Medicine and Health Sciences Commons^™

Mental Health Service Use In The Kingdom Of Saudi Arabia, Abdulaziz S. Alangari

Graduate Theses, Dissertations, and Problem Reports

Objectives: The goal of this project was to increase knowledge concerning the current prevalence, needs and barriers to mental health service use in the Kingdom of Saudi Arabia (KSA). It’s purpose was to gather data that would help to inform future policy decisions aimed at optimizing the use and availability of these services in the KSA. There were three specific aims: 1) Examine the barriers to initiation and continuation of mental health treatment in people with a disorder diagnosed during the previous 12-months. 2) Explore the prevalence and predictors of mental health treatment dropout. 3) Examine the prevalence and patterns …

Therapeutic Approaches To Recovery In West Virginia, Rachel A. Wattick

Graduate Theses, Dissertations, and Problem Reports

Substance use disorder (SUD) is a prevalent problem in the United States, with 19.7 million Americans aged 12 and older battling an SUD in 2017. Multiple factors influence the risk that someone will develop an SUD, including family history, childhood trauma, community factors, and poverty. West Virginia has the highest rate of overdose deaths in the nation, and individuals in WV are at high risk of SUD due to the aforementioned risk factors. There are a variety of treatment options available to someone with an SUD. These include outpatient or inpatient treatment, detoxification, therapeutic communities, and collegiate recovery programs. Despite …

Three Essays On Health Economics And Policy Evaluation, Shishir Shakya

Graduate Theses, Dissertations, and Problem Reports

This dissertation consists of three essays on the U.S. Health care policy. Each paragraph below refers to the three abstracts for the three chapters in this dissertation, respectively. I provide quantitative evidence on how much Prescription Drug Monitoring Programs (PDMPs) affects the retail opioid prescribing behaviors. Using the American Community Survey (ACS), I retrieve county-level high dimensional panel data set from 2010 to 2017. I employ three separate identification strategies: difference-in-difference, double selection post-LASSO, and spatial difference-in-difference. I compare how the retail opioid prescribing behaviors of counties, that are mandatory for prescribers to check the PDMP before prescribing controlled substances …

Evidence Of Y Chromosome Long Non-Coding Rnas Involved In The Radiation Response Of Male Non-Small Cell Lung Cancer Cells, Tayvia Brownmiller

Graduate Theses, Dissertations, and Problem Reports

Non-small cell lung cancer (NSCLC) is the number one cause of cancer related mortality in the United States and worldwide. Advanced and therapeutically resistant lung tumors contribute to the high rate of mortality from NSCLC, therefore there is a need for new methods of diagnosing and treating this disease. Long non-coding RNAs (lncRNAs) have been shown to be a crucial component of human molecular biology, regulating nearly every cellular pathway from chromatin condensation to transcription and translation. Furthermore, many lncRNAs have been classified as oncogenes or tumor suppressors, highlighting the various molecular mechanisms they are involved in regarding the formation …

Multimorbidity, Immune Checkpoint Inhibitor Use, And Healthcare Expenditures Among Older Patients With Late-Stage Melanoma, Pragya Rai

Graduate Theses, Dissertations, and Problem Reports

With decades of unchanged cancer care with no added survival benefit, immune checkpoint inhibitors (ICI) changed the treatment landscape of late-stage melanoma in 2011. A key factor in determining the use of ICIs is the presence of pre-existing chronic conditions, which can influence the outcome. However, the prevalence of multimorbidity (defined as presence of two or more chronic conditions) among older patients with late-stage melanoma remains unknown. It also remains unknown if the presence of multimorbidity factors into the use of ICIs. Hospital-related factors associated with ICI use have been studied. Yet, patient-level factors, such as age, sex, marital status, …

Integrating The Natural Healing Process For Post-Traumatic Stress Disorder Treatment In Veterans Through A Healing Garden., Taiwo A. Ajibade

Graduate Theses, Dissertations, and Problem Reports

In 2002, several ex-service personnel brought a court case against the Ministry of Defense for the inability to identify PTSD issues at an early stage and to provide support and effective treatment (Langston et al. 2007). Also in recent times, reports have suggested that US marine and army infantry units returning from duty in Iraq and Afghanistan have a higher level of expected proportions of mental disorders and that about 10% of personnel are returning home are with symptoms of post-traumatic stress disorder (Smith et al., 2008). This discovery made it pertinent to look for natural ways to assist veterans …

