Medicine and Health Sciences Commons^™

Investigating The Impact Of Phthalate Exposures From Personal Care Products On Uterine Fibroid Incidence And Prevalence In Us-Born Black Women, Ella Brissett

CMC Senior Theses

Uterine fibroids are benign tumors composed of smooth muscle cells and connective tissue that develop within or on the walls of the uterus. Despite being non-cancerous, they can severely affect quality of life by causing heavy bleeding, chronic pain, and reproductive complications. Fibroids are typically found in women of reproductive age, but they disproportionately affect Black women, who experience higher incidence and severity. The underlying causes of this disparity is poorly understood; however, an emerging body of research is highlighting the role of phthalates, endocrine-disrupting chemicals found in many personal care products, in exacerbating fibroid development. Through a critical analysis …

Essential Caretaking For Artists With Disabilities: Exploring The Overlooked Histories Of Hazel Knapp And Grandma Moses, Bryan P. Martin

Dissertations and Theses

This thesis explores the intersection of disability studies and art history, addressing the underrepresentation of disability in scholarship, especially concerning medical sociology and caretaking. Focusing on two early-twentieth-century self-taught American artists, Hazel Knapp (1908–95), who fell into obscurity, and Anna Mary Robertson Moses (1860–1961), best known as Grandma Moses, this is a comparative analysis of how disability influenced their artistic practices and shaped their divergent career outcomes. Knapp was born with Charcot-Marie-Tooth disease, a neurodegenerative disorder, and fell into obscurity due to a lack of support for her condition, but experienced a promising start to her career that included patronage …

Exploring The Impact Of Covid-19 And The Role Of The Church On African Americans’ Mental Well-Being In South Georgia, Adrian D. Lewis

College of Graduate Studies: Theses & Dissertations

The emergence of COVID-19 in 2020 disrupted the social dynamics of communities in the United States. Furthermore, public health mandates led to closures that changed how populations access faith. Historically, African Americans have utilized the church to cope with societal stressors. This study will explore the history of church utilization in the African American community, assess how COVID-19 public health mandates led to church closures for the first time in recent history and impacted this marginalized population, and provide a qualitative perspective on the quality of life during the closures and what changed after the closures for African Americans in …

On! Original Flavor Oral Nicotine Pouch Characterization: Biorelevant In Vitro Nicotine Release Apparatus Assessment, Jason C. Funderburk, Melissa Morgan, Maria Lasaosa Garcia, Andreas S. L. Mendez, Matthew S. Halquist

Graduate Research Posters

Background: Oral nicotine pouch (ONP) use is rising. The sales of ONPs in 2019 were 126 million units, increasing to 808 million units in 2022. Understanding ONP in vitro release is critical for assessing exposure to ONP products.

Methods: The commercial brand ON! ONPs with nicotine label claims of 2, 4, and 8 mg, were evaluated in vitro for cumulative nicotine release using the bidirectional transmucosal apparatus (BTA) for 90 minutes. Nicotine quantification was performed by HPLC-PDA. For pH determination, ONP samples were prepared in water or artificial saliva (pH 6.8) with measurements for 30 minutes. BTA results were compared …

Hypnosis: An Evidenced Based Treatment, Gregory P. Brown

Psychiatry & Behavioral Health Faculty Research

Review of meta analyses and systemic review level studies of hypnosis in the treatment of anxiety, burnout, and depression.

Prevalence Of Depression And Its Coping Strategies Among Rural And Urban Geriatric Population, Mohit Negi, Smitha M C

Digital Journal of Clinical Medicine

Background: Aging is a natural process, and older age is a period in which most aspects of life require support from others. Globally, Depression is a serious public health concern among elderly populations. The aim of this study was to estimate the prevalence of depression and its coping strategies among geriatric population and to evaluate the association between socio-demographic factors and level of depression.

