Public Health Commons^™

Biofeedback Gaming For Substance Use Disorder, Rebecca L. Chevrel

University Honors Theses

Substance Use Disorder (SUD) and stress are often predictive of one another, bidirectionally causal, and mutually intensifying. This thesis describes the bi-directional connection between physiological stress-modulating systems and Substance Use Disorder, and explores some emerging biofeedback stress-reduction gaming technology as a potential adjunct to recovery treatments. Improving autonomic balance, often described by Heart Rate Variability, has been shown to be beneficial for physical and psychological recovery, as well as improving self-control. For this reason, regular biofeedback for stress relief could be helpful in augmenting SUD treatment and preventing relapse. This exploration found that presenting it through a gaming lens may …

The Impact Of Stress During Adolescence And The Prevalence Of Pediatric Obesity, Olatunbosun Olakunri, Venkat Venkataraman

Rowan-Virtua Research Day

Obesity is a chronic condition that can be attributed to myriad factors including socioeconomic status, biological risk factors, and various environmental factors. These factors can be considered stress factors, and exposure to various levels of stress can impact the development of stress within the pediatric patients. The purpose of this study is to assess the association between the environmental, mental, social, physical, and psychological stress adolescents are exposed to and how they contribute to the prevalence of pediatric obesity throughout the United States. Understanding these risk factors can help us as a community and most importantly as clinicians develop better …

The Consequences Of Homophobia: Analysis Of Discriminatory Medical And Legislative Policies And Their Influence On Health Disparities, Kaiden J. Fandel

Honors Thesis

Are there specific roots that influence the introduction and incorporation of discriminatory medical policies? What are the sources of such stigma, discrimination, and prejudice, in what forms does such discrimination take place, and what negative impacts does such hatred have on health outcomes, quality of care, and health disparities? Through a review of existing literature on this topic, intertwining the examination of the evolution of discriminatory policies and other explanatory literature in the United States, this thesis aims to answer the questions above, and explain the roots of such homophobic discrimination and its prevalence in the United States. Through the …

Protocols For Enhancing The Role And Value Of Spiritual Care Resources In The Metropolitan Nashville Police Department, Garrett Harper

Doctor of Ministry Theses

This thesis addresses the assessment of innovative practices in police chaplaincy. The purpose of the project intervention is to develop protocols that can guide police chaplains through an assessment process. The intervention relies on practical theology as exemplified through the ministry of chaplaincy. This ministry comprises police chaplains offering spiritual comfort to persons encountering critical incidents involving violence, accident, or other trauma-intensive events and situations. Adoption of innovations can allow police chaplains to be more effective in fulfilling many outward-focused tasks such as delivery of death notifications. I conclude that: (1) police chaplaincy is amenable to use of protocols to …

Retention, Adherence, And Acceptability Testing Of A Digital Health Intervention In A 3-Group Randomized Controlled Trial For Chronic Musculoskeletal Pain, Jennifer Kawi, Chao Hsing Yeh, Lauren Grant, Xinran Huang, Hulin Wu, Chunyan Hua, Paul Christo

Journal Articles

OBJECTIVES: Evaluate a digital health intervention using Auricular Point Acupressure (APA) for chronic musculoskeletal pain in terms of participant retention, adherence, acceptability, and satisfaction. Chronic musculoskeletal pain is a global concern and there are persistent challenges in pain management. Despite the value of digital health interventions, these interventions need to be fully evaluated for feasibility.

METHODS: We conducted a 3-group, longitudinal, randomized controlled trial (RCT). After Institutional Review Board approval, we posted recruitment flyers in a university, healthcare clinics, and community settings. Participants were randomized into an in-person + app group (n = 8), virtual + app group (n = …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Scholarly Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

Everyone Deserves A Dental Home, Loren C. Baim Dds

The New York State Dental Journal

With knowledge and preparation, dental practices should be able to accommodate the growing population of people on the autism spectrum.

