Medicine and Health Sciences Commons^™

An Examination Of Harm During The Real-Life Experience, Michelle E. Balch

Antioch University Dissertations & Theses

The Real-Life Experience (RLE) has been described as a coercive and arbitrary requirement without evidence of validity or reliability. This can cause more harm than it prevents for a significant subset of transition-seeking transgender clients. For these reasons the RLE was dropped from the WPATH Standards of Care after version six. However, the RLE has been adopted by a number of health insurance companies as a measure of readiness to receive transition services. An Interpretative Phenomenological Analysis (IPA) and semi-structured interviews of five individuals were conducted to evaluate their perceptions of RLE and the meaning they attach to their broader …

Geriatric Care In Corrections: An Exploratory Study Of Cross-Disciplinary Perspectives On The Needs Of An Aging Prison Population, Cynthia A. Scheiderer

Antioch University Dissertations & Theses

The incarcerated population in the United States is aging. The proportion of adults 55 or older in prison rose from 3% in 1993 to 16% at year-end 2022 (Carson & Sabol, 2016; Carson & Kluckow, 2024). Researchers have consistently found evidence that the prevalence of disabilities and functional impairment is higher among older adults who are incarcerated than among those in the community. As the incarcerated population ages, corrections professionals responsible for providing safety, housing, and health care must respond to the needs of the population. In this qualitative study, 21 corrections professionals from the disciplines of custody, classification, medical, …

Childhood Aggression: A New Conceptualization, Hannah G. Harrison

Antioch University Dissertations & Theses

Childhood aggression is a frequently observed behavioral phenomenon, yet lacks a precise
definition in both the DSM-5-TR and current research literature. Definitional ambiguity and
construct enmeshment continue to create construct confusion for researchers, clinicians, and
informants. This empirical review of the current literature and diagnostic criteria examines how
childhood aggression has been historically conceptualized, defined, and described. The primary
aim was to identify and clarify inconsistencies in current definitions and to address knowledge
gaps to improve diagnostic clarity. Through a thematic synthesis of recent literature, several key
issues emerged: the absence of a precise definition of childhood aggression; reliance on …

Embracing The Suck: Overcoming Moral Injury-Related Attachment Trauma Through Outdoor Adventure, Emerald D. Ralston

Antioch University Dissertations & Theses

Moral injury is increasingly recognized as a distinct and debilitating consequence of military service, arising when individuals engage in, witness, or are unable to prevent actions that transgress their deeply held moral beliefs. In this dissertation, I argue that this form of trauma can be experienced as an attachment rupture, particularly when the military—functioning as an institutional attachment figure—betrays the servicemember’s trust. Such experiences compromise internal working models (IWMs) of self, others, and the world, and may result in complex trauma symptoms, including dissociation, depersonalization, and profound relational disconnection. These injuries are frequently stored in the body, rendering traditional cognitive …

Caretaker Of Captors: The Experience Of Role Conflict Among State Correctional Officers, Camille M. Botticelli-Pohl

Antioch University Dissertations & Theses

A variety of policies at the national level over the last 70 years have resulted in the mass incarceration of various marginalized populations, inclusive of individuals with mental health problems or severe mental illness. Although Constitutional mandates require that psychology staff be available at all state and federal facilities, these providers spend a fraction of the time with incarcerated people than correctional officers do. Correctional officers seem to play an important, if often overlooked, supporting role in the management of the day-to-day lives of people in custody, including elements of their mental health care. They are also, theoretically, tasked with …

Nature Interaction Assists With Coping And Resilience: An Interaction Pattern Approach With Adolescents With Histories Of Trauma In A Youth Group Home, Chrystal L. Dunker

Antioch University Dissertations & Theses

Adolescents with histories of trauma often experience disruptions to their emotional, social, and behavioral development. For those living in group home settings, supportive environments can play a key role in fostering healing and resilience. While nature interaction is increasingly recognized as a valuable way to support mental health and resilience, little research has explored its role in these settings. This study introduces an innovative methodology—the Interaction Pattern Approach (IPA)—to examine the role of nature interaction in coping and resilience for 12 adolescents with Adverse Childhood Experiences (ACEs) living in a youth group home. In this design, IPA integrates photovoice data …

Stigma Of Obesity And Healthcare Utilization, Moya A. O'Leary

Antioch University Dissertations & Theses

The impact of personal factors on healthcare utilization is an essential area of research to improve overall health outcomes among the population. This study explored the relationship between perceived stigma and healthcare avoidance among men and evaluated the relationship between self-reported body mass index (BMI) and avoidance of healthcare appointments due to weight-related stigma and other reasons. This study found no significant relationship between BMI and avoidance of preventive medical appointments due to perceived stigma. However, men from all weight categories endorsed avoiding preventive healthcare appointments due to weight-related reasons and for other reasons. This study explored the reported reasons …

