Medicine and Health Sciences Commons^™

An Analogue Study Of Expected Working Alliance And Hope With Victims Of Military Sexual Trauma Among Civilian And Military-Oriented Therapists, Alishia D. Salyer

Dissertations

Victims of military sexual trauma (MST) face unique challenges as they pursue mental health treatment and supportive care. Understanding what factors impact potential treatment outcomes is critical in aiding in their recovery (Castro et al., 2015; Kroviak, 2020). Although a substantial amount of research has been conducted to evaluate prevalence and client factors associated with treating victims of MST (Teit et al., 2015; Turchik & Wilson, 2010), little is known about therapists’ factors including therapists’ expectations working with such clients. The purpose of this study was to examine the relationships between therapist type (military-affiliated versus civilian), therapist gender, client gender, …

The Effects Of Mindfulness And Exercise On Symptoms Of Parkinson’S Disease: A Systematic Review, Collin Tyler Garner

Dissertations

Parkinson’s Disease (PD) is the second most common neurodegenerative disease affecting which affects motor control, emotional regulation, cognition, and sleep through degradation of dopaminergic neurons. As of 2019, PD affects approximately 8.5 million individuals worldwide, with prevalence estimated to increase to between 8.7 and 9.3 million by 2030. The primary therapeutic approach to PD management is pharmaceutical, relying on dopamine replacement therapy. However, recent research has identified promising complementary therapies such as exercise and mindfulness training.

This review was conducted to compile and present evidence related to the efficacy of exercise, mindfulness, and combined exercise and mindfulness protocols as complementary …

Effects Of A Self-Forgiveness Intervention On Recovery From Substance Use Disorders, Michael Saltzman

Dissertations

Previous research has highlighted the relationship between shame, guilt, and problematic substance use (Gueta, 2013; Luoma et al., 2019; McGaffin et al., 2013; Rahim & Patton, 2015). Self-forgiveness has been associated with positive outcomes for individuals in recovery with substance use disorders (SUDs), though only one prior study has explored the effects of a selfforgiveness intervention for individuals in treatment (Scherer et al., 2011). This study examines the effects of a self-forgiveness intervention on state shame and guilt, state self-forgiveness, and drug avoidance self-efficacy, and it is the first intervention study to focus on self-forgiveness for individuals with SUDs receiving …

Side-Stepping God: How The Nonreligious Find Success In Alcoholics Anonymous, Caitlin Trombley

Dissertations

This dissertation utilized mixed methods research to examine how nonreligious individuals with substance use disorders navigate recovery within—or in spite of—Alcoholics Anonymous (AA). Both the 12-step program itself and Alcoholics Anonymous have long been criticized for being religious and/or spiritual in nature, and some studies have shown that this is particularly challenging for nonreligious individuals seeking recovery. The purpose of this research was to (a) identify differences in recovery resources (recovery capital) between the religious, the nonreligious, those in AA, and those who have adopted alternative forms of recovery; (b) identify barriers that the nonreligious face as they navigate recovery …

A Critical Analysis Of Discrepancies In Behavioral Health Program Ratings By Evidence-Based Practice Registers For Behavioral Health, Miranda Jade Lee-Easton

Dissertations

Decision makers in the behavioral health disciplines are under increasing pressure to identify and implement evidence-based practices (EBPs). These decision makers often do not have the time or expertise to assess primary studies of program efficacy or effectiveness. They could benefit from tools to assist them in identifying and implementing EBPs. One tool is an evidence-based practice register (EBPR). Prior studies have documented that when multiple EBPRs rate a given program, they may come to seemingly conflicting program ratings. The prior research concerning the reason for these conflicts is sparse. The purpose of the present study is to understand how …

Assessing And Characterizing Marijuana Use Disorders (Dsm-5) — National Survey On Drug Use And Health, United States, 2020, Alejandro Azofeifa-Ujueta

