Medicine and Health Sciences Commons^™

Clinicians' Use Of Mhealth Applications In Interventions For Substance Use Disorders, James Daniel Bender

Dissertations

The purpose of the study was to examine how clinicians are identifying, evaluating, and utilizing mHealth apps as treatment adjuncts with their clients who have a substance use disorder. A sample of 93 participants (20 males, 72 females, and 1 not listed) completed measures of demographics and inquiries about their use and evaluation of mHealth apps in their practices. Clinicians who work at mental health centers and private practicing clinicians were recruited. The majority of the sample (71%) reported that they had not utilized mHealth apps with their clients who have a substance use disorder diagnosis. Participants who have attended …

Examining Treatment Acceptability Of An Eight-Week Mindfulness-Based Stress Reduction Protocol, Blake William Palmer

Dissertations

The goal of this study is to examine whether levels of perceived stress, experiential avoidance, personality traits including openness to experience and agreeableness, and demographic variables will predict the treatment acceptability (indicated by responses on the Treatment Acceptability and Adherence Scale) of an eight-week Mindfulness-Based Stress Reduction (MBSR) program. This study collected data in the Spring of 2019. The final number of participants in the study was 116 (40 females, 76 males, Mage = 36, age range: 22-69 years). Participants completed measures including the Perceived Stress Scale (PSS), Acceptance and Action Questionnaire-II (AAQ-II), the agreeableness and openness to Experience domains …

Respecting The Spectrum: Creating A Gender Inclusive Structured Diagnostic Intake Interview, Natalia Andino-Rivera

Dissertations

Transgender and nonbinary (TNB) people, more than ever, are in need of and actively seeking out services in order to cope with the reality of being transgender in the United States. This includes requiring assistance from local and federal governmental systems that do not provide protections for equal housing, workplace discrimination, and healthcare provisions, much less hate crime investigation and prosecution. In 2011, 75% of transgender people were or had been in therapy in the past, with a further 14% intending to participate in therapy in the future. Recently, the newly elected President Joseph Biden issued an executive order (EO) …

Examining Complementary Health Approaches And Integrative Health (Chaih) Practices Among Occupational Therapists In The United States: A Mixed Methods Approach, Sarah M. Renner

Dissertations

The use of complementary health approaches and integrative health (CHAIH) is increasing among adults and children in the United States and continues to grow within various health care settings. With Health and Wellness identified as a key practice area for occupational therapists and the American Occupational Therapy Association supporting the use of CHAIH in occupational therapy (OT) practice, practitioners must offer safe, research-driven treatments supporting this movement. Research around CHAIH continues to grow; yet the gaps in the literature make it difficult to determine how CHAIH is being used in OT practice as well as the practitioner’s perspectives on the …

Characterization, Implementation, And Impact Of Low Stimulation Precautions In Acute Neurological Injury, Alexis Kurek

Dissertations

Recommendations provided by clinical and professional organizations that encourage providing patients with a low stimulation environment following acquired brain injury are prevalent but supported by expert opinion only. Such recommendations are based on extrapolation of what is known about physiological response to environmental stimuli, however such findings are not specific to the patients with acquired brain injury. Recommendations for low stimulation environments lack guidance for their application and implementation of precautions, and there have been no studies investigating their effectiveness at improving clinical outcomes.

The objective of this study is to determine what patient characteristics are associated with prescription of …

Positive Symptoms Of Schizophrenia And Suicide: A Systematic Review Of Gender, Race/Ethnicity, And Premorbid Iq Variables, Susan Diann Paschall

Dissertations

Schizophrenia is an exceptionally debilitating mental disorder. Its effects permeate all facets of psychosocial functioning and it is associated with premature mortality. As such, suicide is of clinical concern. Positive symptoms such as hallucinations and delusions may influence the risk of suicide among individuals diagnosed with schizophrenia, but additional research is necessary, as the limited literature on this topic is dated and includes heterogeneous results. Early recognition of and intervention for suicide risk factors, such as the presence of positive symptoms of psychosis, may reduce mortality rates for individuals with schizophrenia. The present literature review examined the role of gender, …

Leader Development Of The Health Information Management (Him) Professional, Theresa Jones

Dissertations

This study contributes to the body of knowledge in leader development by examining how higher education programs in a female dominated profession assist learners in developing person-related characteristics that support leader development. A ten-part online survey was sent to directors of health information management (HIM) programs accredited by the Commission on Accreditation for Health Informatics and Information Management (CAHIIM). Results suggest an opportunity for improvement in the curriculum for development of person-related characteristics critical for leadership positions. In the interest of the progression of women these results should be taken into consideration.