Methods: A cross-sectional study was conducted among 410 study participants in both rural and urban areas. Geriatric Depression Scale (GDS-15) was used to measure the depression and brief-COPE (28-items) scale was used to measure the coping …

Myocardial Infarction Trends Following Covid-19 Vaccination: A Retrospective Investigation From India, Hema S. Pinnam, Hrithika Madhavan, Jagarlamudi Harshitha, Vikram Patil, Harshita Tiwari, Isha A. Kumthekar, Jampala Sri Mounya

Digital Journal of Clinical Medicine

Background: The relationship between COVID-19 vaccination and the incidence of myocardial infarction remains a topic of debate. The study aimed to analyze the demographic, clinical, and outcome characteristics of MI patients post-vaccination in India, focusing on differences between Covishield and Covaxin recipients.

Methods: The retrospective observational study included 303 MI patients admitted to a tertiary care center. Data were collected on demographics, comorbidities, vaccination status, ICU admissions, and outcomes. The Charlson Comorbidity Index (CCI) was used to assess disease severity. Statistical analyses evaluated the associations between vaccination status, clinical parameters, and mortality.

Results: Among the study population, 74.3% were males, …

Establishing Psychiatry Clubs: Novel Approach To Enhance Psychiatry Teaching Learning In India, Akuti Khanna, Kishor M

Digital Journal of Clinical Medicine

Despite the fact that over 150 million Indians suffer from psychiatric disorders, the country faces a severe shortage of mental health professionals, with less than 1,300 psychiatrists graduating annually. One such solution is the establishment of Psychiatry Clubs in medical colleges, which can significantly enhance awareness, education, and community engagement in mental health. The Psychiatry Club at JSS Medical College, Mysuru, established on October 10, 2023, aims to promote mental well-being, provide peer support, as well as foster professional development through workshops, seminars, and collaborations with other mental health professionals and other student led organisations. These clubs offer a sustainable …

Assessment Of Effectiveness And Evaluation Of Perception Among Students Towards Flipped Classroom Learning: A Prospective Study., Nagaraja Prasad Sai, Vedavathi Hanumaiah, Shreenivas Prabhakar Revankar, Shruthi S. Lingesh, Avanthi Eshwar

Digital Journal of Clinical Medicine

BACKGROUND: Flipped learning (FL) is a teaching learning approach in andragogy. In FL students are involved in self-directed learning with the teacher acting as a facilitator and a moderator. Introduction of Competency Based Medical Education led many educators to shift from traditional teaching to blended teaching learning methods. This study was conducted to assess effectiveness and evaluate students’ perception towards FL.

AIM AND OBJECTIVES: To assess effectiveness of FL teaching in improvement of student scores and to evaluate student’s perception towards FL teaching.

MATERIALS AND METHODS: Pre-class activities included study materials in the form of PowerPoint slides …

Changing Climate, Changing Health: Perspectives From General Population In Mysuru, Lekhashree A, Manirsha P V, Paranthaman Chinnasamy, Srishti Arya, Sunil Kumar D

Digital Journal of Clinical Medicine

Background: Climate change has emerged as a major public health concern, contributing to rising morbidity and mortality worldwide. In India, increasing heat waves, unpredictable rainfall, and deteriorating air quality have intensified climate-sensitive health conditions. This study aims to assess the health impacts of climate change among the general population of Mysuru.

Methodology: A community-based cross-sectional study was conducted among 400 residents of Mysuru (April–June 2024). Participants were recruited through simple random sampling. Data were collected using a pre-tested semi-structured questionnaire via Google Forms. Analysis was performed using SPSS v26, with descriptive and inferential statistics.

Results: Among 400 participants, …

A Cross-Sectional Study Of The Correlation Between Working Models, Work-Life Balance And Psychological Distress In It Professionals In An Urban Setting., Neeharika Krishna Kumar, Ponnammal Sundar Lakshmi, Vathsalya S. Gowda, Kshamaa Haradanahalli Giriprakash, Manju Aswath

Digital Journal of Clinical Medicine

Background: India makes up more than 19% of the global Information Technology (IT) Market. The health and well-being of the population employed in this sector will affect their productivity at work and, in turn, the economic outcome. Changes in working models and altered work-life balance can lead to increased distress in IT Professionals, hence the current study.

