Medicine and Health Sciences Commons^™

Individuals With Developmental Disabilities And Criminal Incompetence : An Analysis Of Predictors To Restoration, Ashley Cahill

Legacy Theses & Dissertations (2009 - 2024)

Competency to stand trial is a concept of jurisprudence preventing the adjudication of individuals who lack the capacity to understand the proceedings against them and which prevents them from assisting in their own defense because of mental disease or “defects”. In the criminal justice system, defendants found incompetent to stand trial are remanded to the care of the mental health system for a period of time to restore their competence. The determination of competency to stand trial is by far the most common psychiatric evaluation requested by criminal courts, and is especially critical for defendants with developmental and intellectual disabilities.

The Effect Of Maternal Dietary Habits During Pregnancy On Neonate Leptin Methylation Patterns And Gestational Age, Sean Fitzpatrick

Legacy Theses & Dissertations (2009 - 2024)

The health of a newborn baby is inextricably linked to the health status of its mother and in turn the mother’s diet during pregnancy. Leptin (LEP) is an adipokine hormone involved in metabolism regulation and has been linked fetal development through the hypothalamic-pituitary-adrenal axis (HPA). Prior work suggests that gestational epigenetic alterations the LEP gene may be sensitive to adverse exposures during pregnancy, which in turn could explain variation in neonate outcomes. However, no prior work has examined this possibility explicitly. The objective of this study was to investigate the association between dietary patterns of mothers during pregnancy and their …

Prospective Observational Study In Patients With Obstructive Lung Disease: Novelty Design, Helen K. Reddel, Maria Gerhardsson De Verdier, Alvar Agustí, Gary Anderson, Richard Beasley, Elisabeth H. Bel, Christer Janson, Barry Make, Richard J. Martin, Ian Pavord, David Price, Christina Keen, Asparuh Gardev, Stephen I. Rennard, Alecka Sveréus, Aruna T. Bansal, Lance Brannman, Niklas Karlsson, Javier Nuevo, Fredrik Nyberg, Simon S. Young, Jørgen Vestbo

Journal Articles: Pulmonary & Critical Care Med

Asthma and chronic obstructive pulmonary disease (COPD) have overlapping clinical features and share pathobiological mechanisms but are often considered distinct disorders. Prospective, observational studies across asthma, COPD and asthma-COPD overlap are limited. NOVELTY is a global, prospective observational 3-year study enrolling ∼12 000 patients ≥12 years of age from primary and specialist clinical practices in 19 countries (ClinicalTrials.gov identifier: NCT02760329). NOVELTY's primary objectives are to describe patient characteristics, treatment patterns and disease burden over time, and to identify phenotypes and molecular endotypes associated with differential outcomes over time in patients with a diagnosis/suspected diagnosis of asthma and/or COPD. NOVELTY …

Behavioral And Socio-Ecological Determinants Of Depression At Different Stages Of The Life Course, Xiao Cong

Legacy Theses & Dissertations (2009 - 2024)

Background:

Assessing The Sustainability Of Collaborations Between Local Health Departments And Nonprofit Hospitals For Population Health, Christopher Mierow Maylahn

Legacy Theses & Dissertations (2009 - 2024)

In 2008, New York’s health commissioner asked LHDs and nonprofit hospitals to collaborate with community partners to conduct community health needs assessments, identify two or three health priorities to focus on, and implement evidence-based strategies to address them. The actions taken as part of the New York State Prevention Agenda mirrored the IRS rules and PHAB recommendations that followed. The dearth of published studies on public health-hospital collaborations and the momentum to understand how communities in New York have responded to the IRS rules and PHAB standards are the impetus for this research.

