Medicine and Health Sciences Commons^™

An Exploration On The Barriers To Accessing Mental Health Services Among South Asian Youth, Oeishi Faruquzzaman

Theses and Dissertations (Comprehensive)

Research in Canada and the United States has found that South Asians routinely underutilize mental health services, however research on the barriers experienced by South Asians is limited, especially research regarding the experiences of South Asian youth (Inman et al., 2014; Islam et al., 2017; Karasz et al., 2016). Through a series of semi-structured interviews (N=20) with South Asian youth between the ages 16 to 27 in the Greater Toronto Area, the present study explores South Asian youths’ experiences accessing mental health services and the impact of COVID-19 on mental health and service use. Thematic analysis of interview data reveal …

Cost Of Care For Asylum Seekers And Refugees Entering The United States: The Case Of Volunteer Medical Providers In El Paso, Texas, Rigoberto I Delgado, Manuel De La Rosa, Marlon A Picado, Lisa Ayoub-Rodriguez, Celia E Gonzalez, Leopold Gemoets

Faculty, Staff and Student Publications

BACKGROUND: Between October 2018, and February 2020, the United States saw an unprecedented increase in the number of asylum seekers and refugees arriving unexpectedly at international crossings along the US-Mexico Border. Many of these migrants needed proper medical attention, and consequently created significant pressure on local health systems. In El Paso, Texas, volunteer clinicians, collaborating closely with religious organizations and non-governmental organizations, provided outpatient medical care for the new arrivals; the county hospital provided in-patient care at local tax payers' expense. The objective of this study was to estimate costs of healthcare services offered by these volunteers in order to …

Distinguish Bipolar And Major Depressive Disorder In Adolescents Based On Multimodal Neuroimaging: Results From The Adolescent Brain Cognitive Development Stud, Yujun Liu, Kai Chen, Yangyang Luo, Jiqiu Wu, Qu Xiang, Li Peng, Jian Zhang, Weiling Zhao, Mingliang Li, Xiaobo Zhou

Faculty, Staff and Student Publications

BACKGROUND: Major depressive disorder and bipolar disorder in adolescents are prevalent and are associated with cognitive impairment, executive dysfunction, and increased mortality. Early intervention in the initial stages of major depressive disorder and bipolar disorder can significantly improve personal health.

METHODS: We collected 309 samples from the Adolescent Brain Cognitive Development study, including 116 adolescents with bipolar disorder, 64 adolescents with major depressive disorder, and 129 healthy adolescents, and employed a support vector machine to develop classification models for identification. We developed a multimodal model, which combined functional connectivity of resting-state functional magnetic resonance imaging and four anatomical measures of …

Sulfhemoglobinemia And Methemoglobinemia Following Acetaminophen Overdose, Justin A Seltzer, Irvan Bubic, Garret A Winkler, Nathan A Friedman, Jessica Bagby, Christian A Tomaszewski, Richard F Clark, Allyson Kreshak, Daniel R Lasoff

Faculty, Staff and Student Publications

INTRODUCTION: Though acetaminophen overdoses are common, acetaminophen induced methemoglobinemia is rare and it is thought to be due to oxidative stress from reactive metabolites. However, few prior cases of sulfhemoglobinemia in the setting of acetaminophen overdose have been reported. We report a case of mixed methemoglobinemia and sulfhemoglobinemia in the setting of a large, isolated acetaminophen ingestion.

CASE REPORT: A 30-year-old African American male presented after intentionally ingesting 50 tablets of 500 mg acetaminophen two days prior. He was cyanotic and tachypneic. Peripheral oxygen saturation was 78 % on room air and minimally improved with high-flow oxygen. He was noted …

Telehealth Delivery Of Acceptance And Commitment Therapy And Recreational Therapy: Supporting People With Chronic Pain During The Covid-19 Pandemic, Grace L. Roy

