Medicine and Health Sciences Commons^™

A Phenomenological Inquiry Into Healthcare Professionals Who Are Experts In Cannabinoid Therapy And The Endocannabinoid System (Ecs), Courtney Collins

Electronic Theses and Dissertations

Cannabis is a prevalent alternative treatment for many symptoms and conditions given its medicinal qualities and few side effects. As legalization for both medical and recreational purposes continue to develop quickly across the United States of America, there is serious discrepancy between legalization and clinical research. Clinical data is difficult since the U.S. federal government still classifies cannabis as a Drug Enforcement Agency (DEA) Schedule I drug with no clearly established medical value. This lag in evidence-base data has affected cannabinoid therapy and endocannabinoid system education (ECS) for healthcare professionals. There are gaps in medical school and continuing medical education …

An Existential Punchline: How Humor Functions In A Young Adult Friendship Facing Advanced Cancer, Megan E. Solberg

Electronic Theses and Dissertations

Young adults (i.e., age 18-39) only comprise 4% of the total cancer population, yet cancers in this group are commonly found at more advanced stages due to situational factors influencing delayed diagnosis including access to healthcare, quality health insurance and competing life demands that may hinder prioritization of healthcare. Young adults with cancer also face unique challenges including higher rates of psychological distress, which may contribute to increased risk of social disconnection in response to cancer. Research suggests that humor may be a helpful coping approach and communication mechanism for mitigating distress and discussing difficult topics. Grounded within the frameworks …

Older Women’S Stories Of Covid-19 Loss: Communicated Narrative Sense-Making Through Photography, Anne Walker

Electronic Theses and Dissertations

The diverse array of challenges associated with the COVID-19 pandemic make it difficult to assess the full impact of this global health crisis. More than 300,000 older Americans died, leaving a nation of grieving survivors in their absence. This profound loss of life will undoubtedly inform the field’s understanding of grief and grieving for many years to come. Pre-pandemic, older women in the United States understood grief to be part of their life stage; COVID-19 amplified the grief experience through both cumulative losses and the isolation particular to the novel coronavirus response. However, few qualitative studies explore older women’s grief, …

The Intersection Of Traumatic Brain Injury And Homelessness, Stephanie A. Chassman

Electronic Theses and Dissertations

The rates of TBI are significantly higher among individuals experiencing homelessness compared to the general population. Up to half of individuals experiencing homelessness may have a TBI. Accurate prevalence rates of TBI among individuals experiencing homelessness are difficult to obtain due to different methods of sampling participants and differing definitions of TBI; therefore, estimates may be underrepresented. Despite past research that has examined the relationship between TBI and homelessness, there are specific gaps in knowledge such as correlates and risk factors of TBI among individuals experiencing homelessness. This three-manuscript dissertation attempts to address these gaps in knowledge.

The first manuscript …

Exploring The Potential For Therapeutic Art-Making In School Psychology Practice: A Single Case Study Of A Training Experience, Alexandra G. Manion

Electronic Theses and Dissertations

The purpose of this study was to investigate the impact of a training experience on the use of therapeutic art-making for school psychologists, with a focus on how to incorporate these concepts into their school-based mental health practice. Therapeutic artmaking includes the use of visual art activities (drawing, painting, clay, and collage) with specific therapeutic intent. Although there are examples of art therapists providing inschool therapeutic art-making services to support the mental health needs of students, there is far less information regarding the use of therapeutic art-making by school-based mental health providers, including school psychologists. This single case study explored …

Understanding And Supporting Asian American Youth’S Mental Health Within Cultural And Family Contexts, In Young Park

Electronic Theses and Dissertations

Mental health problems are a major health issue among East Asian American (EAA) youth. Although previous research has explored the risk and protective factors associated with mental health problems of EAA youth, many studies have employed Eurocentric perspectives, thereby excluding their unique cultural backgrounds, beliefs, and values. To better understand mental health needs and support these youth, further research that identifies different factors associated with mental health problems in their cultural context and assesses evidence-supported and culturally responsive interventions is needed.

