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The Reproductive Health Needs Of Women At Risk Of Hiv Infection In Connecticut, Emily Hoff

Yale Medicine Thesis Digital Library

Background: The number of women involved in criminal justice systems (WICJ) and women who use opioids has been dramatically increasing in the United States. An often-overlooked aspect of healthcare for women at risk of HIV infection (either WICJ or women who use drugs) is reproductive health. We aim to provide a framework, informed by a systematic review and primary data, to guide future interventions addressing the sexual and reproductive health (SRH) needs of women at risk of HIV infection.

Methods: We completed a systematic literature review of the pregnancy prevention and planning needs of US WICJ published in English from …

Trends And Patterns In Use Of Medications For Opioid Use Disorder In A Commercially Insured Population In The U.S., Catherine Serratore

Theses and Dissertations--Pharmacy

Opioid use disorder (OUD) and opioid overdose are pervasive public health problems in the U.S. Medications for opioid use disorder (MOUD) have been shown effective to reduce OUD morbidity and mortality. Two distinct approaches to MOUD are currently used: agonist therapy (methadone or buprenorphine) or antagonist therapy (naltrexone). Limited information is available about the patterns of use, adherence to therapy, and characteristics of those who use agonist vs. antagonist therapy. The objective of this study is to assess recent trends in MOUD, adherence in use of MOUD, and the characteristics of those who use agonist vs. antagonist therapy in a …

A Pilot Of Emergency Department-Initiated Buprenorphine For Opioid Withdrawal And Opioid Use Disorder: A Quality Improvement Project, Jason Lucey

DNP Scholarly Projects

Background: Emergency department (ED) visits for opioid related visits have increased dramatically during the opioid epidemic. Buprenorphine is an evidence-based therapy for treating opioid use disorder (OUD) and withdrawal. Unfortunately, lack of access to pharmacotherapy for OUD, including buprenorphine, remains a challenge. Research supports ED-initiated buprenorphine as a practical, cost-effective strategy which engages patients in treatment better than non-pharmacologic alternatives.

Purpose: The aims of this improvement project were to 1) develop a pilot process in an ED for providing buprenorphine to patients in opioid withdrawal or for OUD; 2) recruit and train a cohort of ED staff on the process; …

Occupational Therapy Community Reintegration For Inmates With Co-Occurring Disorders, Miranda Hosking, Kara Moore

Occupational Therapy Capstones

A co-occurring disorder (COD) is the coexistence of a substance use disorder and mental health disorder (Substance Abuse and Mental Health Services Administration, 2016). The prevalence of inmates with COD in correctional facilities is disproportionately high (Grant, Stinson, & Dawson, 2004). Despite the high incidence, correctional facilities are not equipped to meet the complex needs of individuals with COD, which often leads these individuals to re-offending or re-incarceration (Sacks, Chaple, Sacks, McKendrick, & Cleland, 2012). The role of occupational therapy in this area of practice is not clearly distinguished. However, occupational therapy’s holistic, client-centered, and occupation-based principles position the profession …

Barriers And Facilitators To Recruitment And Enrollment Of Hiv-Infected Individuals With Opioid Use Disorder In A Clinical Trial, Kim Hoffman, Robin Baker, Lynn Elizabeth Kunkel, Elizabeth Needham Waddell, Paula J. Lum, Dennis Mccarty, P. Todd Korthuis

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

The CTN-0067 CHOICES trial tests implementation of extended-release naltrexone (XR-NTX) versus treatment-as-usual (TAU) for opioid use disorders (OUD) in HIV clinics to improve HIV viral suppression. The study team investigated recruitment strategies to elucidate the barriers and facilitators to recruitment and enrollment in the study.

Main text

Methods: Semi-structured, in-depth, digitally recorded interviews were completed with study recruitment-related staff and medical providers (n = 26) from six participating HIV clinics in the fall of 2018. Interviews probed 1) factors that might prevent prospective participants from engaging in study recruitment and enrollment procedures and 2) strategies used by study …

Mentally Ill, Or Mentally Ill And Dangerous?: Rethinking Civil Commitments In Minnesota, Eliot T. Tracz

Mitchell Hamline Law Journal of Public Policy and Practice

No abstract provided.