Implementation Of Mindfulness & Stress Reduction Training For Medical Students, Jill Berenato

SACAD: John Heinrichs Scholarly and Creative Activity Days

Abstract

This proposal advocates for implementing mandatory mindfulness and stress reduction training sessions for surgical students at Philadelphia College of Osteopathic Medicine (PCOM). It is well-documented that medical students, particularly those in surgical disciplines, experience high levels of stress, which can negatively impact their mental health, academic performance and overall well-being. Mindfulness-based interventions have shown promise in reducing stress and enhancing resilience among medical students. By integrating mindfulness training into the surgical curriculum, PCOM aims to equip students with essential coping skills to effectively manage stress, thereby promoting their mental health and academic success. This handout serves to accompany the …

Gut Feelings: A Literature Review On The Gut-Brain Axis And Its Potential Influence On Mood, Grace Johnson

University Honors Theses

In recent decades, research on the gut-brain axis has evolved due to an increasing interest in the connection between gut health and mental health. The gut-brain axis presents a new frontier of health for both medical professionals and psychologists as there is expanding evidence illustrating the comorbidity of gut disorders and mood disorders. Due to the complex nature of studying the gut-brain axis and the myriad of influences on mood disorders such as depression, research has yet to find significant results definitively tying the two together. Nonetheless, the current body of literature on the topic provides a promising outlook on …

The Use Of Optical Coherence Tomography (Oct) And Oct Angiography In Borderline Personality Disorder Compared To Health Control Subjects., Bei Xu, Fangling Li, Zhejia Zhang, Qian Xiao

Journal Articles

BACKGROUND: Optical coherence tomography (OCT) or OCT angiography (OCTA) has been investigated in few research studies of psychiatric disorders. No research has been done using OCT or OCTA in patients with borderline personality disorder (BPD).

METHODS: OCTA measured foveal avascular zone (FAZ), macular vessel density (MVD), and peripapillary vessel density (PVD). OCT measured the peripapillary retinal fiber layer (RNFL) and central retinal thickness (CRT). The study utilized the Ottawa Self-Injury Inventory, Hamilton Anxiety Rating Scale (HAMA), and Global Assessment of Functioning (GAF) to assess the symptom characteristics of individuals with BPD.

RESULTS: Fifty-nine eyes of BPD patients and 58 eyes …

Reimagining Equitable Care: Simulation-Based Education And The Dismantling Of Implicit Bias And Stigma Of Vulnerable Populations In Hospitals, Vanessa Smith

Nursing | Senior Theses

Background: Simulation-based education consists of using high-fidelity mannequins and equipment to provide a safe space for healthcare professionals to practice crucial skills within healthcare. Used within hospitals and schools, simulation most commonly surrounds practicing hands-on skills such as central line insertion, IV insertion, Ultrasound-guided procedures, code blue response, etc. However, a large portion of healthcare that is overlooked is tackling issues within patient-provider relationships. Simulation can help dismantle the negative behaviors and feelings providers push onto patients through the use of standardized patients and role-playing. By using these methods, simulation can reduce providers’ personal implicit biases and the stigma associated …

High-Risk Individuals And Naloxone Use: Implications For Thn Programs In Rural Appalachian Communities, Victor Garcia, Lisa Mccann, Erick Lauber, Christian Vaccaro, Melissa Swauger, Alex Daniel Heckert

Journal of Appalachian Health

Introduction: Take-home naloxone (THN) is being made available across rural Appalachia to curb opioid overdose fatalities. Despite this initiative, some opioid users do not possess naloxone, and if they do, do not administer it to others.

