Medicine and Health Sciences Commons^™

Effect Of A 72 Hour Stroke Care Bundle On Early Outcomes After Acute Stroke: A Non Randomised Controlled Study, Martha Sajatovic, Anthony J. Furlan

Faculty Scholarship

Background Integrated care pathways (ICP) in stroke management are increasingly being implemented to improve outcomes of acute stroke patients. We evaluated the effect of implementing a 72 hour stroke care bundle on early outcomes among patients admitted within seven days post stroke to the national referral hospital in Uganda. Methods In a one year non-randomised controlled study, 127 stroke patients who had ‘usual care’ (control group) were compared to 127 stroke patients who received selected elements from an ICP (intervention group). Patients were consecutively enrolled (controls first, intervention group second) into each group over 5 month periods and followed to …

Providing Pediatric Patients With A Voice : Understanding How Children Want To Live Before They Die, Nina Friedman

Graduate Student Independent Studies

This paper explores what quality of life is for pediatric patients and how health care professionals, a certified child life specialist in particular, can help the patient, family, and medical team to navigate treatment options and decisions regarding end-of-life.

Chhs May 2016 Icymi, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Outcomes In Language And Social Skills As Seen In Children With Autism And Developmental Disabilities Participating In Equine Assisted Activities, Megan Koenigseder

Rehabilitation, Human Resources and Communication Disorders Undergraduate Honors Theses

Individuals with developmental disabilities commonly present characteristics that include deficits in social and communicative abilities. A number of intervention strategies have been implemented, but none have proven to be most effective. A somewhat novel approach known as equine assisted activities and therapies (EAAT) involves the utilization of horses during intervention and has shown to be effective in areas concerning quality of life, social functioning, self-regulation, adaptive behaviors, motor control, and motivation.

The purpose of the current study is to examine the effects of EAA on social skills and expressive language in 2-4 children diagnosed with developmental disability. Participants engaged in …

Art Therapy And Its Impact Upon Marital Communication With Geriatric Adults Suffering From Dementia And Their Spousal Caregivers: An Exploratory Review And Research Study, Ashlyn G. Kubacak

School of Social Work Undergraduate Honors Theses

The World Health Organization estimated that 47.5 million people across the globe were living with dementia in 2015, and this number is expected to increase and eventually double by 2030. The cost of caregiving for someone who has dementia is substantial, with estimated federal costs fluctuating between 157 billion and 215 billion dollars annually. Sixty percent of caregivers rate the emotional strain of caregiving to be “high to extremely high”, and 40% of caregivers are diagnosed with depression. It is therefore important to provide support not only for those persons with dementia, but also for their caregivers in order to …

Comparative Organizational Assessments And Partenship Potential For Sekou Pou Nanm-Yo And Asirans Community Counseling Center, Lauren M. Mawe

Sustainability and Social Justice

This paper assesses the organizational capacity of two small Non-Governmental Organizations (NGOs) in Port-Au-Prince Haiti. Each NGO has a staff of under 15 members. At the time of the assessment, they were both in early stages of their development, with one in its first year of operations, and the other in its fifth year. Both embody grassroots, community organizations because of their connections to the communities in which they work, their willingness to travel to those communities, and their predominantly Haitian staff. The fieldwork included interviews, focus groups, and three months of participant observation and work with these organizations. In …

Behavioral Interventions In Six Dimensions Of Wellness That Protect The Cognitive Health Of Community-Dwelling Older Adults: A Systematic Review, Kelley A. Strout, Daniel J. David, Elizabeth J. Dyer, Roberta C. Gray, Regula H. Robnett, Elizabeth P. Howard