Pay Attention! A Comparative Analysis Of Psychological Assessments And Neurological Mechanisms For Adhd Within A Pediatric Population, Kristen E. Newberry

Antioch University Dissertations & Theses

This study evaluated the predictiveness of the WISC-V, NEPSY-II, CPT-3, and CATA when compared to each other in a sample of 272 children aged 8–16. Archival data was analyzed using binary and multinomial logistic regression models to assess concurrent validity of specific subtests and indexes. Participants were grouped by ADHD subtype (inattentive, combined/hyperactive, or no diagnosis), with gender and executive functioning measures included in the models. Findings indicated that lower Cognitive Proficiency Index (CPI) and executive functioning scores (e.g., Animal Sorting, Response Set) predicted any ADHD diagnosis compared to the no diagnosis group, whereas higher CATA scores predicted lower Inattentive …

For Black College Students Who Considered Dropping Out When Grit Wasn’T Enough: A Mixed Methods Study Exploring The Influence Of Family Messaging On Collegiate Outcomes, Dawn M. Wilson

Antioch University Dissertations & Theses

Black college student outcomes are well researched areas in education literature. This dissertation sought to explore the influence of academic and ethnic racial socialization on experiences of shame and guilt and examine the association of those relationships on Black college student retention and persistence. This study employed an explanatory sequential mixed methods design to investigate the socialization experiences of 272 Black college students in the US. Conditional process model analyses revealed that academic socialization is associated with experiences of guilt and shame—guilt predicted improved retention outcomes, while shame predicted lower retention outcomes. The analysis also revealed that while ethnic racial …

How Marriage And Family Therapy Graduate Programs Awaken, Develop, And Teach Clinical Intuition: A Hermeneutic Qualitative Phenomenological Study, Jessica Fountas

Antioch University Dissertations & Theses

This research explored how marriage and family therapy graduate programs awaken, develop, and teach clinical intuition. Using criterion-based sampling and snowball sampling, six licensed marriage and family therapists participated in a two-step hermeneutic phenomenological study consisting of individual semistructured interviews and a follow-up focus group. Requirements for participation were licensed marriage and family therapists who were in clinical practice, had experienced the phenomenon of clinical intuition and awakening of clinical intuition, and used clinical intuition in therapy with clients and in systemic supervision with supervisees. The research findings highlighted 14 themes: Reflection of the Experience of Clinical Intuition; Bodily Knowing, …

A Phenomenological Study Of How Parents Of Lgbtqia+ Youth Experience School-Based Sex Education, Alisha Bachman

Antioch University Dissertations & Theses

Empirical research on LGBTQIA+ youth and Comprehensive Sex Education is scarce and now, due to the current political climate, is under threat. Utilizing an interpretive phenomenological approach applying ecological systems and queer theory, this study explored the lived experiences of how parents of LGBTQIA+ youth perceive school-based comprehensive sex education. By isolating the phenomenon of comprehensive sex education, this study focused on the immediate context of influence that comprehensive sex education makes on LGBTQIA+ youth and families. This research used data collected through semi-structured interviews with nine different parents. Four themes emerged from the data: Communication and Education about Sexuality …

The Role Of Floodplain Complexity In Wood Turtle Habitat Use, Laura S. Deming

Antioch University Dissertations & Theses

Wood turtles occupy cold, low-gradient riverine habitat throughout the northeastern United State and southeastern Canada. Stream alterations, such as dams, channel straightening, and floodplain development have diminished the natural hydrologic and sedimentation regimes that result in complex channel and floodplain geomorphology. Studies throughout the species’ range have quantified many aspects of their habitat, but none have quantified components of geomorphology of wood turtle sites. The goal of this study was to explore the role of stream channel and floodplain geomorphology in wood turtle habitat use, with specific objectives to (1) quantify components of stream channel and floodplain geomorphic complexity, (2) …

The Importance Of Accessibility, Self-Advocacy, And Affirming Care: An Interpretive Phenomenological Analysis Of Transgender And Gender Diverse Older Adults’ Primary Care Experiences, Jason Vaught