Honors Theses and Capstones

Chronic pain is a significant public health problem that requires person-centered and comprehensive care to address the many socioecological factors that contribute to pain. Within the context of the COVID-19 pandemic, telehealth options for chronic pain management can help more people access the care that they need. The purpose of the current pilot study was to investigate the efficacy and feasibility of delivering a 6-week Acceptance and Commitment Therapy (ACT) and recreational therapy intervention via telehealth for a group of seven participants with chronic pain. It was found that TeleACT-RT was associated with positive behavioral outcomes including increased psychological flexibility, …

Defining Patient-Level Molecular Heterogeneity In Psoriasis Vulgaris Based On Single-Cell Transcriptomics, Yale Liu, Hao Wang, Christopher Cook, Mark A Taylor, Jeffrey P North, Ashley Hailer, Yanhong Shou, Arsil Sadik, Esther Kim, Elizabeth Purdom, Jeffrey B Cheng, Raymond J Cho

Staff and Researcher Publications

Identifying genetic variation underlying human diseases establishes targets for therapeutic development and helps tailor treatments to individual patients. Large-scale transcriptomic profiling has extended the study of such molecular heterogeneity between patients to somatic tissues. However, the lower resolution of bulk RNA profiling, especially in a complex, composite tissue such as the skin, has limited its success. Here we demonstrate approaches to interrogate patient-level molecular variance in a chronic skin inflammatory disease, psoriasis vulgaris, leveraging single-cell RNA-sequencing of CD45+ cells isolated from active lesions. Highly psoriasis-specific transcriptional abnormalities display greater than average inter-individual variance, nominating them as potential sources of clinical …

Decreased Brain Ventricular Volume In Psychiatric Inpatients With Serotonin Reuptake Inhibitor Treatment, P K Bolin, S N Gosnell, K Brandel-Ankrapp, N Srinivasan, A Castellanos, R Salas

Staff and Researcher Publications

Background: Brain ventricles have been reported to be enlarged in several neuropsychiatric disorders and in aging. Whether human cerebral ventricular volume can decrease over time with psychiatric treatment is not well-studied. The aim of this study was to examine whether inpatients taking serotonin reuptake inhibitors (SRI) exhibited reductions in cerebral ventricular volume.

Methods: Psychiatric inpatients, diagnosed mainly with depression, substance use, anxiety, and personality disorders, underwent two imaging sessions (Time 1 and Time 2, approximately 4 weeks apart). FreeSurfer was used to quantify volumetric features of the brain, and ANOVA was used to analyze ventricular volume differences between Time 1 …

Turning Data Into Better Mental Health: Past, Present, And Future, Nidal Moukaddam, Akane Sano, Ramiro Salas, Zakia Hammal, Ashutosh Sabharwal

Staff and Researcher Publications

In this mini-review, we discuss the fundamentals of using technology in mental health diagnosis and tracking. We highlight those principles using two clinical concepts: (1) cravings and relapse in the context of addictive disorders and (2) anhedonia in the context of depression. This manuscript is useful for both clinicians wanting to understand the scope of technology use in psychiatry and for computer scientists and engineers wishing to assess psychiatric frameworks useful for diagnosis and treatment. The increase in smartphone ownership and internet connectivity, as well as the accelerated development of wearable devices, have made the observation and analysis of human …

A Novel Approach To Link Genetics And Human Mri Identifies Akap7-Dependent Subicular/Prefrontal Functional Connectivity As Altered In Suicidality, Guillermo Poblete, Tien Nguyen, Savannah Gosnell, Olutayo Sofela, Michelle Patriquin, Sanjay J Mathew, Alan Swann, David A Nielsen, Thomas R Kosten, Ramiro Salas

Staff and Researcher Publications

Background: Brain imaging and genetics are fields acquiring data at increasing speed, but more information does not always result in a better understanding of the underlying biology. We developed the ProcessGeneLists (PGL) approach to use genetics and mRNA gene expression data to generate regions of interest for imaging studies.