Library Services Faculty Publications

OBJECTIVES: To systematically identify, appraise, and summarize research on the effects of behavioral interventions to prevent cognitive decline in community-dwelling older adults using a holistic wellness framework. DESIGN: Systematic review of randomized controlled trials that tested the effectiveness of behavioral interventions within each of the six dimensions of wellness: occupational, social, intellectual, physical, emotional and spiritual. Databases searched included PubMed MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, ALOIS, and The Grey Literature Report through July 1, 2014. SETTING: Community. PARTICIPANTS: Individuals aged 60 and older (N = 6,254). MEASUREMENTS: Consolidated Standards of Reporting Trials Checklist. RESULTS: Eighteen studies met the inclusion criteria. …

Contingency Management Works, Clients Like It, And It Is Cost-Effective., Kimberly C. Kirby, Lois A Benishek, Mary B Tabit

College of Science & Mathematics Departmental Research

No abstract provided.

Facilitating Effective Communication Between First Responders And Older Adults During Fall Incidents: An Educational Intervention, Krystin M. Beeman, Erica L. Berger, Isabel A. Cabezas, Nicole M. Mathews

Dissertations, Masters Theses, Capstones, and Culminating Projects

PURPOSE. The purpose of this project was to provide first responders with communication strategies for older adults that may help when responding to fall- related calls. General information was also provided to First Responders on working with older adults with a focus on the aging process, fall risk factors, and communications strategies.

METHODS. A series of educational sessions to first responders at a local fire district were developed and presented by occupational therapy students. Materials were developed by presenters from evidence-based resources and tailored to the target population. Each presentation focused on statistics about older adults, the aging process, fall …

Enhancing Access To Alcohol Use Disorder Pharmacotherapy And Treatment In Primary Care Settings: Adapt-Pc, Hildi J. Hagedorn, Randall Brown, Michael Dawes, Eric Diepernick, Donald Myrick, Elizabeth M. Oliva, Todd H. Wagner, Jennifer P. Wisdom, Alex Harris

Health Policy and Management Faculty Publications

Background: Only 7.8% of individuals meeting diagnostic criteria for alcohol use disorder (AUD) receive treatment in a given year. Most individuals with AUDs are identified in primary care (PC) settings and referred to substance use disorders (SUD) clinics; however, only a minority of those referred attend treatment services. Safe and effective pharmacological treatments for AUD exist, but they are rarely prescribed by PC providers. The objective of this study is to refine, implement, and evaluate an intervention to integrate pharmacological AUD treatment options into PC settings. This paper provides a detailed description of the intervention design and the evaluation components. …

Assessing Cultural Competence In A Mental Health Outpatient Facility., Alexis N. Keen Crook

Electronic Theses and Dissertations

Cultural competence is a concept that has been thoroughly investigated in healthcare, but there is a dearth of literature and research on this topic as it pertains to mental health services. In healthcare, research has shown that a lack of cultural competence is directly linked to high levels of misdiagnoses, mistrust of healthcare and professionals, and overall poor health in minority populations. Using the Campinha-Bacote model for cultural competence in health care, I explore how cultural competence is defined and operationalized in an outpatient mental health facility. I hypothesize that, similar to research addressing cultural competency in healthcare systems, cultural …

African American Female Offender's Use Of Alternative And Traditional Health Services After Re-Entry: Examining The Behavioral Model For Vulnerable Populations, Carrie B. Oser, Amanda M. Bunting, Erin L. Pullen, Danelle Stevens-Watkins

Sociology Faculty Publications

This is the first known study to use the Gelberg-Andersen Behavioral Model for Vulnerable Populations to predict African American women's use of three types of health services (alternative, hospitalization, and ambulatory) in the 18 months after release from prison. In the multivariate models, the most robust predictors of all three types of service utilization were in the vulnerable theoretical domains. Alternative health services were predicted by ethnic community membership, higher religiosity, and HIV/HCV. Hospitalizations were predicted by the lack of barriers to health care and disability. Ambulatory office visits were predicted by more experiences of gendered racism, a greater number …

Capturing Success At Autistry Studios: A Qualitative Study, Ali Ives, Vince Colombano, Joey Bava