This three-manuscript dissertation is presented in three papers. The first manuscript presents an integrative conceptual framework that uses two …

Organellar Zn2+ Homeostasis And The Role Of Trpml Channels In Neuronal Lysosome Physiology And Axonal Transport, Taylor Franklin Minckley

Electronic Theses and Dissertations

Zinc (Zn²⁺) is crucial for proper cellular function, and as such it is important to measure and track Zn²⁺ dynamics in living cells. Fluorescent sensors have been used to estimate Zn²⁺ content of subcellular compartments, but little is known about endolysosomal Zn2+ homeostasis. Similarly, although numerous sensors have been reported, it is unclear whether and how Zn²⁺ can be released from intracellular compartments into the cytosol due to a lack of probes that can detect physiological dynamics of cytosolic Zn²⁺. My dissertation started with comparing and characterizing different Zn²⁺ sensors including the …

Exploring The Relationship Between Historical Redlining And Place-Based Reproductive Health Inequities: A Qualitative Gis Approach, Kristi L. Roybal

Electronic Theses and Dissertations

Individual-level risk factors and characteristics do not fully explain racial, ethnic, and socioeconomic inequities in preterm birth in the United States, and evidence suggests that medical advancements, increased access to prenatal care, and high per-capita spending on health care have done little to reduce these inequities. Health inequities research has shifted its attention from individual-level factors that influence health outcomes to the social determinants of health. Neighborhoods, considered an important upstream social determinant of health, can influence health outcomes through their social, service, and physical environments, and have been consistently linked to birth outcomes. Despite increased attention to neighborhood influences …

Well-Being Development: Parents’ Perceptions Of Gifted Adolescents, Barbara Moncure Washington

Electronic Theses and Dissertations

The purpose of this study was to examine parents’ perceptions of well-being development in their gifted adolescents. This was a qualitative study that used Narrative Inquiry as a research approach. Cloninger’s (1993) Psychobiological Model of Temperament and Character the (TCI) and Clandinin and Connelley’s (2000) Three-Dimensional Narrative Inquiry Space were utilized to address the research questions: What are parents’ perceptions of temperament in their gifted adolescent? What are parents’ perceptions of character in their gifted adolescent? What are the parents’ perceptions of well-being development? Dabrowski’s Theory of Positive Disintegration (TPD) provided an analysis lens for the study.

The framework for …

Mitigating Weight Stigma In The Medical System: Self-Compassion For Nursing Students, Ellen C. Joseph

Electronic Theses and Dissertations

Weight stigma is a form of oppression that has been shown to have a detrimental impact on the well-being of people with higher weight. Healthcare providers are one of the most common sources of weight stigma, and their stigmatizing beliefs have been found to be associated with differential care for patients with “obesity”. The current study aimed to explore the feasibility of the loving-kindness meditation (LKM) as a brief intervention that reduces weight bias in nursing students by increasing self-compassion, positive, other-focused emotions, and cognitive flexibility, in order to improve compassionate care for patients with higher weight. Participants (189 nursing …

Antioxidant Biomarkers And Nutraceutical Therapeutics In Neurodegeneration And Neurotrauma, Lilia A. Koza

Electronic Theses and Dissertations

Mild traumatic brain injury (mTBI), yielding a Glascow Coma Scale of 13-15, is the most commonly occurring severity of TBI. Pathology from mTBI consists of blood brain barrier disruption, neuroinflammation, oxidative stress, excitotoxicity, mitochondrial dysfunction, protein aggregation, axonal degeneration, and resulting neuronal death. These processes deplete the body’s endogenous antioxidant system. We report a retrospective analysis of antioxidant blood biomarkers in patients with a history of mTBI from a local sports medicine clinic, Resilience Code. We found persistent sex-specific antioxidant depletions in mTBI patients associated with worsened symptomology.

Certain populations, such as athletes, are at high risk for repetitive mTBI …

Maternal Hpa Axis Function During Parenting Is Associated With Reduced Brain Activation To Infant Cry And More Intrusive Parenting Behavior, Andrew Erhart

Electronic Theses and Dissertations

Previous research indicated that maternal cortisol function and maternal brain response to infant stimuli are separately related to differences in parenting behavior. Evidence from animal models have demonstrated that chronically high cortisol concentration alters brain structure and function, suggesting that studying these two mechanisms together may further improve understanding of parental behavior in human mothers. First time mothers of infants aged 1-7 months old (M age = 3 months) were recruited to participate. Mother’s cortisol concentration was measured during a naturalistic interaction with their infant and their behavior was coded for maternal sensitivity and nonintrusiveness. In a separate session using …

