cole

Theses and Dissertations

Lay health information mediary behavior (LHIMB) describes individuals seeking health information to relay to others. The current study examines LHIMB as a relationship between eHealth literacy and unrequested health advice (UHA). 254 undergraduate students completed a survey addressing eHealth literacy levels, general UHA behaviors and specific UHA episodes. Results on general UHA behaviors indicate no significant relationship exists between eHealth literacy and utilizing UHA in health decision-making or frequency of offering UHA. However, self-perceived health status and degree of health worry significantly predict using UHA in health decision-making. Further, as health worry increases, participants appear significantly more likely to receive …

Effects Of Dietary Preference On The Experience Of Anxiety, Depression And Acute Stress Response, Shaun Stearns

Theses and Dissertations

Research has demonstrated that high saturated fat and low carbohydrate consumption may provide physiological benefit in the treatment of major neurological disorders, though not much research has explored if these benefits extend to the experience of anxiety, depression, stress and physical symptoms. The purpose of this study was to explore the relationship between fat consumption and negative emotional/physiological states (anxiety, depression, stress and physical symptoms). This study also explored how fat consumption can alter one's response to an acute stress. Participants completed an online survey indicating their food preferences and their responses to a number of self-report scales such as …

Memory Retrieval Is Maintained By Intrinsic And Synaptic Plasticity In Prelimbic Cortex, James Otis

Theses and Dissertations

Abnormally strong memories underlie common disorders including addiction and post-traumatic stress disorder (PTSD). Memory disruption would therefore be beneficial for treatment of these disorders. Evidence reveals that cocaine conditioned place preference (CPP) memories are susceptible to long-lasting disruption during memory retrieval. For example, inhibition of β-adrenergic receptor (β-AR) activity within the prelimbic medial prefrontal cortex (PL-mPFC) prevents cocaine CPP memory retrieval, and this retrieval impairment is both long-lasting and prevents subsequent reinstatement of the CPP. Despite this, whether PL-mPFC β-AR activity is a fundamental mechanism required to maintain retrieval of other memories is unclear. Furthermore, how PL-mPFC β-AR activity maintains …

Does Stigma Against Smokers Really Motivate Cessation? A Moderated Mediation Model On The Effect Of Anti-Smoking Campaigns Promoting Smoker-Related Stigma On Cessation Intentions, Jinyoung Kim

Theses and Dissertations

Over the past decade, an increasing number of strong tobacco control legislations (e.g., high cigarette taxes and strict ban on smoking in public places) have passed through Congress to reduce the size of smoking population in the United States. As a part of such national efforts, anti-smoking campaigns have been introduced to curb health problems associated with smoking. Recent anti-smoking campaigns often employ de-normalization strategies that portray smoker(s) as deviant and stigmatized minorit(ies) and smoking as an abnormal and non-mainstream activity in order to better stimulate cessation. As a result of implementing such stigmatization tactics, prevalence of smoking at a …

The Subjective Well-Being Of Youth Heads Of Households In Rural Southern Malawi, Pamela Fruechting

Theses and Dissertations

Youth-headed households in HIV-endemic sub-Saharan Africa face harsh realities of poverty and loss of parental care. Scientific knowledge of these youth is generally limited to socio-economic and psychological indicators of vulnerability while much less is known about youth-centric meanings of well-being. This is the first known study on the subjective well-being of youth heads of households.

The purpose of this exploratory, youth-centric, qualitative study was to identify experiences of subjective well-being, factors for regulating well-being, and meanings of well-being among youth heads of household in the Thyolo and Chiradzulu districts of rural southern Malawi. The theoretical foundation for this study …

Effects Of Traffic And Air Pollution On Risk Of Preterm Birth And Low Birth Weight Outcomes In Milwaukee County, 2005-2010, Deborah Lynn Pasha James