Developing A Diagnostic Tool Of A Community’S Health, Ruth Kurtycz

Dissertations

Where we live can affect nearly every aspect of our lives, including how long those lives will be. Previous studies have demonstrated large health disparities between communities in the United States; since the health of a community can significantly impact its residents, evaluating and predicting community health is of interest to many people. Currently the Federal government collects and publishes data on community-level demographics, housing, crime rates, and disease. State-level and non-governmental agencies track and share community housing prices, school performance, neighborhood safety, and other characteristics. In short, there is a wealth of information but the work being done around …

The Acquisition Of Dental Competencies And Clinical Skills: Perceptions From Students, Faculty, Practicing Dentists And Industry Professionals In The Dominican Republic, Laura Virginia Reyes Alardo

Dissertations

The Dominican healthcare system faces many challenges, and dental education is not an exception. The lack of competencies established for dentistry is one of the most critical challenges that dentistry faces. There is no way to guarantee that all dentists receive the same quality education with no standards and lack of competencies. Previous research has revealed that the competencies achieved by dental students determine the way such students develop their professional practice in the future as dental graduates (Alcota, De Gauna, & González, 2016). However, there is a lack of shared language observed in dental education around the world. Not …

A Quantitative Assessment Of Marital Quality Among Couples In Kerala, India, Grace Kochuparambil

Dissertations

The increasing number of divorces and domestic violence in Kerala, India points out the need to assess marital quality among couples in Kerala. The lack of assessment tools in the native language prevents evaluating Malayali couples' marital relationships. The purpose of the proposed study was to examine couples' marital quality in Kerala and validate the translated Marital Adjustment Questionnaire (MAQ) and Marital Quality Scale (MQS), the M-MAQ and the M-MQS, respectively. The instruments were translated into Malayalam through a forward and backward translation. A quantitative survey research design collected data from a criterion[1]based sample of 260 couples in Kerala using …

Epigenetic Modifications In Metabolic Syndrome: Identification And Evaluation Of Early Indicators Using A Rodent Model System, Ashok Daniel Pragasam

Dissertations

It is increasingly realized that mechanisms of developmental plasticity rather than pathology independently facilitate the size of developing embryos during early development. Changes in the early developmental environment alter the metabolic traits resulting in diseases, including metabolic syndrome, including type 2 diabetes and obesity in adulthood. Molecular and epidemiological studies have documented an association between Lower Birth Weight (LBW) and increased risk of developing metabolic syndrome. Henceforth, using birth weight as a marker, two groups of normal birth weight range rat pups, Lower Birth Weight (LBW, 5th to 25th percentile) and Average Birth Weight (ABW, 50th to 75th percentile) as …

Insights Into The Packaging Of Mouse Mammary Tumor Virus (Mmtv) Genomic Rna By Identifying Pr77ᴳᴬᴳ Binding Sites Involved During Its Selective Encapsidation, Akhil Chameettachal

Dissertations

Selective encapsidation and/or packaging of retroviral genomic RNA (gRNA) by Gag during retrovirus assembly is a crucial step for generating infectious virus particles. Despite having been studied extensively, the mechanism by which the retroviral Gag precursor selects and packages the retroviral genome remains largely unclear. Therefore, to understand the molecular mechanism(s) of mouse mammary tumor virus (MMTV) gRNA packaging, as a first step, expression of full-length recombinant Pr77^Gag -His6-tag fusion protein in bacteria was done. The recombinant Gag protein was then purified from the soluble fractions of bacterial cultures using immobilized metal affinity chromatography (IMAC) and size exclusion chromatography …

Exposure And Handling Practices Of Healthcare Professionals For Cytotoxic Drugs In The Workplace Environment, Laila Masoud Al Alawi

Dissertations

Introduction: Occupational exposure to cytotoxic drugs is associated with various unfavorable health outcomes. There is currently no safe level for occupational exposure to cytotoxic agents. Healthcare workers’ adherence to cytotoxics control measures is of primary importance to minimize the risk from exposure to these agents.

