Medicine and Health Sciences Commons^™

Physician Burnout: Slowing The Burn Through Positive Deviance Strategies, Swapna Reddy

Dissertations and Theses (Open Access)

Introduction: Affecting 42% of physicians in the United States, “physician burnout” is considered a public health crisis with adverse impacts for personal providers, patients and organizations. Though much research has been devoted to the existence and causes of burnout, to date few studies have been conducted to identify factors associated with physician fulfillment. Aims: This dissertation research was intended to increase and improve knowledge of factors effective in contributing to physician professional fulfillment utilizing a Positive Deviance based approach. To that end, two studies were conducted: the first, a narrative review of the literature to identify specific correlates of physician …

Bayesian Modeling Of Censored Data With Application To Meta-Analysis Of Immunotherapy Trials, Xinyue Qi

Dissertations and Theses (Open Access)

My dissertation builds on a systematic review of 125 clinical trials reporting on treatment-related adverse events (AEs) associated with PD-1/PD-L1 inhibitors published from 2010 to 2018. The motivating dataset contained the following study-level components extracted from each publication: trial name, number of treated patients, selected immunotherapy drug, dosing schedule, cancer type, number of AEs within each category, and the pre-specified criteria for AE reporting. The number of AEs were reported based upon all-grade (Grade 1-5) and Grade 3 or higher (Grade 3-5) severity. My overall objective was to increase our understanding of the toxicity profiles of five most common cancer …

How To Make Critical Decisions Amid Covid-19 Pressures, David Chan

Research Collection School of Social Sciences

Time pressure and ambivalence are common when people make decisions in a crisis. Understanding the psychological dynamics helps us slow down to make better decisions.

The Adult Public’S Perception Of The Utility Of Play Therapy, Margaret L. Hindman

Graduate Theses and Dissertations

Children communicate through symbolism and play as toys are children's words and play is their language (Landreth, 2012; Oaklander, 1988; Piaget, 1951; Ray, 2016). Play therapists facilitate developmentally appropriate support for children (Landreth, 2012). Often parents are unaware of the importance of play in children’s counseling (Brumfield & Christensen, 2011; Landreth, Bratton, Kellam, & Blackard, 2006).

Since adults often make decisions for children, it is important to know adults’ perceptions of play therapy utility. There is little research on parents’ knowledge of mental health services especially research specific to play therapy (Gallo, Comer, & Barlow, 2013; O’Connor & Langer, 2018). …

Medical Noncompliance In A Pediatric Patient Living In A Single-Parent Household, Lucy Obianuju Norrell

Electronic Theses and Dissertations

Abstract Noncompliance is a patient’s inability to comply with the recommended treatment for their complete recovery from an ailment, while compliance is the extent to which a patient adheres to the provider’s directive, such as medication and orders given. The purpose of this study was to determine if motivational interviewing when applied to noncompliant pediatric patients from single-parent households, would improve global medical compliance in this population as compared to the standard of care at the end of three months. Thirty-two participants were recruited using the homogeneous purposeful sampling. The project employed a mixed-method approach. Fred Kleinsinger’s noncompliant behavior tool …

Rejection Sensitivity And Social Support As Predictors Of Peer Victimization Among Youth With Psychiatric Illness, Katherine C. Hyde

Graduate Theses and Dissertations

In this study, I examined whether rejection sensitivity and perceptions of social support predicted concurrent peer victimization in a sample of adolescents with psychiatric illness. Participants included 43 adolescents, aged 12-18 with diverse psychiatric diagnoses, who were recruited from a summer residential treatment program. Participants completed measures of peer victimization, perceptions of social support, and rejection sensitivity. Participants also completed the global victimization item in the Revised Olweus Bully/Victim Questionnaire, which allowed for comparison of rates of peer victimization across studies (Solberg & Olweus, 2003). Results replicate and extend previous research that indicates adolescents with psychiatric illness experience high rates …

Within-Person Variability Of Internal And External Sexual Consent, Malachi Willis

Graduate Theses and Dissertations

Background: Sexual consent is often conceptualized as an internal willingness to engage in sexual activity, which can be communicated externally to a sexual partner. Preliminary evidence indicates that people’s sexual consent varies from day to day. Study designs that assess sexual consent at multiple time points (e.g., experience sampling methodology [ESM]) are needed to better understand the within-person variability of sexual consent; however, extant validated measures of sexual consent are not appropriate for ESM studies, which require shorter assessments due to the increased burden this methodology has on participants. As such, the goal of this dissertation was to develop valid …