Theses and Dissertations

Between 2005 and 2010, infants born to non-Hispanic black mothers experienced a 3-fold elevated risk of infant mortality compared to those born to white and Hispanic mothers. Preterm birth (PTB) and low birth weight (LBW) are strong predictors of infant mortality. To our knowledge, this is the first study of Wisconsin births to evaluate the effect of social and environmental factors on risk of PTB and LBW. We hypothesize that the observed racial inequalities in PTB and LBW are related to traffic density and air pollution. The Milwaukee INFANTS Study used 2005-2010 electronic birth record data (N = 85,045) geocoded …

Health Information Behavior And Paternal Involvement Of Low-Income Expectant And Recent Fathers, Emily M. Cramer

Theses and Dissertations

Given the importance of paternal involvement in maternal and child health, the current transdisciplinary investigation is a step towards unraveling factors related to paternal involvement by taking a closer look at low-income expectant and recent (E/R) fathers' health information behavior. The study evaluates the belief that information acquisition associates with fathers' involvement in the pregnancy, childbirth, and childcare. A total of 186 E/R fathers (68 low-income) completed a survey about their information needs, sources of information, and information-seeking behavior. A strong association between E/R fathers' health information-seeking behavior and paternal involvement was observed, and the relationship persisted among low-income groups. …

Walk It Off!: The Relationship Between Physically Active And Passive Coping Style And Perseverative Cognition, Michelle Rosalie Di Paolo

Theses and Dissertations

ABSTRACT

WALK IT OFF!: THE RELATIONSHIP BETWEEN PHYSICALLY ACTIVE AND PASSIVE COPING STYLE AND PERSEVERATIVE COGNITION

by

Michelle R. Di Paolo

The University of Wisconsin-Milwaukee, 2013

Under the Supervision of Professor Marcellus Merritt

The main aim of the current study is to assess if a relationship exists between self-selected coping styles and levels of perseverative cognition (PC). Recent pilot studies have revealed a relative distinction between the coping styles people choose when coping with stress, i.e., those that are physically active (PAC) like going for a walk, jogging, or lifting weights, and those that are physically passive (PPC) like reading …

Parents' Treatment Of Their Children's Pain At Home: Pharmacological And Non-Pharmacological Approaches, Ayala Y. Gorodzinsky

Theses and Dissertations

During childhood, individuals often experience pain on a daily or nearly daily basis (American Academy of Pediatrics and American Pain Society, 2001). Pain can be treated using pharmacological or non-pharmacological techniques. This study will focus on the techniques provided by parents, since parents most often treat children's painful experiences at home (Finley, McGrath, Forward, McNeill & Fitzgerald, 1996). The processes involved in parental decision-making regarding which techniques to use include a combination demographic, availability and perceived need factors (Andersen, 1995). Seven hundred and fifty-six parents of children 6 to 17 years completed a survey regarding use and effectiveness of pharmacological …

Essays In Health Economics And Public Health Policy, Rahi Abouk

Theses and Dissertations

This dissertation consists of three essays. In the first essay I study the effect of texting bans on fatal accidents on roadways. Since 2007, many states passed laws prohibiting text messaging while driving. Using vehicular fatality data from across the United States and standard difference-in-differences techniques, bans appear moderately successful at reducing single vehicle, single occupant accidents if they are universally applied and enforced as a primary offense. Bans enforced as secondary offences, however, have at best no effect on accidents. Any reduction in accidents following texting bans is short-lived, however, with accidents returning to near former levels within a …

Medicina Del Barrio: Shadow Medicine Among Milwaukee's Latino Community, Ramona Chiquita Tenorio

Theses and Dissertations

As a result of exclusionary state and federal policy decisions on immigration and health care, marginalized immigrants often seek health care in the shadows of U.S. cities through practitioners such as curandera/os (healers), huesera/os (bonesetters), parteras (midwives), and sobadora/es (massagers). under the radar of biomedical practice. This research focuses on this phenomenon in the context of globalized social networks and health care practices of marginalized Latino immigrants in Milwaukee, Wisconsin, and within the broader economic and political context in this country. Latino immigrants continue practicing forms of their medicine even after immigrating to this country. People do not just throw …

Immediate Early Gene Expression In Medial Prefrontal Cortex And Hippocampus As A Function Of Aging, Megha Sehgal