Aims: To develop a protocol for a systematic review and meta-analysis on environmental assessment of cytotoxic drugs in healthcare settings and conduct an environmental assessment study of cytotoxic drugs in two Oncology centers of Abu Dhabi, United Arab Emirates (UAE). In addition to evaluate pharmacists’ and nurses’ Knowledge, Attitudes, and Practices (KAP) towards handling of …

The Role Of Nutrient Sensitive Protein O-Glcnacylation In Developmental Cortical Neurogenesis, Shama Parween

Dissertations

The nutrient responsive O-GlcNAcylation is a dynamic, posttranslational protein modification present on many nucleocytoplasmic and mitochondrial proteins. Previous research has indicated that hyperglycaemia increases the levels of total O-GlcNAcylation within cells. Transcription factors and histones are among hundreds of proteins that have been reported to be O-GlcNAcylated and have importance in cell fate determination during cell growth, proliferation, and differentiation. However, the role of protein O-GlcNAcylation in epigenome control in response to nutritional perturbations is poorly understood. Hyperglycaemia induced protein O-GlcNAcylation have been linked to several pathologies, including obesity, diabetes, cancer, cardiovascular and neurodegenerative diseases. …

Plant-Derived Extracellular Matrix Mimetic Scaffolds For Bone Repair Applications, Jessica Cardenas Turner

Dissertations

Autologous and allogeneic bone grafts are currently used to treat large bone defects or fractures that will not heal. However, for patients with osteoporosis or other conditions that impair the natural bone healing process, such as diabetes, smoking, bed rest, aging, autologous bone graft, which is the patient's own bone, is limited in quantity and its healing potential may be compromised. Allograft bone, or donated bone, lacks the necessary biological activity and has poor integration into defect. There is an urgent need for constructs/grafts capable of promoting bone cell function in fracture healing and large bone defects where the endogenous …

Emergency Department Visits And Hospital Admissions For Adult Cancer Patients Post Outpatient Chemotherapy: Does The Oncology Nurse Navigator Make A Difference?, Sunny L. Stirling

Dissertations

Background: Cancer is the second leading cause of death in the United States and worldwide. Oncology related hospital visits account for over $88 billion annually; 35% of this cost is attributable to inpatient hospital stays even though most cancer treatments are given outpatient. The Centers for Medicare and Medicaid Services introduced the Chemotherapy Measure which tracks Emergency Department visits and hospitalization within 30 days of any outpatient chemotherapy treatment. The Oncology Nurse Navigator (ONN) has offered some benefit in cancer care, but its role in ED visits and hospital admissions is unknown for adult patients with cancer post outpatient …

Food Insecure Copd Patients And Healthcare Utilization: A Retrospective Study, Kristine Mendoza

Dissertations

Abstract

Purposes/Aims: Despite advances in the recognition and treatment of high-cost users of health care, the incidence of healthcare utilization remains high. Rates of hospital admissions and emergency room visits among chronic disease like COPD have become a targeted group for health management. COPD patients have multiple and complex health and social needs, but the impact of their unmet food needs is not well understood and warrants further investigation. The purpose of this study is to explore the relationships between COPD food insecure patients and healthcare utilization in San Diego County.

Background/Rationale: Government programs targeting patients with high healthcare costs …

The Associations Of Chronic Stress, Social Support, Health Behaviors And Metabolic Syndrome Among Hispanic Women, Edna Esquer

Dissertations

The Associations of Chronic Stress, Social Support, Health Behaviors and Metabolic Syndrome Among Hispanic Women

Background: Metabolic syndrome (MetS) prevalence is 25% among Mexican American women 30 – 49 years of age, compared to 22% among non-Hispanic Whites in the United States. Little is known about the additional contributions of chronic stress, social support and health behaviors to the development of MetS among this population.