Purpose: Research findings on risk factors that contribute to opioid overdose are presented. These factors, identified in a sample of 16 overdose cases, are (1) early onset age of opioid use; (2) progressive opioid use; (3) a transition from pain medication to heroin and fentanyl; (4) fears of being arrested at a naloxone intervention if first responders are contacted, and (5) limited knowledge of …

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Para-Infectious Brain Injury In Covid-19 Persists At Follow-Up Despite Attenuated Cytokine And Autoantibody Responses, Benedict D Michael, Cordelia Dunai, Edward J Needham, Kukatharmini Tharmaratnam, Robyn Williams, Yun Huang, Sarah A Boardman, Jordan J Clark, Parul Sharma, Krishanthi Subramaniam, Greta K Wood, Ceryce Collie, Richard Digby, Alexander Ren, Emma Norton, Maya Leibowitz, Soraya Ebrahimi, Andrew Fower, Hannah Fox, Esteban Tato, Mark A Ellul, Geraint Sunderland, Marie Held, Claire Hetherington, Franklyn N Egbe, Alish Palmos, Kathy Stirrups, Alexander Grundmann, Anne-Cecile Chiollaz, Jean-Charles Sanchez, James P Stewart, Michael Griffiths, Tom Solomon, Gerome Breen, Alasdair J Coles, Nathalie Kingston, John R Bradley, Patrick F Chinnery, Jonathan Cavanagh, Sarosh R Irani, Angela Vincent, J Kenneth Baillie, Peter J Openshaw, Malcolm G Semple, Covid-Cns Consortium, Isaric4c Investigators, Leonie S Taams, David K Menon

Journal Articles

To understand neurological complications of COVID-19 better both acutely and for recovery, we measured markers of brain injury, inflammatory mediators, and autoantibodies in 203 hospitalised participants; 111 with acute sera (1-11 days post-admission) and 92 convalescent sera (56 with COVID-19-associated neurological diagnoses). Here we show that compared to 60 uninfected controls, tTau, GFAP, NfL, and UCH-L1 are increased with COVID-19 infection at acute timepoints and NfL and GFAP are significantly higher in participants with neurological complications. Inflammatory mediators (IL-6, IL-12p40, HGF, M-CSF, CCL2, and IL-1RA) are associated with both altered consciousness and markers of brain injury. Autoantibodies are more common …

Policy Review And Recommendation For Secondary Education Np-Led Clinics In The Southeastern United States, Shiney Alex Jacob

Student Scholarly Projects

Secondary-level education involves adolescent children aged 11-12 years to 18-19 with unique healthcare needs. Their healthcare is of significant importance as they are transitioning to adulthood, and a majority of them lack access to primary healthcare needs. Advanced Practice Registered Nurses/Nurse Practitioners (APRNs/NPs) provide high-quality, cost-effective, and evidence-based care to people across the lifespan, and there is minimal utilization of their services in meeting the primary care needs of adolescents at the secondary school level. The purpose of the policy project was to determine if current policies and practices related to school health services in three southeastern states of the …

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 …

The Impact Of The Covid-19 Pandemic On The Well-Being Of People Incarcerated In United States Prisons, Kimberly Rivera

Department of Sociology: Dissertations, Theses, and Student Research

The COVID-19 pandemic has negatively impacted the population as a whole. However, the incarcerated population (which also experiences a variety of health disparities) has been disproportionately affected by the pandemic. Due to overcrowding, poor ventilation, and lack of resources, the incarcerated population already is at a heightened risk for negative health outcomes, made worse by the recent pandemic. To adapt to the rapidly changing conditions during the pandemic in 2020 and into 2022, new safety measures were implemented, but the unintended consequences associated with the implementation of these procedures have yet to be examined empirically. I conducted a qualitative content …

A Helping Hand Out Of The River: Refugee Perspectives For Provider Engagement, Brian L. Isakson, Elizabeth R. Stein, Alexandra Olson, Destiny Waggoner, Jill Holtz, Sara Ali, Suha Amer, Martin Ndayisenga

Journal of Patient-Centered Research and Reviews

Purpose: A growing number of refugee groups are seeking care within the U.S. health care system for medical, psychological, and social needs. Research is limited in understanding refugee-specific conceptualizations of helping relationships and provider characteristics that improve interactions in health systems. This study aimed to identify provider characteristics that facilitate engagement and helpfulness in a refugee-specific population from refugee participant voices to inform future practices of health care clinics.

