Social and Behavioral Sciences Commons^™

Illness Perceptions And Health-Promoting Behaviors: The Buffering Role Of Resilience In Adults With Congenital Heart Disease, Taylor Rose Eldridge

Electronic Theses and Dissertations

Congenital heart defects (CHD) are one of the most prevalent genetic abnormalities, impacting the lives of millions of children, teens, and young adults. Conservative diagnoses estimate that 2.4 million children and adults are living with CHD in the United States (Gilboa et al., 2016). CHD requires consistent cardiac support with multiple surgeries and hospitalizations expected throughout the lifetime, which significantly impacts psychological health. Specifically, patients present with a host of extra-cardiac conditions that impact their quality of life. With advancements in medical technology, mortality rates continue to improve for this population; however, individuals face a number of consequences that impact …

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

An Existential Punchline: How Humor Functions In A Young Adult Friendship Facing Advanced Cancer, Megan E. Solberg

Electronic Theses and Dissertations

Young adults (i.e., age 18-39) only comprise 4% of the total cancer population, yet cancers in this group are commonly found at more advanced stages due to situational factors influencing delayed diagnosis including access to healthcare, quality health insurance and competing life demands that may hinder prioritization of healthcare. Young adults with cancer also face unique challenges including higher rates of psychological distress, which may contribute to increased risk of social disconnection in response to cancer. Research suggests that humor may be a helpful coping approach and communication mechanism for mitigating distress and discussing difficult topics. Grounded within the frameworks …

On-Campus Mental Health Service Use Among College Students With Autism: A Case Study Applying The Andersen Behavioral Model Of Health Services Use, Estella C. Lilyquist

Electronic Theses and Dissertations

The unique set of impairments and limitations presented by students with autism spectrum disorder (ASD) make the accessing of campus-based nonacademic resources more difficult and complicated than their typically developed peers. Each year, the rate of students entering college with disabilities continues to grow, but their mental well-being is relatively poor. The purpose of this qualitative case study was to apply the conceptual framework of the Andersen behavioral model of health services use (ABMHSU) to the experiences of college students with ASD to understand and predict their utilization of campus-provided mental health resources. The participants were seven college students with …

The Impact Of Disruptive Physician Behavior On Support Staff And Patients: A Quantitative Secondary Analysis, Michael C. Marino

Electronic Theses and Dissertations

In this quantitative secondary analysis, the purpose was to examine the nature of disruptive physician behavior (DPB) from the support staff and patient perspectives. Healthcare staffing shortages existed prior to the global pandemic and have increased, creating importance for employee retention and recruitment. I wanted to understand the impact of physician behavior on staff turnover rates in a private oncology practice, its effect on patient satisfaction rates, and to compare these rates of physicians that display DPB with physicians that do not display this behavior in a private hematology oncology community outpatient setting in the Southwest United States. To answer …

The Intersection Of Traumatic Brain Injury And Homelessness, Stephanie A. Chassman

Electronic Theses and Dissertations

The rates of TBI are significantly higher among individuals experiencing homelessness compared to the general population. Up to half of individuals experiencing homelessness may have a TBI. Accurate prevalence rates of TBI among individuals experiencing homelessness are difficult to obtain due to different methods of sampling participants and differing definitions of TBI; therefore, estimates may be underrepresented. Despite past research that has examined the relationship between TBI and homelessness, there are specific gaps in knowledge such as correlates and risk factors of TBI among individuals experiencing homelessness. This three-manuscript dissertation attempts to address these gaps in knowledge.