From "Hooah" To "Om": Mindfulness Practices For A Military Population, Kimberlee B. Bonura, Dawn M. Fountain

Journal of Social, Behavioral, and Health Sciences

Mindfulness practices, in general, have a growing body of evidence of effectiveness for improving both physical health and mental health. Further, these practices are showing promise when implemented with military populations for mental health issues such as PTSD. Challenges arise for practitioners in understanding the military's cultural differences and the functional aspects of mindfulness that may be specifically useful to military members. We outline strategies for referring military members to quality services and instruction, as well as best practices for connecting with military clients. Recommendations are made for further research with female service members and using single case design.

Workshop #6: Psychological Adjustment For The 2020 Hurricane Season During Covid-19 Pandemic: After-Action Report (Aar), Converge Nsf Working Group, Joshua G. Behr, Wie Yusuf, Jennifer Marshall, Elizabeth Dunn

Presentations, Lectures, Posters, Reports

Participants in the CONVERGE COVID-19 Working Group’s Workshop #6 on Psychological Adjustment breakout sessions discussed the critical threats to psychological health and well-being facing shelter staff, volunteers, and clients in the 2020 hurricane season.

It is widely recognized that people are approaching the 2020 hurricane season under unusual levels of stress. The COVID-19 pandemic has created chronic stressors that individuals are already managing in addition to addressing new acute fears like –will I get sick if I go to a shelter? These new and exacerbated stressors are a risk for higher levels of burnout, compassion fatigue, and ill-being. …

A Case For Delirium Risk Prediction Models To Aid In Triaging Resources To Those Most At Risk An Integrative Literature Review, Tammy Perttula

Nursing Masters Papers

Abstract

Delirium is a complex syndrome resulting from compounding effects of acute illness, comorbidities, and the environment. It results in adverse outcomes: elevated mortality rates, length of stay, readmissions, institutionalization, long-term cognitive changes, and diminished quality of life. The rate of iatrogenic delirium is astounding, ranging from 10%-89%. There are no curative treatments; thus, primary prevention is the key. The purpose of this literature review is to identify and critique the research for the accuracy of risk stratification and feasibility in practice. Support for interventions that prevent delirium is mounting; however, interventions are resource-intensive and often not implemented. Researchers have …

Aging, Vulnerability And Managing Type 2 Diabetes During A Pandemic, Jasmin Tahmaseb-Mcconatha, Jacqueline Magnarelli, Lauren Stricker

Psychology Faculty Publications

Older men and women have been found to be more vulnerable to negative outcomes should they contract Covid19, particularly if they also have comorbid conditions such as type 2 diabetes. Cultural, racial, ethnic, and social class differences exist in vulnerability to Covid19 and in the prevalence of type 2 diabetes. In the United States, for example, diabetes rates for minority and immigrant populations are higher than for non-Hispanic whites. During the a social health crisis, it is helpful to explore the ways that illness management and associated vulnerability influences the ways that minority elders attempt to maintain and promote their …

Sense Of Purpose In Life And Five Health Behaviors In Older Adults, Eric S. Kim, Koichiro Shiba, Julia K. Boehm, Laura D. Kubzansky

Psychology Faculty Articles and Research

Accumulating evidence shows that a higher sense of purpose in life is associated with lower risk of chronic conditions and premature mortality. Health behaviors might partially explain these findings, however, the prospective association between sense of purpose and health behaviors is understudied. We tested whether a higher sense of purpose at baseline was associated with lower likelihood of developing unhealthy behaviors over time. Prospective data were from the Health and Retirement Study, a national sample of U.S. older adults. Our sample included 13,770 adults assessed up to five times across eight years. Among people who met recommended guidelines for a …

The Impact Of Relationship Wellness Checkups With Gay Male Couples, Mary Minten, Cass Dykeman

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Relationship health impacts many other health outcomes, including physical and mental wellbeing and the health of children in the family system (Goeke-Morey, Cummings, & Papp, 2007; Jaremka, Glaser, Malarkey, & Kiecolt-Glaser, 2013; Jaremka, Lindgren, & Kiecolt-Glaser, 2013; Pihet, Bodenmann, Cina, Widmer, & Shantinath, 2007; Rappaport, 2013; Robles, Slatcher, Trombello, & McGinn, 2014). Despite the importance of relationship health, couples do not regularly seek support for maintaining their connection (Eubanks-Fleming & Cordova, 2012). Early intervention programs that provide support are a growing public health initiative (Cowan & Cowan, 2014). One brief early intervention program, the Marriage Checkup (MC), positively impacts …