Methods: We applied PGL to past suicide attempt (ATT): We averaged the mRNA expression levels of genes (n = 130) possibly associated with ATT (p ≤ 10-3 in a published genome-wide association study, GWAS) in each brain region studied in the Human Allen Brain Atlas (6 ex-vivo brains, 158 to 946 …

Prefrontal Glutamate Neurotransmission In Ptsd: A Novel Approach To Estimate Synaptic Strength In Vivo In Humans, Lynnette A Averill, Lihong Jiang, Prerana Purohit, Anastasia Coppoli, Christopher L Averill, Jeremy Roscoe, Benjamin Kelmendi, Henk M De Feyter, Robin A De Graaf, Ralitza Gueorguieva, Gerard Sanacora, John H Krystal, Douglas L Rothman, Graeme F Mason, Chadi G Abdallah

Staff and Researcher Publications

Background: Trauma and chronic stress are believed to induce and exacerbate psychopathology by disrupting glutamate synaptic strength. However, in vivo in human methods to estimate synaptic strength are limited. In this study, we established a novel putative biomarker of glutamatergic synaptic strength, termed energy-per-cycle (EPC). Then, we used EPC to investigate the role of prefrontal neurotransmission in trauma-related psychopathology.

Methods: Healthy controls (n = 18) and patients with posttraumatic stress (PTSD; n = 16) completed 13C-acetate magnetic resonance spectroscopy (MRS) scans to estimate prefrontal EPC, which is the ratio of neuronal energetic needs per glutamate neurotransmission cycle (VTCA/VCycle).

Results: Patients …

Systematic Review Regarding The Use Of Mindfulness-Based Mobile Applications To Reduce Psychological Symptoms And Enhance Well-Being Among General And Clinical Population Adults: Benefits, Limitations And Future Directions, Brian Clawson

Theses and Dissertations

Mindfulness is now utilized throughout Western Society and is part of the growing behavioral health, self-help, and wellness movements. Mobile applications have become increasingly popular for a wide variety of uses related to physical health, mental health, and self-improvement. Therefore, mindfulness-based mobile applications have promise both as stand-alone tools for end-users seeking self-help resources and as clinician-recommended adjunctive tools to enhance the process and outcomes of professional therapy. This systematic review identified, reviewed, and synthesized the findings from studies (n = 29) concerning the impact of mindfulness-based mobile applications on specific aspects of psychological functioning in both the general population …

Interpersonal Psychotherapy For Depressed Adolescents: A Systematic Review Of Quantitative Studies Exploring Effectiveness, Concomitant Findings, And Mediating And Moderating Variables, Luke Rex

Theses and Dissertations

Depression is one of the leading causes of illness and disability among adolescents. According to the National Institute of Mental Health (2022), almost one-fifth of adolescents ages 12 to 17 years in the United States had at least one major depressive episode in 2020, representing 4.1 million people, and over half did not receive any treatment. An interpersonal approach to therapy for adolescents known as Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), developed by Dr. Laura Mufson, has been regarded as having well-established efficacy in treating depressed adolescents. This systematic review of quantitative studies (without meta-analysis) was conducted to (a) examine …

Private And Federated Deep Learning: System, Theory, And Applications For Social Good, Han Hu

Dissertations

During the past decade, drug abuse continues to accelerate towards becoming the most severe public health problem in the United States. The ability to detect drug­abuse risk behavior at a population scale, such as among the population of Twitter users, can help to monitor the trend of drug­abuse incidents. However, traditional methods do not effectively detect drug­abuse risk behavior in tweets, mainly due to the sparsity of such tweets and the noisy nature of tweets. In the first part of this dissertation work, the task of classifying tweets as containing drug­abuse risk behavior or not, is studied. Millions of public …

Acknowledgment Of Culture And Stereotypes: Black Participants’ Perceptions Of Specific Therapist Behaviors, Tsotso T. Ablorh

Graduate Masters Theses

Mental health disparities for Black people of diverse ethnicities compared to people of other racial identities has been well-documented (Alegría et al., 2008; Maura & Weisman de Mamani, 2017). Research addressing this pervasive systemic and interpersonal problem often focuses on client-related factors that create or intensify barriers to care. However clinician-related factors (i.e., racial identity, multicultural training, implicit biases, behavior, etc.) also have a significant impact on barriers to care, retention in therapy, and clinical outcomes for people of African descent (Larrison & Schoppelrey, 2011; Owen, Imel, Adelson, & Rodolfa, 2012). Researchers suggest that the favoring of historically white perspectives, …

