Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich

Walden Dissertations and Doctoral Studies

When working with patients who have the potential to become physically aggressive, verbal de-escalation is an important technique that can defuse a dangerous situation. At the project site in the mental health emergency department (MHED), workplace violence was on the rise based on the reported use of physical interventions (rates of brief holds and physical restraint use). The purpose of this quality improvement evaluation project was to determine whether an educational training program on verbal de-escalation techniques would increase staff’s confidence in the use of verbal de-escalation and decrease the rate of physical interventions used in the MHED. The change …

Helping In The Home: Counselors’ Experiences Providing Clients With In-Home Services, Melissa Jane Franzen

Walden Dissertations and Doctoral Studies

Counseling is an essential service that helps individuals work through struggles and live their best lives. Such service now includes providing counseling in clients’ homes. Counselors may require specific training or education to prepare for counseling in a home environment. This need for training and education is due to a lack of knowledge of the lived experiences of counselors providing services in the home. Transcendental phenomenology was used to guide a qualitative exploration into the lived experiences of counselors providing services in clients’ homes. Participants were 7 professional counselors, 5 female and 2 male, having met minimum state licensure requirements …

Reducing Recidivism Of Psychiatric Inpatient Clients In Behavioral Health Facilities, Cottrell Jacobs

Walden Dissertations and Doctoral Studies

AbstractResearch shows readmitting clients to inpatient psychiatric facilities within 30 days to one year of discharge can be costly for an organization and may represent less than optimal quality care for clients. The purpose of this study was to obtain an in-depth understanding of practices and barriers to reducing inpatient readmissions by completing a qualitative case study of readmission reduction strategies used by a large inpatient psychiatric facility in the southern United States. The Baldrige excellence framework was used to guide the assessment of the organization. Data collection consisted of five semi-structured interviews with organizational leaders, evaluation of internal archival …

The Lived Experiences Of Black Youth Who Recidivate In Diversion Programs, Justin Richards

Walden Dissertations and Doctoral Studies

There are high rates of recidivism among U.S. Black youth when compared to other races, such as Whites and Hispanics. The purpose of the study was to examine the lived experiences of Black youth in the juvenile justice system and in diversion programs. Using a phenomenological qualitative method, twelve Black adults between the ages of 18 to 40 were interviewed about their lived experiences while participating in mental health courts and in-home probation as youth. The conceptual framework of the study was based on the risk, need, and responsivity model. The primary research question examined the lived experiences and perceptions …

A Behavioral Healthcare Approach To At-Risk Youth Substance Prevention Program Development, Debra Mcintyre

Walden Dissertations and Doctoral Studies

Providing quality services that meet the needs of clients is key to organizational sustainability for behavioral health organizations. Strategic development of substance prevention programs for at-risk youth will play an important role in capacity building. The focus of this study was to identify the need for developing a targeted and effective substance abuse prevention program to support at-risk youth who have trauma experiences before they begin misusing substances to cope with their challenges. The Baldrige excellence framework was used to guide this descriptive case study of a behavioral health organization in the Northeastern region of the United States. The data …

Workplace Psychosocial Factors, Perception Of Organizational Support, And Congregate Workers’ Quality Of Life, Claudine Alicia Cousins

Walden Dissertations and Doctoral Studies

Congregate care organizations employ workers across various environments from shelters, group homes, long-term care homes, and correctional facilities. Congregate care workers in the developmental services sector face numerous risks that affect their quality of life due to workplace stress from daily interactions with individuals with intellectual disabilities and organizational demands. Workers’ perception of the support received from their organization may further impact their quality of life. The purpose of this quantitative study, guided by organizational support theory, was to examine the relationship among the independent variables of workplace psychosocial factors (defined as vicarious trauma, compassion fatigue, mental stress, or burnout), …

Exploring Culturally Competent Mental Health Outreach To Black Churches, Michele Marie Fry

Walden Dissertations and Doctoral Studies

Black individuals and communities have held distrust toward mental health services and experience barriers in seeking services. Although the church is a significant support system in the Black community, it can also pose a barrier to congregation members seeking mental health services, as the Black church community has often stigmatized those seeking mental health services as weak. Ways to reach the Black community with trauma-informed, culturally competent, and spiritually sensitive mental health services through establishing connections with Black churches and church leaders were explored in this study. Previous research indicated that the COVID-19 pandemic increased depression and anxiety in the …

Ambivalence Over Emotion Expression And The Effects Of Religious Coping In African American Christians, Anya Loraine Dobbs

Walden Dissertations and Doctoral Studies

African Americans are 10% more likely than non-Hispanic Whites to report having serious mental health issues from psychological stressors. Mental health concerns, such as depression and anxiety, that arise from psychological stressors, are more than likely to go untreated in African Americans. African Americans are more likely to turn to religion- their church, their pastors, and fellow parishioners to address these concerns. Religion and religious coping has influenced African Americans’ attitudes regarding help-seeking and mental health treatment, with the “Black Church” historically being a source of many things, including mental health care. Pargament’s theory of religious coping served as a …

Mental Health Treatment Services Exposure In Lgbtq+ College Students Of Color, Arianna Kholanjani

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

No abstract provided.