Association Of Common Chronic Pain Conditions To Incident Alzheimer’S Disease And Related Dementias In Two Cohorts Of Older Medicare Beneficiaries, Sumaira Khalid

Graduate Theses, Dissertations, and Problem Reports

Objective: The purpose of this research was to study the collective and incremental association of common non-cancer chronic pain conditions (NCPC) to risk for Alzheimer’s disease and related dementias (ADRD); to explore the potential mediating influence of mood and sleep disorders; and to assess the potential synergistic effects of NCPC’s and multimorbidity on ADRD risk. This research also aimed to study the contribution of NCPC to ADRD risk in poor, rural, underserved United States populations who suffer a disproportionate burden of ADRD risk factors. To achieve these goals, this dissertation pursued three specific aims: 1) assess the association of …

Pulmonary Immune Responses To Respirable Elongate Mineral Particles Of Asbestiform And Non-Asbestiform Morphologies, Timur Khaliullin

Graduate Theses, Dissertations, and Problem Reports

Inhalation exposure to asbestiform elongate mineral particles (EMPs) may cause pulmonary fibrosis, lung and pleural cancer. At the same time, epidemiological evidence for non-asbestiform EMP pathogenicity is scarce, with little if any risk of cancer, but consistent findings of pneumoconiosis and increased mortality. Globally, conditions caused by asbestos exposures contribute most to the occupational cancer burden and are responsible for the increasing mortality for occupational respiratory diseases. Immunological components of the fiber-induced lesions are extremely understudied, partly due to the lack of comparable test articles. In this study I utilized respirable preparations of asbestiform and non-asbestiform riebeckite and tremolite to …

Predictors Of Cardiovascular And Gastrointestinal Disorders, Inappropriate Nonsteroidal Anti-Inflammatory Drug Use, And Alzheimer’S Disease And Related Dementia In Older Adults With Osteoarthritis, Jayeshkumar Patel

Graduate Theses, Dissertations, and Problem Reports

Osteoarthritis (OA) is a degenerative arthritis affecting over 30 million Americans most of whom are over 65 years or older. Its clinical management is complicated by several disease- and treatment-specific factors. These include the co-occurrence of cardiovascular and gastrointestinal disorders (CV-GID), the inappropriate use of non-steroidal anti-inflammatory drugs (NSAID) to manage pain, and the risk of certain age-related chronic conditions like Alzheimer’s disease and related dementia (ADRD). Moreover, older adults with OA are at a higher risk of CV-GID, inappropriate NSAID use, and ADRD. Additionally, these factors can also affect one another in both a positive and a negative way. …

Respiratory Flow Characteristics Of Intensive Care Healthcare Workers Performing Patient Care Activities, Shawn R. Williamson

Graduate Theses, Dissertations, and Problem Reports

In the United States, under OSHA regulations, all respirators used in the workplace must be certified by the National Institute of Occupational Safety and Health (NIOSH). Under current NIOSH standards, loose-fitting powered air-purifying respirators (PAPR) must provide a minimum operational flow of 170 liters per minute. The objective of this study was to characterize the breathing flow rates of nine health care workers during patient care activities typically performed in a hospital's intensive care unit. This characterization will be used to determine the feasibility of lowering the minimum operational flow rate of PAPRS used in health care settings.

Each participant …

Pilot Study Of Behavioral Activation As Adjunct Treatment For Depression In Primary Care, Lindsay Ellen Toler

Graduate Theses, Dissertations, and Problem Reports

Many individuals receiving care at a predominantly free primary health care clinic in the northern part of West Virginia are experiencing depression, and medication therapy is the most common form of management with limited resources for psychosocial treatment. Brief psychosocial therapy interventions provided by the primary care provider should be explored as an adjunct treatment for this population in the primary care setting.

A pilot study was conducted to explore the integration of behavioral activation, a brief psychosocial intervention focused on decreasing depressed behavior by increasing nondepressed behavior to reinforce corresponding improvements in mood. Eligible patients were invited to attend …

Understanding The Host Immune Response Against Pseudomonas Aeruginosa To Develop Novel Therapeutics And Vaccines, Emel Sen Kilic

Graduate Theses, Dissertations, and Problem Reports

Pseudomonas aeruginosa is a Gram-negative opportunistic bacterium that causes a broad range of acute and chronic infections. The high adaptability and emergence of multidrug-resistant strains of this bacterium pose a significant threat to human health. Particularly, pneumonia caused by this pathogen is associated with high morbidity and mortality in immunocompromised patients. To prevent these infections, we aimed to develop novel vaccine strategies by characterizing the host immune response against P. aeruginosa. During respiratory infections, P. aeruginosa first contacts with epithelial cells along the respiratory tract. Using RNA-sequencing, we were able to characterize transcriptional changes of the epithelial cells in …

