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Measuring Goal Attainment In Chronic Disease Self-Management Within Clinical And Research Contexts: Development And Initial Testing Of The Goal Attainment Outcome Measure For Stroke (Gam-S), Barbara Kimmel

Dissertations and Theses (Open Access)

Background and Aims: Self-management (SM) skills help stroke survivors achieve behavior risk factors control. Goal setting and attainment are fundamental for SM. The most salient elements of SM effectiveness and measurements are just beginning to be understood. Investigation of measurement of goal attainment of SM risk factors has been the major aim of the study. My dissertation explores research questions concerning the goal attainment measure using data collected at the Veterans hospital.

Methods and Results: Introductory Chapters 1 and 2, include the background on stroke prevention through self-management interventions and a preliminary literature review of goal attainment in the context …

Integration Of Mindfulness-Based Approaches In The Treatment Of Eating Disorders: A Review Of The Literature, Kimberly Hubinger

Dissertations

In this literature review, mindfulness-based approaches and the effects mindfulness-based approaches have on the treatment of eating disorders was discussed. Professionals are continually seeking ways to enhance the treatment and improve outcomes when working with individuals suffering from eating disorders, and this literature review could help enhance the understanding of incorporating mindfulness techniques. The findings of this paper are meant to benefit clinicians working with patients diagnosed or struggling with an eating disorder.

Healing Beyond Emotional Abuse, Judith Fisher

Lake Union Herald

No abstract provided.

Mathematics Attitudes And Mathematics Performance: Novel Approaches Towards Noncognitive Educational Measurement, Applications To Large-Scale Assessment Data, And Examinations Of Multigroup Invariance, Kalina Gjicali

Dissertations, Theses, and Capstone Projects

Academic performance is predicted by a multitude of demographic, contextual, cognitive, and noncognitive constructs. The noncognitive factors of achievement in mathematics that have previously been explored in depth are study skills, collaborative problem-solving, confidence, self-efficacy, and personality traits (Kyllonen, 2012). Limited applied research has explored the predictive value of noncognitive factors such as attitudes and beliefs in mathematics achievement – even though attitudes towards mathematics are a promising avenue for understanding the variability in mathematics achievement. The current research uses the theory of planned behavior (TPB) to explain high school students’ performance in mathematics in a series of three studies. …

Direct Behavior Observations And Teachers' Ratings Of Internalizing Problem Behaviors, Lauren R. Parker

Honors Theses

Systematic direct observation is a commonly used method in schools to compile data on students' behavior in a naturalistic setting. Internalizing problem behaviors, behaviors such as social withdrawal, somatic complaints, and anxiousness, can lead to adverse consequences and have not, to the researchers' knowledge, been systematically observed in a classroom setting. Additionally, students have never been identified for intervention through direct observation. The researchers administered the Student Internalizing Behavior Screener (SIBS), which is a 7-item, teacher-completed, Likert-type scale which measures occurrences of internalizing problem behaviors. Once scores from the SIBS were calculated, students who scored at-risk were chosen for observation …

Reducing The Risk: Psychological And Technological Approaches For Improving Handwashing Practices In The Foodservice Industry, Jeffrey Allan Clark

Graduate Theses and Dissertations

As Americans are spending greater portions of their dollar on food consumed outside the home, the foodservice industry plays more of an integral part of daily existence compared to previous generations. Given the numerous annual foodborne illness outbreaks that threaten human lives while undermining confidence in the food supply, food safety is a pertinent issue for industry stakeholders, government regulators, and consumers. Food worker handwashing reduces the risk of foodborne illness transmission, yet compliance with this simple behavior is a complex problem. This dissertation addresses, predominantly, the issue of sub-optimal handwashing practices through applying psychology and technology, including wearable computers …

Alcohol Use, Dietary, And Exercise Behaviors: A Latent Profile Analysis Of Young Adult Lifestyle Behaviors, Ryan Wesley Grant

Graduate Theses and Dissertations

As individuals enter adulthood, their lifestyles and lifestyle behaviors begin to change drastically. These lifestyle behavior changes in emerging adulthood provide a foundation for future health behaviors that often persist through all of adulthood. The aim of this study was to use Latent profile analyses (LPA) to discover distinct profiles of homogenous groups of young adults based on alcohol, diet, and exercise behaviors. Overall, five distinct profiles for both males and females were identified: Moderates, Unhealthy Eaters, Medium Drinkers, Healthier Eaters and Exercisers, and Heavy Drinkers. Heavy Drinkers and Unhealthy Eaters were the highest risk groups and reported the highest …