Dissertations

Despite that marijuana (cannabis) is still considered, under federal law, an illegal Schedule I drug, marijuana is the most commonly used illicit substance in the United States. National trend data has shown that the prevalence of marijuana use has increased over time, particularly among those aged 18 years and older. Some individuals can use marijuana without harm; however, long-term and heavy marijuana users may experience health consequences, including marijuana use disorders (addiction). For the last 20 years, existing national and statelevel epidemiological, surveillance, and research data have analyzed marijuana use disorders (MUD) using previous diagnostic criteria (DSM-IV). There is limited …

Research Training And Certification Protocol For Medical Students, Michelle Arisleida Padley

Dissertations

Early and frequent exposure to research is imperative to initiating and sustaining long term for medical student research interest. The attitude and approach of physician mentors has been demonstrated to have a substantial effect on student perceptions of research involvement. The purpose of this study is to determine best practices for assessing student perceptions for a research certification program. An additional long-term objective is to utilize these findings to help maintain interest in research throughout their medical careers. Research is an essential aspect of the prestige of medical schools, and the benefits of academic research institutions have numerous facets, including …

Preclinical Behavioral Assessments Of Mitraginyne, The Main Psychoactive Alkaloid In Kratom, Rachel Burroughs

Dissertations

Mitragyna speciosa (kratom) is a medicinal plant indigenous to Southeast Asia and Africa with a long history of use for a variety of ailments, including diarrhea, pain relief, cough suppression, and amelioration of opiate withdrawal symptoms. Despite its status as an herbal remedy, kratom is banned in some countries due to a myriad of negative health risks. Preclinical psychopharmacology studies of mitragynine (MG), the main alkaloid of kratom, indicate it has opioid-like effects at higher doses and psychostimulant-like effects at lower doses. The current study utilized three rodent behavioral paradigms to evaluate the putative psychostimulant effects of MG. The specific …

Pharmacogenomics Translation In A Community Medical Context Using A Diffusion Of Innovations Framework: Provider Perspectives And Evaluation Implications, Sabrina Ewald Holley

Dissertations

Translation, in the context of medical research, is a process that describes how knowledge and innovation move and change into real world applications and outcomes. This study explores the translation of a medical innovation, pharmacogenomics (PGx), from research into clinical practice using the perspectives of medical providers in a community setting. PGx is the influence of a person’s genetics on drug response. Despite being available for over a decade, PGx testing is not widely adopted. Prior research primarily examined PGx translation in large academic medical centers, but not much is known about it in community practice settings. A better understanding …

Determining The Effectiveness Of Virtually-Delivered Written Exposure Therapy For Treatment Of Posttraumatic Stress Symptoms, Stephanie M. Haft

Dissertations

The COVID-19 pandemic has disproportionately impacted individuals with mental health issues (Swendsen, 2020). Although the peak destruction of the COVID-19 pandemic has passed, the psychological fallout remains. Social isolation, home confinement, and travel restrictions have exacerbated mental health issues during the COVID-19 pandemic, contributing to negative psychological distress (Smith et al., 2020). Survivors of trauma have higher vulnerability to prolonged psychological distress than the general population and others with non-trauma-related mental health conditions, which has been exacerbated during and following the COVID-19 pandemic. For these reasons, survivors of trauma may particularly benefit from virtual-delivery of trauma-focused treatments. Mental health providers …

The Influence Of Demographic, Social, And Economic Factors On Referral For Heart Failure Services, Catherine Elaine Kelty

Dissertations

Patients with end-stage advanced heart failure must go through an extensive evaluation process before being selected for either heart transplantation or left ventricular assist device (LVAD). This evaluation not only assesses a patient’s medical need for advanced heart failure treatments but also includes an assessment of psychosocial and economic factors that may affect a patient’s success post-treatment. While it is important to allocate scarce resources, such as donated organs, to the patients who will benefit the most, there is also a need for equity in the allocation of and access to healthcare services. This raises the question of whether patients …

From Young To Old: The Effects Of Sedentary-Aging And Exercise Interventions On Structural Plasticity Of Lumbar Motor Neurons, Nmj, And Glial Cell Line-Derived Neurotrophic Factor Expression, Alberto Felipe Cintron-Colon

Dissertations

Neuromuscular weakness has been associated with age progression. A possible reason is a disconnection between muscle and neuron, causing components from both the central and peripheral nervous systems to deteriorate. Exercise, however, has beneficial effects for both muscle and nervous tissue, inducing neuroprotection. Neurotrophic factors are powerful regulators of neuronal maintenance and synaptic strength. Glial cell line-derived neurotrophic factor (GDNF) is a neurotrophic factor that has been shown to be a potent survival factor for somatic motor neurons that innervate skeletal muscle.