Hiv Viral Suppression Among People Living With Hiv On Antiretroviral Therapy In Haut-Katanga And Kinshasa Provinces Of Democratic Republic Of Congo, Gulzar H. Shah, Lievain Maluantesa, Gina D. Etheredge, Kristie C. Waterfield, Osaremhen Ikhile, Roger Beni, Elodie Engetele, Astrid Mulenga

Health Policy & Community Health: Faculty Publications

Human immunodeficiency virus (HIV) infections and less-than-optimal care of people living with HIV (PLHIV) continue to challenge public health and clinical care organizations in the communities that are most impacted by HIV. In the era of evidence-based public health, it is imperative to monitor viral load (VL) in PLHIV according to global and national guidelines and assess the factors associated with variation in VL levels. Purpose: This study had two objectives—(a) to describe the levels of HIV VL in persons on antiretroviral therapy (ART), and (b) to analyze the significance of variation in VL by patients’ demographic and clinical characteristics, …

Social Media Usage And Transitioning Into Online Classes During Covid-19- A Survey Of Undergraduate Students In Georgia, United States, Sylvia Ofori, Janet Choongo, Mario Kekop, Gulzar H. Shah, Haresh Rochani, Joseph Telfair

Health Policy & Community Health: Faculty Publications

Previous studies on the use of social media (SM) during the COVID-19 pandemic have focused on the use in sustaining academic communication. This study aimed to assess the association between SM and the ease of transitioning to online classes during the COVID-19 pandemic using survey data from 872 undergraduate students. The findings showed that Snapchat and Instagram were the most preferred social media sites among participants. Compared to students who use SM for < 2 hours a day, use for > 5 hours (AOR= 2.44; 95% CI, 1.13 – 5.25) or 3 to 5 hours a day (AOR = 2.01, 95% CI 1.06-3.81) increased the odds of easily …

Developing A Community-Based Rehabilitation Programs In Elderly Nursing Home: A Brief Descriptive Analysis, Melinda Harini, Dosmaria Dosmaria, Herry Herry, Lisa Emilda, Listyani Herman, Nelfidayani Nelfidayani, Putu K. Mahardini, Shynta D. Hantogo, Widya Meiliana, Ikhsan Johnson, Peggy Peggy, Wanarani Aries, Widjajalaksmi Kusumaningsih, Luh K. Wahyuni

ASEAN Journal of Community Engagement

The need for rehabilitation services in nursing homes (NH) for the elderly is increasing each year, and this need is fulfilled both with ordinary clinical rehabilitation center visits, as well as community-based rehabilitation (CBR) inside the facility. However, a proper situation analysis is needed to establish a well-delivered CBR program in the NH, a niche to be fulfilled in this study. This study used a descriptive measurement and cross-sectional design to target the elderly who are living in the NHs. Consecutive sampling was done in the largest NH in Jakarta, in Cipayung District. Participants who were dependently ambulated were assessed …

Depression And Behavioral Changes Associated With Social Media Dependency During Covid-19 Pandemic Among University Students In Bangladesh: A Cross- Sectional Study, Sushmita Karmokar, Md. Ashraful Islam, Mohammad Hamid Al Muktadir, Rakibul Hasan, Abu Montakim Tareq, Mohammad Nurul Amin, Talha Bin Emran

Makara Journal of Health Research

Background: With its rapid spread, the coronavirus disease 2019 (COVID-19) pandemic had a detrimental effect on students’ psychological well-being, depression, and behavioral changes due to indefinite educational leaves, lockdowns, restricted outdoor activities, and excess use of social media. This study aims to assess the relationship of social media exposure with the psychological well-being, depression, and behavioral changes of Bangladeshi university students.

Methods: A web-based cross-sectional survey was carried out on 530 students from June 17 to July 10, 2020, to evaluate psychological well-being, depression, behavioral changes, and social media exposure via self-reported measures.