The first manuscript …

Factors Associated With Intention To Disclose Concussive Symptoms In Active Duty Soldiers, Carly Beck

Electronic Theses and Dissertations

Background: Concussion disclosure is a heavily researched topic, and while previous literature has explored predictors of concussion disclosure in numerous populations, research within the active duty Soldier population is limited. This study further explored predictors of concussion disclosure to a medical professional or leadership in the active duty Solider population through the lens of the Theory of Planned Behavior. Methods: A cross-sectional electronic survey was distributed to 181 active duty Soldiers. Descriptive statistics were used to report frequency of high intention to disclose concussive symptoms among demographics, and a multivariate regression model was used to assess significant predictors of intention …

Experiences And Perceptions Of Female Athletic Trainers Working With Male Coaches In Male Sports, Sierra Hobday

Electronic Theses and Dissertations

Context: Female athletic trainers are making great strides in a previously male-dominated profession and are also becoming more prevalent in working with male sports teams. Female athletic trainers working within male sports often face gender bias and discrimination which has been found to come from male coaches of these sports. While previous studies have shown male coaches may demonstrate practices of gender bias towards female athletic trainers working in male sports, no studies have focused directly on the male coach and female athletic trainer relationship. Purpose: To examine the experiences and perceptions of female athletic trainers currently working with male …

Maternal Hpa Axis Function During Parenting Is Associated With Reduced Brain Activation To Infant Cry And More Intrusive Parenting Behavior, Andrew Erhart

Electronic Theses and Dissertations

Previous research indicated that maternal cortisol function and maternal brain response to infant stimuli are separately related to differences in parenting behavior. Evidence from animal models have demonstrated that chronically high cortisol concentration alters brain structure and function, suggesting that studying these two mechanisms together may further improve understanding of parental behavior in human mothers. First time mothers of infants aged 1-7 months old (M age = 3 months) were recruited to participate. Mother’s cortisol concentration was measured during a naturalistic interaction with their infant and their behavior was coded for maternal sensitivity and nonintrusiveness. In a separate session using …

Mechanisms Of Sensory Adaptation In The Primate Visual System, Boris Isaac Peñaloza Rojas

Electronic Theses and Dissertations

Under ecological conditions, the luminance impinging on the retina varies within a dynamic range of 220 dB. Stimulus contrast can also vary drastically within a scene, and eye movements leave little time for sampling luminance. In addition, the amount of information reaching our visual system far exceeds the brain’s information processing capacity. Given the limited dynamic range of its neurons and its limited capacity in processing visual information in real-time, the brain deploys both structural and functional solutions that work in tandem to adapt to the surroundings. In this work, employing visual psychophysics and computational neuroscience, we study the mechanisms …

Athletics As A Life Curriculum: Lessons Learned Through Different Aspects Of Athletics, Thomas J. Davis

Electronic Theses and Dissertations

For my dissertation, I decided to write a memoir to have the opportunity to go through the self-reflection process and learn more about my inner self. I wanted to learn how the life experiences I write about have affected me as a student-athlete, coach, teacher, parent, and how they have shaped me into who I am today. I took instances from my life in athletics that I believe are significant in the development of my overall being. Educational scholars such as William Pinar (1995, 2004), John Dewey (1916/2019, 1933), Frederic Gros (2011), Immanuel Kant (1908/2015), Nel Noddings (2005), and Paulo …

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with …

Health Insurance Plan Design And Chronic Disease Management, Daniel E. Feldman

Electronic Theses and Dissertations

Each year, Americans spend more money on health care than any other industrialized nation, despite comparable mortality rates for people with risk factors for heart disease. The reasons for this lack of health care value in the US are numerous and complex – including market distortions like supplier-inflated pricing and regulatory structures that enable consumers to utilize ubiquitous, high-cost medical technologies that yield uncertain benefits. Health insurance, once thought to be an insignificant contributor to rising health spending, has changed considerably in the past few decades in ways that make it more accessible and more generous in coverage. Health insurance …

Automatic Exposure Control During Computed Tomography Scans Of The Head: Effects On Dose And Image Quality, Stephen D. Osborne

Electronic Theses and Dissertations

Automatic exposure control (AEC) is effective at reducing potentially harmful radiation doses without sacrificing image quality for many types of computed tomography (CT) scans. However, there is a need for more information regarding the use of AEC for CT head scans. This study was conducted at Johnson County Community Hospital in Mountain City, TN. Preexisting adult CT head scans (n)60 were randomly selected to form 2 stratified samples, (n)30 each. One sample used a standard protocol, and the other used a protocol with a mA-modulated AEC system, Siemens CARE Dose 4D. Causal-comparative analyses were conducted, and …

