Digital Commons Network^™

Encouraging Medication Compliance By Implementing A Medication Adherence Tool, Regina Taylor

Doctoral Projects

Medication non-adherence has been a common and challenging problem in health care, especially among mental health patients. Studies show medication compliance among psychiatric patients has been at a lower rate than patients with physical conditions. Non-compliance with medications has been one of the considerable contributions to rapid psychiatric hospital readmission. Rapid readmissions have been costing health care billions of dollars annually. The stigma behind mental health has a large contribution to why mental health patients are non-compliant with their psychotropics. Utilization of the Medication Adherence Rating Scale (MARS) on a patient to evaluate the patient's willingness and ability to take …

Demographic And Clinical Associations To Employment Status In Older-Age Bipolar Disorder: Analysis From The Gage-Bd Database Project, Amulya Mallu, Carol K. Chan, Kaylee Sarna, Joy Yala, Farren B.S. Briggs, Martha Sajatovic

Faculty Scholarship

Objective: The current literature on employment in older adults with bipolar disorder (OABD) is limited. Using the Global Aging and Geriatric Experiments in Bipolar Disorder Database (GAGE-BD), we examined the relationship of occupational status in OABD to other demographic and clinical characteristics. Methods: Seven hundred and thirty-eight participants from 11 international samples with data on educational level and occupational status were included. Employment status was dichotomized as employed versus unemployed. Generalized linear mixed models with random intercepts for the study cohort were used to examine the relationship between baseline characteristics and employment. Predictors in the models included baseline demographics, education, …

Planners Vs. Non-Planners: Do Preterm Births Impact Future Contraceptive Use?, Jessie Moore

NYMC Student Theses and Dissertations

Background: In the United States, 45% of all pregnancies are unintended and occur when contraception is not used or is used inconsistently. Among those pregnancies, 1 in 10 women will experience a preterm birth, which is defined as a birth occurring before 37 weeks gestation. Women who have delivered preterm are at an increased risk for preterm birth in future pregnancies and are encouraged to wait at least 18 months between giving birth and getting pregnant again. Among women who have experienced a preterm birth, the desire to delay future pregnancy or avoiding it all together often becomes a necessity …

Design Guidelines For Homeless Shelter And Resource Center Site Plans, Samuel Johnson

All Graduate Reports and Creative Projects, Fall 2023 to Present

Homelessness is one of the most pressing humanitarian issues facing the country today. Lack of affordable housing, among many other complicating factors, have led to many cities scrambling to find both short-, middle-, and long-term solutions to the issue. The Covid-19 pandemic added a disruption in services, critical record-keeping, and data-gathering, which has further confounded experts looking for an effective path forward. As it stands, there is a significant gap in academic research addressing best practices for shelter site design, particularly as it relates to landscape. The role of landscape and greenspace within and around a shelter is not well …

Spotlight On Mental Health On A Healthcare Campus: An Assessment Of Psychological Trauma Awareness, Training, And Treatment In The University Of Nebraska Medical Center College Of Public Health Community, Jenny E. Mueller

Capstone Experience: Master of Public Health

Background: Psychological trauma has been recognized as a public health concern of epidemic proportions globally. Public health community awareness of and education in trauma is likely to be integral to preparing future public health professionals to work effectively and safely in the field. Currently, the extent of trauma awareness, training, and treatment on the University of Nebraska Medical Center College of Public Health (UNMC COPH) campus is not known.

Aims: The aims of this project are to investigate and assess the level of psychological trauma awareness, training, and treatment on the UNMC COPH campus; and to provide recommendations for actions …

Implementing A Systematic Depression Screening In The Primary Care Setting, Cassandra Moore

Doctoral Projects

The Advanced Practice Nurse is responsible for providing quality care and treatment for the whole person. 3 John 1:2 KJV states, “I wish above all things that you may prosper and be in health, even as your soul prospers” (King James Bible, 2023, para. 2). To prosper and be in health refers to a holistic approach in which the mind, body, and spirit of an individual is considered. Mental health care is an integral part of the holistic health approach.

