Medicine and Health Sciences Commons^™

Children And Adults With Long Term Services And Support Needs: Mainecare And Medicare Expenditures And Utilization, State Fiscal Year 2010, Stuart Bratesman Mpp, Julie T. Fralich Mba, Tina Gressani, Eileen Griffin Jd

Disability & Aging

This report is one of a series of reports prepared by the USM Muskie School on MaineCare members who are dually eligible for MaineCare and Medicare Services. An earlier report provided a high level overview of the MaineCare and Medicare use and expenditure patterns for all members who were dually eligible in state fiscal years (SFY) 2008 to 2010. Both reports were prepared as part of the Maine State Profile Tool grant funded by the Centers for Medicare & Medicaid Services. This second report analyzes the characteristics, use and expenditure patterns of sub-populations of long term service users including adults …

Subsidized Housing, Public Housing, And Adolescent Violence And Substance Use, Tamara Leech

Department of Public Health Scholarship and Creative Works

This study examines the separate relationships of public housing residents and subsidized housing residence to adolescent health risk behavior. Data included 2,530 adolescents aged 14 to 19 who were children of the National the Longitudinal Study of Youth. The author uses stratified propensity methods to compare the behaviors of each group—subsidized housing residents and public housing residents—to a matched control group of teens receiving no housing assistance. The results reveal no significant relationship between public housing residence and violence, heavy alcohol/marijuana use, or other drug use. However, subsidized housing residents have significantly lower rates of violence and hard drug use, …

Building A Strategic Framework For Comparative Effectiveness Research In Complementary And Integrative Medicine, Claudia M. Witt, Margaret Chesney, Richard Gliklich, Lawrence Green, George Lewith, Bryan Luce, Anne Mccaffrey, Shelly Rafferty Withers, Harold C. Sox, Sean Tunis, Brian M. Berman

Dartmouth Scholarship

The increasing burden of chronic diseases presents not only challenges to the knowledge and expertise of the professional medical community, but also highlights the need to improve the quality and relevance of clinical research in this domain. Many patients now turn to complementary and integrative medicine (CIM) to treat their chronic illnesses; however, there is very little evidence to guide their decision-making in usual care. The following research recommendations were derived from a CIM Stakeholder Symposium on Comparative Effectiveness Research (CER): (1) CER studies should be made a priority in this field; (2) stakeholders should be engaged at every stage …

Metabotropic Glutamate Receptor 5 In The Medial Prefrontal Cortex: Role In Cocaine Sensitization And Addiction, Kristin Marie Timmer

Theses and Dissertations (ETD)

Cocaine sensitization is associated with cocaine-induced hyperexcitability of pyramidal projection neurons within the medial prefrontal cortex (mPFC). Such hyperexcitability presumably results in increased glutamatergic input to reward-affiliated brain regions such as the ventral tegemental area (VTA) and nucleus accumbens (NAc), consequently facilitating drugseeking behavior. Metabotropic glutamate receptor 5 (mGluR5) has been implicated in cocaine addiction and demonstrated to increase neuronal excitability, therefore, the aim of the present study was to investigate the effect of intra-mPFC mGluR5 manipulation on behavioral and neurochemical sensitization and drug-seeking. Bilateral cannulae were implanted into the mPFC of male Sprague-Dawley rats and mGluR5 antagonist MTEP (15 …

The Initial Development Of Child-Focused Interventions In The Treatment Of Maternal Substance Abuse And Child Neglect, Kendra Tracy

UNLV Theses, Dissertations, Professional Papers, and Capstones

This single case study focuses on the development and evaluation of child focused interventions for the treatment of child neglect and concurrent maternal substance abuse that were incorporated into Family Behavior Therapy (FBT). The participants were a mother referred by the Department of Family Services and her child. The child participated in three child focused interventions that were developed to decrease child behavior problems, increase support and communication, and prevent future neglect by strengthening the mother & child relationship. Although not a focus in this study, the mother participated in traditional FBT adult focused intervention components. The chief aim of …