This study aims to evaluate changes in structural plasticity of motor neurons in the lumbar spinal cord and …

Evaluating Hospital Community Benefit And Community Health Improvement Requirements, Shelly Johnson

Dissertations

The Internal Revenue Service's (IRS) hospital community benefit standard aims to improve the community's health, it is a test the IRS uses to determine whether a hospital is organized and operated for the charitable purpose of promoting health. Participation in this program is required of all not-for-profit hospitals in the US, who spend billions of dollars annually in community benefit in place of taxes. Hospitals must annually submit IRS form 990 Schedule H and are required to report costs associated with their provision of community benefit spending. In addition, a hospital must conduct community health needs assessment (CHNA) and implementation …

Generation Status, Ethnic Identity, Colonial Mentality, And Enculturation In Filipino Americans, Kamille Patricia Urmaza La Rosa

Dissertations

Filipino Americans’ psychological experiences pertaining to their generation status, ethnic identity, enculturation, and colonial mentality are rarely studied in counseling psychology due to inconsistent disaggregation of Asian American and Pacific Islander (AA&PI) data (Agbayani-Siewert, 2004; Espiritu, 2003; Nadal et al., 2010; Okamura, 2013). Literature suggests that the study of these constructs related to their mental health can guide more culturally informed care for this historically excluded population (David & Nadal, 2013; Nadal, 2020). The current study used an exploratory design to test six research hypotheses and accomplish the following: examine relationships between the constructs, investigate intergenerational differences, validate a measure …

The Influence Of Integrated Behavioral Health Primary Care Setting On The Utilization Of Mental Health Services And Depression Treatment Response Among Men, Tendai Masiriri

Dissertations

The 2010-2013 National Health Interview Survey showed that nearly 9% of men had daily feelings of anxiety or depression, yet less than 41% sought help for their symptoms (Blumberg et al., 2016). Men are more reluctant than women to seek help (Angst et al., 2002; Brownhill et al., 2005). The failure to seek help among men is associated with multiple factors related to stigma and gender, yet male suicide rates are approximately 3-5 times higher than their female counterparts. However, they have a higher likelihood of seeking help from a medical provider rather than a mental health provider. If men …

The Role Of Youth Characteristics, Home Ecology, And Child Maltreatment In The Severity Of Problematic Sexual Behaviors And Conduct Problems, Ariel K. Berman

Dissertations

A multitude of individual, familial, and environmental variables have previously been identified as contributing to the development of problematic sexual behaviors (PSB) and general conduct problems (CP) in youth. The majority of these studies have focused either on individual youth characteristics or parenting behaviors such as child maltreatment. Although researchers examining contributions to PSB and CP generally acknowledge the importance of the impact of the home environment on youth behavior, few researchers have included family characteristics of both parents and siblings in their analyses. Additionally, some factors that have been identified as having great importance in general juvenile delinquency, such …

Informing Cognitive Screening In The Young Adult Population, Samantha L. Mcdaniel

Dissertations

The clock drawing test (CDT) is a cognitive screening measure with sound psychometric properties which has been well researched over the past century. The CDT is a popular tool for many healthcare professionals to administer independently or as part of a more thorough cognitive evaluation. Given the drastic technological and social developments over the years since the CDT was developed as well as the persistent research focus on older adult populations, a gap in the CDT literature presented for young adults, who may have difficulty drawing an analog clock. Identifying cognitive impairment can improve health outcomes. The young adult population …

Lxr Acts As A Differentiator In The Regulation Of Fas And G6pdh Gene Expression Under Insulin Resistant Conditions, Jaafar Hachem

