Medicine and Health Sciences Commons^™

Improving Access For Medicare Inpatient Psychiatric Patients: A Health Policy Analysis, Malinda B. Whitfield

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The Medicare Inpatient Psychiatric Services (IPS) policy, originally developed in the 1960s and without any significant or meaningful updates since the 1980’s, is physician specific, does not reflect the current model of care for psychiatric inpatients, and is restrictive for psychiatric mental health nurse practitioner (PMHNP) practice. The policy is complex, consists of outdated regulations, and results in millions of dollars in compliance costs for Inpatient Psychiatric Facilities (IPFs) annually (NABH, 2019). Although clearly an important part of the inpatient psychiatric services team, PMHNPs are not identified or defined in the policy (Center for Medicare and Medicaid Services [CMS], 2019). …

Tabletop Role-Playing Games As Autism Psychotherapy: A Video-Cued Multivocal Clinical Ethnography, Adina Rubin-Budick

Electronic Theses and Dissertations

This qualitative study is a video-cued multivocal ethnography that analyzed the clinical reasoning and perspectives of psychotherapists using Tabletop Role-Playing Games (TRPG) as a therapeutic treatment for children and adolescents diagnosed with Autism Spectrum conditions. With a growing number of TRPG therapists nationwide using this modality in their clinical practices, this study aimed to develop a clearer understanding of the ways in which their therapeutic orientation, gaming practices, and knowledge of Autism Spectrum Conditions informs their use of TRPG psychotherapy with Autistic clients.

Research that focuses on clinical decision-making and the knowledge that informs clinical interventions and technique generally refers …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

Empowering Nurses To Recognize Post-Stroke Depression In The African American Community, Deidra Frisbie, Robin Simon

Doctor of Nursing Practice Projects

African Americans (AA) have the highest prevalence of stroke and death compared to other racial groups in the United States. Post-stroke depression (PSD) affects approximately 1/3 of all stroke patients and is underdiagnosed in the African American community.

Aim: By using a mHealth mobile app and a Psychiatry provider list at discharge, PSD can be identified, and interventions initiated, thus decreasing the sequela of PSD in AA.

Methods: Nurses were provided education on PSD, expressions of depression in African-Americans, cultural humility, implicit bias, and the importance of the nurse's role in developing a therapeutic relationship.

Results: Quantitative analysis revealed the …

The Art Of Surviving: Alchemy Of Healing Trauma In Relation To Identity: A Self Study., Rebecca Morgan

Electronic Theses and Dissertations

The following thesis explores trauma’s physical and psychological aspects concerning identity as an artistic practice. Through exploring materials, subject matter, and media, my approach to trauma is based on personal and socially engaged experiences and my attempt to re-conceptualize that experience through the language of contemporary art. Extensively this work is governed by childhood memories and the critical aspect of being raised as a female in a patriarchal society. Being raised female comes with a certain number of expectations and requirements. This work creates a physical and spiritual connection between trauma and the identity of what is female. Discussing these …

An Updated Look At Mental Health Services In American Public And Private Prisons, Lieren E. Tyira

Student Theses

People residing in American prisons have the legal right to mental health care while incarcerated (Justia, 2021). This is important, as the prevalence of mental disorders is high in this population (Prins, 2014), and incarceration is a psychologically damaging experience, which hinders a person’s success at rehabilitation. Numerous of issues related to the mental health services (MHSs) in both public and private prison facilities have been reported in recent years, which warrants systematic exploration. The little existing research comparing the presence of MHSs in these facilities has produced mixed results, it uses out-of-date datasets, and none has explored MHSs in …

Parent-Child Relationships And Parental Distress As Moderators Between Chronic Illness And Psychological Problems In Emerging Adults., Abigail Kukay

Theses and Dissertations

The current study aimed to better understand how parental functioning and parent-child relationships might moderate the effects of chronic illness on psychological problems in emerging adulthood. Three hypotheses were made: (1) the presence and severity of chronic illness would associate positively with emerging adult psychological problems, (2) parental distress would moderate the effects between chronic illness presence/severity and emerging adulthood psychological problems, and (3) parent-child relationship quality would moderate the effects between chronic illness presence/severity and emerging adult psychological problems. Data analysis consisted of testing interaction effects, pairwise parameter comparisons, and multiple group analysis. The three-way interaction between endorsing a …

Data-Driven Neuroanatomical Subtypes In Various Stages Of Schizophrenia: Linking Cortical Thickness, Glutamate, And Language Functioning, Liangbing Liang

