Medicine and Health Sciences Commons^™

The Ethical Justification Of Increasing Awareness Of Preventive Medicine Among Healthcare Professionals, Patients And The General Public In The United States, Karishma Ether Moazzam

Electronic Theses and Dissertations

While practiced for centuries, preventive medicine has received increased attention during the recent times. Preventive medicine has a distinct mission to protect, promote, and maintain health as well as to prevent diseases, disabilities, and premature deaths. It aims to fulfill its mission through the combined form of clinical intervention and health promotion. In the recent years, preventive medicine has begun to lean more towards the clinical interventions, taking away from the health promotion. This imbalance has caused preventive medicine to lose its effectiveness in fulfilling its mission. One of the leading causes for such imbalance is the lack of proper …

Automatic Exposure Control During Computed Tomography Scans Of The Head: Effects On Dose And Image Quality, Stephen D. Osborne

Electronic Theses and Dissertations

Automatic exposure control (AEC) is effective at reducing potentially harmful radiation doses without sacrificing image quality for many types of computed tomography (CT) scans. However, there is a need for more information regarding the use of AEC for CT head scans. This study was conducted at Johnson County Community Hospital in Mountain City, TN. Preexisting adult CT head scans (n)60 were randomly selected to form 2 stratified samples, (n)30 each. One sample used a standard protocol, and the other used a protocol with a mA-modulated AEC system, Siemens CARE Dose 4D. Causal-comparative analyses were conducted, and …

An Exploratory Study Of Duty-Related Stress Among Conservation Officers, Logan Ledford

Electronic Theses and Dissertations

Research relating to police stress has typically focused on officers working in urban areas, neglecting their rural counterparts. This is especially true of conservation officers, who are tasked with enforcing laws in state parks and other recreational areas. To date, only a handful of studies have sought to better understand their experiences and perceptions. The current study seeks to further our understanding of conservation officer stress in three unique ways: (1) via applying McCreary and Thompson’s (2006) operational police stress scale (PSQ-Op) to the population, (2) determining whether officer characteristics (e.g., age, education, length of service) affect perceived stress, and …

Exploring The Match Demands Of Division I Women’S Collegiate Soccer, Robert W. Sausaman

Electronic Theses and Dissertations

The purpose of this dissertation is to shed light on the physical demands of women’s soccer at the NCAA division I college level. Though research does exists describing the physical demands of women’s soccer, the vast majority seeks to explain the physical demands association with the professional and international level. This dissertation sought to: 1) examine the physical demands of NCAA division I women’s soccer and 2) observe changes in physical demands of two NCAA division I women’s soccer players over a four-year career using a case study approach.

Study 1 examined the physical demands of twenty-three athlete from a …

Comparative Spending Of Medicaid Dollars On Child Participants Of Kentucky’S Sobriety Treatment And Recovery Teams Program Versus A Matched Comparison Group., Matthew Thomas Walton

Electronic Theses and Dissertations

Child protective services agencies have long observed the complicating role that parental substance use and addiction plays in cases of child maltreatment. Families who struggle with these problems present unique challenges for child welfare professionals. These families are typically more difficult to engage, more likely to have children removed from the home, and have poorer outcomes when compared to other families. These poorer outcomes often include health problems. Addiction has well-known effects on health, and the specific manifestations of these problems for parents have been documented for years in child protection casework. However, what has been less investigated are the …

Impact Of Adverse Childhood Experiences On Mental Health Outcomes And Related Prescription Practices In A Psychiatric Inpatient Sample, Carrie Lemay

Electronic Theses and Dissertations

A definitive association between adverse childhood experiences (ACEs) and negative physical and mental health outcomes has been established. There is evidence that individuals in forensic psychiatric facilities are disproportionately exposed to ACEs, which may impact severity, prognosis, and age of onset of psychiatric symptoms, including behavioral concerns of institutional aggression, self-harm behaviors, and suicide attempts. Such psychiatric and behavioral concerns are often managed through multiple psychotropic prescriptions, leading to psychotropic polypharmacy. This study evaluated the relationship between ACEs, mental health and behavioral concerns, and psychotropic polypharmacy through analysis of archival data from a forensic inpatient psychiatric facility. A total of …