Results: The prevalence of …

An Investigation Into Caffeine Consumption And Self-Reported Dependency In The Republic Of Ireland, Gavin Buckley, Ciara Murphy, Nora O'Sullivan, Róisín Spriggs

International Undergraduate Journal of Health Sciences

Objectives: To explore the consumption of caffeine containing beverages by the Irish population and to investigate their self-perceived dependency on such products.

Methodology: An online survey was distributed with national access to Irish adults which was open to responses from 25^th February to 7^th March 2021 inclusive. A total of 417 responses from participants over 18 years of age were validated and analysed using Microsoft Excel.

Results: Tea was the most commonly consumed caffeinated product among the Irish population, with the majority of respondents stating their consumption began before 10 years old. The majority of respondents did not …

Exploration On High School Students’ Grit: Its Effects On The Students’ Potential Development, Ahmad Yudiar, Eka Sakti Yudha, Sartono Sartono

Jurnal Kajian Bimbingan dan Konseling

The education process in Indonesia has been implemented using a variety of modern tools, but it should be understood that the quality of learning activities in the classroom is also influenced by the interactions that occur in the classroom. Teachers must understand that to create interaction in the classroom, they must first understand the grit level that can help make learning fun. The purpose of this study was to determine the grit level of high school students in Bangka Belitung Province, Indonesia. This research is survey research conducted in Bangka Belitung Province and involves 770 respondents. The results showed that …

College Students’ Academic Procrastination During The Covid-19 Pandemic: Focusing On Academic Achievement, Abd Basith, Md Shahinoor Rahman, Usina Robert Moseki

Jurnal Kajian Bimbingan dan Konseling

This research aims to describe the level of college students’ academic procrastination, analyze differences in academic procrastination among the college students, and analyze the relationship between academic procrastination and academic achievement. This research uses a quantitative method with a survey and correlational design. The research population is 620 Sekolah Tinggi Keguruan dan Ilmu Pendidikan Singkawang (STKIP) Singkawang college students. The sample is taken using a simple random sampling technique as many as 352 college students (76 male and 276 female). The instrument used in data collection is the academic procrastination scale and great point academic. The data are analyzed using …

Indonesian Adaptation Of The Multicultural School Counseling Behavior Scale, Endang Rifani, Munik Yuni Artika, Indrajati Kunwijaya, Haris Yuftika Hani

Jurnal Kajian Bimbingan dan Konseling

School counselors should possess multicultural competence as an important aspect in the implementation of guidance and counseling services. Counseling services require school counselors to empower students who have different cultural backgrounds from theirs. The Multicultural School Counseling Behavior Scale (MSCBS) is a scale to measure the school counselors’ multicultural competence represented by their attitudes and behavior in implementing guidance and counseling services in schools. This study aims to adapt the MSCBS into Indonesian, considering the limited multicultural competency measuring tool for school counselors that includes the attitudes and behavior of school counselors in counseling. The research subjects were 257 junior …

Developing Specialization Model Applications For High School Students, Agus Triyanto, Septinda Rima Dewanti, Widya Juwita Sari

Jurnal Kajian Bimbingan dan Konseling

This study aims to produce a model application of specialization for the majors of high school students. The research method used is the Borg and Gall development research method. The research procedure was carried out by conducting a literature review and preliminary study, planning, developing, validating, revising, testing on research subjects, revising, and finalizing and socializing the application specialization model. The research instrument used is a rating scale. Data analysis was carried out by averaging expert judgments on applying the specialization model that had been developed. In addition, data were also obtained from the results of student interest. The expert …

The Effectiveness Of Solution-Focused Brief Therapy To Reduce Generation Z Anxiety In The Age Of Disruption, Rizqi Lestari, Budi Astuti

Jurnal Kajian Bimbingan dan Konseling

Generation Z’s use of technology inevitably allows them to get a lot of information from all over the world. Excessive information that has not been verified can cause anxiety. This study aims to determine the effectiveness of the solution-focused brief therapy approach to reducing anxiety experienced by Generation Z in the era of disruption. This research is an experimental research type of single-subject research. The research subjects were three counselees who were selected using purposive sampling with the initials NI, TS, and WD. The data collection technique in this study was obtained based on the self-assessment sheet that was conducted …