Examining The Factors That Mediate The Relationship From Legal Advocacy Satisfaction To Resilience, Desta T. Gebregiorgis

Clinical Psychology Dissertations

Sexual assault is a public health issue that can impact one’s resilience. Using a multisystemic approach to resilience, there may be person-level and environment-level factors that can affect one’s resilience, such as one’s coping self-efficacy, satisfaction with the court process, and negative effects associated with court process. Legal advocacy programs, such as those offered by the King County Sexual Assault Resource Center (KCSARC), support clients during the court proceedings. In order to better serve KCSARC’s clientele, it is helpful to understand how the legal advocacy program impacts post-trauma resilience. This dissertation had three phases: (a) evaluating the structural validity of …

Womanism & Wellbeing: A Manuscript Dissertation Exploring The Effects Of Shame, Loss And Gender Issues, Christy Angelle-Vidrine Bauman

Education Dissertations

The purpose of this study is to contribute to the research on gender issues and psychological well-being across the adult lifespan utilizing qualitative research examining factors (e.g., societal influences, sexual objectification, shame, loss, meaning-making, and internal identity) in developing resilience and mitigating mental health issues. This paper discusses the importance of addressing well-being through expression of loss, meaning-making, and social impact. This manuscript style dissertation will review publications in such areas as sexuality, spirituality, grief, shame, intimacy, social, and interpersonal relationships. The exploration of biopsychosocial impacts as it relates to meaning-making, resilience, and communal involvement. The three publications will be …

Impacts Of Motor And Sensory Impairment On Language In Young Children With Autism, Elizabeth A. Bisi

Clinical Psychology Dissertations

Children with autism spectrum disorder (ASD) present with varying degrees of deficit in the broader areas of social communication and stereotyped behaviors, but emerging research proposes delayed motor skill and atypical sensory processing as additional factors worth closer examination. In the current study, I sought to investigate the impacts of visual motor skills and sensory differences on language ability in young children with autism. I hypothesized that young children with autism, atypical sensory processing (Short Sensory Profile, 2^nd Edition), and impaired visual motor integration (Beery VMI, 6^th Edition) would have the most impacted language ability scores (Differential Ability …

Smartphone Applications Targeting Borderline Personality Disorder Symptoms: A Systematic Review And Meta-Analysis., Gabrielle Ilagan, Evan Iliakis, Chelsey Wilks, Ipsit Vahia, Ipsit Vahia, Lois Choi-Kain, Lois Choi-Kain

Psychology Faculty Works

Background: Smartphone applications could improve symptoms of borderline personality disorder (BPD) in a scalable and resource-efficient manner in the context limited access to specialized care. Objective: This systematic review and meta-analysis aims to evaluate the effectiveness of applications designed as treatment interventions for adults with symptoms such as anger, suicidality, or self-harm that commonly occur in BPD. Data sources: Search terms for BPD symptoms, smartphone applications, and treatment interventions were combined on PubMed, MEDLINE, and PsycINFO from database inception to December 2019. Study selection: Controlled and uncontrolled studies of smartphone interventions for adult participants with symptoms such as anger, suicidality, …

Maternal Immune Activation Alters Fetal Brain Development And Enhances Proliferation Of Neural Precursor Cells In Rats, Kelly J. Baines, Dendra M. Hillier, Faraj L. Haddad, Nagalingam Rajakumar, Susanne Schmid, Stephen J. Renaud

Brain and Mind Institute Researchers' Publications

Maternal immune activation (MIA) caused by exposure to pathogens or inflammation during critical periods of neurodevelopment is a major risk factor for behavioral deficits and psychiatric illness in offspring. A spectrum of behavioral abnormalities can be recapitulated in rodents by inducing MIA using the viral mimetic, PolyI:C. Many studies have focused on long-term changes in brain structure and behavioral outcomes in offspring following maternal PolyI:C exposure, but acute changes in prenatal development are not well-characterized. Using RNA-Sequencing, we profiled acute transcriptomic changes in rat conceptuses (decidua along with nascent embryo and placenta) after maternal PolyI:C exposure during early gestation, which …