Purpose: Describe the associations between chronic stress, social support, and health behaviors and the presence of MetS in Hispanic women living in an underserved community.

Methods: A retrospective cohort study design. The Adult Treatment Panel …

Strategies For The Improvement Of Healthcare Through Simulation, Roger Lankheet

Dissertations

Title:Strategies for the improvement of healthcare through simulation

Background: Medical errors continue to plague the healthcare industry. The annual rates of morbidity are approximately 2.69 million (AHRQ, 2019), while mortality rates exceed 400,000 per annum (Makary & Daniel, 2016). There may be no panacea to combat these egregious rates. However, simulation of patient care events may better prepare healthcare professionals to prevent medical errors as it has been proven to be an effective learning strategy (Kirkham, 2018), enhancing skills while gaining experiential knowledge, without risk to actual patients.

Purpose: The purpose of this qualitative study was to gain a …

Synthesis And Self-Assembly Of Amphiphilic Block Copolymers For The Fabrication Of Non-Spherical Polymersomes, Tamuka Chidanguro

Dissertations

Polymersomes, also known as polymer vesicles, have gained a lot of interest over the past two decades. These hollow spherical systems are made via the self-assembly of amphiphilic block copolymers and have found use in a range of areas from drug delivery, to cellular models, to nanoreactors. Their hollow nature allows them to carry hydrophilic cargo in their inner compartment and hydrophobic cargo in their membrane. Over the last decade, increasing efforts have focused on controlling the morphology of polymersomes. Research has shown that polymersome morphology plays an important role for instance in drug delivery, where tubular or rod-like vesicles …

Behavioral Economic Modeling Of The Effects Of Symptom, Severity, And Cost On Seeking Medical Care, Mark J. Rzeszutek

Dissertations

While the United States has some of the highest healthcare spending in the world, it has some of the worst health outcomes. For example, maternal mortality in the United States is almost five times as high as in other similarly wealthy countries. It also has the highest rates of avoidable deaths. One of the reasons for this may be the cost of accessing healthcare due to privatized insurance. For example, Americans may avoid important preventive medical visits and other health screeners due to cost. While lack of health insurance has been correlated with decreased health utilization, a precise understanding of …

Facilitating Implementation Of In-Room Whiteboards In The Skilled Nursing Environment Using The Parihs Framework, Ashley Lubbers

Dissertations

The application of research to practice is a difficult task to successfully carry out for many healthcare professionals and organizations. The Promoting Action on Research Implementation in Health Services (PARIHS) framework is a tool that acts as an implementation guide for translating research evidence to practice. This study explored the use of an adapted version of the PARIHS framework as a guide to implementing in-room whiteboards in a skilled nursing facility (SNF) on their short-term rehabilitation wing. While the utility of in-room whiteboards has been demonstrated in the acute care setting, there are few studies of their use in SNFs. …

On Prediction Of Early Signs Of Alzheimer’S— A Machine Learning Framework, Abdalrahman Alsaedi

Dissertations

Dementia is a collective term used to indicate a loss of memory functions with the presence of at least one additional loss of a major cognitive ability that hinders a person’s previous level of functioning. Studies show that dementia is highly age- associated and that the most common cause of dementia is Alzheimer’s disease. Early recognition of Alzheimer’s disease, before irreversible damage to the brain has already occurred, is paramount to slowing or preventing the disease. Therefore, algorithms for the prediction of early signs of dementia are essential. Machine learning approach has been reported to use several data sources such …

Neonatal Toxic Stress And Long-Term Neurodevelopment In Premature Infants, Rachelle Sey

Dissertations

Background: Evidence suggests the presence of complex biologic connections between the social environment, neurologic development, and long-term health. Premature infants spend many months in the Neonatal Intensive Care Unit (NICU) often separated from their parent(s). Decrease in the age of viability threshold allows extremely preterm infants to benefit from lifesaving therapies; however, they are frequently exposed to significant stressors that increase their risk for adverse neurodevelopmental outcomes.