The Place And Role Of Pharmacy Benefit Management (Pbm) Companies In Us Healthcare System, George Mattis Ii

Electronic Theses and Dissertations

On average, prescription drugs cost US consumers more than any other developed country in the world. US drug makers claim that intermediaries in the prescription drug supply chain, companies called pharmacy benefit managers (PBM), are forcing them to increase their drug prices. PBMs counter that the discounts they receive from drug makers are channeled to insurers. This thesis will examine the role that PBMs play in the prescription drug supply chain and determine what effect they have on drug prices. This thesis will utilize a comparative static model, Structure, Conduct, Performance (SCP) framework to analyze the pharmaceutical manufacturing and the …

Mechanisms Of Sensory Adaptation In The Primate Visual System, Boris Isaac Peñaloza Rojas

Electronic Theses and Dissertations

Under ecological conditions, the luminance impinging on the retina varies within a dynamic range of 220 dB. Stimulus contrast can also vary drastically within a scene, and eye movements leave little time for sampling luminance. In addition, the amount of information reaching our visual system far exceeds the brain’s information processing capacity. Given the limited dynamic range of its neurons and its limited capacity in processing visual information in real-time, the brain deploys both structural and functional solutions that work in tandem to adapt to the surroundings. In this work, employing visual psychophysics and computational neuroscience, we study the mechanisms …

Human Genetics, Psychotropic Drugs, And Acts Of Violence, Selma Jolanda Eikelenboom-Schieveld

Electronic Theses and Dissertations

From the start of the use of psychoactive prescription medications in the 1950s, physicians reported paradoxical adverse reactions, ranging from newly developing depressions to an increase in existing mood disorders, and extremely violent and bizarre acts of suicide and homicide. In this research, it is hypothesized that the pharmacological properties of the prescribed drugs or the interaction between the drugs and the enzymes that are primarily responsible for their metabolism (cytochrome P450s) could cause these reactions. Given that acts of violence could be medication-induced, the role of the rate of drug metabolism is discussed. Genetic testing of certain CYP450s could …

The Colored Pill: A History Film Performance Exposing Race Based Medicines, Wanda Lakota

Electronic Theses and Dissertations

Of the 32 pharmaceuticals approved by the FDA in 2005, one medicine stood out. That medicine, BiDil®, was a heart failure medication that set a precedent for being the first approved race based drug for African Americans. Though BiDil®, was the first race specific medicine, racialized bodies have been used all throughout history to advance medical knowledge. The framework for race, history, and racialized drugs was so multi-tiered; it could not be conceptualized from a single perspective. For this reason, this study examines racialized medicine through performance, history, and discourse analysis.

The focus of this work aimed …

A Phenomenological Study Of The Experiences Of Military Families, Who Have Children With Disabilities And Maladaptive Behavior, With School-Based Mental Health Personnel, Londi J. Segler

Electronic Theses and Dissertations

This qualitative study used a phenomenological approach to capture the lived experiences of military families who have children with disabilities and maladaptive behavior to note risk and protective factors that might impede the mental health development of that population of student. Through interviews with at-home-caregivers, I explored their experiences with public school staff, outside mental health services, and school psychologists. Study findings revealed that participants felt they were going to battle with school staff who were not willing to incorporate culturally responsive practices when working with their children. School staff who implemented regular bi-directional communication were more likely to gain …

The Experiences Of Ncaa Student-Athletes With An Eating Disorder Or Disordered Eating, Rachel E. Taylor

Electronic Theses and Dissertations

The purpose of this study was to explore the experiences of student-athletes who had an eating disorder or disordered eating (ED/DE) while competing for the National Collegiate Athletic Association (NCAA). Integrating criticism and connoisseurship and critical evocative portraiture, four post-collegiate women who participated in cross country and track, who were either clinically diagnosed with an ED/DE or who self-diagnosed, participated in two interviews to describe their experiences with and the impact of ED/DE on their athletic pursuits, academic pursuits, as well as their relationships with coaches, teammates, and family. The analysis of these interviews showed the complexity of this topic. …