Csa Survivors: What Heals And What Hurts In A Couple Relationship, Laura S. Smedley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Childhood sexual abuse (CSA) is a significant trauma that affects a person's self-concept and the ability to form healthy intimate relationships later in adulthood. Approximately 20% of adults who experience childhood sexual abuse go on to evidence serious psychopathology in adulthood (Harway & Faulk, 2005). Besides individual disturbances, CSA survivors struggle with many relational difficulties. These difficulties are usually most pronounced among their intimate partners (Reid, et al., 1995). According to attachment theory, attachment injuries are best healed in the context of a healthy, intimate relationship (Kochka & Carolan, 2002) (MacIntosh & Johnson, 2008). Conversely, the couple relationship may be …

Couples' Process Of Healing From Infidelity While In Therapy, Jordan Mark Staples

UNLV Theses, Dissertations, Professional Papers, and Capstones

Infidelity is one of the most common presenting problems for couples and marriage therapists. It is widely acknowledged to be a destructive phenomenon for a couple's relationship and is one of the most difficult presenting problems to treat. Treatment models for infidelity vary and have little empirical testing. The purpose of the proposed study was to investigate the client's perspective of the process for healing from infidelity. Additionally, the proposed study looked to qualitatively assess and amalgamate participants' experience of the healing process for infidelity. Themes and relationships among these themes were identified using open, axial, and selective coding processes. …

An Evaluation Of Social Capital's Effect On Depression Among Adolescents, Ezechukwu Awgu

Dissertations

Mental illness has been described as a “global burden of disease,” and depression accounts for a large part of the burden (Aslund, Starrin, Nilsson, 2010). In 2009, 35.7 percent of the adolescent population in the United States who reported past-year symptoms of a major depressive episode, for example, feelings of sadness, discouragement, loss of feelings of self-worth, and loss of interest in social activities, also used illicit drugs including marijuana, inhalants, hallucinogens, cocaine, heroin, and prescription-type psychotherapeutics for non-medical purposes (SAMHSA, 2009, APA, 1994). Additionally, substance abuse due to alcoholism was among the major causes of death for adolescents aged …

Equine-Assisted Psychotherapy: A Descriptive Study, Erica Jex Gergely

Dissertations

The current study seeks to examine the program operations and treatment practices of individuals and organizations providing equine-assisted therapy services nationwide. Currently, there are several hundred programs across the United States that utilize equine-assisted therapy to treat common mental health problems in children, adolescents, and adults. Not all equine therapy programs function under the same theoretical model and therefore do not deliver treatment services using equivalent principles or techniques. In addition, program policies, procedures, and ethical guidelines of each provider vary. To date, there exists a paucity of research regarding equine-assisted therapy including both qualitative and quantitative data.

The present …

Predictors Of Drug Court Client Graduation, Marie E. Gill

Theses and Dissertations (ETD)

Background: Substance use disorder in the United States adversely effects society by burdening the justice system with offender incarceration for drug-related crimes, it also strains in the healthcare system with costs in excess of $216 billion dollars for treatment of drug-related mental and physical illnesses. Many offenders of nonviolent crimes with substance use disorder have been diverted to Drug Court (DC) for year-long supervised community-based drug addiction treatment as an alternative to incarceration for non-violent drug-related crimes. Drug Court program outcomes, however, have been studied as a criminal justice intervention, rather than a primary care mental health intervention. The majority …

Perceived Neighborhood Safety And Psychological Distress: Exploring Protective Factors, Jaime Booth, Stephanie L. Ayers, Flavio F. Marsiglia

The Journal of Sociology & Social Welfare

While a growing body of literature has established a relationship between "disordered" neighborhoods and psychological distress, less is known about the specific mechanisms at work. Using data collected in the 2008 Arizona Health Survey (N = 4,196), hierarchal linear regression was conducted to assess both the independent effect of perception of neighborhood safety on psychological distress, as well as the mediating effects of powerlessness, social isolation and mistrust. The findings suggest that the more safe individuals feel in their neighborhood, the less psychological distress they experience (b = 1.07, SE = .17, p < .001). This relationship appears to be partially mediated by feelings of powerlessness, social isolation and mistrust, indicating potential risk and protective factors.

The Health Of Rural Grandparents Raising Grandchildren, Kimberly Y. Robitaille

Theses and Dissertations (ETD)

Introduction: Grandparents are becoming increasingly responsible for raising their grandchildren. Previous studies have noted physical and mental health limitations for custodial grandparents. Grandparents face numerous challenges in raising grandchildren and consequently, experience high stress levels. However, coping and social support have been found to mediate grandparent stress. Rural custodial grandparents have been an understudied population. Using the Stress Process Model, this study extends the knowledge of rural grandparents raising grandchildren by describing the relationships among physical and mental health, stressors, coping, and social supports for custodial grandparents living in Western Kentucky.