Comparative Analysis Of Early And Late Tracheostomy Among Patients With Acute Heart Failure Exacerbation, Trends, Clinical And Economic Outcome Assessment, From 2005 To 2014 Nationwide, Min Ji Kwak

Dissertations and Theses (Open Access)

Heart failure is one of the leading causes of high morbidity and mortality. Acute exacerbation of heart failure may result in acute respiratory failure, which requires mechanical ventilator support. Despite supportive management, patients can fail extubation of the endotracheal tube and need a tracheostomy to continue mechanical ventilator support. However, optimal timing of tracheostomy has been controversial. Systemic study to assess the clinical and economic outcome of early tracheostomy among patients with acute heart failure exacerbation is lacking. The purpose of the study was to assess the national trend of tracheostomy among those who are admitted for acute respiratory failure …

Concurrent And Concordant Oral And Genital High Risk Human Papillomavirus Infections In The United States Population; Results From National Health And Nutrition Examination Survey (Nhanes), James M. Custer

Dissertations and Theses (Open Access)

Human papillomavirus (HPV) is a common sexually transmitted disease which infects various sites in the body including the genitals, oral cavity, and anal regions. Very little research has assessed the prevalence of concurrent and concordant high risk (HR) HPV oral and genital infections in the general United States population despite the fact that HR HPV oral pharyngeal cancers are on the rise in the US, particularly in men. To further our understanding of HR HPV concurrent and concordant infections we aim to estimate the prevalence of HR HPV concurrent and concordant infections in the U.S. population, and for men and …

Predictors Of Non-Adherence To Primary Care Follow-Up After Diagnosis Of Asymptomatic Hypertension In The Emergency Department, Stephanie Cornell

Dissertations and Theses (Open Access)

Background: One strategy to decrease uncontrolled hypertension is to increase follow-up with primary care after diagnosis of asymptomatic hypertension in the Emergency Department (ED). To improve such interventions, this study identified risk factors of nonadherence among individuals 18-60 years old with a diagnosis of asymptomatic hypertension in the ED and access to care. Methods: Data was obtained from the IBM® MarketScan® Commercial Database between January 2012 and September 2015. Rates of non-adherence to follow-up was determined for individuals discharged from the ED with a primary diagnosis of essential hypertension. Multivariate logistic regression was used to calculate adjusted odds ratios. Demographic …

Estimating The Usual Intake From Fruits And Vegetables Consumed By Children At Baseline In Tx Sprouts, Taryn Alkis

Dissertations and Theses (Open Access)

Background: Past studies developed two- and three-part models to estimate the usual intake of episodically consumed foods in adults but not in children. The goal of this study is to evaluate if the three-part method is successful, by incorporating the dietary screener and two 24-hour recalls, in estimating the usual intake of fruits and vegetables consumed by boys and girls at baseline in TX Sprouts. Methods: Secondary data analysis of two 24-hour recalls and a dietary screener from TX Sprouts. Two approaches were used. First, the three-part model estimated the distribution of the usual intake of fruits and vegetables in …

The Prevalence Of Birth Defects Among Non-Hispanic Asians And American Indians/Alaska Natives In Texas, 1999-2015, Van Le

Dissertations and Theses (Open Access)

Background: Birth defects are disproportionately higher among certain race/ethnic groups. We examined how birth defects prevalence differs among the less studied non-Hispanic (NH) Asian and any American Indian/Alaska Native (AI/AN) populations, relative to NH Whites. Methods: Data were obtained from the Texas Birth Defect Registry from 1999 to 2015 for infants born to Texas-resident mothers who were NH White, NH Asian, or AI/AN. This covers a livebirth population of 2.6 million. Prevalence ratios were calculated for NH Asians and AI/ANs (relative to NH Whites) for 44 birth defects using Poisson regression and were adjusted for maternal age. Results: After adjustment, …

Geospatial Analysis Of Pediatric Tuberculosis In Bohol, Philippines: Disease Clusters And Access To Care, Lauren M. Leining

Dissertations and Theses (Open Access)