Comparative Spending Of Medicaid Dollars On Child Participants Of Kentucky’S Sobriety Treatment And Recovery Teams Program Versus A Matched Comparison Group., Matthew Thomas Walton

Electronic Theses and Dissertations

Child protective services agencies have long observed the complicating role that parental substance use and addiction plays in cases of child maltreatment. Families who struggle with these problems present unique challenges for child welfare professionals. These families are typically more difficult to engage, more likely to have children removed from the home, and have poorer outcomes when compared to other families. These poorer outcomes often include health problems. Addiction has well-known effects on health, and the specific manifestations of these problems for parents have been documented for years in child protection casework. However, what has been less investigated are the …

Impact Of Adverse Childhood Experiences On Mental Health Outcomes And Related Prescription Practices In A Psychiatric Inpatient Sample, Carrie Lemay

Electronic Theses and Dissertations

A definitive association between adverse childhood experiences (ACEs) and negative physical and mental health outcomes has been established. There is evidence that individuals in forensic psychiatric facilities are disproportionately exposed to ACEs, which may impact severity, prognosis, and age of onset of psychiatric symptoms, including behavioral concerns of institutional aggression, self-harm behaviors, and suicide attempts. Such psychiatric and behavioral concerns are often managed through multiple psychotropic prescriptions, leading to psychotropic polypharmacy. This study evaluated the relationship between ACEs, mental health and behavioral concerns, and psychotropic polypharmacy through analysis of archival data from a forensic inpatient psychiatric facility. A total of …

Blacklegged Tick (Ixodes Scapularis) Distribution In Maine, Usa, As Related To Climate Change, White-Tailed Deer, And The Landscape, Susan P. Elias

Electronic Theses and Dissertations

Lyme disease is caused by the bacterial spirochete Borrelia burgdorferi, which is transmitted through the bite of an infected blacklegged (deer) tick (Ixodes scapularis). Geographic invasion of I. scapularis in North America has been attributed to causes including 20th century reforestation and suburbanization, burgeoning populations of the white-tailed deer (Odocoileus virginianus) which is the primary reproductive host of I. scapularis, tick-associated non-native plant invasions, and climate change. Maine, USA, is a high Lyme disease incidence state, with a history of increasing I. scapularis abundance and northward range expansion. This thesis addresses the question: “To …

Social Aspects Of Food-Sensitive Adults, Jean Elizabeth Duane

Electronic Theses and Dissertations

People living with food-related illnesses find themselves subjugated by commonly held ideologies causing awkwardness in social situations. The current study is a qualitative analysis addressing how people with celiac disease (CD) navigate social situations in light of dominant beliefs that influence behaviors. Initially, I identify macro-level patriarchal, religious, sexist, ableist and etiquette-related commensality ideologies that disadvantage those with CD. Drawing from the communication narrative sense making (CNSM) theory that supports storytelling and memorable messages as a sense-making tool for individuals diagnosed with chronic illness and their family members, this work highlights retrospective stories and memorable messages from 20 randomly selected …

Assessing Readiness For Group Therapy In Primary Care: An Initial Survey Exploring Need, Philip Randall

Electronic Theses and Dissertations

Primary care providers have become the front line of treatment for mental health in the United States. Group interventions have been argued to be an effective way to treat more patients with fewer resources, which could reduce the burden of psychopathology on primary care settings. Group therapy faces many barriers to successful implementation in primary care, including site constraints, provider perceptions, population needs, and recruiting difficulties. A survey was developed to assess primary care providers’ perspectives on these areas and distributed via online survey to practitioners in Appalachia; 28 providers responded. No hypotheses were supported, likely a result of the …

Designing Interactive Virtual Environments With Feedback In Health Applications., Yi Li

Electronic Theses and Dissertations

One of the most important factors to influence user experience in human-computer interaction is the user emotional reaction. Interactive environments including serious games that are responsive to user emotions improve their effectiveness and user satisfactions. Testing and training for user emotional competence is meaningful in healthcare field, which has motivated us to analyze immersive affective games using emotional feedbacks. In this dissertation, a systematic model of designing interactive environment is presented, which consists of three essential modules: affect modeling, affect recognition, and affect control. In order to collect data for analysis and construct these modules, a series of experiments were …

