Medicine and Health Sciences Commons^™

Differences In Phq-9 Depression Severity Between Adults Receiving Ketamine Or Ketamine-Assisted Psychotherapy, Sophie Lake Oswin

Walden Dissertations and Doctoral Studies

Treatment-resistant depression (TRD) affects roughly 2.8 million or 1.1% of the United States population. Many traditional treatments of mental disorders including various types of psychotherapy and pharmacotherapy do not provide adequate symptom reduction for clients, and many clients diagnosed with TRD seek out nontraditional treatments such as ketamine and psychedelics for their antidepressant effects. Due to the dissociative nature of psychedelic medication wherein resistance is reduced, and a trance-like state is induced, ketamine-assisted psychotherapy (KAP) has great potential as an adjunct to ketamine therapy. Procedures of KAP have been in development for the last 7 years and a consensus on …

Examining Help-Seeking Intentions Among Female Veterans With Military Sexual Trauma, Elizabeth Pirone

Walden Dissertations and Doctoral Studies

An estimated 38.4% of military women have experienced military sexual trauma (MST) at some point in their careers. Because MST experiences can be confounding, navigating beliefs toward treatment resources and seeking help can be challenging. The problem under study was that no literature examined multiple constructs of the health belief model (HBM) together as a foundational tool to identify perceptions of help-seeking intentions among female veterans with MST experiences. Guided by the HBM, the purpose of this study was to examine the relationship between health motives, perceived severity of emotional or nervous problems, perceived benefits of getting help for emotional …

The Effect Of Community Health Linkages On Suicide Rates In Veterans, Erica Anderson

Walden Dissertations and Doctoral Studies

Suicide risk is a public health issue. It is a complex and poorly understood mental health and societal threat. This study examined veteran suicide rates and their relationship to family and social support, as measured by the social association rate, mental health funding per capita, and the lethality of the method rate. The interpersonal-psychological theory of suicide and the social-ecological model are the theoretical frameworks that guided the study. Both theories emphasize the complexity surrounding suicide at the state level as it is related to the individual, social, environmental, and political landscape related to veteran suicide. The quantitative bivariate correlation …

Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice

Walden Dissertations and Doctoral Studies

Health-related quality of life (HRQoL) is a theoretical concept that intertwines physical, mental, emotional, and social functioning, with a focus on the impact that health status has on quality of life. Although sociodemographic factors are associated with lower HRQoL, how these factors influence HRQoL in military veterans is less understood. The study’s purpose was to examine the relationships between sociodemographic characteristics (gender, military pay grade, military branch, and geographic location) and perceived HRQoL measured by the SF-8 survey among veterans living in a metropolitan community in the Mid-Atlantic region of the United States. A cross-sectional recruitment study design yielded 90 …

Effect Of Family Engagement On The Behavioral Health Of Mentally Ill Offenders, Jessica Rae Horn

Walden Dissertations and Doctoral Studies

In the United States, 40% of incarcerated individuals have been diagnosed with a mental health disorder, but they often lack the support system needed to navigate their incarceration. This study addressed ways to understand how family engagement opportunities can improve the behavioral health of mentally ill offenders. Specifically, five research questions were used to explore the degree to which the practice of family engagement was understood as a method for providing support to mentally ill incarcerated individuals. The study followed the Baldrige Framework of Excellence to identify current organizational leadership and management issues that can help reach its goals, improve …

Behavioral Health Leadership Strategies To Increase Telehealth Engagement, Ramona Singletary-Robertson

Walden Dissertations and Doctoral Studies

One of the challenges brought on by the recent COVID-19 pandemic has been the promotion and use of telehealth services. While recent data from Medicare has depicted an increase in this new service delivery modality (over 4,000%), there has been a stark disparity in the use of telehealth services in lower socioeconomic demographics, such as rural and underrepresented communities, and among Medicare recipients. Equitable, consistent, and optimal service expansion of the telehealth modality requires therapists and leaders of behavioral health organizations to develop and deploy creative tactics to remedy this disparity. In this case study, leaders of Miss Emma's Behavioral …

Incorporating Public Health Into Transportation Decision Making, Bruce Appleyard, Tim Garrett

Mineta Transportation Institute

Investments in transportation have the potential to significantly affect public health outcomes. Decisions to build highways, transit, or bikeways, for example, influence how residents and visitors move around a metropolitan area. Personal travel habits and proximity to transportation infrastructure play a role in how likely people are to be physically active or be exposed to dangerous traffic and toxic pollution. For this study, the research team reviewed the literature that links transportation infrastructure, the surrounding built environment context, and public health outcomes such as chronic heart and lung diseases, obesity, and death. The team then researched publicly available data that …

Community Engagement In Precision Medicine Research: Organizational Practices And Their Impacts For Equity, Janet K Shim, Nicole Foti, Emily Vasquez, Stephanie M Fullerton, Michael Bentz, Melanie Jeske, Sandra Soo-Jin Lee

Center for Medical Ethics and Health Policy Staff Publications

Background: In the wake of mandates for biomedical research to increase participation by members of historically underrepresented populations, community engagement (CE) has emerged as a key intervention to help achieve this goal.