Worldwide, children represent approximately 10% of global tuberculosis (TB) cases. We recently reported a high tuberculin skin test (TST)-positive prevalence (355/5,476; weighted prevalence=6.4%) among children (<15 years) throughout the island of Bohol, Philippines, with some geographically isolated communities having prevalence as high as 29%. In this study, we conducted a secondary geospatial and hot-spot analysis of this household-based cluster survey to assess the association between access to care (distance to a health care facility) and TST-positive prevalence. Our analysis indicated that villages with high TST-positive prevalence (≥10%) were significantly further from Provincial Health Office based in the capital city of Tagbilaran in time-distance (p=0.0001, r=0.2387) and kilometers (p=0.0011, r=0.3170). Similarly, prevalence was positively correlated with distance to the municipal Rural Health Unit (RHU), where most receive their medical care, in time-distance (p=0.0055; r=0.0415); however, the association was not significant in kilometers (p=0.3315; r=0.0715). Distance to health care facilities could represent an obstacle to access to care, thereby limiting diagnosis and treatment and resulting in increased risk of transmission to others in the community. Health care outreach in geographically isolated areas is critical to treatment and control of efforts for pediatric TB.

Bayesian Estimation Under Informative Sampling: Investigating The Association Between Depression And Inflammation, Paula Lopez Gamundi

Dissertations and Theses (Open Access)

Survey data is often collected using complex sampling designs so that the probability of being included in the study is related to the outcome of interest (i.e. informative sample). Recently, a novel fully-Bayesian method has been developed for modeling data under informative sampling. Initial results indicate that this novel construction reduces bias in variance estimates compared to other pseudo-Bayesian techniques. The performance of this method has yet to be compared to traditional Frequentist approaches, which typically rely on Taylor series linearization (TSL) or resampling techniques for standard error (SE) estimation. Here, we modeled the relationship between depression and inflammation using …

A Mendelian Randomization Study Of Circulating Gamma Prime Fibrinogen And Total Fibrinogen Levels On Venous Thromboembolism And Ischemic Stroke Subtypes, Jillian Maners

Dissertations and Theses (Open Access)

Introduction: Fibrinogen is a key component of the coagulation cascade, and variation in its circulating levels may contribute to thrombotic diseases, such as venous thromboembolism (VTE) and ischemic stroke. Gamma prime (γ′) fibrinogen is an isoform of fibrinogen and has anticoagulant properties, including inhibiting thrombin and slowing platelet aggregation, that may affect clot formation.

Methods: Two-sample Mendelian randomization (MR) was applied to estimate the causal effect of total circulating fibrinogen and its isoform, γ′ fibrinogen, on risk of VTE and ischemic stroke subtypes using summary statistics from published genome-wide association studies of fibrinogen, VTE, and ischemic stroke, and an unpublished …

Evaluating Religiosity Across The Lifespan And Fatalistic Beliefs Among Patients Of A Chronic Care Management Intervention Program With Type 2 Diabetes, Cindy Lynn Salazar

Dissertations and Theses (Open Access)

The overall goal of the present study was to assess the effect of fatalistic beliefs and lifetime religiosity on glycemic control and blood sugar monitoring behavior among Mexican-American participants of a chronic care management intervention program of the Rio Grande Valley. In order to achieve these aims, a mixed methods prospective longitudinal study design was utilized among approximately 500 participants of the Salud y Vida program. Qualitatively, a phenomenological approach was used to analyze semi-structured interview data assessing fatalism and religiosity and type 2 diabetes management among 15 participants stratified by engagement in the Salud y Vida program. Fatalistic beliefs …

Evaluating The Impact Of Heal Pregnancy Intervention On Breastfeeding Initiation And Duration, Dolly Noel Rinehart

Dissertations and Theses (Open Access)

Despite nationwide improvements in breastfeeding behaviors, many minority, low-socioeconomic status women in the United States fail to follow breastfeeding recommendations. Healthy Eating Active Living (HEAL), a free antenatal program in Houston, Texas, teaches pregnant women healthy lifestyle behaviors and promotes breastfeeding. The objective of this paper was to determine the impact of HEAL on breastfeeding initiation and length of breastfeeding duration among predominantly low income, minority, underserved women in Houston, TX. Methods: HEAL is a natural experiment rooted in Social Cognitive Theory and Theory of Planned Behavior. Data was collected from two sources, the HEAL pregnancy post-delivery survey and the …

Role Of Disinfectants In The Eradication And Propagation Of Clostridiodes Difficile Infection, Tasnuva Rashid

Dissertations and Theses (Open Access)

Introduction:

Clostridioides difficile is a motile, gram-negative, toxin-producing bacteria responsible for the majority of the nosocomial as well as community-acquired infection in the US and worldwide. A high rate of morbidity, mortality, recurrences, healthcare cost coupled with frequent epidemic outbreaks with drug-resistant strains has classified C. difficile as a pathogen with an urgent threat to human health. Current guidelines regarding disinfectant use are either limited or absent or are not effective in reducing the environmental burden of C. difficile. The aims for this study was first to determine the in vitro efficacy of select hospital disinfectants in eradicating the spores …