Is Acupuncture Effective In Reducing Opioid Cravings In Detoxifying Opioid Abusing Adults?, Sarah Kish

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is acupuncture effective in reducing opioid cravings in detoxifying opioid abusing adults?”

STUDY DESIGN: A review of three RCTs published in English, each of which was published in 2009, 2013 and 2014 respectively.

DATA SOURCES: Three randomized controlled trials (RCTs) published in peer-reviewed journals that evaluate the effectiveness of acupuncture to reduce opioid cravings found via PubMed and ScienceDirect.

OUTCOMES MEASURED: Opioid cravings via 100 millimeter analog scale score, the Maudsely craving score consisting of five-point Likert scales and withdraw symptoms as measured by a 4-point …

An Evaluation Of Dsm–5 Section Iii Personality Disorder Criterion A (Impairment) In Accounting For Psychopathology., Chelsea E. Sleep, Donald R. Lynam, Thomas A. Widiger, Michael L. Crowe, Joshua D. Miller

Department of Psychological Sciences Faculty Publications

An alternative diagnostic model of personality disorders (AMPD) was introduced in DSM–5 that diagnoses PDs based on the presence of personality impairment (Criterion A) and pathological personality traits (Criterion B). Research examining Criterion A has been limited to date, due to the lack of a specific measure to assess it; this changed, however, with the recent publication of a self-report assessment of personality dysfunction as defined by Criterion A (Levels of Personality Functioning Scale—Self-report; LPFS-SR; Morey, 2017). The aim of the current study was to test several key propositions regarding the role of Criterion A in the AMPD including the …

Polysubstance Opioid Use In A Justice-Involved Population: An Analysis Of Patterns And Reentry Outcomes, Amanda Marie Bunting

Theses and Dissertations--Sociology

The public health crisis surrounding opioid use is pronounced among justice-involved populations, who face high rates of overdose mortality as well as HIV, and hepatitis C due to injection drug use. The majority of opioid-related overdoses are due to polysubstance use (PSU), and a better understanding of the prevalence and patterns of PSU are necessary in order to inform interventions. This dissertation project has three aims: (1) understand the patterns of opioid PSU among a justice-involved population, (2) identify PSU patterns most at-risk for post-release relapse, and (3) examine engagement in post-release health service utilization. Post-release aims are guided by …

Evaluating The Impact Of An Intervention To Promote Empathy For Patients With Substance Use Disorder In A Rural Emergency Department, Theresa Poling

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background

Negative attitudes of health professionals towards patients with SUD are common and contribute to suboptimal health care for this marginalized group of patients (Van-Boekel, Brouwers, Van-Weeghel & Garretson, 2013).

Objectives

Promoting empathy in the Emergency Department (ED) has the potential to increase nursing staff’s awareness of their attitudes and perceptions toward patients with SUD, thereby decreasing the stigma associated with addiction and improving patient care and patient outcomes. The rationale for implementing this project was to evaluate a tool to promote empathy. This tool was developed by the student researcher based on a literature search and analysis.

Design

This …

Gun Violence Screening In The Adolescent Setting, Amy Burnett

DNP Projects

Objective: The purpose of this project was to implement a routine gun violence screening tool into practice in order to assess the need for this type of screening in the Adolescent Medicine Clinic at the University of Kentucky.

Methods: This study used a quasi-experimental one group posttest design to examine the impact of the implementation of a gun violence screening tool on the proportion of patients screened and the proportion of patients referred for intervention that screen positive.