How 6-12th Grade Staff Support Students With Depression: A Pilot Study To Develop Measures Of Implicit Associations, Explicit Attitudes And Helping Behavior, Paul M. Thompson

Electronic Theses and Dissertations

Students with emotional disabilities are disproportionately suspended and expelled in K-12 schools. Attribution theory suggests individuals are less likely to provide assistance to others if they believe the individuals are responsible for their own difficulties. To test attribution theory, this study created new measures of explicit attitudes and implicit associations of licensed 6-12th grade staff regarding students with depression as well as a helping behavior measure of staff toward students with depression. The survey was distributed within a single school district in the western United States. A majority of the sample (N = 52) held a mental health license (60%), …

Fostering Trauma-Informed Schools By Considering The Experiences Of Teachers In Working With Trauma-Exposed Students, Allison A. Stiles

Electronic Theses and Dissertations

High rates of trauma exposure among youth in the United States and the detrimental effects of trauma on students’ psychosocial and academic outcomes are well-established. Such findings have engendered the emergence of trauma-informed schools across the nation. While research regarding trauma-informed schools has understandably focused on the needs of students, shockingly little is known about teachers’ experiences in working with trauma-exposed students. In particular, very few studies have examined the relationship between teachers’ indirect exposure to student trauma and related symptoms of secondary traumatic stress (STS), as well as factors that may predict STS levels or explain variation in the …

Photoassisted Synthesis Of Complex Polyheterocycles Via Esipt-Driven Dearomative Intramolecular Cycloadditions, Dmitry Kuznetsov

Electronic Theses and Dissertations

This research is focused on the development of novel photoassisted synthetic methodologies that provide straightforward access to complex and diverse libraries of polyheterocycles from modularly assembled precursors. All methods are based on the dearomative cycloadditions between two components: (i) o-azaxylylenes, generated by the excited-state intramolecular proton transfer, and (ii) tethered arene groups.

We have demonstrated the synthetic utility of four new photoinduced processes that yield complex products amenable for post-photochemical modifications:

• [4+4] Cycloaddition of o-azaxylylenes to 1,3,4-oxadiazoles with subsequent dinitrogen extrusion. This reaction furnishes compounds outfitted with epoxide fragments, which undergo ring-openings with various nucleophiles; furthermore, the oxidized products …

Evaluation Of A Sexual Health Training For Child Welfare Workers, Katie Massey Comsb

Electronic Theses and Dissertations

Background: Elevated rates of early pregnancy and parenting among youth in foster care (YFC) are well documented. Training child welfare workers to provide sexual health information and resources is stated throughout the extant literature as a pressing need in efforts to prevent unintended pregnancy among YFC. However, few child welfare agencies offer such training to their workers, and little is known about the extent to which conversations about sexual and reproductive health already occur between child welfare workers and youth. Thus, this study aimed to: a) assess baseline attitudes, knowledge, and communication among child welfare workers regarding sexual health of …

Social Aspects Of Food-Sensitive Adults, Jean Elizabeth Duane

Electronic Theses and Dissertations

People living with food-related illnesses find themselves subjugated by commonly held ideologies causing awkwardness in social situations. The current study is a qualitative analysis addressing how people with celiac disease (CD) navigate social situations in light of dominant beliefs that influence behaviors. Initially, I identify macro-level patriarchal, religious, sexist, ableist and etiquette-related commensality ideologies that disadvantage those with CD. Drawing from the communication narrative sense making (CNSM) theory that supports storytelling and memorable messages as a sense-making tool for individuals diagnosed with chronic illness and their family members, this work highlights retrospective stories and memorable messages from 20 randomly selected …

Behind The Mask Of Morality: (E)Urochristian Bioethics And The Colonial-Racial Discourse, Jennifer L. Mccurdy

Electronic Theses and Dissertations

The discipline of bioethics is insufficient and ineffective in addressing the persistent issues of racism and racial inequalities in healthcare. A minority of bioethicists are indeed attentive to issues such as implicit bias, structural racism, power inequalities, and the social determinants of health. Yet, these efforts do not consider the colonial-racial discourse -- that racism is an instrument of eurochristian colonialism, and bioethics is a product of that same colonial worldview. Exposing mainstream bioethicists to the work of anti-colonial scholars and activists would provide bioethicists a framework through which they would be better equipped to address issues of race through: …