Right Size Me : Policy Responses To The Obesity Eidemic And Behavioral Change, Wenhui Feng

Legacy Theses & Dissertations (2009 - 2024)

Obesity is a critical health and social concern. Almost 40% of American adults are obese, creating more than $300 billion dollars in annual medical costs. While obesity is a public concern that has been on the policy agenda for some time, obesity policies have proven difficult to formulate, adopt and implement in practice. In this dissertation, I explore three obesity-related policies – adoption of obesity prevention policies by local health department, calorie labeling on restaurant menus and food assistance benefits – and find the importance of ideological and political considerations for obesity policies at different stages in the policy process …

Development Of The Sexual Minority Affirmative Practice Scale, Ryan Craig Ebersole

Legacy Theses & Dissertations (2009 - 2024)

Literature on the practice of affirmative psychotherapy with sexual minority (SM) clients has steadily increased over the past two decades in recognition of the unique experiences and mental health needs of this marginalized population. SM-affirmative psychotherapy is an approach to psychotherapy that is culturally-responsive, actively affirms the validity of SM identities and experiences, and promotes the resilience of SM clients in the face of stigma. To date, much of the extant research on SM-affirmative psychotherapy has focused on therapist factors and perspectives. Further, most previous research on SM clients’ experiences in therapy has been qualitative, due in part to the …

Endogenous Policy Design In Healthcare : A Case Study Of Emergency Department Crowding, Katrina Alexandra Hull

Legacy Theses & Dissertations (2009 - 2024)

The United States’ health care system has faced growing per capita use, and subsequent crowding, of the emergency department since the 1990’s, evidenced by longer wait times and the institution of ambulance diversions. Emergency departments are but one element of a complex system, with difficulties which persist despite policy efforts.

Depression, Sensation-Seeking Behavior And Violence As Mediators Of The Association Between Childhood Adversity And Substance Use Disorder, Calvin Wong

Legacy Theses & Dissertations (2009 - 2024)

Background:

Risk Factors For Gestational Diabetes In Upstate New York Women & Implications For Practice, Margaret Versteegen

Legacy Theses & Dissertations (2009 - 2024)

Gestational diabetes mellitus (GDM) is a form of diabetes, or abnormal blood glucose (sugar) metabolism, diagnosed during pregnancy. Pregnant, non-diabetic women who are initially noted to experience high blood glucose levels during their pregnancy are considered to have GDM (ADA, 2016b). GDM has significant implications for infant and maternal morbidity and mortality, with adverse pregnancy outcomes such as infant macrosomia, difficult birth requiring cesarean section, and postpartum hemorrhage (Kamana, Shakya, & Zhang, 2015). In the majority of cases, GDM goes away once the baby is born, but around 5-10% of women with GDM go on to have type 2 diabetes …

The Long-Term Consequences Of Adolescents' Comparative Economic Position In School, Kiwoong Park

Legacy Theses & Dissertations (2009 - 2024)

The goal of this dissertation project is to investigate how adolescents’ comparative socioeconomic positions within their schools shape their short- and long-term outcomes, including later health, educational expectations and attainment, and the risk of having a nonmarital first birth. Although social comparison theory posits that individual well-being depends on the standings of others with whom one compares oneself, as well as on one’s own absolute standing, the empirical evidence of the theory has been mixed and controversial. This project argues that inconsistent findings may arise from difficulty in measuring reference groups, temporal ambiguity between exposures and outcomes, and methodological limitations.

The Cognitive And Contextual Underpinnings Of Food Cravings : A Multi-Method Exploration, Martha Niemiec

Legacy Theses & Dissertations (2009 - 2024)

The notion of addiction pervades Western vernacular. While firmly established in the substance and drug literature, the concept of addiction is now increasingly associated with other ingested substances (coffee, chocolate, highly processed foods) and a range of compulsive behaviors (gambling, sex, online social networking, gaming). Addiction is associated with substantial morbidity and mortality, and a greater understanding of its etiology has significant public health implications. The physiological mechanisms thought to contribute to the development and maintenance of addiction (tolerance, withdrawal, and, possibly, craving) are widely considered hallmark features and primary treatment targets, while psychological and contextual factors are often underappreciated …

Response To "From A Polemic Paradox To A Proper Perspective Of Job Burnout And Job Satisfaction, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

Juárez García and colleagues considered that “part of the conceptual and empirical problem of burnout is that many researchers force it into a biomedical disease model despite its being a psychosocial one.” Problematically, these authors’ scholastic argument a priori excludes biological or bodily factors from psychological conceptualizations. Scientists usually face considerable difficulties when trying to describe complex processes. If the understanding of biological processes sheds light on the complex processes that bear on burnout, then there is no reason to exclude research on those processes.