Results: There were 44 adolescent patients that participated in this study (n=44). Twelve out of 44 participants screened positive, which means they …

Pharmacodynamics Of Monoamine Transporter Releasing Agents And Reuptake Inhibitors, Alexa Holloway

Theses and Dissertations

Ligands of the human monoamine transporters encompass a wide range of both illicit and therapeutic drugs that act upon neural circuitry related to reward, motivation, and the processing of salient stimuli. The present study utilizes two methods for analyzing transporter substrates and inhibitors in order to characterize activity and assess potency. The first measures transient changes in intracellular calcium as a surrogate for transporter activity by harnessing the electrical coupling of monoamine transporters and L-type calcium channels. This is used to analyze novel chimera of the strong hDAT inhibitors methylphenidate and ��-PPP in order to assess the contribution of specific …

Mapping Addiction: A Digital Psychogeographic Approach To America's Addiction Epidemic, Clayton Benjamin

Electronic Theses and Dissertations

Focusing on policy consultation, my dissertation consults on the current US addiction epidemic and aims to answer, "What is our disposition to addiction?" Borrowing and clarifying Ulmer's MEmorial method, as established in his text Electronic Monuments, the dissertation combines the ancient Greek practice of theoria, Deleuzian theory, and psychogeographic counter-mapping methods to trace ways in which ideological apparatuses construct addiction. The aim of the dissertation is to reveal an abject value by constructing MEmorials which provide space for individuals to mourn loss and see their relation to that loss. Through mourning, individuals strengthen their ties to other community members and …

Program Review Of Naloxone Training Within The Wisconsin Department Of Corrections’ Community Corrections Division, Chelsea Calhoon

All Graduate Theses, Dissertations, and Other Capstone Projects

One of the fastest growing drug problems in the United States is the abuse of opioids (United States Department of Health & Human Services, 2018). With the rising overdose rates, the criminal justice system may offer a pivotal role in the decrease of overdose deaths through opioid overdose recognition and naloxone administration training (World Health Organization, 2014). Training evaluation based on the Effectiveness Theory find significant predictors of training effectiveness and retention to be correlated with the training program, age, and employment tenure (Cowman & McCarthy, 2016). This thesis’ research question is, “Do demographics correlate to training retention for opioid …

Introduction To Community Psychology: Becoming An Agent Of Change, Leonard A. Jason, Olya Glantsman, Jack F. O'Brien, Kaitlyn N. Ramian

College of Science and Health Full Text Publications

Introduction to Community Psychology: Becoming an Agent of Change tells the story of community psychologists, who view social problems as being due to the unequal distribution of resources, which causes poverty, homelessness, unemployment, and crime. In addition, because no condition or disease has ever been eliminated by just dealing with those with the problem, community psychologists focus their work on prevention. Finally, community psychology shifts the power dynamics so that community members are equal members of the team, as they provide unique points of view about barriers that need to be overcome in working toward social justice. In a sense, …

Insuring Graduation: An Analysis Of The Association Between Student Health Insurance And Graduation, John Robert Lovett

All ETDs from UAB

Most college students have access to basic health services through their campus’ college health program. Unfortunately, students who lack health insurance may be limited in their access to health services beyond the acute care provided, which may manifest in a myriad of adverse outcomes; ultimately resulting in withdrawal from college without graduating. Student health insurance plans (SHIPs) are high-quality, affordable insurance plans specially designed to meet this need. This study utilized survival analysis to examine the temporal nature of college graduation behavior, as it related to student health insurance status. The results of this study show no significant relationship between …

Clinicians' Attitudes Toward Sex Offender Treatment, Vallerie Hancock

Walden Dissertations and Doctoral Studies

Clinician attitudes toward a client have a significant influence on outcomes for that client's treatment. Exploring the attitudes of clinicians toward sex offenders can provide additional insights into methods to improve treatments for this population. The purpose of this qualitative grounded theory study was to examine the attitudes of clinical professionals who work with sex offenders to identify the specific ways that these attitudes influenced professional behaviors and client interactions. Grounded theory was used to move beyond a general description of the issue to formulate a theory regarding clinician work with sex offenders and its implications. The sample comprised 10 …

Is It Who Am I Or Who Do You Think I Am? Identity Development Of Adolescents With Substance Use Disorders, Danielle N. Treiber