Methods: A mixed methods approach was used to examine …

The Effects Of A Summer Camp Experience On Factors Of Resilience In At-Risk Youth, Marybeth Merryman, Amanda Mezei, Jill A. Bush, Marcie Weinstein

The Open Journal of Occupational Therapy

This pilot study addressed the impact of a summer camp experience on at-risk middle school youth by exploring self-reported growth in skill development and resilience. Campers who attended a five-week summer day camp were compared to a control group who maintained typical activities throughout the summer. Results showed statistically significant differences in the campers’ belief of a good future for themselves (U = 179.40, P = 0.05). Campers reported sustained or positive growth in domains of social skills and positive values from the baseline to a six-month follow up. Three significant themes emerged from individual in-depth interviews including: (a) engagement …

Understanding The Risky Sexual Behaviors Of Study Abroad Students, Ashley Schaffer

Theses and Dissertations

Using the Triandis Model of Interpersonal Behavior (TIB) this study examined the influence of environmental and individual characteristics on predicting risky sexual behaviors of study abroad students. This study utilized a two-stage, qualitative and quantitative methodological framework. First, focus groups with previous study abroad students were held in order to gather data that informed the development of assessment. Second, data was subsequently collected from 128 study abroad students. The TIB significantly predicted a participant's intentions to engage in risky sexual behavior with the construct labeled subjective social norms emerging as a significant predictor. The model also significantly predicted engaging in …

Using A Healing Wheel In The Healing Journey, Rebecca Tadlock-Marlo

Faculty Research & Creative Activity

Mindfulness can be most comprehensively defined as a multifaceted, present-moment awareness intervention that capitalizes on self-perceptions (Gehart & McCollum, 2007; Nanda, 2009). Native American practices can be easily translated into counseling mindfulness techniques to aide in the healing journey of multicultural clients (Burks & Robbins, 2011; Durtschi,Rybak & Decker-Fitts, 2009; Garrett et al., 2011; Turner & Pope, 2009). A Medicine Wheel, or Sacred Hoop, is just one of the many ways to help individuals heal through mindfulness practices. Through the use of creating and discussing a healing wheel with clients, counselors can promote a context for understanding, respecting, and valuing …

Using A Healing Wheel In The Healing Journey, Rebecca L. Tadlock-Marlo

Faculty Research & Creative Activity

Mindfulness can be most comprehensively defined as a multifaceted, present-moment awareness intervention that capitalizes on self-perceptions (Gehart & McCollum, 2007; Nanda, 2009). Native American practices can be easily translated into counseling mindfulness techniques to aide in the healing journey of multicultural clients (Burks & Robbins, 2011; Durtschi,Rybak & Decker-Fitts, 2009; Garrett et al., 2011; Turner & Pope, 2009). A Medicine Wheel, or Sacred Hoop, is just one of the many ways to help individuals heal through mindfulness practices. Through the use of creating and discussing a healing wheel with clients, counselors can promote a context for understanding, respecting, and valuing …

Racism And Illicit Drug Use Among African American Women: The Protective Effects Of Ethnic Identity, Affirmation, And Behavior, Danelle Stevens-Watkins, Brea Perry, Kathi L. Harp, Carrie B. Oser

Sociology Faculty Publications

Though recent evidence indicates that rates of illicit drug use among African American women are now higher than the national average, little is known about the etiology of substance use in this population. In addition, the effects of racism and other cultural factors are understudied and may be unique amongst African American women. This cross-sectional study explores risk and protective factors for drug use among 204 African American women. More specifically, associations between racism experiences and drug use are investigated in the context of potential moderating influences (i.e., psychosocial resources, social safety net variables, and cultural identity and practices). Findings …

Htlv-1 And -2 Infections Among 10 Indigenous Groups In The Peruvian Amazon, Isaac E. Alva, E. Roberto Orellana, Magaly M. Blas, Antonio Bernabe-Ortiz, Armando Cotrina, Marina Chiappe, Tadeusz J. Kochel, Cesar P. Cárcamo, Patricia J. García, Joseph R. Zunt, Anne L. Buffardi, Silvia M. Montano

School of Social Work Faculty Publications and Presentations

Infections with HTLV-1 and -2 were detected in 12 (1.9%) and 6 (0.9%) indigenous individuals living in 27 Amazonian villages in Peru. All infections occurred in Shipibo-Konibo people. HTLV was more common among participants living in villages distant from larger port cities and women with non-monogamous sexual partners.

