Medicine and Health Sciences Commons^™

The Quest For Self: Using Mandala Art In Reflective Practice Journaling, Kathleen Quinn

Comparative Woman

This article is a nexus of research, personal journaling reflections, and mandala creation from the authors own journals and focuses on the use of Mandalas as part of a reflective practice journaling process. Attention to mandala usage within reflective practice considering depth interiority, engaging and sharing with others. The authors approach to mandala construction is included followed by an exercise for observation and assessment of mandalas. The structure for reflective practice helps shape transformational leaders, using expressive arts, narratives in journaling. This transformational Discovery pathway and narrative exercises can be used for creating professional learning communities. This form of reflective …

As A Pediatrician, I Don’T Know The Second, Third, Or Fourth Thing To Do: A Qualitative Study Of Pediatric Residents’ Training And Experiences In Behavioral Health, Rachel Petts Phd, Jeffrey D. Shahidullah Phd, Paul W. Kettlewell Phd, Kathryn A. Dehart Md, Kris Rooney Md, Ilene G. Ladd Ms, Tyler Bogaczyk Bs, Sharon L. Larson Phd

International Journal of Health Sciences Education

Despite a mandated 1-month rotation in developmental-behavioral pediatrics (DBP), pediatric residents report inadequate training in behavioral health care. As a first step in much needed curriculum development in this area, this study sought to assess learner experiences regarding the management of behavioral health problems during residency. Four focus groups were conducted for residents in years 1-3 of training in 2 residency programs in a northeastern state. Transcripts were analyzed and coded by researchers through qualitative classical content analysis. The exploratory analysis revealed 9 key themes: time requirements, rapport building, resources and referrals for behavioral health, psychiatric medications, diagnosis vs. treatment, …

Treating Comorbid Ptsd And Bpd: A Dialectical Approach, Meredith Pescatello

Intuition: The BYU Undergraduate Journal of Psychology

According to the Biosocial Developmental Model for Borderline Personality Disorder (BPD), individuals with a biological vulnerability (i.e., heightened emotional sensitivity and impulsive tendencies), plus an invalidating environment may develop BPD (Crowell, Beauchaine, & Linehan, 2009). Individuals with BPD are especially difficult to treat, because of their “extreme emotional, behavioral, and cognitive dysregulation” (Crowell, Beauchaine, & Linehan, 2009). Though challenging to treat, BPD can be successfully treated using Dialectical Behavior Therapy (DBT) (Linehan, 1993; Linehan 2015). Similarly, Posttraumatic Stress Disorder (PTSD) is complex and often burnout inducing to treat, because of the intensity of the emotional content related to traumatic events …

Ethical Implications Of Treatment For Gender Dysphoria In Youth, Kelsey Hayes

Journal of Health Ethics

This manuscript explores ethical implications on treatment for youth with diagnosed gender dysphoria. The ethical considerations outlined and analyzed in this essay involve illuminating an understanding of whether the administration of pubertal suppression with GnRH agonists, and cross-sex hormones to children with gender dysphoria is morally justified as treatment to manage their psychological distress, or if safer more understood alternatives exist. This essay emphasizes that as health care professionals we must ensure youth with gender dysphoria receive adequate medical treatment and care however, this essay concludes through extensive literature review, that the use of inconclusive and under researched methods to …

Involuntary Termination From Substance Use Disorder Treatment: Unknown Phantoms, Red Flags, And Unexplained Medical Data, Izaak L. Williams

Journal of Human Services: Training, Research, and Practice

In the United States, all treatment programs receiving public funds are required by law to regularly submit admission and discharge data, inclusive of the forced/involuntary termination or administrative discharge of clients, to their local state authorities. In some states, this requirement even extends to programs not receiving public funds. The aim of collecting discharge data—collected under the auspices of the Substance Abuse and Mental Health Services Association [SAMHSA]—is to assist state and county authorities, funders, and accreditors to monitor recovery-focused program performance. However, investigation here undertaken shows that published discharge data from many state treatment settings are perennially and grossly …