Antioch University Dissertations & Theses

The present study explored the lived experiences of Transgender and Gender Diverse (TGD) older adults when receiving primary care. The methodology utilized for this study was Interpretive Phenomenological Analysis (IPA). Three participants completed individual, semi-structured interviews. The themes that emerged included “Lack of Accessibility to Services,” “Need for Self-Advocacy,” and “Value of Affirming Care from Providers.” These results illustrated the multifarious needs that arise for TGD older adults when accessing primary care. The findings provided recommendations for healthcare organizations, primary care physicians, and other healthcare professionals. Specifically, the recommendations emphasized two key practices for physicians treating TGD older adults: (1) …

Reality Shock And Systemic Strain: Understanding The Lived Experiences Of Pre-Licensed Mental Health Counselors, Sara Al-Khedairy

Antioch University Dissertations & Theses

The counseling profession is struggling to meet the rising demand for mental health care due to a growing workforce shortage driven by burnout, inadequate support, and low compensation—pressures that disproportionately impact pre-licensed clinicians. Despite their critical role in sustaining the field, pre-licensed counselors often face systemic barriers with little structural support. This qualitative study explored the lived experiences of pre-licensed clinical mental health clinicians through social-ecological and reality shock theories. Participants included 14 pre-licensed clinical mental health counselors who had graduated from CACREP-accredited programs within the last five years. Individual interviews were conducted to gain a deeper understanding of participants’ …

Exploring The Lived Experience Of Grief In Adults With Attention Deficit Hyperactivity Disorder, Martina Bauer

Antioch University Dissertations & Theses

The purpose of this phenomenological descriptive-interpretive study was to understand the lived experience of maintaining attention to one’s responsibilities while grieving among adults diagnosed with ADHD who have recently experienced bereavement in the United States. The population for this study included adults aged 18 and over who had experienced the loss of a loved one in the past 5 years and had a current diagnosis of ADHD. Participants were recruited using a sample of convenience via social media, email, and flyers, employing a snowball sampling technique. There were eight participants who met the inclusion criteria and participated in a semi-structured …

Experiences Of Dissertating Students: What Works?, Laura Durkin

Antioch University Dissertations & Theses

This study explores the experiences of doctoral graduates from Council for Accreditation of Counseling and Related Educational Programs (CACREP)-accredited Counselor Education and Supervision (CES) programs. Guided by theoretical frameworks on student attrition and institutional racism, the research investigates three primary questions: (1) What dissertation- specific programmatic factors influence time to completion for CES doctoral students? (2) What interventions most strongly promote a sense of social integration and belonging? and (3) What interventions most strongly promote academic integration and confidence in students’ ability to succeed? Data were collected anonymously through an online survey, which included demographic and open-ended questions. Twelve participants …

Examining The Addictive Qualities Of Smartphone Usage, Daniel J. Pasquini

Antioch University Dissertations & Theses

Individuals in today’s society, both nationally and globally, have become exceedingly reliant on their smartphones, i.e., cellular devices with the ability to perform many tasks similar to a traditional computer, for both recreational and productivity purposes. As smartphones become increasingly accessible and affordable for the general population, smartphone usage will continue to grow exponentially. As a result, a comprehensive investigation into the possible addictive properties of smartphone usage is warranted. The purpose of this study is to examine and highlight any possible addictive qualities of excessive smartphone usage. The research methodology that will be implemented within the study will be …

Journey To Well-Being: An Exploration Of Thrivership Post-Domestic Violence, Kader Gumus

Antioch University Dissertations & Theses

Domestic violence profoundly affects multiple facets of a survivor’s life. While most existing literature on survivorship addresses the immediate aftermath of domestic violence, this study delves into the extended process following the trauma of abuse to attain “thrivership,” a new concept in the scholarly and practice literature that emphasizes enduring well-being and flourishing. This dissertation examines the journeys from surviving to thriving for 13 women who transformed themselves and their lives to achieve well-being after traumatic domestic violence. Bronfenbrenner’s ecological systems theory was applied to examine the multiple layers of environmental influences on an individual’s development, including the micro, meso, …

Factors Contributing To Teacher Attrition From The Perspectives Of Teachers Who Left The Profession, Malik Padgett

Theses and Dissertations

This applied dissertation examined teacher attrition, a persistent challenge in K–12 education. Nearly 20% of teachers leave by their third year, with up to 50% departing by the fifth year. High turnover disrupts learning, strains resources, and diminishes educational quality, particularly in under-resourced communities. Addressing these issues is crucial for improving retention and fostering stability.