Methodology: The current cross-sectional descriptive study assessed 247 IT professionals. A semi-structured questionnaire was used for socio-demographic details, working models and work-life balance. Kessler Psychological Distress Scale (K10) Plus was used to assess psychological distress. Statistics and correlations were done using SPSS 20. …

A Study Of Electrocardiogram And Echocardiography Parameters Of Post Covid – 19 Patients, Venkateswararao K, Durga Prasad Sadhupati

Digital Journal of Clinical Medicine

Background: Coronavirus Disease – 2019 [COVID-19] infection is multisystem disease not restricted to the lungs it has negative impact on Cardiovascular system by activation of ACE-2 receptors causing plaque stability, vascular inflammation and MI. ECG and 2D ECHO is a simple bed side diagnostic test can be used to assess cardiovascular disease involvement in such patients. We aimed to find out ECG and 2D ECHO abnormalities of Covid – 19 patients. To Study relation of SARS-COV-2 infection and Prevalence of Cardiovascular disease.

Methods: We perform Cross Sectional study among 500 Post Covid – 19 patients [>20 and

Results: Out …

Subclinical Myocardial Disease: The Next Frontier In Cardiovascular Prevention., Param Darpan Sheth, Chandana S., Nimrah Rehman

Digital Journal of Clinical Medicine

Subclinical myocardial disease refers to pathological cardiac changes that precede overt symptoms. It represents an emerging frontier in cardiovascular disease prevention; wherein early detection of myocardial dysfunction could allow timely intervention to avert heart failure (HF) and other outcomes. This narrative review summarizes the current and emerging tools for detecting subclinical myocardial disease, including advanced cardiac imaging and circulating biomarkers, and discusses their potential to improve risk stratification and preventive care in asymptomatic high-risk individuals. Novel echocardiographic measures such as global longitudinal strain (GLS) can unmask subtle systolic dysfunction despite preserved ejection fraction, while cardiac magnetic resonance (CMR) tissue mapping …

Comparison Of Transversus Abdominis Plane Block Versus Intrathecal Clonidine In Lower Segment Caesarean Section - A Prospective Observational Study, Christy Maria Paul, Dr Somsundar R G Associate Professor, Dr Archana B N Assistant Professor, Dr. Shivakumar G Pofessor And Hod

Digital Journal of Clinical Medicine

Comparison of Transversus Abdominis Plane Block versus Intrathecal Clonidine in Lower Segment Caesarean Section - A Prospective Observational Study

Background and Objective: In the majority of abdominal procedures, transverse abdominis plane block, one of the fascial plane blocks, has been used extensively to treat post-operative pain. Ultrasound has gained popularity in the management of cesarean patients due to its ease of use and reduced adverse effects.To assess the effectiveness of ultrasound guided transverse abdominus plane block with intrathecal clonidine for post surgical pain control in lower segment cesarean patients.

Material and Methods: This prospective observational study was done in …

Yoga As A Self-Care Practice For Mental Health Counselors Who Treat Trauma, Kari Michelle Fitzgerald

Graduate Research Theses & Dissertations

Given the high rates of burnout and compassion fatigue among trauma-exposed counselors, understanding effective self-care practices is critical for sustaining clinical effectiveness and well-being. Utilizing Interpretative Phenomenological Analysis (IPA), exploration of the lived experiences of licensed mental health counselors who treat trauma and use yoga as a self-care practice was conducted. Eight participants who were regular yoga practitioners each participated in one semi-structured interview and submitted one pre- and one post-interview reflective journal entry. Thematic analysis was used to identify six major themes; 1) emotional impact and sacred responsibility of clinical work, 2) yoga as a regulating and restorative practice, …

To Be Soft Again: A Phenomenological Study Of Uncertainty And Resilience In Childbearing During The Covid-19 Pandemic, Marcianna Nosek

Nursing and Health Professions Faculty Research and Publications

Background:

During the COVID-19 pandemic, uncertainty was exacerbated in experiences of pregnancy and childbirth as people navigated through uncharted territory. Building resilience may be one effective way to cope. However, for those who carry a heavier burden in upholding others, a societal expectation of “toughness” and the ability to endure may lead to an appearance of resilience, while on the inside, well-being may be compromised.