I Am Tired Of Teaching: Relationship Between Teachers’ Boredom And Their Psychological Disorders During Covid-19 Pandemic, Imam Ariffudin, Ajeng Intan Nur Rahmawati

Jurnal Kajian Bimbingan dan Konseling

The continuous practice of online learning potentially carries boredom and negative effects on teachers’ psychology. This study investigates the effects of boredom on teachers’ psychological disorders during online learning. This correlational study used an explanatory design, involving 113 teachers from different educational levels (junior, senior, and vocational schools) in Malang, Indonesia. The participants were selected through cluster random sampling technique. The data collection process was carried out using two standardized instruments, the DASS 21 (Depression, Anxiety, and Stress Scale) and ABS-10 (Academic Boredom Scale). The obtained data were analyzed using correlation and linear regression analysis to examine the relationship and …

A Cross-Sectional Survey Of Potential Factors, Motivations, And Barriers Influencing Research Participation And Retention Among People Who Use Drugs In The Rural Usa, Angela T. Hetrick, April M. Young, Miriam R. Elman, Sarann Bielavitz, Rhonda L. Alexander, Morgan Brown, Elizabeth Needham Waddell, P. Todd Korthuis, Kathryn E. Lancaster

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: Despite high morbidity and mortality among people who use drugs (PWUD) in rural America, most research is conducted within urban areas. Our objective was to describe influencing factors, motivations, and barriers to research participation and retention among rural PWUD.

METHODS: We recruited 255 eligible participants from community outreach and community-based, epidemiologic research cohorts from April to July 2019 to participate in a cross-sectional survey. Eligible participants reported opioid or injection drug use to get high within 30 days and resided in high-needs rural counties in Oregon, Kentucky, and Ohio. We aggregated response rankings to identify salient influences, motivations, and …

The Resilience Vaccine, Sara Horton-Deutch T. Duffy

Master's Projects and Capstones

Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.

This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …

Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this study is to develop and implement a de-escalation toolkit to help improve memory, retention, and utility of de-escalation techniques within an outpatient mental health crisis stabilization unit.

Problem: The aforementioned crisis stabilization unit has elevated rates of patient aggression/violence and staff present with difficulty recalling de-escalation techniques due to the lapse in memory and/or retention.

Methods: The project was introduced to the stakeholders of the crisis stabilization unit and input was obtained on the design and components of the toolkit. Various analyses were conducted to ensure the appropriate implementation of the project.

Intervention: A de-escalation …

Implementation Of A Mental Health Environmental Risk Assessment Tool, Alan Le

Doctor of Nursing Practice (DNP) Projects

Background: Patient suicide is a serious safety issue, especially in mental health settings since suicides disproportionately affect psychiatric patients. Environmental hazards are a primary contributing factor in patient suicide cases.

Problem: Mental health staff may lack tools and training to perform proper environmental risk assessments, which is the case at a psychiatric crisis residential center in northern California that utilized no environmental risk assessment tool.

Methods: An environmental risk assessment tool was implemented at the site for four months to increase staff confidence, ability to identify hazards and decrease risk of patient suicides.

Interventions: The Suicide and …

Optimizing Postpartum Care By Ongoing Care Coordination Initiatives (Cci) In Screening And Management Of Postpartum Depression (Ppd) Among Clients In An Obgyn Practice: A Quality Improvement Project., Jennifer Broussard

Doctor of Nursing Practice (DNP) Manuscripts

Background: Postpartum depression (PPD) is defined as physical, emotional, and behavioral changes that occur after the birth of a child. Postpartum depression is complex and a mix of physical, emotional, and behavioral changes (Cleveland Medical Clinic, 2018). Postpartum depression screening is of high importance at a comprehensive postpartum visit. The consequences of a patient suffering postpartum depression can be serious and early recognition and interventions improve outcomes for the patient as well as the infant. Problem: There is a lack of screening for PPD among postpartum clients and this period is critical for the mother and the infant (American College …