Theses and Dissertations

Normal aging is accompanied by cognitive decline that differs from other aging-related pathological states like Alzheimer's disease. With an increasing proportion of the world population falling in an age group of 65 years and above, a preventive gerontological approach would improve the quality of life in the elderly. Especially important in this regard is the early detection of cognitive decline, so that appropriate measures can be taken to prevent development of cognitive deficits. Impairment in cognitive flexibility, the ability to modify a previously learnt behavior, is one such measure of impairment across species in aged animals. Previous work from our …

Relationship Between Hpv Vaccination And Sexual Activity, Sexual Health Care Utilization, And Perceived Risk, Danielle Lee Jirovec

Theses and Dissertations

The relationship between sexual activity, sexual health care utilization, and perceived risk for HPV-related outcomes was examined in sample of college women, to explore recent concerns that HPV vaccination may be related to an increase in risky sexual behaviors. Vaccinated and not vaccinated women completed an anonymous, online survey including age of vaccination, age at each sexual partner, condom use, use and intentions to use sexual health care services, and perceptions of risk. Vaccinated women also reported perceptions of change because of vaccination. Women were matched on age, race, and poverty status. Number of partners since vaccination was calculated among …

Investigation Of Web-Based Motivational Interviewing To Increase Physical Activity Participation Among Adults, Sasha Karnes

Theses and Dissertations

Interventions to enhance physical activity (PA) participation are needed given the high prevalence of under-activity and inactivity (CDC, 2001) and related occurrence of negative health consequences among the general adult population (Kung, Hoyert, Xu, & Murphy, 2008). Preliminary support for a therapeutic technique called Motivational Interviewing (MI) suggests promise for application to enhance PA participation (Burke, Arkowitz, & Menchola, 2003). Given the need for interventions to enhance PA and the preliminary support for MI as an intervention to increase PA, the aims of the current study were to: (a) determine if web-based MI is effective in enhancing PA participation, and …

The Relationship Among Maternal Parenting Stress, Coping, And Depressive Symptoms Across Time, Karen Foren Lake

Theses and Dissertations

This study was a secondary analysis in which the relationship among maternal parenting stress, coping, and depressive symptoms over time in 161 low-income mothers who participated in an Early Head Start Pathways Project were examined. Measurements were assessed longitudinally over a 12 year period of time. Direct and indirect relationships were proposed between maternal mastery, pre-existing depressive symptoms, relationship with significant other, child behavior, child temperament, maternal parenting stress, coping, and later depressive symptoms. Results from path analyses showed that when assessed earlier in the childbearing years, mastery, depressive symptoms, relationship with significant other, child temperament, child behavior, and maternal …

An Anaylsis Of Patient-Physician Discourse: Comparing Physician Diagnostic Scripts To Patient Social Script Expectations, Denis Grimes

Theses and Dissertations

This study examines how participants interpret physicians' diagnostic discourse and physician interruptions during the patient's disclosure of problems and concerns. Using medical diagnostic scripts written for upper respiratory infections, participants' reactions to physician attentiveness and physician interruptions were measured. When physicians interrupt patients during the patient's disclosure of problems and concerns, interruptions violate patient's social script expectations and negatively affect patient satisfaction. Physicians' demonstrations of attentiveness and explanations of the purposes for the interruptions do not compensate for interruption's effects, and satisfaction with physician behavior is reduced.

Quality And Coordination Of Care For Persons With Brain Injury In The Community: Developing A Survey, Brian Philip Johnson

Theses and Dissertations

Background: Because of increasing demand on primary care physicians and a complex, fragmented, healthcare "system", people now must coordinate their own healthcare and services. In response, care coordination has become a clinical specialty, typically done by nurses or social workers. People with disabilities (PWD) also must coordinate their care, including health and disability-support services, knowing who to call, advocating for themselves, and scheduling appointments, among other things. Such demands can be particularly problematic after brain injury, which may impair abilities to prioritize, coordinate, manage, and schedule activities. Coordinating services requires participation of the PWD, and supportive significant others (SSO). At …