Methods: Using interviews, observations, and document analysis, we examine how stakeholders in precision medicine research understand and seek to put into practice ideas about who to engage, how engagement should be conducted, and what engagement is for.

Results: We find that ad hoc, opportunistic, and instrumental approaches to CE exacted significant consequences for the time and resources devoted to engagement and the ultimate impacts it has on research. …

A Need For Further Education On Buprenorphine In Pain Medicine, Jamal Hasoon, Anvinh Nguyen, Ivan Urits, Christopher Robinson, Omar Viswanath, Alan D Kaye

Faculty, Staff and Student Publications

With the ongoing opioid epidemic in the United States there has been a strong transition towards utilizing multi-modal analgesia, interventional procedures, and non-opioid medications when managing acute and chronic pain. There has also been an increased interest in utilizing buprenorphine. Buprenorphine is a novel long-acting analgesic with partial mu-opioid agonist activity that can be utilized for analgesia as well as opioid use disorder. Buprenorphine also has a unique set of side effects as well pharmacodynamic and pharmacokinetic properties that require special attention, especially if these patients require future surgical interventions. Given the increased interest in this medication we believe that …

Validation Of A Process For Shared Decision-Making In Pediatrics, Douglas J Opel, Holly Hoa Vo, Nicolas Dundas, Heather Spielvogle, Amanda Mercer, Benjamin S Wilfond, Jonna Clark, Carrie L Heike, Elliott M Weiss, Mersine A Bryan, Seema K Shah, Carolyn A Mccarty, Jeffrey D Robinson, Jennifer Blumenthal-Barby, Jon Tilburt

Center for Medical Ethics and Health Policy Staff Publications

OBJECTIVE: We sought to confirm, refute, or modify a 4-step process for implementing shared decision-making (SDM) in pediatrics that involves determining 1) if the decision includes >1 medically reasonable option; 2) if one option has a favorable medical benefit-burden ratio compared to other options; and 3) parents' preferences regarding the options; then 4) calibrating the SDM approach based on other relevant decision characteristics.

METHODS: We videotaped a purposive sample of pediatric inpatient and outpatient encounters at a single US children's hospital. Clinicians from 7 clinical services (craniofacial, neonatology, oncology, pulmonary, pediatric intensive care, hospital medicine, and sports medicine) were eligible. …

Technology Adoption Of Computer-Aided Instruction In Healthcare: A Structured Review, Queenie Kate Cabanilla, Frevy Teofilo-Orencia, Rentor Cafino, Armando T. Isla Jr., Jehan Grace Maglaya, Xavier-Lewis Palmer, Lucas Potter, Dave E. Marcial, Lemuel Clark Velasco

Electrical & Computer Engineering Faculty Publications

Computer-Aided Instruction (CAI) is one of the interactive teaching methods that electronically presents instructional resources and enhances learner performance. In health settings, using CAI is one of the important ways to improve learners' knowledge and usefulness in their healthcare specialization yet there is still a lack of research that offers a comprehensive synthesis of investigating into the adoption of CAI in healthcare. This research aims to provide a comprehensive review of related literatures on the enablers and barriers for technology adoption of CAI in healthcare. 31 journals were analyzed and revealed that several studies were utilizing the Unified Theory of …

Precision Medicine Approach To Alzheimer’S Disease: Rationale And Implications, Dale E. Bredesen, Kat Toups, Ann Hathaway, Deborha Gordon, Henrianna Chung, Cyrus Raji, Alan Boyd, Benjamin D. Hill, Sharon Hausman-Cohen, Mouna Attarha, Won Jong Chwa, Alexei Kurakin, Michael Jarrett

University Faculty and Staff Publications

The neurodegenerative disease field has enjoyed extremely limited success in the development of effective therapeutics. One potential reason is the lack of disease models that yield accurate predictions and optimal therapeutic targets. Standard clinical trials have pre-determined a single treatment modality, which may be unrelated to the primary drivers of neurodegeneration. Recent proof-of-concept clinical trials using a precision medicine approach suggest a new model of Alzheimer’s disease (AD) as a chronic innate encephalitis that creates a network insufficiency. Identifying and addressing the multiple potential contributors to cognitive decline for each patient may represent a more effective strategy. Here we review …