Antioch University Dissertations & Theses

The purpose of this study was to unearth how adolescents with substance use disorders achieve the task of identity formation and the construction of self-concept in the midst of the drug culture and society that exists. It sought to uncover the social constructs designed to ignore and/or remove human complexities and allow an intersectional approach to be brought to a study on this population. Historically, there has been a failure to investigate the underlying social attitudes and behaviors that impact the very delicate and vulnerable process of finding self. Psychosocial and relational adjustment are strongly influenced by the extent to …

The Experiences Of African American Marriage And Family Therapists: Their Contributions To The Marriage And Family Therapy Field, Leila Linntoya James

Antioch University Dissertations & Theses

In this dissertation, I seek to understand the factors that play a role in the success of African American Scholars in the Marriage and Family Therapy field, by conducting an extensive literature review of factors that may affect matriculation and retention through lived experiences. In the study, I use narrative inquiry, research questions and Husserlian Phenomenological methodology to explore the challenges important to the African American journeys toward success. In the first chapter, I introduced the criteria in which the study focused which highlighted four areas of accomplishments including clinical, teaching, supervision, and research. dissertation that follows. The second chapter …

Shifting Sexual Violence Prevention Messaging: Placing Blame Where It Belongs While Fostering Collective Empowerment And Self-Efficacy, Jacquelyn Mesenbrink, Gemma Skuraton, Lauren O. Patterson, Nandi A. Marshall

Eagles Talking About the Public’s Health

No abstract provided.

Understanding The Impact Of Choice Claims In Health Policy Among Veteran Patients, Stacie Marie Rivera

Walden Dissertations and Doctoral Studies

The patient-as-consumer has emerged as a narrative in the government health care system that cares for beneficiary veteran patients, elevating the phenomenon of choice in health care legislation and administration. The problem of the submerged state of a health policy was the issue examined within the context of access to health care and what patients experience when choice is present. The purpose of this study was to explore the motivations of beneficiary veteran patients to choose a preventive care option, a seasonal flu shot, at a private sector retail pharmacy rather than at their government health care provider, with the …

Hiv/Aids And Behavioral Risk Factors Among Former Texas Prison Inmates, Scarlett Lusk-Edwards

Walden Dissertations and Doctoral Studies

As of the end of 2010, .9% (20,093) of the inmate population under the care of the U.S. Federal Bureau of Prisons and 1.7% (2,394) of the inmate population under the care of the Texas Department of Criminal Justice were living with HIV/AIDS. The purpose of this quantitative correlational study was to analyze the relationships between HIV/AIDS status and former inmate demographic characteristics, intravenous drug use (IDU), and social support networks. The behavior models of importation and deprivation formed the theoretical frameworks used to explore the relationship between HIV/AIDS and behavioral risk factors for released Texas prison inmates. Fifty former …

Court Personnel Attitudes Towards Medication-Assisted Treatment: A Statewide Survey, Barbara Andraka-Christou, Meghan Gabriel, Jody L. Madeira, Rod D. Silverman

Articles by Maurer Faculty

Background: Despite its efficacy, medication-assisted treatment (MAT) is rarely available in the criminal justice system in the United States, including in problem-solving courts or diversionary settings. Previous studies have demonstrated criminal justice administrators' hostility towards MAT, especially in prisons and jails. Yet, few studies have examined attitudes among court personnel or compared beliefs among different types of personnel. Also, few studies have explored the relationship between MAT education/training and attitudes. Finally, few studies have directly compared attitudes towards methadone, oral buprenorphine, and extended-release naltrexone in the criminal justice system.

Methods: We modified a survey by Matusow et al. (2013) to …

Religion In Incarcerated, Jewish, Female Inmates, Marcia Janine Kesner

Theses and Dissertations

This study explored the role religious belief and practice played amongst Jewish, female inmates during their incarceration. A group of ten correctional chaplains who work with Jewish, female, inmates and a comparison group of ten chaplains who work with Protestant, female inmates were interviewed. The study determined the reasons for and benefits of religious observance among these inmates and included assisting in dealing with fear, providing a sense of peace, and deceitful motives for personal gains. Religious practice also assisted inmate populations in healing from trauma, improving self-respect and self-esteem, building support systems, and additionally for Jewish, female inmates constructing …