Electronic Thesis and Dissertation Repository

The considerable variation in the spatial distribution of cortical thickness changes has been used to parse heterogeneity in schizophrenia. We aimed to recover a ‘cortical impoverishment’ subgroup with widespread cortical thinning. We applied hierarchical cluster analysis to cortical thickness data of three datasets in different stages of psychosis and studied the cognitive, functional, neurochemical, language and symptom profiles of the observed subgroups. Our consensus-based clustering procedure consistently produced a subgroup characterized by significantly lower cortical thickness. This ‘cortical impoverishment’ subgroup was associated with a higher symptom burden in a clinically stable sample and higher glutamate levels with language impairments in …

Salesperson-Customer Dyads In The Casino Gaming Industry: How Sales Competencies And Relationship Lifecycles Influence Customer Satisfaction And Account Profitability, Alicia Lechtenberger

UNLV Theses, Dissertations, Professional Papers, and Capstones

Developing extraordinary relationships between sales personnel and customers is essential to corporate success. To meet the increasing demands of customers within the hospitality industry, corporations must ensure they pair customers with salespeople who are highly competent, possessing refined and adaptable skill sets that directly increase customer satisfaction and account profitability. Corporations spend billions of dollars annually on hiring and training salespeople; yet, salespeople often quit or miss their quota targets. Considering this industry-wide business problem, the purpose of this dissertation study was to determine how sales competencies influence customer satisfaction and account profitability while taking into consideration the duration of …

Customer Willingness To Pay For All-Inclusive Resorts: A Choice-Based Conjoint Analysis, Liheng Zhang

UNLV Theses, Dissertations, Professional Papers, and Capstones

This dissertation examined customers’ willingness to pay for all-inclusive resorts using choice theory, the theory of bundling, and prospect theory. This dissertation also contributed to the current research by determining (a) the attributes that affect customers’ willingness to pay for an all-inclusive resort and (b) whether a reference price will affect customers’ willingness to pay. We also take into account the effect of the COVID-19 pandemic on customers and whether the pandemic will influence customers’ purchase behavior at this particular time. The choice-based conjoint analysis results showed that all eleven attributes—price, hotel star rating, type of room, location, food options, …

The Morgue The Merrier? Covid19-Related Threat, Existential Isolation, & Well Being, Lauren P. Sedivy

ETD Archive

Prior research suggests that COVID-19 perceived threat and existential isolation (EI) would be associated with an individual’s subjective health, levels of anxiety, and feelings of hope relating specifically to the COVID-19 pandemic. However, it was unclear whether such concerns might be unique predictors (no interaction, two cumulative main effects) or interact (one effect modifies the other). To learn more about the possible combined effects, I analyzed data gathered via MTurk, during an 11-week period at the height of the COVID-19 pandemic (March-June 2020). Method: This study (N = 2,673) measured perceived COVID19-related threat, EI, anxiety, subjective health, and hope. Results: …

Preclinical Behavioral Assessments Of Mitraginyne, The Main Psychoactive Alkaloid In Kratom, Rachel Burroughs

Dissertations

Mitragyna speciosa (kratom) is a medicinal plant indigenous to Southeast Asia and Africa with a long history of use for a variety of ailments, including diarrhea, pain relief, cough suppression, and amelioration of opiate withdrawal symptoms. Despite its status as an herbal remedy, kratom is banned in some countries due to a myriad of negative health risks. Preclinical psychopharmacology studies of mitragynine (MG), the main alkaloid of kratom, indicate it has opioid-like effects at higher doses and psychostimulant-like effects at lower doses. The current study utilized three rodent behavioral paradigms to evaluate the putative psychostimulant effects of MG. The specific …

Individual Differences In Lpp Amplitude And Theta Power Predict Cue-Induced Eating During A Cued Food Delivery Task, Kyla Gibney

Dissertations & Theses (Open Access)

Due to individual differences in the brain’s reward system, some individuals are more vulnerable than others to maladaptive, reward-seeking behaviors, such as substance use or compulsive eating. A body of research has demonstrated that individuals who attribute higher levels of incentive salience to reward-associated cues than to pleasant images (termed “C>P group” throughout) are more vulnerable to compulsive eating than those who attribute higher incentive salience to pleasant images than reward- associated cues (P>C group). Meanwhile, a separate body of research has demonstrated that cognitive control also regulates eating by enabling top-down attentional control. This dissertation aims to …