Reintegration Of Child Soldiers In Burundi: A Tracer Study, Mark J.D. Jordans, Ivan H. Komproe, Wietse A. Tol, Aline Ndayisaba, Theodora Nisabwe, Brandon A. Kohrt

Psychiatry and Behavioral Sciences Faculty Publications

Background

Substantial attention and resources are aimed at the reintegration of child soldiers, yet rigorous evaluations are rare.

Methods

This tracer study was conducted among former child soldiers (N=452) and never-recruited peers (N=191) who participated in an economic support program in Burundi. Socio-economic outcome indicators were measured retrospectively for the period before receiving support (T1; 2005–06); immediately afterwards (T2; 2006–07); and at present (T3; 2010). Participants also rated present functional impairment and mental health indicators.

Results

Participants reported improvement on all indicators, especially economic opportunity and social integration. At present no difference existed between both groups on any of the …

System Dynamics Modeling Of Prescription Opioid Pain Reliever Abuse, Alexandra Nielsen

Systems Science Friday Noon Seminar Series

The nonmedical use of prescription opioid pain relievers and associated overdose deaths have been labeled an epidemic by the Centers of Disease Control and Prevention. While these medicines play an important role in the treatment of pain, the benefits of opioids for the treatment of pain need to be balanced against these very real risks. Alex has been working closely with Professor Wayne Wakeland, Teresa Schmidt, and Dr. Dennis McCarty (OHSU) to create a dynamic systems-level model of opioid use, abuse, and diversion in order to give context to current research in this area and to provide a better understanding …

Research Brief: "Impact Of The Seeking Safety Program On Clinical Outcomes Among Homeless Female Veterans With Psychiatric Disorders", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the effect of the Seeking Safety program's services on improvement in PTSD, psychiatric symptoms, and social support among homeless female veterans. In policy and practice, clinicians should be trained on how to use the program to better serve homeless female veterans, and policymakers should push for clinician training for those who work with homeless veterans. Suggestions for future research include applying this study and the Seeking Safety program to non-VA healthcare systems, assessing substance use within the program, and assessing the long-term effects of the Seeking Safety program.

Treating The Spirit: An Ethnographic Portrait Of Senegalese Animist Mental Health Practices And Practitioners In Dakar And The Surrounding Area, Caitlin Mckinley

Independent Study Project (ISP) Collection

Animist beliefs and practices are deeply ingrained in Senegalese society, even in the metropolitan area of Dakar and have prevailed in Senegal despite the many influences of Islam and colonization. Animist mental health practices are especially interesting because of the influx of Western mental health practices in the wake of modernization. Merging traditional and Western mental health practices challenges the completely different worldviews from which each school of thought stems. For those seeking treatment, this duality makes it tricky to receive the help that they need. The purpose of this study is to explore animist Senegalese mental health treatments, traditional …

Art As A Cure: Analyzing Healthcare Treatment For The Mentally Ill Through The Lens Of Art Therapy Programs In Dakar, Senegal, Sofia Porter-Castro

Independent Study Project (ISP) Collection

Mental illness is a malady that affects roughly 2.3 million people in Senegal ("Statistics by Country” 2012), but the wide and sometimes opposing range of healing practices suggests that the attitudes surrounding mental illness are still largely contested. This is especially true in Senegal’s capital, where advances in medicine in big city hospitals are growing while ties to traditional beliefs and practices remain strong. Alternative therapies, such as art therapy, provide an opportunity for practitioners to explore different techniques for treating the mentally ill while still integrating elements of the local culture. It is precisely this integration that this paper …

Storytelling And Healing: The Influence Of Narrative On Identity Construction Among Hiv Positive Individuals In Kisumu, Kenya, Kimberly Leon