Variability In The Analysis Of A Single Neuroimaging Dataset By Many Teams, Rotem Botvinik-Nezer, Tom Schonberg, Russell A. Poldrack, Zachary J. Cole, Matthew R. Johnson, Phui Cheng Lim, Evan N. Linz, Douglas H. Schultz, Joshua E. Zosky, Narps Management Team, Jean M. Vettel, More Than 100 Other Co-Authors

Department of Psychology: Faculty Publications

Data analysis workflows in many scientific domains have become increasingly complex and flexible. To assess the impact of this flexibility on functional magnetic resonance imaging (fMRI) results, the same dataset was independently analyzed by 70 teams, testing nine ex-ante hypotheses. The flexibility of analytic approaches is exemplified by the fact that no two teams chose identical workflows to analyze the data. This flexibility resulted in sizeable variation in hypothesis test results, even for teams whose statistical maps were highly correlated at intermediate stages of their analysis pipeline. Variation in reported results was related to several aspects of analysis methodology. Importantly, …

Differences In Brain Activity Patterns During Creative Idea Generation Between Eminent And Non-Eminent Thinkers, Evangelia G Chrysikou, Constanza Jacial, David B Yaden, Wessel Van Dam, Scott Barry Kaufman, Chris Conklin, Nancy Wintering, Rebecca E Abraham, Rex E Jung, Andrew B. Newberg

Marcus Institute of Integrative Health Faculty Papers

An influential model of the neural mechanisms of creative thought suggests that creativity is manifested in the joint contributions of the Default Mode Network (DMN; a set of regions in the medial PFC, lateral and medial parietal cortex, and the medial temporal lobes) and the executive networks within the dorsolateral PFC. Several empirical reports have offered support for this model by showing that complex interactions between these brain systems account for individual differences in creative performance. The present study examined whether the engagement of these regions in idea generation is modulated by one's eminence in a creativity-related field. Twenty (n …

Covid-19: A New Chapter In The Loneliness Epidemic, Nancy Zhu

Social Space

We live in an era of increasing innovation and connectivity. It's said that we have the world is at our fingertips, with social media granting us the ability to link up quickly and easily with anyone across the globe. Yet the irony is that loneliness is a trusty companion in a modern and interconnected world.

Covid-19 And Procrastination: The Struggle To Stay Motivated In A Pandemic, Singapore Management University

Social Space

COVID-19 has led to the cancellation of countless internships, travel plans, summer jobs, music concerts and festivals, graduations, conferences, you name it. Fixed deadlines have become fluid, and both short-term and long-term goals are presently at the mercy of something far beyond our control. In the face of a global pandemic, we may find ourselves wondering, “Why bother planning for anything anyway?" Yet this very mindset is the crux of the coronavirus procrastination problem, says CHARDONNAY NEEDLER.

Diffusion Dispersion Imaging: Mapping Oscillating Gradient Spin-Echo Frequency Dependence In The Human Brain., Aidin Arbabi, Jason Kai, Ali R Khan, Corey A Baron

Brain and Mind Institute Researchers' Publications

PURPOSE: Oscillating gradient spin-echo (OGSE) diffusion MRI provides information about the microstructure of biological tissues by means of the frequency dependence of the apparent diffusion coefficient (ADC). ADC dependence on OGSE frequency has been explored in numerous rodent studies, but applications in the human brain have been limited and have suffered from low contrast between different frequencies, long scan times, and a limited exploration of the nature of the ADC dependence on frequency.

THEORY AND METHODS: Multiple frequency OGSE acquisitions were acquired in healthy subjects at 7T to explore the power-law frequency dependence of ADC, the "diffusion dispersion." Furthermore, a …

What Explains The Relationship Between Spatial And Mathematical Skills? A Review Of Evidence From Brain And Behavior, Zachary Hawes, Daniel Ansari

Brain and Mind Institute Researchers' Publications

There is an emerging consensus that spatial thinking plays a fundamental role in how people conceive, express, and perform mathematics. However, the underlying nature of this relationship remains elusive. Questions remain as to how, why, and under what conditions spatial skills and mathematics are linked. This review paper addresses this gap. Through a review and synthesis of research in psychology, neuroscience, and education, we examine plausible mechanistic accounts for the oft-reported close, and potentially causal, relations between spatial and mathematical thought. More specifically, this review targets candidate mechanisms that link spatial visualization skills and basic numerical competencies. The four explanatory …