A Meta-Analytic Review Of Cognitive Functioning In Negative And Positive Symptoms Of Schizophrenia, Tiffany Forsythe

Electronic Theses and Dissertations

The purpose of the study was to conduct two meta-analytic reviews examining cognitive functioning and schizophrenia. The first review examined the literature comparing the cognitive functioning of schizophrenic patients to healthy controls. A second review examined the cognitive functioning within schizophrenic patients, examining the differences between individuals with primarily positive symptomatology and those with primarily negative symptomatology. The first meta-analysis included 19 studies which assessed 861 schizophrenic patients and 858 healthy volunteers overall. The second meta-analysis included 10 studies comparing the cognitive functioning of 1,263 schizophrenics across positive and negative symptoms. Results of the first review indicated that healthy controls …

Blacklegged Tick (Ixodes Scapularis) Distribution In Maine, Usa, As Related To Climate Change, White-Tailed Deer, And The Landscape, Susan P. Elias

Electronic Theses and Dissertations

Lyme disease is caused by the bacterial spirochete Borrelia burgdorferi, which is transmitted through the bite of an infected blacklegged (deer) tick (Ixodes scapularis). Geographic invasion of I. scapularis in North America has been attributed to causes including 20th century reforestation and suburbanization, burgeoning populations of the white-tailed deer (Odocoileus virginianus) which is the primary reproductive host of I. scapularis, tick-associated non-native plant invasions, and climate change. Maine, USA, is a high Lyme disease incidence state, with a history of increasing I. scapularis abundance and northward range expansion. This thesis addresses the question: “To …

Precision Medicine And It's Ethical And Social Implications: Public Health And Gobal Persepctives, Evangel Sarwar

Electronic Theses and Dissertations

Ever since President Obama's launch of the Precision Medicine Initiative (PMI) in 2015, precision medicine (PM) has been anticipated as the new paradigm for healthcare with the capacity to “empower patients, researchers, and providers to work together toward the development of individualized care,” through research, technologies, and policies (President Obama, 2015). Precision Medicine (PM), in the form of genomics, offers unprecedented promise of providing new tools for improving health and reducing the burden of diseases, not just for the U.S. - but also globally. According to World Health Organization, genomics research and precision medicine will play a major part in …

“I Do Have A Softer Side”: A Phenomenological Investigation Of The Prisoner-Dog Relationship In The Canine Partners For Life Training Program, Kathleen Kocherzat

Electronic Theses and Dissertations

This qualitative study investigated the relationship between incarcerated dog handlers and the service dogs they trained. Six men at a large northeastern prison were interviewed during the summer of 2017; all were current or former dog trainers in the Canine Partners for Life (CPL) training program. The men were serving prison sentences ranging anywhere from several years to life without parole. The interviews focused on their lived experience, rasing and training puppies for a period up to eighteen months. The qualitative data consisted of approximately thirteen hours of transcribed interviews, which were then interpreted using the phenomenological psychological method developed …

Learning Science: Physical And Life Sciences In Curricula Across U.S. Schools Of Nursing, Valerie C. Sauda

Electronic Theses and Dissertations

Nursing educators are being challenged to provide curriculum that meets the changing healthcare environment and demand for creative, innovative nurses to assist in transforming healthcare into the future (Benner, Sutphen, Leonard, & Day, 2010; Institute Of Medicine, 2011). The liberal education provided within a baccalaureate of science in nursing (BSN) degree program provides a diversity of courses within the curriculum, including courses in the natural, physical, mathematical, and social sciences (American Association of Colleges of Nursing [AACN], 2008). Although nursing programs have included science courses in curriculum since the early 1900s (Nutting & Dock, 1907), there is lack of nursing …

An Exploration Of Factors Of Lgbt Cultural Competency Among Prospective Healthcare Professionals, Heather Isbell