The Impact Of Video-Taped Social Modeling On Alcohol Outcome Expectancies Of Young Adults And The Role Of Social Anxiety, Kyle Kevin Jackson

Graduate Theses and Dissertations

Alcohol outcome expectancies (AOEs) represent people’s ideas about the effects of alcohol (Fromme, 1993). Positive AOEs particularly have been identified as a potential risk factor for hazardous drinking (e.g., Brown et al., 1985). The exact mechanisms that modify AOEs are not fully understood. Further, people higher in social anxiety may be especially receptive to social modeling due to attentional bias shift towards others in social contexts (Rapee & Heimberg, 1997). The current study examined how social anxiety and social modeling associate with AOEs. It was hypothesized that 1) those in the social modeling treatment condition would have higher social anxiety-adjacent …

A Structural Examination Of The Connection Between The Amygdala And Nucleus Accumbens In Adolescents With Clinical Anxiety, Alyssa Griffith

Biological Sciences Undergraduate Honors Theses

The prominence of anxiety disorders in today’s general population is a major public health concern. Advancing research of the underlying pathophysiology of anxiety disorders can lead to the discovery of effective treatment interventions to treat the mental and physical symptoms of anxiety, and thus improve quality of life. This study aimed to examine two brain areas in the limbic and reward systems, the amygdala and Nucleus Accumbens (NAcc), and the structural white matter connection between them. This neural circuit assigns affective valence to environmental stimuli and motivates behavior to avoid potential harm. This study utilized diffusion Magnetic Resonance Imaging (dMRI) …

Multilingualism And Memory: Investigating Possible Differences In The Abilities Of Monolingual And Multilingual College Students, Clara E. Barned

Honors Projects

This study investigated whether there is a difference in the memories of monolingual and multilingual undergraduate students using simple memorization tasks. There were 46 participants, 30 of which were monolingual (only knew one language) and 16 of which were multilingual (knew two or more languages). There was found to be no significant difference between the performance of the two groups, with the data generating a p-value of 0.557. This study further suggests related avenues of research and ways in which the study could be improved in the future.

Serious Leisure, Job Task Load, & Satisfaction, Carson Matsick

All Theses

The study examined the relationship between degree of leisure seriousness and leisure, job, and life satisfaction, as moderated by perceived job mental workload. Serious leisure has largely been studied in reference to general life satisfaction and health outcomes, and less research exists to examine whether serious leisure participation may influence work. This study tested the following hypothesis: the relationship between serious leisure participation and employee well-being is moderated by mental workload on the job, such that a) as mental workload increases, then serious leisure participation and satisfaction will be less strongly positively correlated, and b) as mental workload decreases, then …

The Impact Of Covid-19 On Recreational Therapists Working In Inpatient Mental Health Settings, Summer Matics

All Dissertations

Since 2020, the novel coronavirus (COVID-19) has impacted the lives of the general public, but healthcare workers including those that work in inpatient mental health settings have seen long-lasting impacts in their workplace. Recreational therapists (CTRSs) are among the mental healthcare workers that have been impacted by the pandemic but there is no existing research that specifically studies their lived experiences. This study used the theoretical foundations and methods of hermeneutic phenomenology in order to describe how COVID-19 has impacted CTRSs’ workplace from a safety perspective, their stress and coping, and also their supervisory duties. Seventeen participants were recruited and …

Weekly Telehealth Weigh-In For Bmi Reduction, Kelly Ahmad

Student Scholarly Projects

Practice Problem: The citizens of the United States are known for being overweight or obese. The Centers for Disease Control and Prevention (CDC, 2021) reported that approximately 74% of adults are either overweight or obese. PICOT: The PICOT question that guided this project was In overweight adults (P), does telemonitoring weekly for counseling and weigh-in (I) compared to current practice (C) decrease BMI over an 8-week period of time (T)? Evidence: The citizens of the United States are known for being overweight or obese. The Centers for Disease Control and Prevention (CDC, 2021) reported that approximately 74% of …

Investigating The Income Academic Achievement Gap: An Exploration Of The Roles Of Mindfulness And Self-Concept Clarity In Low-Income College Students., Natalie Burke