Methods: Semi-structured interviews with refugee participants were conducted to assess 1) experiences moving on from difficult experiences, 2) engagement with the health system, and 3) provider characteristics that facilitated engagement and …

The Relationship Between Parental Trauma History And Perceptions Regarding Their Child’S Healthcare And Utilization Of Healthcare Services, Krishna Patel

Theses and Dissertations

Abstract

TITLE: The Relationship Between Parental Trauma History and Perceptions Regarding Their Child’s Healthcare and Utilization of Healthcare Services

Adverse child events (ACEs) have been associated with a number of physical and mental health problems and have also been linked to increased health care utilization. While parents who have an ACE history may tend to seek healthcare services for themselves, limited studies have examined the impact of their trauma history on seeking healthcare services for their child. Healthcare utilization may also depend on the parents’ level of health anxiety, as well as their anxiety about their child’s health status. This …

Psychological Violence And Manipulative Behavior In Couple: A Focus On Personality Traits, Carmela Mento, Clara Lombardo, Nicholas Whithorn, Maria Rosaria Anna Muscatello, Antonio Bruno, Maura Casablanca, Maria Catena Silvestri

Journal of Mind and Medical Sciences

Psychological violence is characterized by systematic denigration and humiliation of the partner (victim). It is an insidious and manipulative behavior put in place to ensure that the victim begins to doubt themselves, and their own judgments, to the point of feeling confused and wrong. This behavior pattern is called Gaslighting and the personality traits are characterized by lack of empathy, psychopathy, narcissism and Machiavellianism. These three conditions are part of the so-called dark triad and distinguished by the lack of empathy. The aim of this study is to explore psychological aspects and consequences of Gaslighting phenomena. This systematic review was …

The Pornography Industry's Disinformation Campaign On Addiction Recovery Resources, Darryl Mead

Dignity: A Journal of Analysis of Exploitation and Violence

As pornography became increasingly popular online, many unsuspecting consumers reported adverse effects. These included sexual dysfunctions, such as lack of response with real partners, delayed ejaculation, erectile difficulties, and sexual compulsivity. Some pornography consumers began congregating in online self-help portals (forums and websites) to assist one another in quitting or reducing problematic pornography use. The popularity of the self-help resources and their potential to dampen the profits of a lucrative industry resulted in disinformation campaigns run by individuals connected to the pornography industry. In this article, I examine how a paper containing significant inaccuracies about the people organising the online …

The Eyes Beyond The Screen: Digital Media Policy And Child Health, Yahia Al-Qudah

Research Symposium

Background: Modern communication technology and digital media have provided society with a foundation for instant messaging. Pictures, videos, and texts connect individuals with families, friends, and the world. Consequently, digital media has accelerated exposure to risk in which children and adolescents are most vulnerable. This project’s objective is to 1) congregate and highlight current knowledge about the impact of digital media on child health, and 2) underline deficiencies in related laws and regulations as well as offer solutions in digital media policy.

Methods: A systematic literature review was conducted through the JAMA Pediatrics database with keywords such as “digital media,” …

Improving Minors' Access To Treatment For Opioid Use Disorder: A Policy Analysis, Sara Jane Hamilton

Master's Projects and Capstones

As the opioid epidemic continues to have devastating effects on our communities, medications to treat opioid use disorder (MOUDs) are severely underutilized especially for adolescents. Unlike adults, minors need parental approval before obtaining MOUDs presenting a key barrier to timely treatment. Being able to treat adolescents as soon as they are ready is critically important for people with OUD, and while cost and other barriers have been addressed in the literature, there is a paucity on how parental consent affects the accessibility of treatment. This paper aims to explore a potential policy in California that addresses the lack of access …

Adverse Childhood Experiences Among Adolescent Girls In Residential Treatment: Relationship With Trauma Symptoms, Substance Use, And Delinquency, Akemi E. Mii