Effect Of Western Diet And Caloric Substitution With Apple Pomace On Fatty Acid Composition And Gene Expression In The Hypothalamus Of Growing Female Sprague-Dawley Rats, Ayad Abdulhamid Alawadi

Graduate Theses, Dissertations, and Problem Reports

The hypothalamus plays a major role in regulating food-intake and energy-expenditure. Hypothalamic dysfunction implicated in neurodegenerative diseases is characterized by diet-induced neuroinflammation and energy dysregulation. Apple pomace, a waste byproduct of processing, is rich in polyphenols and soluble fibers, has the potential to ameliorate diet-inducing inflammation. The objective of this study was to determine the effects of Western diet and caloric substitution of Western diet with 10% apple pomace on brain fatty acid composition and gene expression related to hypothalamic function and health in growing female rats. Growing female Sprague-Dawley rats (age 22-29 days) were randomly assigned (n=8 rats/group) to …

Environmental Contaminants, Parasitism, And Neoplasia In White Perch Morone Americana From Chesapeake Bay, Usa, Mark Arnold Matsche

Graduate Theses, Dissertations, and Problem Reports

White perch are an abundant demersal fish species in freshwater and oligohaline habitats of the Chesapeake Bay. An avoidance of salinity > 12-15 ppt generally restricts the distribution and movements of fish to within tributaries in the mid to lower Bay, which over time has resulted in the formation of at least three separate stocks in Chesapeake Bay. Sub-populations of white perch that are partially isolated may serve as sentinels of the conditions or stressors in the tributaries in which they reside. Fish are exposed to a variety of environmental contaminants and other anthropogenic stressors that can vary in magnitude based …

The Interplay Of Progestins, Matrix Metalloproteinases, And The Aging Brain, Keyana Nicole Porter

Graduate Theses, Dissertations, and Problem Reports

Progestins are synthetic hormones that are designed to mimic the biological actions of progesterone. They, however, possess other pharmacological actions and properties, in addition to their progestational activities. Medroxyprogesterone Acetate (MPA) is a progestin used globally in the hormonal contraceptive, Depo Provera®, by women in their reproductive prime and is a major compound found in hormone therapy (HT) formulations used by menopausal women. MPA is used by approximately 1 in 5 adolescents and adult women in the United States who are sexually active. Globally, nearly 48 million women utilize injectable contraceptives to prevent pregnancy, with most users utilizing MPA as …

Childhood Anxiety, Cognitive Behavioral Therapy And/Or Pharmacological Treatment, Jennifer S. Mccarthy

All Graduate Theses, Dissertations, and Other Capstone Projects

Objective: Evaluate best practice in managing anxiety in the pediatric population, including both school age children and adolescents. This literature review compared pharmacological treatment and cognitive behavioral therapy (CBT)’s effectiveness on the management of anxiety within the pediatric population.

Background: Up to 25% of children in the United States are affected by a mental health disorder, anxiety being the most prevalent. Childhood anxiety can have a distressing impact on social, family, and academic functioning. If persisting into adulthood it increases the risk of developing other co-occurring mental health conditions, substance abuse issues, and contributes to impaired employment retention and socioeconomic …

Metformin’S Role In The Prevention Of Type 2 Diabetes In Individuals Diagnosed With Prediabetes: A Systematic Literature Review, Jillian Williamson

All Graduate Theses, Dissertations, and Other Capstone Projects

The United States is facing a growing epidemic of unchecked and untreated individuals with prediabetes. While lifestyle interventions have remained the gold standard of treatment, has this been enough? A literature review was carried out to identify metformin’s role in treatment and management of prediabetes as well as perceived barriers to its prescribing. A total of 24 articles met inclusion criteria. Main findings include (a) metformin is effective in reducing the incidence of diabetes, though not as effective as lifestyle interventions; (b) certain populations did benefit more from metformin usage then other populations; (c) there was more treatment compliance with …

The Efficacy Of Cognitive Behavioral Therapy In The Treatment Of Adults With Obesity, Hallie M. Tiffany