Objectives:

This study is part of a larger phenomenological study that explored the broad research question: What is the lived experience of childbearing during the COVID-19 pandemic? Specific themes of uncertainty and resilience are reported …

Association Between Trust In The Incumbent President And Covid-19 Preventive Behaviors During The Pandemic In Four Latin American Countries, Juliana Mejía-Grueso, Gloria Isabel Niño-Cruz, Javiera Alarcón-Aguilar, Pablo Roa-Urrutia, Sergio Mauricio Moreno-López, Adriano Akira Ferreira Hino, Alexandre Augusto De Paula Da Silva, Fernando López, Deborah Salvo, Rodrigo Siqueira Reis, Guillermo Rosas, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

The COVID-19 pandemic revealed disparities in policy responses in Latin America. We examined the association between trust in the president and COVID-19 preventive behaviors in Brazil, Chile, Colombia, and Mexico. We used data from the Collaborative COVID-19 Response Survey by the McDonnell Academy at Washington University in St. Louis (United States), from September 2020 to March 2021. Nonprobabilistic sampling included adult citizens from the four countries. Multivariate negative binomial regression models were applied. The study included 8,125 participants, with Brazil showing the lowest adherence to preventive behaviors (65.5%). Increased adoption of preventive behaviors was linked with ages 18-26 (aIRR = …

Influence Of Multi-Species Data On Gene-Disease Associations In Substance Use Disorder Using Random Walk With Restart Models, Erich J. Baker, Everest U. Castaneda, Sharon Moore, Jason A. Bubier, Stephen K. Grady, Michael A. Langston, Elissa J. Chessler

Funded Scholarship

A major challenge lies in discovering, emphasizing, and characterizing human gene-disease and gene-gene associations. The limitations of data on the role of human gene products in substance use disorder (SUD) makes it challenging to transition from genetic associations to actionable insights. The integration of data from multiple diverse sources, including information-dense studies in model organisms, has the potential to address this gap. We demonstrate a modified performance of the Random Walk with Restart algorithm when multi-species data is integrated in the heterogeneous network within the context of SUD. Additionally, our approach distinguishes among disparate pathways derived from the Kyoto Encyclopedia …

Using Mindfulness To Manage Moral Injury In Veterans: Feasibility And Satisfaction Of A Pilot Randomized Controlled Trial, Michelle L. Kelley, Adrian J. Bravo, Elizabeth E. Burgin, Susan A. Gaylord, Christine Vinci, Megan Strowger, Jeffrey M. Gabelmann, Joseph M. Currier

Psychology Faculty Publications

Objective

The present study assessed program feasibility and satisfaction among recent-era veterans who participated in Mindfulness to Manage Moral Injury (MMMI), a live facilitated web-based 7-week mindfulness-based program targeting moral injury among veterans.

Method

In total, 56 post-9/11 veterans were recruited with 28 randomized to the MMMI condition and 28 to the Education and Support (ES) condition. Most participants identified as being White (71.4%), male (66.1%), and had a reported mean age of 41.50 years (Median = 39.50, SD = 9.26).

Results

Among the 56 participants, 82.1% attended at least one treatment session and 44.6% completed all seven sessions. There …

Check Your Data Before You Wreck Your Model: The Impact Of Careless Responding On Substance Use Data Quality, Abby L. Braitman, Anna M. Petrey, Jennifer L. Shipley, Rachel Ayala Guzman, Emily Renzoni, Alison Looby, Adrian J. Bravo

Psychology Faculty Publications

Background: The accuracy of survey responses is a concern in research data quality, especially in college student samples. However, examination of the impact of removing participants from analyses who respond inaccurately or carelessly is warranted given the potential for loss of information or sample diversity. This study aimed to understand if careless responding varies across a number of demographic indices, substance use behaviors, and the timing of survey completion.

Method: College students (N = 5809; 70.7% female; 75.7% White, non-Hispanic) enrolled in psychology classes from six universities completed an online survey assessing a variety of demographic and substance use-related information, …

Psychometric Evaluation Of A Novel Measure Of Trauma-Related Cannabis Use To Cope, Sage E. Hawn, Terrell A. Hicks, Christopher Latourrette, Anita Thomas, Daniela Chaname, Sarah Ehlke, Abigail Powers Lott

Psychology Faculty Publications

Background: Posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) are commonly comorbid and are associated with many negative public health outcomes. One plausible explanation for this comorbidity comes from a self-medication framework, which suggests people use cannabis to cope with PTSD symptoms. Despite theoretical and empirical evidence for PTSD-related cannabis use to cope, no measure of this construct exists.