Exploring Early Temperament Predictors Of Maladaptive Behavior In A Group Of Elementary School Age Children With Autism Spectrum Disorder, Caren D. Rhodes-Doudna

Electronic Theses and Dissertations

The current study is an ex post facto nonexperimental design analyzing archival data collected from previous trials of a large-scale longitudinal study conducted by researchers at JFK Partners, Center of Excellence in Autism and Neurodevelopmental Disabilities in collaboration with the University of Colorado Anschutz Medical School (Principal Investigator: Susan Hepburn, Ph.D.). Specifically, the study looked at the temperament characteristics of mood, intensity, adaptability, and approach measured within early childhood and how they relate to later maladaptive behavior within a group of elementary age children diagnosed with ASD. Maladaptive behavior is a particularly salient outcome, as it impacts the child and …

Social Determinants Of Health Theory: Policy Entry Points For Healthcare Providers, Kiah R. Vandergrift

Electronic Theses and Dissertations

This thesis examines a shifting paradigm in the U.S. healthcare system that will re-define the role that the healthcare provider plays in the production of health. It does this by first acknowledging two differing economic theories on the production of health: Human Capital Theory and Social Determinants of Health theory, and how both schools of thought have contributed to the paradigm that healthcare providers only play a role in the end stages of health production - to heal those who are already ill. However, policy, payment, and delivery system reforms have begun to force healthcare providers to re-think how they …

How Informational Imperfections Lead To Sub-Optimal Solutions In Health Savings Plan And Potential Remedies In A Competitive Marketplace, Jacob Gene Dengg

Electronic Theses and Dissertations

In the growing trend of consumer-driven health insurance, more consumers than ever have access to a high-deductible health plan paired with a health savings account, where consumers can save pre-tax income for healthcare but also face higher out-of-pocket prices, in hopes that consumers will become smarter shoppers. The Health Savings Plan is successful at lowering costs, but at the expense of consumers lowering their adherence to healthcare, raising health risk. Even in a competitive market, HSP plan designs require smart shoppers and more active healthcare self-management, but without dealing with the informational imperfections that need to be overcome to encourage …

Stigma In The Post Crisis Age: External Barriers To Accessing Hiv Treatment, Internalized Trauma, And Strategies Of Support In Orlando, Florida, Julian Cerrell Nilsson

Electronic Theses and Dissertations

In 2017, The CDC (center for disease control and prevention) released a memo confirming popular medical opinion that an HIV positive person with an undetectable viral load was unable to transmit the HIV virus. While treatment and prevention options are advancing, this advancement may not translate directly into reduced stigma, which is produced and reproduced by external barriers to accessing healthcare, and internalized by HIV positive people as emotional trauma. This research explores the relationship between the availability of contemporary resources for the treatment and prevention of HIV/AIDS, and the environment of stigma experienced by positive gay and bisexual men …

Psychotropic Medications And Children: Perceptions Of Mental Health Professionals, Elinor Jane Brereton

Electronic Theses and Dissertations

This project explores mental health professionals' perspectives on the prescription of psychotropic medications to children. It emphasizes the placement of biomedicine within its larger social, economic, and political context, and the influence these structures have on the way mental illness is conceptualized and treated in children. Eight semi-structured interviews were conducted in Denver, Colorado with psychiatrists, psychologists, social workers, and a pharmaceutical board member to capture multiple perspectives from different positionalities within the field. Participants discussed factors that they believe influence prescribing practices including: professional role changes, issues of access, limited evidence, cost, and institutional pressures to practice within a …

An Exploratory Study Of Session Limited Models Of Therapy Outcomes In An Employee Assistance Program, Ivy C. Donaldson

Electronic Theses and Dissertations

Employee Assistance Programs (EAPs) have grown increasingly popular over recent years. The prevalence of organizations utilizing and investing in EAP services for their employees has grown; however, companies that purchase EAPs are not well-informed as to which session-models are most effective for various diagnoses. The current study is the first to explore treatment outcomes of session-limited models (measured by Therapist Perception of Change, TPC) for diagnoses (anxiety and depression) in an EAP delivery system. Outcomes were measured by TPC ratings including: a) Regressed, b) remained at Baseline, c) Improved, and d) issue was Resolved. Analyses (Chi-Square and =t-test) were used …