Deep Brain Stimulation For Pediatric Dystonia: Clinicians' Perspectives On The Most Pressing Ethical Challenges, Kristin M Kostick-Quenet, Lavina Kalwani, Laura N Torgerson, Katrina Munoz, Clarissa Sanchez, Eric A Storch, J S Blumenthal-Barby, Gabriel Lazáro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Pediatric deep brain stimulation (pDBS) is commonly used to manage treatment-resistant primary dystonias with favorable results and more frequently used for secondary dystonia to improve quality of life. There has been little systematic empirical neuroethics research to identify ethical challenges and potential solutions to ensure responsible use of DBS in pediatric populations.

Methods: Clinicians (n = 29) who care for minors with treatment-resistant dystonia were interviewed for their perspectives on the most pressing ethical issues in pDBS.

Results: Using thematic content analysis to explore salient themes, clinicians identified four pressing concerns: (1) uncertainty about risks and benefits of pDBS …

Renewed Calls For Abortion-Related Research In The Post-Roe Era, Sophie L Schott, April Adams, Ryan J Dougherty, Taylor Montgomery, Folasade C Lapite, Faith E Fletcher

Center for Medical Ethics and Health Policy Staff Publications

Nearly 50 years after Roe versus Wade, the United States Supreme Court's decision in Dobbs versus Jackson Women's Health Organization unraveled the constitutional right to abortion, allowing individual states to severely restrict or ban the procedure. In response, leading medical, public health, and community organizations have renewed calls for research to elucidate and address the burgeoning social and medical consequences of new abortion restrictions. Abortion research not only includes studies that establish the safety, quality, and efficacy of evidence-based abortion care protocols, but also encompasses studies on the availability of abortion care, the consequences of being denied an abortion, and …

Interactive Association Of Posttraumatic Stress Disorder, Apolipoprotein Ε4 Genotype, And Age On Cognitive Functioning, Karen A. Lawrence, Colton Rippey, Bianca Welikson, Robert H. Pietrzak, Thomas G. Adams Jr.

Psychology Faculty Publications

Background: The ε4 allele of the apolipoprotein (APOE) gene and posttraumatic stress disorder (PTSD) are associated with cognitive deficits. Both associations may vary depending on age. No previous study has examined a possible three‐way interaction between APOE ε4, PTSD, and age on cognitive functioning.

Methods: Data were analyzed from 1244 European‐American U.S. military veterans who participated in the 2011 National Health and Resilience in Veterans Study (NHRVS). Analyses of covariance were used to examine the main effects and in- teractions of APOE ε4, PTSD, and age on learning/working memory (LWM) and attention/psychomotor (APM) performance.

Results: A significant three‐way interaction between …

Revisiting The Rainbow: Culturally Responsive Updates To A Standard Clinical Resource, Angela M. Dietsch, Richard Mocarski, Debra A. Hope, Nathan Woodruff, Miechelle Mckelvey

Department of Special Education and Communication Disorders: Faculty Publications

Purpose

Cultural responsivity is essential for efficacious and affirming clinical relationships. This may be especially important with historically marginalized clients, such as transgender and gender-diverse (TGD) people seeking behaviorally based affirming communication services. We recommend modifications to standard tools for diagnostics and training that otherwise might undermine our efforts to create an inclusive and affirming environment.

Method

Modifications to the Rainbow Passage, a standardized paragraph utilized for eliciting speech samples in clinical settings, focused on nongendered terminology and the elimination of content with religious connotations.

Results

The recommended edits to the Rainbow Passage maintain similar length, cadence, and phonetic balance …

Epigenetics And Social Inequalities In Asthma And Allergy, Elizabeth S. Clausing, Cassidy J. Tomlinson, Amy L. Non

School of Global Integrative Studies: Faculty Publications

Respiratory illnesses, such as asthma and allergy disorders, are disproportionately more common among minority racial/ethnic groups and those of low socioeconomic status. In the United States, asthma prevalence and severity are highest among Puerto Ricans (19.2%), American Indians/Alaska Natives (13%), and Black Americans (12.7%) and higher in families living below the poverty threshold than among those living above it (11% vs 8%–9%).¹ Many studies of asthma/allergy inequalities assume that genetic differences underlie racial/ethnic differences in these disorders, pointing to genetic ancestry differences between races, but most genetic variants fail to explain racial/ethnic differences and are usually studied only in …