All Graduate Theses, Dissertations, and Other Capstone Projects

Obesity is a complex condition increasing in prevalence and consequence throughout the United States and the world. Obesity is affected not only physiologically but by one’s psychological aspects of life. Obesity contributes to countless chronic health conditions and thus greatly impacts a person’s wellness. A literature review was conducted to identify the following if in obese adults the benefit of cognitive behavioral therapy for weight loss and/or maintenance. A total of 10 articles met inclusion criteria from searches from databases that included ProQuest, Medline, CINAHL, Cochrane, and PsycINFO as well as bibliography review. Level of evidence includes two articles that …

Search For The Cause Of Vaping Associated Lung Injury In Adolescents, Alexandra E. Krueger

All Graduate Theses, Dissertations, and Other Capstone Projects

In August 2019 an unexplained, exponential rise in severe respiratory illnesses in previously healthy young adults, swept across America catching the attention of medical providers. Hospital admissions for lung injury increased 10-fold over two months’ time leaving practitioners scrambling for answers. All affected patients were found to have used e-cigarettes prior to symptoms and endorsed using nicotine and marijuana vape pens. The medical community quickly began to search for the cause of these vaping associated lung injuries. Understanding the mechanism of injury is important in order to assist in educating the public about the risks associated with e-cigarettes. The aim …

Benefits Of Exercise On Mental Health: Literature Review, Angela Ristau

All Graduate Theses, Dissertations, and Other Capstone Projects

Providers diligently educate patients on exercise to reduce the risk of cardiovascular disease, hypertension, diabetes, and stroke. However, in recent years, providers judiciously educate patients on exercise and its correlation to improving or impacting mental health disorders. Physical activity has been steadily shown to relate to improved physical health, life satisfaction, cognitive functioning, and psychological well-being. A large body of literature examines the impact of physical activity and exercise on mental health. There is a growing interest in the use of exercise in the treatment of depression and anxiety, as a primary option or as an adjunct to pharmacological treatment. …

Probiotics And The Prevention Of Clostridioides Difficile: A Review Of Existing Systematic Reviews, Andrea L. Onstad

All Graduate Theses, Dissertations, and Other Capstone Projects

Clostridioides difficile is the leading cause of infectious diarrhea (Vernaya et al., 2017). Probiotics have been proposed to provide a protective benefit against Clostridioides difficile infection (CDI). The objective of this literature review was to examine the research evidence pertaining to the use of probiotics for the prevention of CDI in individuals receiving antibiotic therapy. A systematic literature review of studies published between 2015 and 2019 was performed. Five databases were searched, which yielded 10 systematic reviews that met strict inclusion criteria. Overall, the majority of evidence indicated that probiotics versus no treatment, placebo, or usual care have the potential …

Medical Utilization In The Context Of Culture: Analyzing The Concepts, Benefits And Drawbacks Of Sri Lankan Biomedical And Ayurvedic Healthcare, Miriah Rajaguru

All Graduate Theses, Dissertations, and Other Capstone Projects

Sri Lanka is an island inhabited by a culture more than 5,000 years old. The primary medicine utilized by this culture in precolonial times is known as Ayurveda. During colonization, Sri Lanka was introduced to biomedicine and forced to negate Ayurvedic medicine. Throughout the years, rather than abandoning their indigenous medical practice, Sri Lanka incorporated biomedicine and Ayurvedic medicine into their medically plural society. Today, Sri Lankans utilized both medicines for different ailments, concerns and conditions. Utilizing a variety of anthropological methods and theories, this study gathered qualitative information from 39 Sri Lankan informants. These informants were recruited to find …

Perceptions, Attitudes, Self-Efficacy, And Behaviors Of Mouthguard Use Among Collegiate Athletes, Heather Prosser

All Graduate Theses, Dissertations, and Other Capstone Projects

With the high risk of dental trauma in contact sports, it is important that all athletes have a strong foundation of how to prevent such injuries. Properly fitted mouthguards are the best available protective equipment to prevent orofacial trauma; however, previous research has found them underutilized, with the need for evidence-based interventions to promote mouthguard use among athletes. This study used a descriptive, cross-sectional, correlational research design, focusing on studying collegiate athletes at one large, Midwestern university, to determine their current attitudes, perceptions, self-efficacy, and behaviors of mouthguard use during participation in a contact sport. A convenience sampling technique was …

Human Papillomavirus (Hpv) Infection And Vaccine Knowledge And Attitudes Among University Students, Mckenzie Schmitz