Social-Ecological And Protective Factor Approach To Managing Parental Incarceration, Jacquelyn Harris

Dissertations

Mass imprisonment does not only impact the incarcerated individual; it also affects approximately five million children in the United States. Researchers identified and compare the impact of parental incarceration on child development. They acknowledged the protective factors across the lifecycle from a social-ecological perspective and specifically related to parental incarceration. The comprehensive literature review inspired an innovative model, the social-ecological and protective factor approach to managing parental incarceration. The primary goal of this model is to combat the detrimental effects of parental incarceration by identifying protective factors across the lifecycle and throughout the microsystem, mesosystem, and exosystem. This model is …

Bridging The Gap: Understanding Non-Offending Parental Responses To Their Children's Sexual Abuse., Jennifer Latreill, Psy.D.

Dissertations

The parental response to children's disclosure of childhood sexual abuse (CSA) is the most critical and important factor regarding the child's post trauma trajectory and overall trauma resolution. Understanding parental responses and the factors that prompt acceptance versus disbelief among the non-offending parent (NOP) is vital to children's success following disclosure given the weight of the NOPs response and its impact on long-term consequences of CSA. This literature review provides a comprehensive summary of what may deter the NOP from recognizing intrafamilial sexual abuse, factors that may contribute to the NOPs disbelief following disclosure, and possible clinical implications of such …

Exploration Of Physician Attitudes About Self-Care And Personal Mental Health: Possible Barriers To Physician Well Being, Candich Farrar

Dissertations

The present study was designed to examine physicians’ mental health, attitudes, and behaviors toward self-care and the utilization of mental health services. As the medical field can be very demanding and exhausting, it is believed that many physicians suffer from mental illnesses such as anxiety and depression. However, it was theorized that many physicians do not engage in adequate self-care regimes or seek support and suppress their symptoms, which may further exacerbate their illnesses. A thorough literature review was performed to explore the following: possible barriers to physicians seeking mental health services to address high rates of mental illnesses, physicians …

Development Of An Aba Tool Kit For Audiologists To Increase Hearing Aid Wear Time In Individuals With Autism, Lindsay Brown

Dissertations, Theses, and Capstone Projects

When working with individuals with the dual-diagnosis of hearing loss and Autism Spectrum Disorder (ASD), audiologists are often faced with unique challenges and must adapt their approach in order to more effectively address the needs of these individuals. Currently, there is only a small body of research focused on the special considerations required for appropriately fitting and utilizing amplification for children with the dual-diagnosis of hearing loss and ASD. Subsequently, recommendations and strategies for clinicians to implement when faced with these common challenges, specifically of hearing aid compliance and appropriate hearing aid wear time, are lacking. It is important to …

Scope Of Attention Variation As A Function Of Anxiety And Depression, Kathleen Anne O'Donnell

Electronic Theses, Projects, and Dissertations

As a social species, correct emotional perception is so vital, that the human brain has evolved a mechanism to control attentional choices by exerting a narrowed field of perception during danger, called the scope of attention (SoA). The SoA determines what information will be focused on or ignored by blocking the perception of non-relevant items and increasing selective focus on danger; even if danger is merely a sad-face. The emotional items blocked from perception cannot be remembered because they were never perceived. But, attention-control to emotional stimuli also varies with mood, as seen in mood-disorders. A mood-disorder’s effect upon the …

Role Of Micro-Rna For Pain After Surgery: Narrative Review Of Animal And Human Studies, Juan P Cata, Aysegul Gorur, Xiaoyi Yuan, Nathaniel K Berg, Anil K Sood, Holger K Eltzschig

Faculty, Staff and Student Publications

One of the most prevalent symptoms after major surgery is pain. When postoperative pain treatment is unsatisfactory, it can lead to poor surgical recovery, decreased quality of life, and increased health care costs. Current analgesics, single or in combination, have limited efficacy due to low potency, limited duration of action, toxicities, and risk of addiction. The lack of nonaddictive strong analgesics along with the over prescription of opioids has led to an opioid epidemic in the United States. Therefore, there is an urgent need for the development of newer analgesics. Microribonucleic acids (miRNAs) are small noncoding RNA molecules that modulate …