Self-Reported Nutritional Status, Executive Functions, And Cognitive Flexibility In Adults, Siamak Khodarahimi

Journal of Mind and Medical Sciences

Objectives. The purpose of this study was to investigate the relationship between nutrition status, executive cognitive functions, and cognitive flexibility; and to analyze the role of gender, age, and nutrition status in the prediction of executive cognitive functions and cognitive flexibility in a sample of Iranian adults. Background. This study is based on the hierarchy of needs, health beliefs, developmental, cognitive and psychophysiological conceptualizations of nutrition and their plausible influences on human cognitive functions and cognitive flexibility.

Materials and Methods. The randomly selected sample consisted of 200 adult participants (M=99 and F=101) from Eghlid City, the north of Fars province, …

Ssri Maintenance Therapy Reduces Rate Of Recurrence For Elderly Patients With First Episode Of Major Depression, Blake J. Arthurs

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Reynolds CF 3rd, Dew MA, Pollock BG, et al. Maintenance treatment of major depression in old age. N Engl J Med. 2006 Mar 16;354(11):1130-8. doi: 10.1056/NEJMoa052619. Based on the appraisal, long term SSRI maintenance therapy is recommended for elderly patients suffering from first episode of major depression.

"Born Out Of Fear": A Grounded Theory Study Of The Stigma Of Bipolar Disorder For New Mothers, Walker Ladd Ph.D.

The Qualitative Report

Childbirth is an established trigger for the onset of bipolar disorders (BD) in the postpartum period, causing significant pathology and disability. Research has shown that the stigma of mental illness for new mothers is a powerful obstacle to care, preventing women from accessing critical treatment and social support. However, the majority of research has examined the relationship between the stigma and postpartum depression, leaving a gap in knowledge regarding stigma and postpartum bipolar disorder. The problem addressed in this grounded theory study was the lack of knowledge regarding the stigma of a diagnosis of bipolar disorder (BD) in the first …

Conflicts, Concerns And Family Circumstances In Custodial Grandmothers Over 8 Years, Cristina Noriega, Carol Musil, Jaclene Zauszniewski, Camille Warner

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

Although many grandmothers raising grandchildren experience transitions in their roles as family strains and circumstances change, little longitudinal data has been examined. This qualitative study assessed the relationships between custodial grandmothers’ appraisals of their family conflicts and concerns and family circumstances across eight years. Participants were thirty-five Ohio grandmothers who were raising their grandchildren in 2006-2007 and provided additional self-report survey data in 2008-2009 and 2014-2015. Data were gathered from open-ended questions that were analyzed through conventional content analysis. The reported concerns were financial and emotional difficulties, grandchildren outcomes, mental and physical health of the grandchild and other family members, …

Kinship Diversion In The District Of Columbia: A Review Of Local Practice To Inform National Policy, Marla P. Spindel, Beth A. Stekler, Stephanie Ridgway Mcclellan

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This article addresses a practice commonly known in the child welfare community as “kinship diversion,” where a child welfare agency informally places children with relatives as an alternative to foster care. While evidence predominantly shows that abused and neglected children have better outcomes when they are placed with relatives when they cannot remain safely at home, serious concerns about these children’s safety and well-being arise when the placement with relatives is informal. Indeed, it is often not understood that these same relatives can be approved as foster parents and can receive essential financial assistance and supportive services to help safely …

Complexities And Challenges Of Nonduality, Elizabeth Stephens

CONSCIOUSNESS: Ideas and Research for the Twenty-First Century

States of consciousness referred to as nonduality, awakening, enlightenment, moksha, peak experience, unitive states, or void states, among other terms, have garnered increasing secular attention and have become a topic of psychological and neuroscientific research. A review of the literature revealed many challenges to studying this set of states, such as inconsistent conceptualizations, a variety of models and theories, and conflicting descriptions indicating that the actual experience may not live up to the superlative descriptions found in historical texts or the expectations put forth by nondual teachers. A great deal more empirical research on this topic is needed, and researchers …