Associations Between Personality Style, Perceptions Of Health Coaching And Percent Of Starting Weight In Meal Replacement Program Participants, Anne E. Sawyer

Electronic Theses and Dissertations

Purpose: To determine if personality style and an individual’s perception of their health coaching experience impact their ability to lose weight and/or maintain weight loss. Methods: An electronic survey was distributed to 20,000 current and past meal replacement program participants. Personality style was assessed via the Ten Item Personality Inventory, providing individual perceptions of each of the Big Five personality domains (extraversion, agreeableness, conscientiousness, emotional stability, and openness to experience). The Working Alliance Inventory (Short Revised) was used to assess three key perceptions of health coaching: 1) agreement on the goals of coaching (goal), 2) agreement on the tasks of …

Monitoring Pollen Counts And Pollen Allergy Index Using Satellite Observations In East Coast Of The United States, Murat Cagatay Kececi

Electronic Theses and Dissertations

Allergic diseases have become increasingly common over the world during the last four decades, and they are affecting millions of people. Pollination is an important process in the life cycle of plants. However, pollen exposure is associated with allergic diseases such as asthma and seasonal allergic rhinitis (hay fever). As a result, the total annual expenditure for asthma-associated morbidity is about $56 billion in the United States, and the overall cost of allergic diseases is over $18 billion annually. For allergic rhinitis, the annual medical cost is approximately $3.4 billion. The intensity and frequency of the pollen exposures can be …

Spirituality And Psychological Well-Being Among Als Caregivers: Hope And Perceived Stress As Mediators, Bridget R. Jeter

Electronic Theses and Dissertations

The empirical study of the salutary relationship between spirituality/religiousness and psychological well-being is burgeoning. However, mechanisms of this association have received less empirical attention. Theory suggests that spirituality/religiousness may lead to positive psychological characteristics such as hope, which may function as a means of coping in the context of a significant stressor or stressful situation. The perceived burden and stress associated with caring for individuals with chronic illnesses such as ALS is significant, and caregivers may be at risk for increased symptoms of depression, symptoms of anxiety, somatic symptoms, and other deleterious psychological well-being related outcomes. Within the context of …

Mental Health Referral In Primary Care: Influence Of A Screening Instrument And A Brief Educational Intervention, Michael T. Miesner

Electronic Theses and Dissertations

Although less than half of all patients with mental disorders seek mental health treatment per se, approximately 80% of all people will visit their primary care physician (PCPs) within a year (Strosahl, 1998). However, it is not well understood how to best handle patients presenting with mental health issues in primary care practices. The purpose of this project was to implement an intervention involving a screening measure for anxiety and mood disorders in a primary care setting to increase the volume of anxiety and mood disorder screening, to increase the accuracy of disorder detection, and to also enhance PCPs patterns …

Persistent Oral Dyskinesias Induced By Long-Term Haloperidol Treatment Is Dissociated From Changes In Neostriatal B(Max) And Mrna Content For Dopamine D(2) Receptors, Nuoyu Huang

Electronic Theses and Dissertations

Due to the presumed associations of dopamine (DA) receptor supersensitivity phenomena in both long-term neuroleptic-treated tardive dyskinetic rats and neonatal 6-hydroxydopamine (n6-OHDA)-lesioned rats, we studied the influence of haloperidol on n6-OHDA-lesioned rats. At 3 days after birth rats received 6-OHDA-HBr (200 $\mu$g, bilateral intracerebroventricularly; desipramine pretreatment, 20 mg/kg, 1h) or vehicle. Two months later haloperidol (1.5/kg/day $\times$ 2 days/week for 4 weeks, then 1.5 mg/kg/day, every day for 10 months) was added to the drinking water. Spontaneous oral activity of intact and n6-OHDA-lesioned rats receiving haloperidol was reached and maintained at significantly higher levels after 15 weeks of haloperidol treatment. …