Electronic Theses and Dissertations

Literature suggests there is a relationship between cultural competency and health outcomes as well as a perceived fear of discrimination LGBT individuals face when attempting to receive healthcare services. The aim of this study is to assess the level of LGBT CC (cultural competency) among prospective professionals who are expected to provide health care services and to explore factors that affect those attributes. Multiple linear regressions were conducted to test the effect of the following factors of LGBT CC: postsecondary experience, relations with LGBT individuals, and religion using a sample of 57 different healthcare students in a faith-based university during …

Understanding Substance Use And Recovery In Maine: A Culture-Centered Approach, Carter Hathaway

Electronic Theses and Dissertations

There is ever-increasing attention to Maine’s substance use problem, particularly in the case of opioid-related deaths. With yearly death tolls increasing, citizens of Maine wonder what the best methods are in approaching the issue and preventing further harm. While statistics about the issue are repeated in news coverage and by political figures, there is a need to understand what substance use and recovery actually mean to individuals who experience them on a daily basis. The following thesis uses Mohan J. Dutta’s (2008) culture-centered approach to health communication to explore the meanings of substance use and recovery as well as the …

Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.

Electronic Theses and Dissertations

Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …

The Effects Of Two Novel Anti-Inflammatory Compounds On Prepulse Inhibition And Neural Microglia Cell Activation In A Rodent Model Of Schizophrenia, Heath W. Shelton

Electronic Theses and Dissertations

Recent studies have shown elevated neuroinflammation in a large subset of individuals diagnosed with schizophrenia. A pro-inflammatory cytokine, tumor necrosis factor-alpha (TNFα), has been directly linked to this neuroinflammation. This study examined the effects of two TNFα modulators (PD2024 and PD340) produced by our collaborators at P2D Bioscience, Inc., to alleviate auditory sensorimotor gating deficits and reduce microglial cell activation present in the polyinosinic:polycytidylic (Poly I:C) rodent model of schizophrenia. Auditory sensorimotor gating was assessed using prepulse inhibition and microglial activation was examined and quantified using immunohistochemistry and confocal microscopy, respectively. Both PD2024 and PD340 alleviated auditory sensorimotor gating deficits …

Investigating Predictive Relationships Between Speech-Language Pathology Graduate Students' Sense Of Classroom Community, Perceived Learning, And Perceived Anxiety., Emily B. Schantz

Electronic Theses and Dissertations

Mental health is an all-encompassing term that focuses on a person’s ability to achieve work-life balance inclusive of positive mental health and mental ill-health. Current trends suggest an overall increase in mental ill-health for undergraduate and graduate students. McMillan and Chavis’ sense of community theory provided the theoretical framework for this study. This study aimed to examine whether speech-language pathology graduate students’ sense of classroom community and perceived learning predict anxiety levels while controlling for demographic variables. Three-hundred-sixteen master’s level speech-language pathology students completed an online survey containing the Generalized Anxiety Disorder Questionnaire, Perceived Learning Scale, and Classroom Community Scale. …

The Shape Study : The Survey Of Health And The Perceived Environment Study., Colette Patrice Davis

Electronic Theses and Dissertations

Introduction: Few studies have considered how an individual’s perception of their built environment may be a risk factor for being overweight or obese. Adolescents may be particularly vulnerable in the context of “impoverished environments”, which they may perceive to be difficult, dangerous, resource deficient, and unaesthetic. This study aids in clarifying how the built environment influences the risk of obesity among adolescents residing in a neighborhood in Louisville, KY. Objective: The overall objective was to conduct a cross-sectional epidemiologic pilot study among adolescents aged 12-17 years residing in West Louisville, Kentucky to evaluate the association between perceptions of …

Hemoglobin A1c Levels And Sport Participation In Children With Type 1 Diabetes., Amy Kozerski

Electronic Theses and Dissertations

This study’s purpose was to determine a possible difference in hemoglobin A1c levels and sport participation in children with type 1 diabetes. Patients with provided consent via an iPad electronic informed consent/assent (preamble) completed a physical activity and sport participation survey. The survey was linked to their medical chart including demographic and diabetes medical history (e.g. HbA1c). The analyses provided a sample of 120 participants, 40 in the no sport participation group and 78 in the sport participation group with 56 females and 64 males, with an average age12.94±2.8 years. An independent sample t-test, removing one outlier from the …