Mental illness affects approximately one in five adults (52.9 million) in the United States alone (National Institute of Mental Health …

Anxiety Screening At A Psychiatric Inpatient Facility: A Quality Improvement Project, Irene Akwitti

Doctor of Nursing Practice

Background. Generalized anxiety disorder is characterized by persistent anxiety and uncontrollable worry occurring more days than not for a minimum of 6 months (Patriquin & Mathew, 2017). Presently, anxiety screening and evidence-based practice treatment for adults are suboptimal. It is impossible to overemphasize the importance of early diagnosis and prompt treatment of generalized anxiety disorder in patients. Purpose. The purpose of this quality improvement project was to implement the Generalized Anxiety Disorder-7 (GAD-7) screening tool, a validated, evidence-based instrument, in a psychiatric inpatient facility to improve early detection and treatment of anxiety disorders in patients. Methods. Staff members were educated …

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

Dissertations

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

Crushing The Contents Of Valbenazine Capsules For Potential Addition To Soft Foods Or Administration Via Gastrostomy Tube, Martha Sajatovic

Faculty Scholarship

Purpose: One-capsule, once-daily valbenazine is approved for tardive dyskinesia and under evaluation for chorea associated with Huntington's disease, conditions in which patients often experience dysphagia. In vitro studies were conducted to assess the suitability of crushing the contents of valbenazine capsules (40 and 80 mg) for mixing with soft foods or liquids or administration via a gastrostomy tube (G-tube). Methods: In study 1, the dissolution of whole valbenazine capsules and crushed capsule contents were measured serially for 1 hour. In study 2, valbenazine recovery was evaluated after crushed contents were mixed with soft foods, buffer solutions (pH range, 1.2–6.8), and …

Barriers In Immigrant Mental Healthcare: Women, Children And Fathers, Alisa Pickett

Honors Theses

The American Psychological Association has identified immigrant families as a vulnerable population, whose access to mental healthcare is impacted by numerous barriers (DeAngelis, 2023). Within these communities there is a need for mental health resources, but due to the many barriers these communities face they are often left without care. In this literature review, I will identify the mental health needs, and the barriers that each member of the family (e.g., mothers, children, and fathers) uniquely faces. The discussion will review how these barriers are currently being addressed, specifically looking at changes within practices, use of logotherapy, and changing the …

Unmasking And Addressing Burnout In The Mental Health Profession, Sara Edwards

University Honors Theses

Burnout poses a significant challenge among mental health workers, impacting both the well-being of practitioners and the outcomes for their patients. The key inquiries guiding this literature review are: what factors contribute to burnout, and what interventions are essential for treating and preventing burnout in mental health professionals? The findings reveal that factors such as level of experience, lack of quality supervision, vicarious trauma, working conditions, and personal beliefs significantly contribute to burnout. Effective prevention and treatment measures for mental health workers vulnerable to burnout encompass self-monitoring, participation in support groups, additional training, and organizational interventions. These insights could serve …

Exploring The Influence Of Technology-Supported Immersive Experiences: The Case Of Golf Simulators As A Way Of Relieving Stress In The Workplace, Luka Van Der Merwe

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study explores the impact of immersive technology, specifically golf simulators, on relieving work-related stress among hotel industry employees. The purpose of the current study was to examine how hotel employees perceive the use of immersive technology as a form of stress relief. The study was developed to learn whether hotel employees experience work-related stress, and if so, how they cope with it. The study also aimed to determine whether they would be interested in utilizing a golf simulator as a new form of stress relief if it were offered to them free of charge by their employer. Interviewing hotel …

A Cross-Sectional Analysis Of Adverse Childhood Experience Exposure On Cancer Diagnosis Utilizing The 2022 Behavioral Risk Factor Surveillance Survey Data, Emma Zipperer

Capstone Experience: Master of Public Health

Objective: To determine the association between Adverse Childhood Experiences (ACEs) and cancer diagnosis based on ACE exposure levels.

Methods: We utilized data collected in the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey. The study population (n=54,148) was restricted to states that reported on the optional model of experiencing ACEs and those who responded about cancer diagnosis. A univariate analysis, bivariate analysis and a multivariate logistic regression were performed. Odds of cancer diagnosis among those with differing ACE exposure levels were calculated.