Dissertations, Masters Theses, Capstones, and Culminating Projects

This qualitative study examined the perceived outcomes of participation at Autistry Studios among young adult students with Autism Spectrum Disorder (ASD). Autistry Studios is a unique program offering services to individuals with ASD similar to that of a pre-vocational training program. The mission of Autistry Studios is to help students with ASD become independent adults by engaging in “project-based therapy.” A setting is provided where individuals with ASD can achieve personal and functional growth with the use of creative resources like art supplies, raw materials, and power tools to pursue and complete a project that is client-centered. The purpose of …

The Development Of Sexual Attitudes In The Family Of Origin And Sexual Satisfaction Later In Life, Bryant Christlieb

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine if variance for individuals’ sexual satisfaction as well as attitudes toward sexual instrumentality, sexual permissiveness, sexual communion and attitudes could be predicted by family sexual communication during adolescence as well as various demographic factors such as age, years together, gender, race, income level, religion, religiosity and sexual orientation. This was done by recruiting 250 people via Mechanical Turk (www.mturk.com) and through undergraduate courses at the University of Nevada-Las Vegas. The researcher used an enter-method multiple regression model and Kendall’s Tau for non-parametric data. The results of this study show that sexual satisfaction …

Eight Steps To Weight Loss: Development Of An Evidence-Based Collaborative Provider-Patient Workbook For Overweight Or Obese Adults, Katherine Ann Wagner

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite decades of effort on the part of health care providers and policy makers to reduce the prevalence of obesity, the prevalence of obesity in the United States remains high (CDC, 2015). In the adult population ages 20 years of age and older, 35.7% are considered obese. The annual medical costs for people who are obese are $1,429 higher than people of a healthy weight (CDC, 2013). Obesity increases the risk for chronic health conditions such as hypertension, type 2 diabetes, hypercholesterolemia, coronary heart disease, stroke, asthma, arthritis, and cancer (Hammond & Levine, 2010). Over-weight and obesity are the main …

Women And Healthcare In Appalachia: Impeding Circumstance And The Role Of Technology, Ashley Cano

Electronic Theses and Dissertations

For decades, healthcare access and quality in central and southern Appalachia have trailed the rest of the country. Entrenched poverty and low educational attainment compound healthcare problems. This study examines the healthcare obstacles women encounter in southern and central Appalachia and analyzes how technology use, such as Internet searching and social media affect women’s healthcare decisions. Data were analyzed from four focus groups conducted with women from the region. Results indicate that seeing a physician or not did not influence women’s propensity to search the Internet for health-related information or to seek support through social media sites. Additionally, women reported …

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 …

Staff Interactions And Affect In Persons With Dementia: An Observational Study Of A Memory Care Unit, Keirstin V. Meyer

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

It is estimated that the number of people in the United States living with dementia in 2015 will nearly triple by the year 2050. With no cure for dementia, we are faced with providing care in a way that maximizes well-being. The majority of prior research focused on the best ways to reduce behavioral problems and mood disorders, such as depression and anxiety. The objective of this study was to increase knowledge about the social influences on well-being in persons with dementia, particularly from staff in residential memory care units. This study found that the most common interaction type from …

Relationship Between Parental Alcoholism And Family Unpredictability, Kamie L. Stephens

Honors Theses

This research is a retrospective study on adult children of alcoholics using a previous researcher’s, Dr. Ross, unpredictability scale. Family Unpredictability is defined as “a lack of consistency in family behaviors and regulatory systems,” (Ross and Hill, 2000). There is currently a lack of research related to parental alcoholism and its effect on family structure. The researcher hopes to gain insight on the relationship between parental alcoholism and family unpredictability. Previous research suggests children growing up with a caregiver who is an alcoholic experience a higher level of unpredictability in the home. Examples of this unpredictability are: a decreased amount …

Instilling Hope: Showing Individuals With New Disabilities Between The Ages Of 18 And 24 That Suicide Is Not The Answer, Christine Ann Whiting

Graduate Theses and Dissertations

The purpose of this dissertation is to explore what can be done to mitigate the onset of a disability for young adults aged 18-24 in order to prevent suicidal thoughts or actions. Research suggests that many factors play into suicidal ideation for this young population, including lost hope, lack of coping mechanisms, lack of financial security and bullying. The goal of this research is to determine what rehabilitation professionals can do differently that will hopefully eradicate suicide for this group.