Strategies For Nursing Staff Working In A Correctional Facility., Ima James

Walden Dissertations and Doctoral Studies

As primary care providers in correctional facilities, correctional nurses are expected to balance inmates' healthcare needs with the security demands of the facility. This project explored whether an evidence-based education program could provide strategies for promoting health, a healthy work environment, and a sense of well-being to improve the knowledge, coping skills, and well-being of nurses working in a correctional occupational setting. Twenty nurses participated in an educational intervention project that was guided by the transactional theory of stress. Using a pretest/posttest design, data were collected over a 2-week period and calculated using means and percentages. The descriptive statistics using …

Demographic And Symptomology Differences Among Sexually Assaulted Children With Posttraumatic Stress Disorder, Kathleen Bethel-Pracht

Walden Dissertations and Doctoral Studies

Trauma due to sexual assault becomes a life changing event during a child's critical developmental years. Bronfenbrenner's ecological systems theory outlines the process of understanding an individual's environment and how disruptions in one level may affect other levels. This study determined if gender and ethnicity among sexually traumatized children diagnosed with post-traumatic stress disorder (PTSD) predict symptom severity as measured by the Trauma Symptom Checklist for Children (TSCC) after controlling for the socioeconomic level and home environment. The population consisted of 126 children aged 8 through 16 with at least a second-grade reading level. Multiple regression examined whether male and …

Living Arrangements, Referral Source And Young Adult Admissions To Drug Treatment, Daniel Samaila

Walden Dissertations and Doctoral Studies

Abuse of painkiller drugs and non-medical use of drugs among young adults continues to be a public health crisis in the United States. Living arrangements and source of treatment referral were considered as the social context that could contribute to increased admissions to treatment for drug abuse. The purpose of this study was to examine the relationship between, independent living arrangement, the principal source of referral, and abuse of opioid, heroin, and cocaine. Steered by the conceptual framework of the biopsychosocial model, this study used the data from the 2015 Treatment Episode Data Set: Admissions managed by the Substance Abuse …

Hiv Testing And Black Men Who Have Sex With Men, Stephaun Elite Wallace

Walden Dissertations and Doctoral Studies

HIV incidence among Black men who have sex with men (BMSM) is extremely high in contrast to their estimated population size and compared to other racial groups. Researchers have established that a significant proportion of these new cases annually originate from HIV transmission by BMSM who are unaware of their HIV status. The purpose of the study was to assess the relationship between age, sexual behavior, social support, substance use, internalized homophobia, depression, and HIV test history in BMSM. Guided by the social ecological model (SEM) as the conceptual framework, a quantitative cross-sectional study was designed to analyze secondary data …

Community Health Worker's Perceptions Of Integration Into The Behavioral Health Care System, Juliette Swanston Jenkins

Walden Dissertations and Doctoral Studies

Mental illness in the United States is a major public health problem. According to the Substance Abuse and Mental Health Services Administration, in 2017, 18.9% of adults in the United States had a mental illness. The purpose of this study was to gain insight into the perceptions held by community health workers (CHWs) regarding their integration into the behavioral health care system in Maryland. Using a social constructivism paradigm and phenomenological approach, a purposive sample of 11 CHWs who supported patients with behavioral health conditions in 17 counties in the state were interviewed. Howlett, McConnell, and Perl'€™s five stream confluence …

Psychosocial Differences In Far Right, Far Left, Islamic, And Single Issue Lone Extremists, Tamara Marie Lamontagne

Walden Dissertations and Doctoral Studies

Acts of lone extremism are on the rise, yet little is known about who commits these acts. Research in this area has failed to delineate by extremist subtype. This has led to the misconception these acts and actors present with such variance psychosocially that they cannot be predicted. The purpose of this research was to assess whether statistically significant relationships exist between lone extremist subtypes on the psychosocial variables of mental illness, substance use, and having radicalized friends or family members. The conceptual framework for this study was De La Corte's psychosocial principles of terrorism, which addressed the social and …