Mechanisms Of Trinucleotide Repeat Instability During Dna Synthesis, Kara Y. Chan

Theses and Dissertations--Toxicology and Cancer Biology

Genomic instability, in the form of gene mutations, insertions/deletions, and gene amplifications, is one of the hallmarks in many types of cancers and other inheritable genetic disorders. Trinucleotide repeat (TNR) disorders, such as Huntington’s disease (HD) and Myotonic dystrophy (DM) can be inherited and repeats may be extended through subsequent generations. However, it is not clear how the CAG repeats expand through generations in HD. Two possible repeat expansion mechanisms include: 1) polymerase mediated repeat extension; 2) persistent TNR hairpin structure formation persisting in the genome resulting in expansion after subsequent cell division. Recent in vitro studies suggested that a …

Evaluating The Impacts Of Antidepressant Use On The Risk Of Dementia, Ran Duan

Theses and Dissertations--Epidemiology and Biostatistics

Dementia is a clinical syndrome caused by neurodegeneration or cerebrovascular injury. Patients with dementia suffer from deterioration in memory, thinking, behavior and the ability to perform everyday activities. Since there are no cures or disease-modifying therapies for dementia, there is much interest in identifying modifiable risk factors that may help prevent or slow the progression of cognitive decline. Medications are a common focus of this type of research.

Importantly, according to a report from the Centers for Disease Control and Prevention (CDC), 19.1% of the population aged 60 and over report taking antidepressants during 2011-2014, and this number tends to …

Autonomy, Intimate Partner Violence, And Maternal Health-Seeking Behavior: Findings From Mixed-Methods Analysis In Kenya, Charlotte E. Warren, Pooja Sripad, Charity Ndwiga

Reproductive Health

Gendered norms and discriminatory practices often limit women’s decision-making power, which over time can lead to social norms that systematically disadvantage women. Aspects of empowerment were explored in a global evaluation of Demographic and Health Survey data that measured how gendered social norms influenced maternal health-seeking behaviors. Analysis specifically explored associations of women’s autonomy and acceptability of intimate partner violence against women (IPVAW) on antenatal care use and facility delivery in 63 low- and middle-income countries. Service utilization is positively associated with increased autonomy and negatively associated with increased acceptability of IPVAW, but variability exists across countries and regions. In …

Reference Guide: Factorial Focus Group Analysis Methods For Studying Social Norm Change, Bettina Shell-Duncan, Amadou Moreau, Katherine Wander, Sarah Smith

Reproductive Health

The factorial focus group methodology described in this guide provides a powerful means of illuminating the social norms that uphold female genital mutilation/cutting (FGM/C), and the ways in which meanings have at times become contested or rejected. The methods described here can be applied to the study of a wide range of behaviors influenced by social norms, such as early marriage, adoption of contraception, and more.

Actionable Patient Safety Solutions (Apss) #6: Hand-Off Communications, Steven Barker, Nick Adams, Misti B. Baskett, Victoria Baskett, Michael Becker, Michel Bennett, Laressa Bethishou, Mike Ramsay, Jeff Dunn, Hisham El-Bayar, William Floyd, Frank Gencorelli, Christina Hazekamp, Kristy Blomquist, Edwin Loftin, Ariana Longley, Jacob Lopez, David Lubarsky, Pete Melrose, Brent Nibarger, Karen Rehling, Patricia Roth, Kris Stegner, Laura Townsend

Pharmacy Faculty Articles and Research

Hand-off communications, or hand-off processes, involve the transition of care as well as the transfer of patient-specific information by one healthcare professional to another with the purpose of providing a patient with safe, continuous care. A successful hand-off can only be achieved by effective communication.