Nursing Perception Of Psychogenic Nonepileptic Spells: Improving Patient Outcomes, Amanda J. Cramer

Doctor of Nursing Practice Scholarly Projects

Patients with psychogenic nonepileptic spells (PNES) have generally poor outcomes and many fail to engage in evidence-based treatments (Thompson et al., 2013). Negative healthcare provider perceptions have been implicated as a barrier to patient engagement in treatment recommendations for PNES (Whitehead, Kandler, & Reuber, 2013; Worsely et al., 2011). Illness perception of these patients has been evaluated from the perspective of physicians in multiple settings but perceptions by nurses are not well studied despite the close interactions that nurses have with these patients.

This project used Pender’s health promotion model to collect information about the nursing experience with patients with …

Juvenile Justice—Translational Research On Interventions For Adolescents In The Legal System (Jj-Trials): A Cluster Randomized Trial Targeting System-Wide Improvement In Substance Use Services, Danica K. Knight, Steven Belenko, Tisha Wiley, Angela A. Robertson, Nancy Arrigona, Michael Dennis, John P. Bartkowski, Larkin S. Mcreynolds, Jennifer E. Becan, Hannah K. Knudsen, Gail A. Wasserman, Eve Rose, Ralph Diclemente, Carl G. Leukefeld, Jj-Trials Cooperative

Behavioral Science Faculty Publications

Background: The purpose of this paper is to describe the Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, a cooperative implementation science initiative involving the National Institute on Drug Abuse, six research centers, a coordinating center, and Juvenile Justice Partners representing seven US states. While the pooling of resources across centers enables a robust implementation study design involving 36 juvenile justice agencies and their behavioral health partner agencies, co-producing a study protocol that has potential to advance implementation science, meets the needs of all constituencies (funding agency, researchers, partners, study sites), and can be implemented …

Applying Experience-Based Co-Design With Vulnerable Populations: Lessons From A Systematic Review Of Methods To Involve Patients, Families And Service Providers In Child And Youth Mental Health Service Improvement, Alison Mulvale, Ashleigh Miatello, Christina Hackett, Gillian Mulvale

Patient Experience Journal

The objective was to identify methods used to involve patients, family and service providers in child and youth mental health service improvement research. We analyzed the alignment of methods used with Experience-Based Co-Design (EBCD) methodology, and how power imbalances among participants were addressed. A systematic review of the English-language peer review literature since 2004 was carried out. The EMBASE, Scholar’s Portal, PubMed, Web of Science databases and the Ontario College of Art and Design University libraries were searched electronically for variations of ‘child’, ‘mental health’, ‘experience-based co-design’, ‘participatory research’ and ‘health care services’. Textual data was systematically extracted and analyzed. …

Redefining Medicine: The Epistemology, Political Theory, And Phenomenology Of Health And Disease, Jacqline J. Murillo

Creative Activity and Research Day - CARD

This thesis argues that health needs to be redefined in a more comprehensive fashion, namely as a physiological/biological state, with social, environmental, and individual determinants always related to one’s personal needs to achieve one’s life plan. The benefits of this new definition include more emphasis on the distribution of health as a social good.