Innovation And Equity In Public Health Research : Testing Arts-Based Methods For Trauma-Informed, Culturally-Responsive Inquiry., Tasha Golden

Electronic Theses and Dissertations

As the field of Public Health has shifted from a biomedical paradigm to a social ecological approach, focusing on health equity and social determinants of health, it has increasingly acknowledged the roles of culture and trauma in health outcomes. The field has responded by modifying some research practices, but continues to prioritize conventional methodologies—with few options designed to foreground trauma- and cultural-responsiveness. Unfortunately, to the extent that conventional approaches require health to be defined, communicated, or valued according to dominant norms, they risk perpetuating inequities. Health equity therefore requires the development of research methodologies that increase inclusivity and access, elicit …

Wellness Policy Awareness Among School Leaders And The Impact On Written Policy Scores, Mariah Reil

Electronic Theses and Dissertations

Background: All schools participating in the National School Lunch Program must possess a written School Wellness Policy (SWP) as mandated by the Healthy, Hunger- Free Kids Act of 2010.1 School officials and leaders play a major role in SWP implementation. It is essential to written SWP implementation that school level officials and leaders in the district are aware of the SWP. However, the association between school leader awareness of SWP and policy quality has not yet been studied.
Purpose: The purpose of the present study was to determine if school leader awareness of a SWP impacts the written SWP quality. …

The Relationship Between Campus Wellness Center Usage And Symptoms Of Depression In College Freshmen, Allison Leonard

Electronic Theses and Dissertations

There is limited research done on the relationship between the program utilization at a campus wellness facility and the symptoms of depression in college freshmen. College students have been found to have a higher prevalence of depressive symptoms than the general population, possibly due to the stressors college life can add. Studies have been done on the effects of physical activity as an intervention for depression as well as on the benefits of campus wellness facilities; however, there have been few studies that look at both campus recreation and depression. The author’s purpose for this study was to see if …

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 …

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 …

Valuation Of Mentorship In Pharmacy Education And The Impact Of Perceived Personal Relevance, Ashley Stubblefield Crumby

Electronic Theses and Dissertations

Mentorship is an important component of personal and professional development for student pharmacists. This research measured the value of mentorship in this population examined potential influencing factors and the likelihood to participate in a mentoring relationship and identified preferences for the mentoring relationship. Data collection involved survey self-report of student pharmacists (P1-P4) at four participating universities. An adapted 29-item Mentoring Functions Scale (MFS) was used to measure value with functions divided into career and psychosocial categories. The highest ranked mentoring functions were psychosocial with an average score of 9 or greater on the 10-point scale. Perceived personal relevance measured using …

Reward And Punishment: The Neural Correlates Of Reinforcement Feedback During Motor Learning, Christopher Mark Hill

Electronic Theses and Dissertations

‘By the carrot or the stick’ reward or punishment has been contemplated by instructors to motivate their pupils to learn a new motor skill. The reinforcements of reward and punishment have demonstrated dissociable effects on motor learning with punishment enhancing the learning rate and reward increasing retention of the motor task. However it is still unclear how the brain processes reward and punishment during motor learning. This study sought to investigate the role of reinforcement feedback in cortical neural activity associated with motor learning. A novel visuomotor rotation task was employed with reward punishment or null feedback as the participants …

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 …

Let Me Upgrade You: Common Measures In Public Health Accreditation Action Plans, Gurleen K. Roberts

Electronic Theses and Dissertations

Objectives: The purpose of this study is to understand the success rates for health departments pursuing and achieving accreditation in version 1.0 and 1.5 of the Public Health Accreditation Board (PHAB) standards and measures. During the accreditation process, health departments that present performance gaps are asked to complete an Action Plan to specify how they plan to improve to meet the desired conformity. This study will highlight specific measures that are often included in Action Plans so that health departments pursuing accreditation can be better prepared to address these common pitfalls.

Methods: This study is a non-experimental, secondary …