Electronic Theses and Dissertations

The purpose of the current study was to examine whether linguistic patterns previously associated with trait mindfulness and self-concept clarity in low-income college students’ application essays are associated with academic performance and psychosocial variables. The aims of the study were as follows: 1) Explore relations between linguistic markers that have been previously associated with higher mindfulness/self-concept clarity and GPA and 2) Explore relations between linguistic markers that have been previously associated with higher mindfulness/self-concept clarity and anxiety/depression. Participants were 54 undergraduate students in the Cardinal Covenant program (a scholarship program for students from low-income families) who began college in the …

Blind Spot: Implicit Bias In Health Care And Its Awareness Among Nursing Students At The University Of Southern Mississippi, Debora Skaliks

Doctoral Projects

While prejudice and bias are eminent topics in our society, implicit bias or unconscious bias is not as easily detected. Even though implicit bias may be a familiar concept to many, numerous healthcare workers frequently do not recognize the extent of harm such biases can impose on patients' health and outcomes. The Blind Spot DNP project exposed in this research paper explores the relentless question of the correlation between implicit bias awareness, implicit bias education, and its impact on health care. This Doctor of Nursing Project (DNP) project aimed to analyze whether implicit bias education and testing could increase unconscious …

Lifestyle Choices Related To Food Consumption And Their Relationship To Depression, Steven L. Jennings Jr.

Dissertations

Dieting, or the act of restricting oneself to small amounts or particular kinds of foods on the basis of health, spirituality, lifestyle, and moral decisions, is a practice that dates to 1066 A.D. However, with social media being as influential as it is, one might believe dieting is a new obsession or at least an obsession to which popular culture is returning. Despite this, it is only in recent years that researchers have begun to focus on the health benefits of such behaviors. The present study was designed to take this focus a step further by exploring the potential risks …

Does Time Equal Money? Temporal Discounting And Self-Control: Insight Into The Rationality Of Personal Financial Decision-Making, Joshua Epstein

USF Tampa Graduate Theses and Dissertations

Exponential and hyperbolic intertemporal choice models have been widely investigated to measure an individual’s degree of impulsivity in behavioral economics. Hyperbolic discounting research identifies subject’s disproportionately high subjective value to immediate rewards, to the extent that it is not in their best interest. Furthermore, preference reversals have shown subjective value demonstrates an inversely relationship proportional to delay.

Investigation into whether visual representations influence conservative personal finance savings behavior was demonstrated in this study by presenting a multitude of visualizations before allocation of limited monetary resources. Evaluation of the neighbor effect was tested to determine whether comparing individuals to their peers …

Hiv And Early Life Stress On Neuroimaging And Risky Behavior, Paola Garcia Egan

Dissertations

This study examined the interactive effects of early life stress (ELS) and HIV on brain morphometry, diffusion-basis-spectrum-imaging (DBSI), risky decision-making, and sex-risk behavior. 122 people with HIV (PWH) and 113 people without HIV (PWoH), free of major psychiatric illness and neurological confounds, were stratified into high (≥ 3 events) vs. low (< 3 events) ELS [PWoH/low ELS (n = 57), PWoH/high ELS (n =56), PWH/low ELS (n = 43), PWH/high ELS (n = 79)] and underwent structural magnetic resonance imaging, DBSI, neuropsychological, and risky-behavior assessment; all PWH were virologically controlled. Compared to PWoH, PWH had smaller orbitofrontal cortex (OFC), parietal lobes, insula, caudate and anterior cingulate. No ELS effects were detected in volumetric measures. Significant interactions were found between HIV serostatus and ELS on the OFC and on cellularity of the inferior fronto-occipital fasciculus after multiple comparisons adjustment. Specifically, PWH/high ELS exhibited significantly smaller OFC and PWoH/high ELS show significantly larger OFC than the other groups. PWoH/high ELS exhibited higher DBSI cellularity (neuroinflammation proxy) of the inferior-occipital-fasciculus compared to PWoH/high ELS. Regardless of HIV status, executive function moderated the relationship between the OFC and sex-risk behavior such that individuals within the sample who performed above average on a measure of executive function and had a larger OFC reported fewer sex partners in past six months than individuals with smaller volumes. No interaction was found between HIV serostatus and ELS on risky behavior measures. Clustering analyses defined ELS subgroups in PWH that were determined by demographic characteristics, duration of infection, recent CD4+ T-cell count, nadir CD4+ T-cell count and high/low ELS.Even in PWH that are virologically controlled, without major current psychiatric comorbidities, there is evidence of a synergistic impact of ELS and HIV on OFC volumes. Higher volumes in the OFC were detrimental when associated with lower executive function scores or advantageous when associated with higher executive function. Findings suggest that ELS is associated with different brain signatures among PWoH and virally suppressed PWH. However, ELS was not directly associated with risky behaviors, and subgroups in PWH were characterized by demographic variables, past substance use and HIV clinical variables.