Stroop Interference With Sesame Street Characters, Christopher Koch

Faculty Publications - Psychology Department

The Stroop task is a robust task, making it a useful assessment of automatic processing, it is also associated with reading ability. This limits the utility of the Stroop task to children with a sufficient reading level. Non-word Stroop tasks may be alternatives for non-readers or beginning readers. For example, Prevor and Diamond (2005) showed that Stroop interference could be obtained using pictures (e.g., heart, frog). This study explored using Sesame Street characters to create Stroop interference. Elmo, Kermit, and Cookie Monster were shown in red, green, and blue to first through fourth grade students. RTs for color incongruent trials …

The Impact Of Olfactory Cues On Attention: The Case Of Stroop Interference, Jonathan K. Ham, Christopher Koch

Faculty Publications - Psychology Department

This study explores the relationship between odor imagery, color associations, and visual attention through a Stroop-task based on common odor-color associations. This Stroop-task was designed using three fruits with odor-color associations: lime with green, strawberry with red, and lemon with yellow. Each possible word-color combination was lexically presented in the experimental trials. Three experiments were conducted that used the Stroop-task with different odors present. They suggest that odor imagery can affect visual attention, the inhibition of odor-color associations, and that odor imagery appears to be facilitated in the presence of a related odor.

Head Injuries And The Hearing Screening Inventory, Christopher Koch, Abigail Anderson

Faculty Publications - Psychology Department

Head trauma can lead to problems with the ear and auditory pathway. These problems can involve tympanic membrane perforation, fragments in squamous epithelium, damage to the ossicles, or ischemia of the cochlear nerve. It is common for behavioral checklists, for concussion or head injuries, to include an item about hearing difficulty. In the present study, 152 introductory psychology students completed a survey in which they indicated if they had ever had a concussion or sustained a head injury. Approximately one-third (35.53%) of the sample had a history of head trauma. The Hearing Screening Inventory was also part of the survey. …

Reliability And Test Differences For The Impact: Implications For Concussion Testing Programs, Christopher Koch, Sean Robertson

Faculty Publications - Psychology Department

This study was conducted to determine the long-term relatability of ImPACT scores among young athletes. Youth sport participants (n=294) who completed ImPACT tests one year apart were included in the study. Ages ranged from nine to 14 with a mean of 11.42 (SD = .96). The majority (n = 215) were males. Test-retest reliabilities for verbal memory, visual memory, response time, and impulse control were statistically significant but weak, ranging between .33 and .49. The index score had poor test-retest reliabilities (r = .26). Visual-motor test-retest reliability was also significant but moderate (r=.68). Scores for the verbal memory subtest and …

The Impact Of Olfactory Cues On Attention: The Case Of Reverse Stroop Interference, Jonathan K. Ham, Christopher Koch

Faculty Publications - Psychology Department

Ham and Koch (2019) found that an odorant could influence interference on a modified Stroop task. This study was conducted to examine the impact of olfactory cues on reverse Stroop interference. Across three experiments, participants completed a modified reverseStroop task in which they identified a word (strawberry, lime, lemon) in different color fonts (red, green, yellow). Although the words were fruit names instead of color names, each word had some degree of association with a particular color (e.g., lime and green). In Experiment 1, congruent and incongruent trials were presented without an odorant. No differences were found between congruent and …

Signs Of Humanity – A Researcher-Artist Collaboration, Katherine Brierly, Steven Buffer, Kaela Edwards, Zach Fusfeld, Jenna Garret, Nisha George, Katie Holland, Nichole Holmes, Josephine Hwang, Alyssa Tate, Emily Wei, Rosemary Frasso, Willie Baronet

JCPH at APHA 2019

A team of Jefferson students, alumni and faculty in collaboration with artist Willie Baronet, employed qualitative methods to explore poverty in Philadelphia.

Background

The Signs of Humanity (SOH) Project is a researcher-artist collaboration. This joint venture was designed to explore the interactions between people using signs to ask for help and those who pass by with the goal of reducing the dehumanization of this community. The research arm was designed to qualitatively explore the experiences of people who seek financial support or in-kind help from passersby. This is referred to as "panhandling" in the literature and that term will be …

« More Than Brides Alliance (Mtba) » : Rapport D’Évaluation À Mi-Parcours Au Mali Et Au Niger, Andrea J. Melnikas, Grace Saul, Mouhamadou Gueye, Aissa Diarra, Sajeda Amin