The study explored key factors driving attrition, including inadequate compensation, excessive workload, insufficient professional development, and limited administrative support, especially in the post-COVID era. Grounded in transformational leadership theory, the research highlighted the role of leadership in fostering morale and ethics rather than merely transactional …

Lived Experience Of Middle School Science Teachers During The Covid-19 Pandemic, David E. Abbott Jr.

Theses and Dissertations

The COVID-19 pandemic significantly disrupted education worldwide, compelling schools to adopt remote teaching and learning. This phenomenological study examined the lived experiences of six middle school science teachers in an Alabama school district during this period. Data were collected through interviews and reflective journals maintained for 2 weeks following the interview. The research investigated how teachers navigated shifting instruction to remote settings, engaged students, assessed and monitored their progress, and managed challenges. Guided by the technological pedagogical and content knowledge (TPACK) framework, findings revealed that teachers leveraged a combination of technological, pedagogical, and content knowledge to adapt their instruction. Despite …

Gambaran Putus Obat Berdasarkan Sosial-Demografi Pada Penderita Tuberkulosis Di Indonesia Tahun 2023: Cross-Sectional Study, Anindya Oktaria Yudhanti, Arina Syahida Hurva Radisan Saf, Benita Riska, Enita Fransiska Tamba

Jurnal Epidemiologi Kesehatan Indonesia

Introduction: Tuberculosis is an infectious disease that spreads through the air. Based on data at the international and national levels, there has been an increase. Most pulmonary TB patients are cured with consecutive antibiotic treatment for 6-9 months, but there are still patients who eventually drop out of treatment. This could be a challenge in achieving the international tuberculosis elimination target of 2035 and the national target of 2030. Methods: This study analyzed the socio-demographic distribution and dropout analysis of Tuberculosis patients in Indonesia in 2023 based on SKI data with a cross-sectional study type. Results: The incidence of drug …

Gambaran Kasus Gondongan Pada Sekolah Dasar Negeri 010 Makroman, Samarinda, Dwi Listiani, Ashri Budi Astuti, Jami'an Jami'an, Eko Prasetya Budi, Arif Sumarianto, Irfansyah Baharuddin Pakki

Jurnal Epidemiologi Kesehatan Indonesia

Mumps is an infectious disease caused by a viral infection, often attacking the salivary glands, especially the parotid glands. This disease is self-limiting and common in elementary school children. This study aims to describe the prevalence, symptoms, and impact of mumps in students of SD Negeri 010 Makroman, Samarinda, as well as evaluate risk factors and relevant prevention efforts. With a descriptive research design, data was obtained from a population of 307 students through secondary data from the Makroman Health Center and direct on-site investigations. An attack rate of 3.58% indicates a limited impact on at-risk populations, but it is …

Heterogeneous Clustering Of Multiomics Data For Breast Cancer Subgroup Classification And Detection, Joseph Pateras, Musaddiq Lodi, Pratip Rana, Preetam Ghosh

Computer Science Faculty Publications

The rapid growth of diverse -omics datasets has made multiomics data integration crucial in cancer research. This study adapts the expectation–maximization routine for the joint latent variable modeling of multiomics patient profiles. By combining this approach with traditional biological feature selection methods, this study optimizes latent distribution, enabling efficient patient clustering from well-studied cancer types with reduced computational expense. The proposed optimization subroutines enhance survival analysis and improve runtime performance. This article presents a framework for distinguishing cancer subtypes and identifying potential biomarkers for breast cancer. Key insights into individual subtype expression and function were obtained through differentially expressed gene …

Deepssetracer 2.0: Improved Deep Learning Model Performance For Protein Secondary Structure Segmentation From Cryo-Em Maps, Bryan Hawickhorst, Thu Nguyen, Willy Wriggers, Jiangwen Sun, Jing He

Computer Science Faculty Publications

DeepSSETracer is a method for segmenting protein secondary structure from medium-resolution (5-10Å) cryogenic electron microscopy (cryo-EM) density maps. We conducted experiments and ablation studies to examine the effects of normalization methods, max-pooling, activation functions, and loss calculation region on DeepSSETracer. By combining multiple technical improvements, the performance of the new version, DeepSSETracer 2.0, was significantly enhanced compared to DeepSSETracer 1.1. On a set of 77 test cases, the weighted average per-voxel F1 score increased from 62.1% to 70.3% for helix detection, and from 47.8% to 62.5% for β-sheet detection. While each of the five modifications in the network enhanced the …

Benchmarking And Improving Foundation Model Dietary Estimates From Meal Images, Yongcheng Mu, Jiangwen Sun, Jing He