Trauma Recovery: A Heroic Journey, Brenda Keck, Lisa Compton, Corie Schoeneberg, Tucker Compton

Heroism Science

Trauma survivors who choose to enter into trauma recovery may be viewed as individuals embarking on a hero’s journey. Historically, many of the coping strategies utilized by individuals who are experiencing post-traumatic stress have been viewed as inherently disordered and personally dysfunctional. An alternative perspective of these behaviors calls for an examination of strengths present within trauma survivors, suggesting a reframe of their symptomology as ingenuity in coping during adverse circumstances and an appreciation for the difficulty of living with traumatic memories. This article highlights the challenging process of trauma recovery as it parallels Campbell’s (1949) metaphor of the hero’s …

Journey Interrupted: A Phenomenological Exploration Of Miscarriage, Marit A. Watson, Vanessa D. Jewell, Sarah L. Smith

The Open Journal of Occupational Therapy

Background: Miscarriage is a significant life event that impacts occupational performance, identity, and competence and that influences perceptions of motherhood. Because of the lack of social rituals often attributed to the death of a loved one, miscarriages may result in disenfranchised grief, which impedes coping.

Methods: This phenomenological study explored the impact of miscarriage on relationships, perceptions of motherhood, and the meaning of occupation in the context of grief. Data was collected through semi-structured interviews (N = 4) and completion of a brief demographic questionnaire. The interviews were digitally recorded, transcribed verbatim, and reviewed to ensure accuracy. Using inductive thematic …

The Victimization Of The Misconceived: The Mentally Ill In The Criminal Justice System, Margarita Trejo

Themis: Research Journal of Justice Studies and Forensic Science

It is unfortunate to say that the number of people who suffer from a serious mental illness has been drastically increasing in the criminal justice system since the late 1960s. This drastic change has captivated the minds of the public, forced them to develop a fallacious stereotype, and labeled the mentally ill population as wrongdoers. This image, however, is inaccurate. In reality, these people are the victims of a broken system. This paper establishes the victimization that a person with a serious mental illness experiences as they are processed through the criminal justice system. The following elaborates how victimization is …

Nativity Differences In Stress Among Asian And Pacific Islander American Women, Brittany N. Morey, Gilbert C. Gee, Salma Shariff-Marco, Gem M. Le, Alison J. Canchola, Juan Yang, Laura Allen, Sandra Lee, Roxanna Bautista, Trish Quema La Chica, Winston Tseng, Pancho Chang, Scarlett Lin Gomez

Journal of Health Disparities Research and Practice

According to the Stress Process Theory, people who are marginalized in society encounter more stress than those in more advantaged positions. Immigrants are one such marginalized group in the United States (US) who may experience greater psychological stress than their US-born counterparts due to (1) severing of social ties; (2) social disadvantage and marginalization; and (3) adaptation to a new environment. This study examines the disparity in stress by nativity, and how social factors contribute to this disparity for Asian and Pacific Islander (API) women. Data come from the Asian Community Health Initiative, which included a sample of 291 foreign-born …

Insane: James Holmes, Clark V. Arizona, And America's Insanity Defense, Eric Collins

Journal of Law and Health

Insanity is a legal term of art that changes definitions depending on the legal standard in American jurisprudence, which explains why a man who mental health professionals described as having an uncontrollable obsession with killing people can be found not insane and guilty. This Note addresses the current state of the Insanity Defense Reform Act of 1984 and its widespread implementation at the state level. Part II supplies background information on the history of the insanity defense and how it has transformed over the years in American jurisprudence. Part III provides an analysis of the of the insanity defense. Part …

Post-Traumatic Stress Disorder: Review Of Dsm Criteria And Functional Neuroanatomy, Cornelius W. Thomas