Objective: We sought to address this gap by developing and validating a novel measure of PTSD-specific cannabis self-medication, which we have termed the Trauma-Related Cannabis Use to Cope (TRCU) questionnaire.

Method: The psychometric properties of the TRCU and how it …

Family Stress Processes Underlying Covid-19-Related Economic Insecurity For Mothers And Fathers And Children's Internalizing Behavior Problems, Joyce Y. Lee, Shawna J. Lee, Sehun Oh, Amy Xu, Angelise Radney, Christina M. Rodriguez

Psychology Faculty Publications

COVID‐19 and its economic fallout have resulted in unprecedented financial insecurity and material hardship for many American families, with a disproportionately negative impact on children and families from socioeconomically disadvantaged contexts. The current study applied the family stress model to examine the family processes underlying pandemic‐related economic insecurity and children's internalizing behaviours. Online survey data from an economically diverse sample of mothers and fathers, who experienced at least one type of pandemic‐related economic insecurity in the United States (N = 259), were collected across two longitudinal time points in the early weeks of COVID‐19: (1) 14 April and (2) 30 …

Identifying Salient Social, Environmental, And Situational Contexts Of College Drinking: Impacts Across Drinking Outcomes, Abby L. Braitman, Jennifer L. Shipley, Megan Strowger, Emily S. Renzoni

Psychology Faculty Publications

Background and Objectives: Drinking context, such as where, why, and under what social conditions drinking occurs, is consistently associated with daily variability in alcohol use. However, ecological momentary assessment (EMA) requires very brief measurement, not allowing for as many contextual assessments as researchers may like. The current investigation examined common contextual predictors and their associations with different alcohol outcomes.

Methods: A sample of N=528 college drinkers completed three surveys about their most recent drinking episode. This included contextual predictors (location, social context, who was present, alcohol offers, and drinking motives), as well as typical drinking outcomes (number of drinks, estimated …

Evaluation Of A 20-Item Version Of The Trauma-Related Drinking To Cope Questionnaire, Sage E. Hawn, Lauren Smith, Kaytlin Armitage, Selah Ball, Cathy Lau-Barraco, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Objectives: This study sought to develop and psychometrically evaluate an expanded version of the Trauma-Related Drinking to Cope (TRD) scale, a four-item self-report tool, which was developed to address a crucial gap in self-medication research. Before the development of the TRD, no measures existed which assessed alcohol use for coping with symptoms of posttraumatic stress disorder (PTSD) specifically. Previous work showed that the TRD has strong psychometric properties and clinical utility in its ability to identify individuals with PTSD who may be at risk for developing comorbid alcohol use disorder (AUD). The aim of the present study was to develop …

Understanding The "Paradox" In Black-White Alcohol Outcomes: Examining High-Effort Coping And Health Behaviors With A Focus On Black Populations And College Students, Rachel Ayala Guzman, Abby L. Braitman

Psychology Faculty Publications

Despite experiencing more physical health disadvantages and psychosocial stressors, Black Americans consistently report better mental health outcomes compared to White Americans—a phenomenon commonly referred to as the Black-White health paradox. Alcohol research has identified another racial paradox suggesting Black Americans are at greater risk for alcohol-related problems despite drinking less than White Americans, which is known as the Black-White alcohol paradox. While both paradoxes are well-documented, few studies have examined their potential overlap or how insights from one might inform understanding of the other. Although the alcohol paradox is usually examined among older adults, it may be important to consider …

Drinking Motives And Alcohol Sensitivity Mediate Multidimensional Genetic Influences On Alcohol Use Behaviors, Jeanne E. Savage, Spit For Science Working Group, Danielle M. Dick

Psychology Faculty Publications

Background

Genetic influences account for a substantial proportion of individual differences in alcohol use behaviors (AUBs). However, multiple distinct sets of genes are linked to different AUBs via uncertain causal links. Here, we explore whether intermediate neurobiological traits mediate the relationship between polygenic scores (PGSs) and multiple AUBs, with the aim to better understand processes captured by different genetic profiles.