Computer Science Faculty Publications

Accurate quantifying dietary contents, such as calories, proteins, carbohydrates, and fats, from an image of a meal plate is vital for managing diabetes. Recently, Large Multimodal Models (LMMs) have excelled in complex vision-language tasks due to their use of very large, highly diverse data. This study benchmarked the use of seven LMMs that include full and lightweight models of GPT, Gemini, and Llama for nutrition estimation based on Google's Nutrition5k dataset and our own phone-collected DonateAndLearn dataset. We analyzed the performance of LMMs and the RGB-D fusion model, in which the RGB-D model was specifically trained using Nutrition5k data. On …

Closing Racial And Ethnic Disparity Gaps In Pediatric Asthma Follow Up Care - A Quality Improvement Initiative, Ayodele Ayeko

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Closing racial and ethnic disparity gaps in pediatric asthma follow up care - A quality improvement initiative

Ayodele Ayeko

Introduction/Background: Inadequate management of asthma significantly contributes to poor asthma control, poor quality of life (QOL), and high hospitalization rates among pediatric patients. The Global Initiative for Asthma (GINA) guidelines offer recommendations designed to enhance asthma control and improve the quality of life for those affected (2015), including recommendations for close follow up care. At WVU Medicine Children’s Hospital (WVUMCH), insufficient asthma control has been associated with lower clinic follow-up rates and an increase in hospitalization. Although educational initiatives …

Facilitating Independence: Developing A Hands-On Life Skills Program For Youth In Residential Treatment, Shayna Rexrode

Graduate Theses, Dissertations, and Problem Reports (ETD)

Life skills competency in adolescence can be an important predictor of success in adulthood. Educational and training programs focused on life skills can help youth develop the skills that they need to live independently. Though occupational therapy literature surrounding these types of programs is limited, occupational therapy practitioners are qualified to provide intervention in life skills based on the profession’s scope of practice.

This capstone project focused on the development and evaluation of a new life skills program, the Life Skills Practice Program, at a residential treatment facility for youth with substance use and behavioral diagnoses. Stakeholders at the facility …

Quantitative Assessment Of Knee Joint Stability Using Inertial Measurement Units In Patients With Acl Reconstruction Performing Single-Legged Hopping Tasks, Haley Hartman-Mongold

Graduate Theses, Dissertations, and Problem Reports (ETD)

Purpose: The purpose of this study was to examine proximal tibial IMU accelerations between the involved limb and uninvolved limbs of individuals who have undergone ACL reconstruction performing the single-leg hop test battery and to correlate these results to deficits in quadriceps strength and distance hopped. Methods: Thirty-four subjects (19 male, 15 female; age = 20.5 ± 6.7 years; mass = 76.4 ± 15.8 kg; height = 1.74 ± .08 cm) who have undergone unilateral ACL reconstruction were recruited for this study. An isokinetic dynamometer was used to assess the knee extension peak torque on the involved and uninvolved limbs. …

The Impact Of Perfumes And Cosmetic Products On Human Health: A Narrative Review, Sharifa Alblooshi

All Works

Background: The use of perfumes and cosmetic products is widespread, serving personal hygiene, aesthetic, and olfactory functions. However, concerns have been raised regarding the potential health impacts associated with long-term exposure to various ingredients used in these products. Objectives: This narrative review aims to synthesize evidence on the health risks associated with perfumes and cosmetics, focusing on specific health concerns, including fertility, respiratory health, cancer risk, allergies, skin disorders, endocrine disruption, and neurological effects. It also discusses the presence of heavy metals in cosmetics, regulatory challenges, and the need for transparency in ingredient disclosure. Methods: A comprehensive review of the …

An Explainable Ai And Optimized Multi-Branch Convolutional Neural Network Model For Eye Anemia Diagnosis, Kamel K. Mohammed, Nadia Dahmani, Rania Ahmed, Ashraf Darwish, Aboul Ella Hassanien

All Works

This paper proposes a novel, non-invasive approach to diagnosing eye anemia using deep learning techniques. Traditional methods, reliant on invasive procedures like venipuncture, are costly and can cause patient discomfort. Our model leverages a multi-branch convolutional neural network (CNN) architecture, incorporating the Hippopotamus Optimization (HO) algorithm and multiclass support vector machines (SVMs) for enhanced accuracy. To address data imbalance, we employ the Synthetic Minority Oversampling Technique (SMOTE) and data augmentation. The model is trained and evaluated on a dataset of 211 eye images. The model achieves a remarkable 97.06% accuracy, with a Receiver Operating Characteristic (ROC) curve demonstrating an Area …