Evaluating The Multivariate Relationship Between Breastfeeding, Early Childhood Obesity, Asthma, And Mental Illness In Dallas, Tx, Sitara Weerakoon

Dissertations and Theses (Open Access)

The aim of this study was to examine the associations between breastfeeding, asthma and mental illness in North Texas children aged two to five years, and to explore whether these associations are explained by the presence of obesity. The study population comprised of 1,174 children whose caregivers responded to a 2015 survey administered by Children’s Health and the Health & Wellness Alliance for Children. Information on breastfeeding, BMI, asthma, and mental illness were self-reported by primary caregivers. Of the 1,174 children, 61% were breastfed, 13% had asthma, and 17% had a mental illness. The odds of having asthma were 2.28 …

Fire Department Support And Physical Activity Of Volunteer Firefighters: A Cross-Sectional Examination, Sarah Wagner

Dissertations and Theses (Open Access)

Greater health and fitness of volunteer firefighters protects them from cardiovascular disease-related deaths, reduces risk of injury, and improves job performance, which subsequently provides better protection for the majority of the U.S. population who is served by volunteers. Given the strong social support system characteristic of the U.S. fire service, there seems to be potential opportunity to influence the behaviors of firefighters by creating a culture that promotes healthy habits rather than unhealthy. Objective: Determine the association between fire department culture’s encouragement of physical activity and volunteer firefighters’ moderate- to vigorous-intensity aerobic activity. Methods: A cross sectional analysis was performed …

Healthy Life Choice: Using The School-Based Program To Facilitate Change, Jennifer Shaheed

Doctor of Psychology (PsyD)

Research highlights the multiple determinants of weight including poverty, nutrition, and physical activity (Miguel-Berges, 2018). Children and adolescents living in rural areas are at greater risk than their urban counterparts. Regarding physical activity, there are often fewer recreational resources and the high poverty rate precludes transportation or additional fees associated with many extracurricular activities. In response to this problem, research has shown the educational environment is a point of access to reinforce health education and behavior. One evidenced-based program showing significant outcome in improving health behavior is the Healthy Lifestyle Choices (HLC) which is designed to be delivered in an …

The Prevalence And Impact Of Dysmenorrhea In Young Women Within The United States, Annika Johnson Campbell

Doctor of Psychology (PsyD)

International research suggests dysmenorrhea is a common problem among young adult women, with a significant impact on their daily functioning. However, limited research has been conducted on dysmenorrhea in young women in the U.S. The current study analyzed the prevalence, impact, and treatment of dysmenorrhea among 976 young adult women living within the U.S. Using a cross-sectional design, a questionnaire based on previous literature was created. It was then distributed to women between the ages of 18-28 through university email and participant initiated social media distribution. The mean age of participants was 22.27, 85% endorsed dysmenorrhea. Seventy percent of women …

The Effects Of Ambient Temperature And Lighting Intensity On Wheel-Running Behavior In A Diurnal Rodent, The Nile Grass Rat (Arvicanthis Niloticus), Garrett M. Fogo, Alyssa M. Goodwin, Ohanes S. Khacherian, Brandi J. Ledbetter, Andrew J. Gall

Faculty Publications

Environmental conditions, such as the light-dark cycle and temperature, affect the display of circadian rhythmicity and locomotor activity patterns in mammals. Here, we tested the hypothesis that manipulating these environmental conditions would affect wheel-running activity patterns in a diurnal rodent, the Nile grass rat (Arvicanthis niloticus). Grass rats are diurnal in the field, however, a subset switch from a day-active pattern to a night-active pattern of activity after the introduction of a running wheel. The mechanism of this chronotype switch remains largely unknown. In the present study, grass rats were presented with running wheels in 12:12 light-dark conditions. First, subjects …

Introducing A New Prevention Of True Self And Cognitive Dissonance Intervention To Improve Help-Seeking For Female College Students With A Risk Of An Eating Disorder, Margaret A. Hance

Electronic Theses and Dissertations

In the United States, eating disorders affect approximately 20 million women annually (National Institutes of Health, 2011). With such a high prevalence, ensuring help-seeking in individuals with eating disorders is critical. A previously-supported eating disorder prevention approach includes cognitive dissonance intervention (CDI). CDI’s purpose is to change a person’s behavior to reflect their attitude or cognition. While true self intervention has not been with previously been applied to eating disorders, it has been efficacious in improving psychological risk factors associated with eating disorder risk. The current study combined true self and CDI to test a more holistic prevention tool (i.e. …