Purpose: The purpose of this study is to examine the relationship among socio-demographic factors, exposure to stressors in the NICU environment, stress modifiers/buffers, neonatal morbidities at discharge, and 1. 2-year neurodevelopmental outcomes and …

Evaluation Of Telehealth Training To Teach The Stimulus Identification Questionnaire And Multiple Stimulus Without Replacement, Andrea Perez

Dissertations

The field of behavioral gerontology has seen a paucity in literature within the past 15 years focused on updating training technology and teaching best practice skills to staff. Specifically, there is a need to expand the breadth of training research focus areas could more broadly the elderly population (e.g., increasing engagement), to ensure that trainings are designed to equip caregivers with the skills to be independent, and finally, given the frequent staffing challenges experienced by aging settings (Harrington et al., 2020), to explore effective and efficient training techniques that are alternatives to lengthy, in-person training modalities. Given the personnel challenges, …

The Neuroanatomical, Neurochemical, And Phenomenological Correlates Of Social Bonding, Empathy, And Flow In Music Improvisation, Edward A. Roth

Dissertations

The three studies in this dissertation explore the biological and phenomenological under-pinnings of music improvisation related to bonding, empathy, and flow. Musical improvisation is a multi-dimensional behavior encompassing motor, cognitive, affective, and often social domains, and as such, it is reasonable to consider that music improvisation shares many characteristics with other forms of non-musical extemporaneous behavior, such as carrying on a verbal dialogue. The primary aims of this three-study dissertation were to (1) determine the feasibility of the study designs and interdisciplinary methods; (2) examine potential differences in the neuroanatomical and neurophysiological correlates of improvisation between non-musicians and musicians; and …

Psychological Wellbeing And Sense Of Community Among African Americans: Does Purpose In Life Matter?, Yatesha D. Robinson

Dissertations

This dissertation examined the relationships between sense of community, purpose in life, and psychological wellbeing among African Americans. It investigated whether purpose in life moderated the relationship between sense of community and psychological wellbeing. Although previous studies have linked a sense of community and purpose in life with wellbeing, few studies have examined these relationships among African Americans using a multidimensional model. The data for the current analysis were drawn from the third wave of the National Survey of Midlife Development in the United States study (MIDUS 3), collected between 2013–2014. The sample included 98 African American men (n …

A Study Of Communication Practices Between Office And Field-Based Personnel In Home Healthcare Agencies, Ruth M. Bates-Hill

Dissertations

The population of developed countries is rapidly aging. People want to age in their residence, and as they advance in years, most people will need assistance with activities of daily living and perhaps medical assistance to remain at home. Home health aides provide a large portion of such care. However, the annual turnover rate of home health aides exceeds 60% due to factors such as low wages, poor benefits, and a challenging work environment. Many studies have been conducted to elucidate the factors contributing to job satisfaction in the home health aide population, yet despite decades of research, turnover among …

Strategies Exemplary Mental Health Leaders Use To Stay Grounded While Working With Veterans, Audrey Dangtuw

Dissertations

Purpose. The purpose of this explanatory mixed method study was to identify and describe what exemplary mental health leaders in Puget Sound area mental health facilities serving veterans do to maintain their physical, emotional, intellectual, social, vocational, and spiritual health based on the six dimensions of Rosen's (2014) healthy leader model.

Methodology. An explanatory mixed methods approach was selected to allow the triangulation of data to increase the validity of the findings. The study analyzed quantitative surveys to identify how exemplary mental health leaders rate their use of grounded leadership strategies and qualitative semi-structured interviews to identify strategies exemplary mental …

Evaluation Of An Elopement Risk Assessment Tool In An Acute Inpatient Psychiatric Hospital, Beth Lockhart

Dissertations

Persons admitted to acute care, inpatient psychiatric facilities often pose a threat to themselves or others, a situation which could quickly devolve if they were to leave treatment prematurely. There is a need for an elopement risk assessment with appropriate interventions correlating to level of risk. An acute care, inpatient psychiatric hospital implemented an elopement risk assessment tool in March of 2020. This quality improvement project used an observational descriptive design and comprised of a retrospective chart review, aimed to determine the effectiveness of the risk assessment tool on decreasing elopements. Charts of those that eloped in 2019 (n=8) and …