All Graduate Theses, Dissertations, and Other Capstone Projects

HPV is the “most common sexually transmitted infection,” with approximately four out of five sexually active individuals getting infected at some point in their lives (Planned Parenthood, n.d.b, para.1). Cancers of the throat, mouth, cervix, anus, penis, and vagina have all been linked to HPV infections. In addition to being tested for HPV, the utilization of barrier methods and reduction of risky sexual risk behaviors, are the best ways to prevent and treat sexually transmitted infections. This study contributes to existing literature on university students’ knowledge and attitudes about HPV infections and the vaccination. This study was conducted using descriptive, …

Know Before You Play: Associations Between Race, Education, And Hiv Susceptibility, Anfa Mohamed Diiriye

All Graduate Theses, Dissertations, and Other Capstone Projects

Black women are disproportionately affected by HIV in the United States. This paper analyzes the associations between race, education, and HIV susceptibility, furthering previous research to understand if educational attainment reduces HIV susceptibility and if reduction patterns are similar for Black and White women. The CDC’s National Survey of Family Growth 2015-2017 was used to analyze associations using binary logistic and multiple regression models. HIV susceptibility was operationalized through four measures: condom use, having a partner with concurrent sexual relationships, having had an STD, and age at first sex. Black women were not found to be significantly more susceptible to …

Sexual Consent In Middle School Sex Health Education: An Analysis Of Health Education Standards In Minnesota, Ashley Parent

All Graduate Theses, Dissertations, and Other Capstone Projects

Comprehensive sex education is designed to teach sexual health, reproductive health, human sexual anatomy, safe sex, birth control and sexual abstinence. Consent education focuses on sexually transmitted infection (STI), pregnancy prevention, sexual identity, and the risks of sexual violence (Willis, 2019). This qualitative content analysis and survey will explore consent education in middle schools adopted in Minnesota from the past ten years. The research questions for this study are: is consent a part of sex education? How has consent been taught in 8-10 grades in Minnesota over the past 10 years? What frameworks are being used to teach consent to …

Assessment Of Intensive Care Family Satisfaction, Jami Burnette

Doctor of Nursing Practice Projects

There continues to be an unknown factor in knowing true patient and family satisfaction within the intensive care unit (ICU) setting. Current literature reveals surveys used to measure patient satisfaction do not pertain to the ICU setting. Patients often do not remember the ICU stay due to critical illness and are unable to actively participate with care. Families act as surrogates, are included in patient care, and collaborate with nursing and medical teams to help make care decisions. Families are integral in the patient care process and are vital members of the health care team. Even though families are included …

Implementing Safeplan: A Communication Template For Emergency Nurses Caring For Psychiatric Patients, Michele Leigh Rudisill

Doctor of Nursing Practice Projects

This DNP Project explored the impact of introducing a communication template for emergency department (ED) nurses to use during handoff when caring for psychiatric patients. This need was identified as ED nurses are now caring for psychiatric patients for longer periods of time in the ED setting, sometimes weeks to months, due to limited inpatient mental health resources and resources in the community. ED nurses’ perceptions were surveyed and the need for a standardized, yet flexible communication template was identified. The literature was reviewed, and no such template was identified specific to ED nurses caring for the psychiatric patient population. …

Simulation Impact On Medication Administration Safety: A Simulation Quality Improvement Project, Stacy Simpson

Doctor of Nursing Practice Projects

Background: Two medication simulations increasing in rigor, patient acuity, and distractions were implemented among undergraduate nursing students.

Objectives: To increase nursing student confidence, knowledge, and competence when administering medications.

Design: Two medication administration simulations were implemented and data was collected from students via a pre-simulation quiz, observation during the simulation via a Clinical Simulation Evaluation Tool, and student evaluation of the simulation with a modified version of the Simulation Evaluation Tool Likert scale.

Settings: Gaston Community College nursing simulation lab.

Participants: 53 undergraduate nursing students enrolled in NUR 101 and 42 students in NUR 102 …

Preparing Ambulatory Care Leaders For Service: Onboarding To Mentorship, Kara Simpson

Doctor of Nursing Practice Projects

At a large academic medical center in the Southeastern United States, a gap was identified in the process for onboarding and mentorship new leaders in the ambulatory care setting. Based on the evidence in the literature, a standardized onboarding and mentorship program can improve job satisfaction and retention of leaders. A program was developed to bridge this gap and provide educational support for new leaders. Participants completed surveys at the onset and conclusion of the program with a validated survey tool. While the quantitative results were not statistically significant, the feedback from the participants indicated the time spent in the …