Poverty, Gender, and Youth

L’Alliance « Plus qu’une épouse » (More Than Brides Alliance—MTBA) a été formée, rassemblant les forces d’une équipe diversifiée, compétente pour la mise en œuvre et la recherche de programmes destinés aux adolescents. Le volet recherche de l’Alliance MTBA vise à fournir des preuves et des connaissances sur ce qui fonctionne pour retarder le mariage des enfants en Inde, au Malawi, au Mali, au Niger et au Pakistan en évaluant le programme d’intervention de l’Alliance MTBA et en examinant les facteurs spécifiques du mariage des enfants dans chaque contexte. Dans ce rapport, nous visons à évaluer les succès du programme …

The Girl Roster: A Practical Tool For Strengthening Girl-Centered Programming, Population Council

Poverty, Gender, and Youth

This brief describes the Girl Roster^TM, a practical tool designed by the Population Council to help practitioners understand their program areas and elicit foundational information to intentionally link girls—especially highly marginalized adolescent girls—to the vital resources, facilities, and services to which they are entitled but often have limited or no access. The tool is a user-friendly, efficient, and cost-effective way to collect program-relevant information about girls in a community, using a mobile phone–based questionnaire (or, where resources do not permit, paper and pencil). The tool enables users to see a fuller view of girls’ lived realities in defined …

Examining Early Marriage In India: Qualitative Findings, Neelanjana Pandey, Komal Saxena, Andrea J. Melnikas

Poverty, Gender, and Youth

The More Than Brides Alliance (MTBA) implements the “Marriage: No Child’s Play” program (2016–20) in India, Malawi, Mali, Niger, and Pakistan. The MTBA is a holistic program that addresses early marriage through multiple strategies, including: sexual and reproductive health and rights, livelihoods, education, and prevalent community social norms around marriage. Furthermore, the program operates at multiple levels (girl, family, community, block, and district) to address individual, familial, and structural barriers to reducing child marriage in these communities. This report first looks at the legal environment in which programs operate by examining participants’ awareness of laws, acts, and programs related to …

Pediatric Oncology Nurses’ Perceptions Of Prognosis-Related Communication, Amy Rose Newman, Kristin Haglund, Cheryl C. Rodgers

College of Nursing Faculty Research and Publications

Background

Disclosure of prognosis-related information is an essential aspect of communication with pediatric patients with cancer and their families. The nurse is believed to play an important role in this process, but nurse perceptions and experiences have not been well-described.

Purpose

Provide an exploration of pediatric oncology nurses’ experiences with prognosis-related communication (PRC).

Method

Mixed-methods, multiphase design. This paper highlights the qualitative portion of the study.

Findings

Three themes were identified: Importance of collaboration, impact of PRC, and delivery of prognostic information.

Discussion

Collaboration is a critical element of PRC. Nurses are often not included in the disclosure process, which …

Integrating Research And Quality Improvement Using Teamstepps: A Health Team Communication Project To Improve Hospital Discharge, Joseph Beiler, Kristi Opper, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Purpose/Objectives:

The purpose of this article is to describe an innovative approach to the integration of quality improvement and research processes. A project with the objective of improving health team communication about hospital discharge provides an exemplar case.

Description of the Project/Program:

The TeamSTEPPS 10-step action planning guide provided the structure for planning, developing, and evaluating a redesign of interprofessional health team communication to improve hospital discharge led by 2 clinical nurse specialists. The redesign involved development of processes for team bedside rounding, registered nurse bedside shift reports, and briefing tools to support the rounding processes.

Outcome:

Using the TeamSTEPPS …

Signs Of Growth And Healing: Health Care And Science, Richard J. Fehring

College of Nursing Faculty Research and Publications

MY ESSAY ON THE HISTORY OF Catholic Natural Family Planning (NFP) scientists (chapter 8 in this volume) ended with discussing scientists who were active during the papacy of John Paul II (1979-2005). This present essay continues with the time period from approximately 2000 to 2018 and, indeed, into the future. My purpose here, however, is to delineate signs of growth and healing in health care and science related to NFP and not to focus on individual NFP scientists. Given that purpose, recent trends in NFP science and historical factors that influence NFP science can provide us with signs of growth …