College Student Depression: An Examination Of Cardiorespiratory Fitness, Gender And Sexual Orientation Diversity, And Help-Seeking Willingness, Sharon Jalene

UNLV Theses, Dissertations, Professional Papers, and Capstones

Depression is a serious illness characterized by persistent low mood, reduced cognitive capacity, and fatigue. Although treatable, depression is the leading cause of disability and ill-health worldwide and a significant contributor to suicide, the second leading cause of death for young Americans. In any given two-week period, 8.1% of adults in the United States had moderate to severe depression (2013-2016). The rate of depression for females was twice that of males and compared to the majority, sexual and gender minorities (SGM) were at a threefold risk. Furthermore, evidence suggests that depression incidence is three times higher in college students than …

The Relationship Between Aggression And Depression: Testing The Moderating Effects Of Age And Gender, Benjamin P. Comer

Boise State University Theses and Dissertations

The purpose of this thesis is to a) explore the research related to aggression and depression and b) test hypotheses that focus on the relationship between aggression and depression in relation to age and gender over time. Aggression and depression are discussed extensively by examining a broad range of literature that points to environmental, social, individual, psychological, and biophysiological influences. First, aggression and depression are discussed separately in terms of their underlying theory, biosocial perspectives, typologies, behavioral and personality abnormalities, brain structures related to each, and neurochemical/neurological influences. The final sections of the literature review discuss how aggression and depression …

Training Caregivers To Implement A Structured Meal Protocol To Decrease Food Selectivity Among Young Children With Autism, Ronald Joseph Clark

Theses and Dissertations

This study evaluated a method of training caregivers to implement the Structured Meal protocol to treat children with autism who exhibit food selectivity. A treatment package consisting of written instructions and video modeling as well as in-vivo prompting and feedback (when necessary) was used to teach participants to conduct the protocol. A multiple baseline design across participants was used to evaluate the effects of training. In addition to the primary dependent variable (i.e., correct caregiver implementation of the Structured Meal protocol), data on three secondary dependent variables (i.e., child bite acceptance, mouth cleans, and inappropriate mealtime behavior) were collected. Results …

Pocket Ace: Neglect Of Child Sexual Abuse Survivors In The Aces Study Questionnaire, Robyn Dolson

Electronic Theses and Dissertations

In 1998, a seminal study on adverse childhood experiences (ACEs) and subsequent health risks catapulted ACEs and the study questionnaire into the zeitgeist. However, its childhood sexual abuse (CSA) item is problematic as it requires the perpetrator have been 5-years or older than the victim. To assess whether some survivors’ CSA is not identified by the current item, whether their exclusion prevents access to services requiring a four-threshold ACE score, and how their health outcomes compared to other CSA groups and controls, an international sample of 974 women completed an online survey assessing their current health and CSA history using …

First Thirty Days Of Life: Examining Calf Behavioral Development In Beluga Whales (Delphinapterus Leucas) And Pacific White-Sided Dolphins (Lagenorhyncus Obliquidens) At One Zoological Facility, Kendal Smith

Master's Theses

Cetacean development is important for general comparative understanding and the implementation of informed husbandry policies. Due to the inaccessibility of many of these species in the wild, researchers can study managed care populations to better understand basic developmental patterns of cetaceans, as well as to improve husbandry policies for facility animals. However, no previous studies have attempted to observe the behavioral development of Pacific white-sided dolphins (Lagenorhyncus obliquidens). Eight beluga whale calves and four Pacific white-sided dolphin calves were observed for the first 30 days of life to determine the developmental trajectory of several typically monitored behaviors. The …

Working Memory And Mindfulness In An Rct Of Abbt And Ar, Anna M. Hall

Graduate Masters Theses

Working memory capacity (WMC) can be degraded by anxiety, stress, and worry, but can also be protected by mindfulness interventions (Jha et al., 2010). The current study was the first to investigate the relations between WMC, anxiety, and mindfulness within two interventions for Generalized Anxiety Disorder (GAD) that promote mindfulness: Acceptance Based Behavioral Therapy (ABBT) and Applied Relaxation (AR). In this exploratory study, we analyzed a subset of participants from a RCT of ABBT and AR who had completed the Operation Span Task (OSPAN; n = 21). First, we found that pre- to post-treatment measures of WMC (e.g., OSPAN scores) …