Dissertations

Diabetes is a chronic disease that effects 10 percent of the world’s population and causes more than 1.5 million deaths a year and billions of dollars in associated health care cost. It can lead to very serious complications such as renal failure, liver cirrhosis, heart attack, and vision loss. The most common type of diabetes is type 2 diabetes. Type 2 diabetes arises when blood glucose levels remain chronically high due to insulin resistance. The reason for this elevation is due to the failure of insulin to allow tissues to uptake glucose causing problems in subsequent metabolic pathways. Over the …

Parametric Characteristics Of The B6omsi-Re, Sarahelizabeth Janemarie Baguhn

Dissertations

Orientation and mobility specialists for young children who are blind or visually impaired have relied on informal assessments or commercially available tools designed for sighted children to track developmental progress. When Bradley-Johnson (1994) literally wrote the book on assessment in blindness, the sharing and refinement of common tools led to professionals working in teams to sift and winnow the checklists, and move the best available tools into wider circulation. This has led to the evolution of the practitioner made tools becoming the published tools, although they have not yet had statistical evidence to support their efficacy. This three-paper dissertation aims …

Preclinical Behavioral Assessment Of Chronic, Intermittent Low-Dose Psilocybin In Rodent Models Of Depression And Anxiety, Harmony I. Risca

Dissertations

Recent studies have demonstrated the clinical efficacy of psychedelic-assisted psychotherapy for treatment-resistant depression and anxiety. Amidst the overall success of recent clinical trials using a single high dose of psilocybin, anecdotal reports indicate anxiolytic and antidepressant effects following a repeated low dose regimen. As therapeutic outcomes are often tightly intertwined with the individual’s subjective experience, animal models are used as objective measures to investigate the underlying mechanisms responsible for the putative antidepressant/anxiolytic effects of psychedelics. Three rodent models predictive of anxiolytic or antidepressant effects were used to evaluate effects of chronic intermittent low dose (CILD) psilocybin treatment; the Light/Dark conflict …

An Examination Of Types Of Health Insurance And The Reported Prevalence Of Autism In The United States, Jennifer L. Thompson

Dissertations

The prevalence of Autism Spectrum Disorders continues to rise despite barriers of changes to diagnostic criteria and lack of insurance coverage. Increases in prevalence affect costs associated with a disorder since cost of health care services are often estimated based on utilization of services. This can also affect an individual’s ability to access to health care services. To equitably distribute autism services to individuals an accurate estimation of the true prevalence of autism is needed.

Access to health care can be influenced by the type of insurance coverage a person holds. Other factors, such as socio-economic status, ethnicity, location of …

The Impacts Of Aging, Sedentarism, And Exercise On Neurotrophic Factor Expression And Innervation In The Heart And The Effects Of Treatment With Α-Cgrp On Heart Function, Gabriel Almeida Alves

Dissertations

Neurotrophic factors (NFs) are important molecules responsible for development, differentiation, regeneration, and maintenance of new and mature neurons. Neurotrophic factors act as neurocytokines and may assist with the regulation of axonal and dendritic arrangements and synaptic plasticity between neurons themselves or with other non-neural target tissues. In this study, we analyze the levels of two NFs: glial cell line-derived neurotrophic factor (GDNF) and nerve growth factor (NGF). Cardiomyocytes produce these neurotrophic factors which assist with the innervation pattern of the heart. The heart is innervated by the two branches of the autonomic nervous system; namely the sympathetic nervous system and …

Developing A Diagnostic Tool Of A Community’S Health, Ruth Kurtycz

Dissertations

Where we live can affect nearly every aspect of our lives, including how long those lives will be. Previous studies have demonstrated large health disparities between communities in the United States; since the health of a community can significantly impact its residents, evaluating and predicting community health is of interest to many people. Currently the Federal government collects and publishes data on community-level demographics, housing, crime rates, and disease. State-level and non-governmental agencies track and share community housing prices, school performance, neighborhood safety, and other characteristics. In short, there is a wealth of information but the work being done around …

Examining Complementary Health Approaches And Integrative Health (Chaih) Practices Among Occupational Therapists In The United States: A Mixed Methods Approach, Sarah M. Renner