Marshall Journal of Medicine

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for post-traumatic stress disorder (PTSD) consist of over twenty possible symptoms that can be divided into six broad categories. These categories correlate with specific brain networks that regulate emotions, behaviors, and autonomic function. Normal functioning of these networks depends on two key regions; the prefrontal cortex and the amygdala. The prefrontal cortex provides top-down executive control over amygdala, whereas the amygdala is critical for threat detection and activation of the ‘fight or flight’ response. Events that trigger extreme and/or prolonged fear can cause persisting dysregulation within the prefrontal-amygdala circuit; resulting …

Uncertainty And Competing Priorities In Shared Clinical Decision-Making, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews observes that a connecting thread among the articles published therein is an element of uncertainty among patients and clinicians. Competing priorities for the patient also may be present. Several approaches to overcoming these prevalent conflicts to delivery of better health care have been proposed, the most important of which may be clinicians embracing a will to practice shared decision-making.

'No Pink Ribbons': How Women's Lived Experiences With Breast Atypia Inform Decisions Involving Risk-Reducing Medications, Sarah L. Goff, Reva Kleppel, Grace Makari-Judson

Journal of Patient-Centered Research and Reviews

Purpose: Atypical hyperplasia (AH) is associated with a nearly 4-fold elevation of lifetime risk for breast cancer, and lobular carcinoma in situ (LCIS) is associated with a 7- to 8-fold risk. Women with AH/LCIS make numerous decisions in the course of treatment, including whether to take a risk-reducing medication, an option relatively few women pursue. We explored women’s decision-making processes through patient narratives in an effort to inform decision supports for AH/LCIS.

Methods: We conducted in-depth interviews with 20 English-speaking women with AH/LCIS and no subsequent diagnosis of invasive breast cancer who had enrolled in the Rays of Hope Center …

A Framework For Conceptualizing How Narratives From Health-Care Consumers Might Improve Or Impede The Use Of Information About Provider Quality, Melissa L. Finucane, Steven C. Martino, Andrew M. Parker, Mark Schlesinger, Rachel Grob, Jennifer L. Cerully, Lise Rybowski, Dale Shaller

Patient Experience Journal

Consumers choosing a health-care provider have access to diverse information including narratives by patients about their prior experiences. However, little research has examined how narratives might improve or impede the use of information about the quality of providers’ performance. This paper describes a conceptual framework for examining mechanisms by which narrative information might influence consumer judgments and decisions about providers. We conducted a conceptual review of risk communication and behavioral decision research. We synthesized the literature to form the foundation of a conceptual framework for assessing how narrative information about provider quality impacts consumer decisions about providers. We identified four …

The Mind-Body Problem; Three Equations And One Solution Represented By Immaterial-Material Data, Ion G. Motofei, David L. Rowland

Journal of Mind and Medical Sciences

Human life occurs within a complex bio-psycho-social milieu, a heterogeneous system that is integrated by multiple bidirectional interrelations existing between the abstract-intangible ideas and physical-chemical support of environment. The mind is thus placed between the abstract ideas/ concepts and neurobiological brain that is further connected to environment. In other words, the mind acts as an interface between the immaterial (abstract/ intangible) data and material (biological) support. The science is unable to conceives and explains an interaction between the immaterial and material domains (to understand nature of the mind), this question generating in literature the mind-body problem. We have published in …

The Proposed Etiologies Of Dissociative Identity Disorder, Jillian Blueford

The Pegasus Review: UCF Undergraduate Research Journal

Dissociative Identity Disorder (DID) evolves after suffering consecutive, traumatizing forms of abuse during an individual's early years. Repetitive abuse can lead an individual to develop two or more personalities, and then experience memory loss or other cognitive gaps in his or her early childhood that continue to the present day. This can have devastating effects on millions of people because a significant percentage of affected individuals do not recognize the symptoms or choose to believe that DID does not exist. By analyzing the literature currently available, this article creates a central base of popular and emerging models that clinicians use …