Methods

We derived four alcohol-related PGSs in participants from Spit for Science, a longitudinal study of college students in the United States (n=4549). Using linear regression, we tested the relationship between PGSs and 22 potential mediators, including personality, …

The Impact Of Socioeconomic Status On Substance Use Amongst The Hispanic Maternal Population, Emily C. Olivo

Honors Undergraduate Theses

Aim: To explore and synthesize existing research that focuses on the relationship between socioeconomic status and the use of substances amongst the maternal Hispanic population. By examining research and these factors, interventions can be identified to lower reported substance use rates amongst Hispanic mothers of childbearing ages.

Background: Minorities such as Hispanic women deal with a myriad of struggles, especially during motherhood. Socioeconomic status and substance use can contribute to a large part of the struggles faced by this population. Hispanic and Latina will be used interchangeably throughout this review of literature.

Method: A comprehensive electronic review of 3 databases …

Organization And Activation Of Caffeine Expectancies, Catherine S. Forsyth

Honors Undergraduate Theses

Caffeine is the most consumed and widely used psychoactive substance in the world. Whether someone uses caffeine or not, expectations about use can be influential to some degree. Expectancies exist everywhere and are extremely influential in all aspects of life. Regarding drug use, expectancies can affect behavior, outcomes, and one’s experience with the drug. Caffeine is no exception, caffeine expectancies have been seen to play a role in several actions such as the development, maintenance, and reinforcement of caffeine use. This study examined latent use profiles of caffeine and relationships between the profiles and the activation of caffeine expectancies. Multidimensional …

Assessing The Relationship Between Perceived Psychological And Physical Pain In Adults With Orthopedic Pain, Daniel C. Karimi Dehkordi

Honors Undergraduate Theses

Suicide remains a public health concern in the U.S., particularly among individuals experiencing chronic pain and psychological distress. This cross-sectional study investigated the relationship between perceived physical and psychological pain in 41 adults with chronic orthopedic conditions. The relationship between other risk and protective factors and perceived levels of pain distress was also examined. Results showed a significant positive correlation between psychological distress and physical pain (r(39) = 0.388, p < .05) and psychological distress and depressive/anxiety symptoms (r (39) = 0.477, p < .01). Psychological distress was moderately associated with feelings of hopelessness (r (39) = 0.403, p < .01), however, the relationship between physical pain and hopelessness was weak and nonsignificant (r (39) = -0.06, p = .71). Contrary to expectations, emotional support did not buffer the effects of psychological distress (r (39) = 0.07, p = 0.66). Mediational analysis confirmed that emotional support did not influence the relationship between physical pain and psychological distress (Beta (β) = -0.969, p = 0.572; Sobel Z = 0.5598, p = 0.575). Age was not correlated with psychological distress (r (39) = -0.24, p = 0.13) or mental health symptoms (r (39) = -0.05, p = .77). While there was no significant difference across sex, males reported higher mental health symptomatology and psychological distress scores than female counterparts. These findings underscore the direct impact of physical pain on psychological distress and challenge assumptions about the protective role of social support. The study highlights the need for integrated, multidisciplinary interventions targeting both physical and psychological pain to mitigate suicide risk among individuals with chronic orthopedic conditions. Future research should iii explore alternative support mechanisms and resilience-building strategies to address the complex interplay of pain, distress, and suicidality.

The Intersection Of Autism Spectrum Disorder And Mental Health: A Focus On College Students, Sudeepta Matha

Honors Undergraduate Theses

Rising prevalence rates of autism spectrum disorder (ASD), changes in diagnostic criteria, and increased public awareness have all contributed to the growing population of college students with ASD. However, many individuals - commonly referred to as the “lost generation” - go undiagnosed, due to experiencing negative interactions with mental health professionals. As a result, these individuals are not given the proper support and interventions required for a successful transition into adulthood, and often face heightened social isolation, academic problems, mental health challenges compared to their neurotypical peers. A combination of these factors can lead to increased suicidal ideation (SI) and …