Differences Between Monolinguals And Bilinguals In Phonetic And Phonological Learning And The Connection With Auditory Sensory Memory, Laura Spinu, Jiwon Hwang, Mariana Vasilita

Publications and Research

Bilingualism has been linked with improved function regarding certain aspects of linguistic processing, e.g., novel word acquisition and learning unfamiliar sound patterns. Two non mutually-exclusive approaches might explain these results. One is related to executive function, speculating that more effective learning is achieved through actively choosing relevant information while inhibiting potentially interfering information. While still controversial, executive function enhancements attributed to bilingual experience have been reported for decades. The other approach, understudied to date, emphasizes the role of sensory mechanisms, specifically auditory sensory memory. Bilinguals outperformed monolinguals in tasks involving auditory processing and episodic memory recall, but the questions whether …

Entomophagy: Mealworm Protein In An Inpatient Hospital Setting (Engagement And Education To Rollout Entomophagy For Improved Nutrition), Caryl Showalter

Department of Entomology: Distance Master of Science Projects

The consumption of insects (entomophagy) is a well-practiced phenomenon in many parts of the world. Western societies, including the US, are among the few places that do not participate in this practice. However, entomophagy has the potential to ease nutritional burdens, globally. While many may believe that nutritional deficits are a relic of more economically challenging times or a problem specifically linked to the low economic countries, the truth is that any area can face this problem. This was made clear in the US during the coronavirus lockdown with an estimated doubling in food insecurity associated with a lack of …

Development Of Competency-Based Online Genomic Medicine Training (Cogent), Susanne B Haga, Wendy K Chung, Luis A Cubano, Timothy B Curry, Philip E Empey, Geoffrey S Ginsburg, Kara Mangold, Christina Y Miyake, Siddharth K Prakash, Laura B Ramsey, Robb Rowley, Carolyn R Rohrer Vitek, Todd C Skaar, Julia Wynn, Teri A Manolio

Faculty, Staff and Student Publications

The fields of genetics and genomics have greatly expanded across medicine through the development of new technologies that have revealed genetic contributions to a wide array of traits and diseases. Thus, the development of widely available educational resources for all healthcare providers is essential to ensure the timely and appropriate utilization of genetics and genomics patient care. In 2020, the National Human Genome Research Institute released a call for new proposals to develop accessible, sustainable online education for health providers. This paper describes the efforts of the six teams awarded to reach the goal of providing genetic and genomic training …

Diagnosing Neurocysticercosis In Skeletonized Human Remains Of Forensic Importance, John O. Obafunwa, Karl Reinhard

Karl Reinhard Publications

Neurocysticercosis is endemic in many parts of the underdeveloped and developing countries, with continuous presence in developed countries due to the influx of migrants from regions where the diseases are endemic. Neuroimaging, anatomic pathological techniques, immunodiagnostic tests, clinical examination and epidemiologic considerations will easily provide the diagnosis. However, physicians in developed countries are perhaps progressively missing the diagnosis, and need to re-acquaint themselves with the condition and acquire a high suspicion index. The authors present a medicolegal case where the forensic team made a conclusion of neurocysticercosis (among other diagnoses), following post mortem examination of a largely skeletonized and mummified …

Documenting The Presence Of Chagas Disease In Prehistoric North America: Applying The Stockholm Paradigm To Archaeoparasitology, Part Ii, Karl J. Reinhard, Daniel R. Brooks, Aida Romera Barbera, T. Michael Fink

Karl Reinhard Publications

The DAMA protocol (Document, Assess, Monitor, Act) is the applied aspect of the Stockholm Paradigm. Evidence from archaeology and history of medicine has a demonstrated value in documenting infection risk for specific study areas. Bioarchaeological remains and historical documents show vivid examples of pathology related to the Chagas disease life cycle. The science of archaeology defines the lifestyles that created risk of triatomine kissing bug infestations and trypanosome protozoa infections. Paleogenetics, in the form of molecular analyses of Trypanosoma cruzi, elucidate the temporal origins of genetic variants and adaptation to human environments. We illustrate how these fields reveal the risk …

Exploring The Evolution Of Trypanosoma Cruzi And The Emergence Of Chagas Disease In The Context Of Environmental Change: Applying The Stockholm Paradigm To Archaeoparasitology, Part I, Aida Romera Barbera, Daniel R. Brooks, T. Michael Fink, Karl J. Reinhard