Results: High ACE exposure had 20% higher odds of cancer diagnosis when compared to low ACE exposure. White, …

Prevalence Of Substance Use Among Lesbian, Gay, And Bisexual High School Students In 2019 Vs. 2021, Jordyn Lee, Elisabeth Hayes, Adam Wyatt

Nursing & Health Sciences Research Journal

Background: Studies suggest that LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning, plus) youth are at increased risk of engaging in alcohol and substance use. The COVID-19 pandemic forced many students to isolate in 2020 and 2021, and the impacts of this have been purported to be detrimental. This study examines the prevalence of alcohol and substance use among lesbian, gay, and bisexual (LGB) U.S. high school students before the pandemic in 2019 versus 2021. Methods: This cross-sectional descriptive study used results from the 2019 Youth Risk Behavior Survey (YRBS) and the 2021 Adolescent Behavior and Experiences Survey (ABES). The 2019 YRBS …

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

Dissertations

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

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

The Predictability Of Body Types, Socio-Demographics And Attitudes Toward Body Factors On The Self-Esteem Of College Students, Pantea Mohammadi

Dissertations (2016-Present)

Objective of the Study The purpose of this empirical investigation will be to determine the predictable relationship between body types of factors, socio-demographic factors, attitudes toward body factors and the self-esteem scores of undergraduate freshmen college students. More specifically, the study will be concerned with predictability of body types, socio-demographic, and attitudes toward body factors of body image, body appreciation, gender, age, physical attractiveness, and satisfaction with physical features of the body on the self-esteem scores among undergraduate freshmen college students. Answers to the following questions will be sought: 1. Do body type factors (body image and body appreciation) have …

The Impact Of Counseling Demographic, Job Related And Professional Factors On Disciplinary Outcomes, Tiffany Chelece Chaney

Dissertations (2016-Present)

Counselors interact with every student on their campus and impact student outcomes. The researcher examined the predictable relationship between counselors’ demographic factors, job-related and professional-related factors (Texas Counseling Association, 2018), and student discipline outcomes (Texas Education Agency, 2021). The researcher used secondary data in the form of discipline frequencies, counselor gender and race of counselors, the Council for the Accreditation of Counseling and Related Educational Programs (CACREP) accreditation status of the counselor’s master’s program, counseling licensure, counselor ratios, and the time counselors spend providing services within the Comprehensive School Counseling Program. This correlational research design allowed the researcher to examine …

The Impact Of “Wellness Factors” And “Psychological Factors” On Perceived Stress Among Licensed Professional Counselors, Chase Allen Walding

Dissertations (2016-Present)

The purpose of this study was to evaluate the relationship between “wellness factors” and “psychological factors” on perceived stress among Licensed Professional Counselors. This study was concerned with the predictability of “wellness factors”, specifically self-care, other-care, and “psychological factors,” including self-esteem, anxiety, and resilience on counselor perceived stress. Counselors in this study are defined as Licensed Professional Counselors, Licensed Professional Counselor Associates (LPC-Associates), and Licensed Professional Counselor Supervisors (LPC-S). The population of this investigation consisted of counselors at various licensure status’ including LPCs, LPC-Ss, and LPC-As that are current and active members of the Texas Counseling Association, Texas School Counseling …

Depressive Symptoms In Autistic Youth With Anxiety Disorders, Rebecca L Greenberg, Andrew G Guzick, Sophie C Schneider, Saira A Weinzimmer, Minjee Kook, Amanda B Perozo Garcia, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Objective: Anxiety and depression often coexist in youth and share overlapping symptomatology; however, little is known about the comorbidity of anxiety and depression in autistic youth. This study explores (1) the frequency of depressive symptoms among autistic children with clinically significant anxiety, (2) clinical variables that may be associated with elevated depressive symptoms, and (3) whether pretreatment depressive symptoms predict cognitive behavioral therapy (CBT) outcomes for anxiety.