Direct And Indirect Influences Of Defendant Mental Illness On Jury Decision Making, Marie Sabbagh

The Pegasus Review: UCF Undergraduate Research Journal

It is a common misconception that individuals with schizophrenia are significantly more dangerous and violent than individuals free of mental illness. This stigmatization may lead to harsher sentences when people with schizophrenia are involved in criminal activities and sentenced by a jury. This study presented four conditions to which participants were randomly assigned, alone or in a group of three, and were asked to sentence a defendant, either with or without schizophrenia. It was hypothesized that group deliberations would result in more lenient sentences for defendants with schizophrenia as compared to individual deliberations. Furthermore, it was predicted that both group …

The Backward Masking Red Light Effect And Schizotypy: The Influence Of Sex, Diana C. Hernandez, Andrea Y. Ranieri

The Pegasus Review: UCF Undergraduate Research Journal

Previous research has shown a unique effect of red light on visual processing related to both schizophrenia and positive schizotypy. The current study examines whether this effect is influenced by sex in a more broadly-defined schizotypy sample. A location backward masking (BM) task with three color background conditions (red, green, and gray) was administered to 34 undergraduate students (59% female) with a high score on the Schizotypal Personality Questionnaire (SPQ) and 39 students (51% female) with a low score. Results revealed that the group by color interaction was significant for the male participants, while it did not approach significance in …

Sourcing Enchantment: From Elemental Appropriation To Imaginal Symbolics, Schwartz, Michael

CONSCIOUSNESS: Ideas and Research for the Twenty-First Century

Critical theorists and social commentators agree that modernity and postmodernity suffer from historical pathologies of world disenchantment. What might be done? Drawing on John Sallis’ phenomenology of the elemental and Tibetan Buddhist teachings on elemental practices, this paper investigates the imagination in its doubling as imaginal in generating a symbolics of the self, world, and other that is always already enchanted; an aesthetics of existence where the world itself shows forth like a work of art replete with exorbitant logics.

Tasseography From Jung's Perspective, Avetisian, Elizabeth

CONSCIOUSNESS: Ideas and Research for the Twenty-First Century

Approaching from Jung’s perspective this paper aims to understand how the unconscious communicates through symbolism that may be the basis for synchronicity arising from mantic procedures. A particular ritual of divination called tasseography will be studied whereby the seer interprets patterns in coffee grounds intuitively and by following a standard system of symbolism to foretell the seeker’s future life events or provide answers to seeker’s pressing life questions. The paper will examine various processes involved in the experience of tasseography and its ritual that enable the reader to predict the seeker’s future or bring light to the present or past …

Human Error Analysis Of Helicopter Emergency Medical Services (Hems) Accidents Using The Human Factors Analysis And Classification System (Hfacs), Paul E. Cline Ph.D.

Journal of Aviation/Aerospace Education & Research

Helicopter Emergency Medical Services (HEMS) is among the most dangerous type of flying in commercial aviation. This research utilized the Human Factors Analysis and Classification System (HFACS) to understand the errors, preconditions and violations that contribute to these accidents. Drawing upon source data from the National Transportation Safety Board’s Aviation Accident Database, HEMS accidents from 2000-2016 were analyzed according to the HFACS framework.

Mental Health In Commercial Aviation - Depression & Anxiety Of Pilots, Maurice C. Dehoff, Stephen K. Cusick

International Journal of Aviation, Aeronautics, and Aerospace

Two landmark accidents invigorated the discussion regarding pilot mental health. Other incidents may also have a mental health component that is related to, but not the direct cause of, the event. It is suspected that these “other incidents” are much more commonplace and while not catastrophic, erode safety. Depression and anxiety are two commonly occurring mental health concerns. Research indicates that a considerable portion of the U. S. population suffers from some form of mental health issue. Most go undiagnosed and untreated. A similar rate of occurrence appears to be found within the airline pilot population. The stigma of mental …