Additionally, redefining health puts the value of the individual’s life rather than the strict monetary value of their needed treatment as a focal point. It also draws more attention to medicine as a practice of care, rather than viewing it simply as a technology or science, …

Using Sbirt As An Intervention For Substance Use In Public Schools, Amanda Higgins

Honors Theses

In Kalamazoo County, youth substance use is on the rise. In recent years (2012-2014), alcohol use has nearly doubled in the adolescent population. With the easy accessibility of alcohol in Kalamazoo, alcohol use among adolescents will continue to rise if early intervention protocols are not implemented. Screening, Brief Intervention, and Referral to Treatment (SBIRT), could be the model of intervention within Kalamazoo public schools, if implemented correctly. According to the Substance Abuse and Mental Health Service Administration (SAMHSA), SBIRT is an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. Public …

Quantifying Syringe Exchange Program Operational Space In The District Of Columbia., Sean T. Allen, Monica Ruiz, Jeff Jones

Prevention and Community Health Faculty Publications

Syringe exchange programs (SEPs) are effective structural interventions for HIV prevention among persons who inject drugs. In 2000, a buffer zone policy (the 1000 Foot Rule) was implemented in Washington, DC, that prohibited SEP operations within 1000 feet of schools. We examined changes in the amount of legal SEP operational space over time. We used data pertaining to school operations and their approximate physical property boundaries to quantify the impact of the 1000 Foot Rule on legal SEP operational space from its implementation in 2000-2013. Adherence to the 1000 Foot Rule reduced SEP operational space by more than 50 % …

Improving The State Of Health Literacy Among American Adults: Why Community Outreach Methods Are More Effective Than Literacy-Level Screenings, Lydia Simpson

Honors Theses

Health literacy refers to an individual’s ability to access and process health information to make important decisions about their health. Unfortunately, millions of American adults have inadequate health literacy skills and are not able to navigate their way through the world of health care. This may lead to disastrous consequences and poor health outcomes. To improve health literacy, nationwide health education programs are imperative. Despite this, low health literacy is often ignored, or only considered for individuals suspected of having low health literacy who might then be administered a screening instrument. A better model for the American health care system …

Examining Multi-Session Brief Intervention For Substance Use In Primary Care: Research Methods Of A Randomized Controlled Trial., Jaclyn E Chambers, Adam C Brooks, Rachel Medvin, David S Metzger, Jennifer Lauby, Carolyn M Carpenedo, Kevin E Favor, Kimberly C Kirby

College of Science & Mathematics Departmental Research

BACKGROUND: Brief interventions such as Screening, a single session of Brief Intervention, and Referral to Treatment (SBIRT) have shown mixed effectiveness in primary care. However, there are indications that multi-session brief interventions may demonstrate more consistently positive outcomes, and perhaps a more intensive approach would be of benefit in addressing substance use in primary care. This study compared the effectiveness of SBIRT with a single BI session (BI/RT) to a multi-session brief-treatment intervention (BI/RT+) in primary care. We also developed easy-to-use, evidence-based materials to assist clinicians in delivering these interventions.

METHODS/DESIGN: This study was conducted in three Federally Qualified Healthcare …

Discriminative Stimulus Properties Of 3.0 Mg/Kg Mephedrone In Rats, Nathyn Thompson

Honors Theses

Consumption of a prominent synthetic cathinone known as mephedrone (4-methylmethcathinone) has become a popular alternative to club drugs such as ecstasy, cocaine, and methamphetamine within the past decade. The pharmacological mechanisms that contribute to its subjective effects have yet to be fully characterized and are thus warranted for investigation. The present study employed drug discrimination methods to train eight male Sprague-Dawley rats to discriminate injections of 3.0 mg/kg mephedrone from saline. Various doses of mephedrone, 3,4-methylenedioxypyrovalerone (MDPV), d-amphetamine (AMPH), cocaine, (+)-methamphetamine (METH), and 3,4-methylenedioxy-methamphetamine (MDMA) were investigated for their ability to substitute for the stimulus cues of the training …

Designing A Mobile Space Habitat Analog, Victor Kitmanyen, Matthew Burkhard, Timothy Disher

Human Factors and Applied Psychology Student Conference

No abstract provided.