Karl Reinhard Publications

The Stockholm Paradigm is an evolutionary synthesis that explains the emergence of novel pathogens in the context of environmental disturbances. Considering the urgent climate change situation, anticipation stands as key to prevent and mitigate the effects that climate change can have in the emergence of pathogens. However, the success of preventive measures is hindered by a limited knowledge of the interplaying dynamics between biology, environment, and culture leading to emerging infectious diseases. For many decades, bioarchaeologists have been gathering data on past human-environment interactions, therefore contributing to the conversation. Archaeoparasitology, at the intersection between pathology, bioarchaeology, and biology, is uniquely …

Examining The Relationship Of Social Inclusion On Job Satisfaction And Turnover Intentions Of Us Post-9/11 Veterans, Sheree' L. Peters

Walden Dissertations and Doctoral Studies

Many American veterans return to the civilian workforce and report having problems reintegrating into society, as well as finding their role in the new corporate social realms. Over 80% leave their civilian jobs within the first two years of employment, and over 70% report experiencing feelings of loneliness. Recently, the World Health Organization reported that the lack of perceived social inclusion also has a significant economic impact on both individuals and societies. A quantitative, nonexperimental methodology was used to examine the moderating relationship of social inclusion on the relationship between job employee turnover intentions of post-9/11 enlisted veterans. This study …

The Human-Canine Bond: Levels Of Stress Among Military Spouses During Deployments, Angela L. De Leon-Muniz

Walden Dissertations and Doctoral Studies

Previous research has found that deployment may impact military spouses’ emotional wellbeing and attachment with family members. There remains a critical gap in the literature regarding difference in stress levels between military spouses who own canines and those who do not. The theoretical foundations for this study were Bowlby’s attachment theory and Bowen’s family systems theory. Research questions included exploring the relationships between (a) pet canine ownership, deployment length of time, and military spouses’ stress levels, and (b) pet canine owners’ pet attachment and stress experienced, when their significant others are deployed. The sample comprised 82 spouses with deployed military …

Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy

Walden Dissertations and Doctoral Studies

Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with …

The Essence Of Therapeutic Relationships In Equine-Assisted Psychotherapy, Joy Clark Akin

Walden Dissertations and Doctoral Studies

AbstractTraditional psychotherapeutic approaches are not always effective in alleviating psychological symptoms and improving functioning in young adults. Equine-assisted psychotherapy (EAP) has been shown as a beneficial alternative therapeutic method developed for clients not helped by traditional methods. However, the essence of the therapeutic relationship that develops between the client, horse, therapist, and equine specialist has not been explored. The purpose of this phenomenological study was to explore the lived experience of the therapeutic relationship in young adults who participated in EAP. The frameworks of person-centered theory and self psychology guided the development of interview questions, data analysis, and interpretation. Four …

False Advertising And Young Girls’ Self Esteem, Caitlin Bohannon

Walden Dissertations and Doctoral Studies

It is becoming impossible to recognize the level of photoshop on advertisements. However, little is known how continuous exposure to such images can negatively impact the short- and long-term psyche of young girls aged 6 to 14 years old. The study’s theoretical framework was Benet’s polarities of democracy, emphasizing freedom and authority and human rights and communal obligations. The research question focused on the negative impacts false advertising has on young girls and what public policies could assist in mitigating these short- and long-term impacts. A general qualitative design, with semistructured interviews of seven adult participants with relevant insight on …

Understanding The Effects Of The Covid-19 Pandemic On West Virginia Students In Secondary School, Hannah Mckenzye Layman

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract 1

Background: The COVID-19 pandemic negatively impacted the mental health of young people. Mental health disparities among youth are abundant, so understanding how the pandemic may have affected specific sub-groups to develop tailored interventions to mitigate variations in health disparities is essential. Methods: School-based survey data from the Young Mountaineer Health Study (YMHS) was used to create generalized estimating equations models predicting anxiety and depression among early adolescents. The cohort sample included 2,322 students. Waves 1, 2, and 3 were collected ~6 months apart. Independent variables included COVID-19-related emotional impact (scale range: 5-25) and social support. Results: Average age …

Effects Of Combined Ethanol And Nicotine Administration On Delay Discounting In Male And Female Sprague-Dawley Rats, Rebecca Lillian Chalme

Graduate Theses, Dissertations, and Problem Reports (ETD)

Ethanol (EtOH) and nicotine (NIC) are among the most commonly used and co-used drugs in the world. Co-use occurs in people who use one or both drugs chronically, but also in people who only consume one or both drugs acutely, often in a “bingeing and chipping” pattern. Given that each drug on its own has previously been shown to affect impulsive choice in delay-discounting procedures, with some indication that drug effects could vary by sex, the purpose of the present experiments was to investigate effects of combined EtOH and NIC at a range of dose combinations on delay discounting in …