Method: Children aged 7 to 13 years (N = 87) and their parents participated in a randomized controlled trial comparing 2 versions of a parent-led, telehealth-delivered CBT program. Parents and children completed a …

Polypharmacy And Medication Fill Nonadherence In A Population-Based Sample Of Adolescent And Young Adult Cancer Survivors, 2008–2017, Christine Markham

Faculty, Staff and Student Publications

PURPOSE: We examined the association between polypharmacy-an established risk factor for nonadherence in the elderly-and medication fill nonadherence in a large national sample of adolescent and young adult cancer survivors (AYAs) in the USA.

METHODS: We pooled data (2008-2017) from the Medical Expenditure Panel Survey. We defined polypharmacy as ≥ 3 unique medications prescribed, based on self-report and pharmacy data, and medication fill nonadherence as self-reported delay or inability to obtain a necessary medication. We estimated prevalence of medication fill nonadherence among AYAs (age 18-39 years with a cancer history). We used logistic regression to estimate the association between (1) …

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 …

Idiographic Coping Outcomes In Youth With Autism Spectrum Disorder And Co-Occurring Anxiety: Results From The Taasd Study, Lesley A Norris, Jonathan C Rabner, Eric A Storch, Jeffrey J Wood, Connor Kerns, Adam B Lewin, Brent J Small, Philip C Kendall

Center for Medical Ethics and Health Policy Staff Publications

Versions of cognitive behavioral therapy (Coping Cat, CC; Behavioral Interventions for Anxiety in Children with Autism, BIACA) have shown efficacy in treating anxiety among youth with autism spectrum disorder. Measures of efficacy have been primarily nomothetic symptom severity assessments. The current study examined idiographic coping outcomes in the Treatment of Anxiety in Autism Spectrum Disorder study (N = 167). Longitudinal changes in coping with situations individualized to youth fears (Coping Questionnaire) were examined across CC, BIACA and treatment as usual (TAU) in a series of multilevel models. CC and BIACA produced significantly greater improvements than TAU in caregiver-reported coping. Youth …

Genome-Wide Significant Risk Loci For Mood Disorders In The Old Order Amish Founder Population, Evelina Mocci, Fernando S Goes, Peter P Zandi, Peter Kochunov, Cristopher Van Hout, Alan R Shuldiner, Toni I Pollin, Braxton D Mitchell, Maja Bucan, L Elliot Hong, Francis J Mcmahon, Seth A Ament

Faculty, Staff and Student Publications

Genome-wide association studies (GWAS) of mood disorders in large case-control cohorts have identified numerous risk loci, yet pathophysiological mechanisms remain elusive, primarily due to the very small effects of common variants. We sought to discover risk variants with larger effects by conducting a genome-wide association study of mood disorders in a founder population, the Old Order Amish (OOA, n = 1,672). Our analysis revealed four genome-wide significant risk loci, all of which were associated with >2-fold relative risk. Quantitative behavioral and neurocognitive assessments (n = 314) revealed effects of risk variants on sub-clinical depressive symptoms and information processing speed. Network …

Behavioral Or Neuropsychiatric Symptoms Of Alzheimer’S Disease: From Psychopathology To Pharmacological Management

Faculty, Staff and Student Publications

Neuropsychiatric or behavioral symptoms of dementia encompass a series of disorders, such as anxiety, depression, apathy, psychosis, and agitation, all commonly present in individuals living with dementia. While they are not required for the diagnosis of Alzheimer's disease (AD), they are ubiquitously present in all stages of the disease, contributing to negative clinical outcomes, including cognitive decline, functional disability, and caregiver burden. Neuropsychiatric symptoms have been conceptualized not only as risk factors but as clinical markers of decline along the AD spectrum. The concept of "mild behavioral impairment", the behavioral correlate of mild cognitive impairment, has been proposed within this …

High School Flash Sexual Health Education Curriculum: Lgbtq Inclusivity Strategies Reduce Homophobia And Transphobia, Elizabeth Baumler