Independent Study Project (ISP) Collection

The principle objective of this Independent Study Project is to investigate the influence of storytelling as a counseling method on conceptions of HIV among HIV positive individuals in the city of Kisumu. Interviews with counselors, community health workers, and HIV support group members were used to determine the role of storytelling in the counseling process. Stories and life experiences were gathered and analyzed in order to extract themes and draw a relationship between the act of storytelling and a person’s perception of their HIV status. Data was collected at various support groups in the Kisumu area and through the help …

Living With Autism In Vietnam, Libie Motchan

Independent Study Project (ISP) Collection

This paper examines the many implications of living with Autism in Vietnam on both affected children and their families. The lack of information, statistics and awareness of autism in Vietnam is reflected in the limited treatment resources available. This study calls attention upon what problems parents are most affected by what they feel needs to change. It also looks at the current sentiment and understanding of autism and its perceived causes. The results of this paper come from background research, observation at clinics and special education facilities, interviews with professionals in the fields of psychology and education, interviews with parents …

The 2002 Bali Bomb: Models Of Sustainable Philanthropy, Lauren Livingston

Independent Study Project (ISP) Collection

Within the first few weeks in Bedulu, I read an ISP written in 1990 concerning mental health facilities in Bali. It was by far one of the most engaging and provocative ISPs I was introduced to; however, giving today’s security precautions and my lack of background in psychology, I easily dismissed it as a possible project. Yet, as ISP time lurched closer, I still had not found an idea that equally excited me. I talked with Bu Ari, and she encouraged me to talk to Ibu Luh Ketut Suryani, the leading psychologist in Indonesia and founder of the Suryani Institute …

Family Aided Community Treatment As An Intervention For The Treatment Of Early Psychosis: A Proof Of Concept Study, Ryan P. Melton

Regional Research Institute for Human Services

Major psychotic disorders are one of the leading causes of disability worldwide, having severe impacts on the people who suffer from the conditions, their families and society. There is evidence that if these conditions are identified and treated early, the prognosis is improved. The purpose of this study is to produce findings related to the use of year long trial of family aided community treatment (FACT) with individuals who are experiencing a first episode psychosis as defined by the SIPS. Using a proof of concept design with multiple repeated measure t tests, this study focused on first-episode psychotic disorder participants …

Pemberdayaan Keluarga Dan Masyarakat Melalui Pelatihan Komunikasi Dalam Keluarga Yang Mengedepankan Kepentingan Anak, Ety Rahayu

Jurnal Ilmu Kesejahteraan Sosial

To be able to realize child welfare, the family, society and the government should pay attention to the rights and needs of children. To ensure the psychological dan social development, children need love, understanding, recreational atmosphere, creative stimulation, self-actualization, and intellectual development. Therefore they require early socialization and basic education, the teaching of social responsibility, social roles and basic skills in order to become useful citizens. Children from poor families are often raised with parenting less conducive to their growth and development. One of the efforts undertaken is through communication training for mothers from poor families. Through this training the …

The Perceptions, Problems, And Possibilities Of Cameroonians With Mental Disabilities: A Case Study Of Le Centre National De Réhabilitation Des Personnes Handicapées De Yaoundé, Lauren Miller

Independent Study Project (ISP) Collection

For my study, I focused on the state of persons with mental disabilities in Yaoundé, Cameroon, a discriminated and marginalized population. I completed an internship at Le Centre National de Réhabilitation des Personnes Handicapées in the special education school as a case study. There, through participant observation, simple observation and interviews as well as outside research, I gathered information regarding my research questions and hypothesis:

1. Who is responsible for the majority of persons with mental disabilities?
2. What are the affects of perceptions of persons with mental disabilities?
3. What are some possibilities for a better life and through what means?

Hypothesis: …

Situation Analysis Of Child Labour In Karachi, Pakistan: A Qualitative Study, Asaad Ahmed Nafees, Kausar S. Khan, Zafar Fatmi, Mubashir Aslam

Community Health Sciences

In Karachi, large employment opportunities, burgeoning population and the availability of cheap labour might be the contributing factors for the increasing prevalence of child labour. A literature review was conducted in 2007 that included published and unpublished literature since 2000. Various organizations working in the field were also covered, while the perception of the child labourers was covered through three focus group discussions. Common health issues among the child labourers in Karachi included respiratory illnesses, fever and generalised pains, as well as drug and sexual abuse. Organisations working for child labour could be broadly categorised into those working for legal …