Department of Psychology: Dissertations, Theses, and Student Research

Adverse childhood experiences (ACEs) refer to negative events during childhood or adolescence including abuse, maltreatment, and exposure to household dysfunction (Kalmakis & Chandler, 2014). ACEs are associated with negative outcomes including mental and behavioral health concerns and offending (Fox et al., 2015). The risk of negative outcomes associated with ACEs increases when an individual experiences polyvictimization (experiencing multiple types of adverse events; Felitti et al., 1998; Finkelhor et al., 2011). A majority of adolescents served by residential treatment programs (RTPs) have experienced polyvictimization (Briggs et al., 2013). Research examining juvenile offending and youth delinquency has focused on boys. Thus, research …

Understanding Mental Health As Public Health, Christi M. Navarro

Faculty Proceedings, Presentations, Speeches and Lectures

In this interactive workshop, we will utilize a multi-level public health framework to illustrate factors of risk and prevention that influence mental health and well-being. We will discuss shifting the narrative of mental health as an individual issue to the responsibility of society, culture, and environment. Participants will reflect on their role and level of influence in this model as well as their potential for action and positive impact.

Evidence-Based Practices And Self-Efficacy: A Quantitative Study Of Mental Health Counselors Treating Clients With Substance Use Disorder, Carl Bastien

Dissertations

Substance use disorder affects a substantial number of individuals in the United States. The specific problem of this research is that it was not known to what extent their use of evidence-based practices is driven by their sense of self-efficacy. The purpose of this quantitative correlational research was to examine to what extent the use of evidence-based practices covary with a sense of self-efficacy for mental health counselors treating individuals diagnosed with a substance use disorder. The study population was 121 mental health counselors who specialized in substance use disorder treatment who completed a digital survey. The study findings did …

Tackling The Complexities Of The Obesity Pandemic Among The Bame Population In The Uk Through Identification Of The Social Determinants Of Mental Health And Wellbeing: A Narrative Review, Johnson Mbabazi, Fiona Macgregor, Jeff Breckon, Dorothy Irene Nalweyiso, Alan Rhodes, Edward Kunonga, Barry Tolchard, Jennifer Teke, Lawrence Achilles Nnyanzi

International Journal of Physical Activity and Health

Obesity's multifaceted causes give rise to a complex and diverse range of health associated morbidities and comorbidities, including diabetes, hypertension, and cardiovascular disease, particularly among British Asian and Minority Ethnic (BAME) populations within in the UK. As found within the recent COVID-19 pandemic these can have wider reaching implications including increased risk of mortality within this population group. Understanding the potential social determinants of the causes of obesity is essential if effective strategies are to be developed to tackle this. A comprehensive search of the CINAHL, ASSIA and Web of Science databases was undertaken with 148 papers identified. Through application …

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …

Dance/Movement Therapy Used As An Intervention To Heal Racial Trauma Within The Black Community: A Literature Review, Jennifer Noboise

Expressive Therapies Capstone Theses

The history of dance within the black community has served an important role while living through a racist and discriminatory society. Dance has been used to express anger, grief, and joy during hardships and moments of rejoicing from the black experience. African American people have endured years of trauma and abuse from oppressive systems. Research has been conducted to demonstrate that dance/movement therapy has been effective in treating those who have experienced a form of trauma since the trauma is stored in the body. Examining trauma symptoms such as anxiety, depression, and substance use, the research found these symptoms diminished …

Medical Interpreters' Work Impact On Their Lives: Understanding Medical Interpreters' Work Experience, Nicholas M. Herrarte Smith

Senior Honors Projects, 2020-current

Medical interpreters in the US are crucial health workers that specialize in facilitating communication between non-English-speaking patients and English medical professionals. Although much research has been done regarding the positive impact of professional medical interpreters on LEP (limited English proficient) patients' health, it is less known how medical interpreters’ lives are impacted in this line of work. Thus, this study was aimed at gaining a better understanding on the impact that this line of work has on the lives of medical interpreters. For this study, a survey was created with questions regarding demographics, interpretation’s certification process, interpreter’s satisfaction/experience, and mental …