Faculty, Staff and Student Publications

Homophobic and transphobic beliefs that lead to bias-based harassment remain a critical concern for young people in the USA. The aim of the present study was to examine the impact of an inclusive comprehensive sex education program (High School FLASH) on homophobic and transphobic beliefs. Data from this study come from a randomized controlled trial that evaluated the impact of High School FLASH on students' sexual behaviors and related outcomes with 20 schools in two U.S. regions (Midwest and South). Following the baseline survey, the 20 schools were randomly assigned to receive FLASH or a comparison curriculum. Ninth and 10th …

Huntington Study Group's Neuropsychology Working Group: Implementing Non-Motor Diagnostic Criteria, Sharlet A Anderson, Adam Piccolino, Antonio L Teixeira, Julie C Stout

Faculty, Staff and Student Publications

Background: The clinical diagnosis of manifest Huntington's disease (HD) relies on a high level of clinical confidence (99% confidence) of HD-consistent motor signs. Longitudinal data have reliably identified cognitive and behavioral dysfunction predating clinical motor diagnosis by up to 15 years. Reliance on motor signs to establish a diagnosis of HD increases risk of early misdiagnosis or delayed diagnosis. Clinical neuropsychologists are uniquely positioned to advise on the clinical application of the Movement Disorder Society Task Force's recently proposed non-motor diagnostic criteria for HD.

Objectives: To provide (1) a recommended clinical approach toward non-motor diagnostic criteria in persons with HD …

Cortical Thickness Is Related To Variability In Heritage Bilingual Language Proficiency, Arturo E Hernandez

Faculty, Staff and Student Publications

Research suggests that bilingual experience is associated with gray matter changes, such that initial language gains are associated with expansion and language expertise is associated with renormalization. Previous studies on language proficiency development primarily focused on between-subjects, quasiexperimental comparisons of monolinguals and bilinguals. This study proposes a new paradigm to examine language expertise and cortical thickness within heritage bilinguals (

What Role Do Parents And Acculturation Play In Chinese Female International High School Students’ Mental Health?, You Wu

Doctoral Dissertations

This study examines the challenges and mental health issues faced by Chinese female international students in private Catholic female high schools in the U.S. It explores three main areas: the types of acculturation challenges students face, the impact of these challenges on their mental health, and the role of parental communication in shaping students' and parents' perceptions of acculturation and mental health. Using qualitative methods, the research involved interviews with nine students and five parents from a girls' Catholic high school in California. Data were collected via narrative-inspired Zoom interviews, and analyzed using phenomenological principles, focusing on understanding the lived …

Stmut: A Framework For Visualizing Somatic Alterations In Spatial Transcriptomics Data Of Cancer, Limin Chen, Darwin Chang, Bishal Tandukar, Delahny Deivendran, Joanna Pozniak, Noel Cruz-Pacheco, Raymond J Cho, Jeffrey Cheng, Iwei Yeh, Chris Marine, Boris C Bastian, Andrew L Ji, A Hunter Shain

Staff and Researcher Publications

Spatial transcriptomic technologies, such as the Visium platform, measure gene expression in different regions of tissues. Here, we describe new software, STmut, to visualize somatic point mutations, allelic imbalance, and copy number alterations in Visium data. STmut is tested on fresh-frozen Visium data, formalin-fixed paraffin-embedded (FFPE) Visium data, and tumors with and without matching DNA sequencing data. Copy number is inferred on all conditions, but the chemistry of the FFPE platform does not permit analyses of single nucleotide variants. Taken together, we propose solutions to add the genetic dimension to spatial transcriptomic data and describe the limitations of different datatypes.

Reducing The No Show Rates For Mental Health Appointments Among Young Adults, Johnnie Carrico

Student Scholarly Projects

Practice Problem: Missed patient appointments have become an increasingly significant issue for healthcare organizations, private practices, and clinics. No show appointments can negatively impact the operational functions of these organizations including lost revenue. The clinical practice site’s pre-intervention no-show rate for young adult mental health appointments was 21%. The high percentage of missed mental health visits has resulted in both lost revenue for the clinic and disruptions in patient care.

PICOT: The PICOT question that guided this project was: In young adults 18-25 years with mental health appointments (P) how does patient preferred appointment reminders (I) compared to …