Internet-Delivered Cognitive Behavioural Therapy For People With Mild Traumatic Brain Injury: A Feasibility Study, Ujjoyinee France Barua

Electronic Thesis and Dissertation Repository

Individuals with mild traumatic brain injury (mTBI) can experience high levels of emotional distress, leading to decreased quality of life and increased health care costs. Bowen's feasibility framework was used to examine the feasibility, acceptability, and limited efficacy of an innovative clinician-guided internet-delivered cognitive behavioural therapy program (ICBT) specialized for people with mTBI to improve their wellbeing. The data illustrated strong adherence and program satisfaction from participants. Likewise, statistically and clinically significant changes in symptoms of unhappiness and anxiety were found, along with improved self-efficacy and quality of life. The findings of this study contribute new knowledge to the emerging …

Utilization Of A Multimodal De-Escalation Class To Improve Staff Confidence When Caring For Behaviorally Escalating Patients, Tara B. Neuner

Graduate Theses, Dissertations, and Capstones

Workplace violence is a common challenge seen in the healthcare settings across the world. This problem is steadily increasing in all types of hospitals, including a level one trauma center located in an urban area. There has been a steady rise in the number of assaults and workplace violence reported from bedside staff at this hospital. The leadership of the organization formed a work group to help combat the workplace violence and staff assaults that were occurring. In this process, a behavior response team was created to help nursing staff with escalating behavior in patients, and to help de-escalate the …

Addictive Social Media Use: Examination Of The Psychometric Properties Of The Arabic Bergen Social Media Addiction Scale And The Mediational Role Of Sense Of Control In The Relationship Between Depression And Social Media Addiction, Louis J. Fourie

Theses

The period of COVID-19 has proven to be a turbulent period where extreme psychological trends can be examined due to lockdown procedures, social isolation, and public fear. The use of technology such as social media has increased with research highlighting the harm of overuse. The purpose of the current study is to investigate the psychometric properties of an Arabic translated version of the Bergen Social Media Addiction Scale (BSMAS) to assess for addictive social media use. Secondly, the study further examines the association between depression, social media addiction, and an individual’s sense of control. Specifically, the potential mediational role of …

The Effect Of Experiential Avoidance And Committed Action On The Relationship Between Anxiety And Quality Of Life In Chronically Ill And Healthy Students, Rufaida Mohammed N Alkhanji

Theses

Chronic illness and anxiety are two factors that have been shown to negatively impact quality of life. In order to better understand the impact of chronic illness on quality of life, researchers have been interested in studying the effects of experiential avoidance and committed action. This thesis aims to examine the roles of experiential avoidance and committed action as potential mediators in the relationship between anxiety and quality of life. It also aims to compare the occurrence of the studied relationships in students with and without chronic illness. 547 participants from two Arab universities completed self-report measures assessing their levels …

Phubbing And Fear Of Missing Out As Mediators Between Problematic Social Media Use And Life Satisfaction Among Young Adults, Najeera Peer Meera Levai

Theses

Recent studies have shown certain risk indicators for young adults' decreased life satisfaction as a result of excessive social media use. However, few studies have looked at possible impact of problematic social media on life satisfaction, and less information is known about the mediating factors that contribute to this association. The purpose of the current study was to determine whether problematic social media use predicts life satisfaction among young adults. It also explored whether phubbing behaviour and fear of missing out might both serve as mediators in this relationship. A sample of 351 young adults (18–25, M_age = 19.74 …

Deceptive Appeals And Cognitive Influences Used In Fraudulent Scheme Sales Pitches, Rafael J. Toledo

USF Tampa Graduate Theses and Dissertations

Fraud schemes exploit the complex interplay that results from utilizing deceptive appeals to activate underlying cognitive influences. This study was designed, first, to identify the deceptive appeals present in the messaging of fraudulent schemes and, second, to identify the underlying cognitive influences being exploited by the deceptive appeals utilized. Findings reveal that effectively used deceptive appeals work to keep viewers’ mental processes in a state of cognitive ease. This state allows cognitive influences--such as heuristics, cognitive biases, and the System 1 mind--to remain in control of mental processing; however, System 1 is prone to accept deceptive beliefs. The results of …