Dissertations

The use of complementary health approaches and integrative health (CHAIH) is increasing among adults and children in the United States and continues to grow within various health care settings. With Health and Wellness identified as a key practice area for occupational therapists and the American Occupational Therapy Association supporting the use of CHAIH in occupational therapy (OT) practice, practitioners must offer safe, research-driven treatments supporting this movement. Research around CHAIH continues to grow; yet the gaps in the literature make it difficult to determine how CHAIH is being used in OT practice as well as the practitioner’s perspectives on the …

Characterization, Implementation, And Impact Of Low Stimulation Precautions In Acute Neurological Injury, Alexis Kurek

Dissertations

Recommendations provided by clinical and professional organizations that encourage providing patients with a low stimulation environment following acquired brain injury are prevalent but supported by expert opinion only. Such recommendations are based on extrapolation of what is known about physiological response to environmental stimuli, however such findings are not specific to the patients with acquired brain injury. Recommendations for low stimulation environments lack guidance for their application and implementation of precautions, and there have been no studies investigating their effectiveness at improving clinical outcomes.

The objective of this study is to determine what patient characteristics are associated with prescription of …

The Acquisition Of Dental Competencies And Clinical Skills: Perceptions From Students, Faculty, Practicing Dentists And Industry Professionals In The Dominican Republic, Laura Virginia Reyes Alardo

Dissertations

The Dominican healthcare system faces many challenges, and dental education is not an exception. The lack of competencies established for dentistry is one of the most critical challenges that dentistry faces. There is no way to guarantee that all dentists receive the same quality education with no standards and lack of competencies. Previous research has revealed that the competencies achieved by dental students determine the way such students develop their professional practice in the future as dental graduates (Alcota, De Gauna, & González, 2016). However, there is a lack of shared language observed in dental education around the world. Not …

Evaluation Of Telehealth Training To Teach The Stimulus Identification Questionnaire And Multiple Stimulus Without Replacement, Andrea Perez

Dissertations

The field of behavioral gerontology has seen a paucity in literature within the past 15 years focused on updating training technology and teaching best practice skills to staff. Specifically, there is a need to expand the breadth of training research focus areas could more broadly the elderly population (e.g., increasing engagement), to ensure that trainings are designed to equip caregivers with the skills to be independent, and finally, given the frequent staffing challenges experienced by aging settings (Harrington et al., 2020), to explore effective and efficient training techniques that are alternatives to lengthy, in-person training modalities. Given the personnel challenges, …

On Prediction Of Early Signs Of Alzheimer’S— A Machine Learning Framework, Abdalrahman Alsaedi

Dissertations

Dementia is a collective term used to indicate a loss of memory functions with the presence of at least one additional loss of a major cognitive ability that hinders a person’s previous level of functioning. Studies show that dementia is highly age- associated and that the most common cause of dementia is Alzheimer’s disease. Early recognition of Alzheimer’s disease, before irreversible damage to the brain has already occurred, is paramount to slowing or preventing the disease. Therefore, algorithms for the prediction of early signs of dementia are essential. Machine learning approach has been reported to use several data sources such …

Psychological Wellbeing And Sense Of Community Among African Americans: Does Purpose In Life Matter?, Yatesha D. Robinson

Dissertations

This dissertation examined the relationships between sense of community, purpose in life, and psychological wellbeing among African Americans. It investigated whether purpose in life moderated the relationship between sense of community and psychological wellbeing. Although previous studies have linked a sense of community and purpose in life with wellbeing, few studies have examined these relationships among African Americans using a multidimensional model. The data for the current analysis were drawn from the third wave of the National Survey of Midlife Development in the United States study (MIDUS 3), collected between 2013–2014. The sample included 98 African American men (n …

A Study Of Communication Practices Between Office And Field-Based Personnel In Home Healthcare Agencies, Ruth M. Bates-Hill

Dissertations

The population of developed countries is rapidly aging. People want to age in their residence, and as they advance in years, most people will need assistance with activities of daily living and perhaps medical assistance to remain at home. Home health aides provide a large portion of such care. However, the annual turnover rate of home health aides exceeds 60% due to factors such as low wages, poor benefits, and a challenging work environment. Many studies have been conducted to elucidate the factors contributing to job satisfaction in the home health aide population, yet despite decades of research, turnover among …