Addressing The Needs Of African American Grandparents: An Intersectionality Perspective, Dorothy Smith-Ruiz, Kendra Jason

The Journal of Sociology & Social Welfare

This study seeks to demonstrate the intersecting structural and compounding challenges African American custodial grandparents experience collectively, rather than as separate non-competing factors, which has been modeled in prior studies. Using a mixed-method research design, the study explored the challenges faced by African American and white custodial grandparents. These challenges included difficulties attaining different types of support, respite care, and programs for teens and special needs grandchildren. Results showed that caregiving challenges among African Americans were more pervasive than their White counterparts. These findings have significant implications for the development of intervention programs for custodial African American grandmothers and their …

Achieving The Sustainable Development Goals: Evidence From The Longitudinal Parenting Across Cultures Project, Jennifer E. Lansford, W. Andrew Rothenberg, Sombat Tapanya, Liliana Maria Uribe Tirado, Saengduean Yotanyamaneewong, Liane Peña Alampay, Suha M. Al-Hassan, Dario Bacchini, Marc H. Bornstein, Lei Chang, Kirby Deater-Deckard, Laura Di Giunta, Kenneth A. Dodge, Sevtap Gurdal, Qin Liu, Qian Long, Patrick S. Malone, Paul Oburu, Concetta Pastorelli, Ann T. Skinner, Emma Sorbring, Laurence Steinberg

Psychology Department Faculty Publications

No abstract provided.

Parent/ Caregiver Burnout With Autism Due To Covid, Leah Recker, Erin Babcock

Williams Honors College, Honors Research Projects

The purpose of this project is to gain an understanding how parents of children with autism are affected by caregiver burnout. We want to understand the different factors that contribute to this burnout and analyze how individuals are affected differently. To do this, we are sending

out a survey using Likert scale items to assess parents’ stress and burnout. We will be carefully selecting statements based off information we gather through peer reviewed journal articles. We would then like the parents to decide how strongly they agree or disagree with each question. This will create a more in-depth picture of …

Co-Constructing Stigma: Treating Trauma In Adolescence, Isabelle Sanderson

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Public stigma and self-stigma are major factors that impede the seeking of mental health treatment as well as the development of an effective therapeutic alliance. This paper explores the co-creation of stigma dynamics from an intersubjective systems theory lens suggesting these dynamics may play a role for adolescent clients who have experienced significant trauma. Specifically, the potential overlooking and/or misdiagnosis of trauma-related experiences and symptoms often occurring with adolescents diagnosed with ADHD may be contributing to a co-constructed dynamic between the therapist and client to avoid an exploration of trauma that would be experienced as more stigmatizing, more threatening, and …

Beyond The Bump: Reconceiving The Philosophy Of Pregnancy, Hazel T. Bianas, Leni Dlr Garcia, Ninotchka Mumtaj B. Albano

Philosophy Department Faculty Publications

French philosopher Hélène Cixous (1976) stressed the importance of feminine writing. She believes that women should take part in sharing their experiences from their own novel points-of-view. We discuss that while pregnancy is an experience unique to women; it has been misappropriated by patriarchal structures throughout the years. The pregnancy bump; which is more than just evidence of the uterus stretching to accommodate the fetus; is a symbol of a woman's triumphs and struggles all throughout conception; pregnancy and childbirth. We show that women have already gone beyond the bump and challenged existing patriarchal systems through different means; as Cixous …

The Harm In Seeking Care: Assessing The Relationship Between Healthcare Discrimination And Healthcare Avoidance Behaviors In The Past Year And Since The Start Of The Coronavirus Pandemic In A Transgender And Gender Independent Sample, Kyle L. Mason

Theses and Dissertations

Background: Gender minorities encounter a myriad of barriers to accessing general and gender affirming healthcare. Financial disparities impacting affordability of healthcare costs and insurance-based denials for gender-affirming care are among prominent barriers discussed. Considerations of the prevalence of stigma, discrimination, and erasure of gender minority identities must not be neglected when seeking to understand healthcare accessibility and utilization in this population. Previous researchers have examined gender minority patients’ experiences of discrimination in healthcare settings and delaying care due to fear of discrimination. There is a dearth of knowledge about the relationship between lifetime exposure to varied forms of healthcare discrimination …

Policies Addressing Barriers To Low-Income Women And Children’S Health Care Utilization In The United States And Kenya: The Role Of Physician Payments And Cash Transfer Programs, Muloongo Simuzingili

Theses and Dissertations

This dissertation examined two policies to improve low-income women and children’s healthcare utilization: physician payments and cash transfer programs. Higher physician payments increase the supply of healthcare services while cash transfers increase individuals’ demand for healthcare services. Cash transfer programs can improve health outcomes, yet the extent to which they are a cost-effective strategy is largely understudied. Therefore, this dissertation examines three overarching research questions:

1. Are Medicaid physician fees associated with access to substance abuse disorder (SUD) treatment among low-income women of reproductive age?
2. Do economic preferences moderate cash transfer program effects on children’s health care utilization? Evidence from a …

College Students' Mental Health And Drug Use Outcomes During The Stay-At-Home Order, Alexander T. Hain

Cal Poly Humboldt theses and projects

The COVID-19 pandemic has affected people of all ages causing increased drug usage and worsening mental health in addition to hospitalization and death. The current study investigated how the United States’ stay-at-home orders affected the mental health and drug use of young adult college students. This population is of particular interest because young adults are at most risk of drug use developing into addiction. Two hypotheses related to the self-medication hypothesis were investigated: (1) there will be a significant increase in drug use during the stay-at-home order when compared to drug use prior to the stay-at-home order and (2) feelings …

Opioid Settlement Funds: Do Not Neglect Patients With Pain, Mark C. Bicket, Barbara Mcquade, Chad M. Brummett

Articles

The opioid crisis has escalated in the setting of the COVID-19 pandemic to new extremes and has claimed more than half a million lives in the US since 2000. Lawsuits to address the civil and criminal liability of drug companies and other groups have originated from federal, state, local, and tribal jurisdictions. When successful, there will likely be billions of dollars and significant discretion as to how these funds are spent. Several groups have produced reports with principles to address the toll of addiction using settlement funds. However, they lack actionable strategies to address the needs of patients with pain, …

As Time Goes By: Understanding Child And Family Factors Shaping Behavioral Outcomes After Traumatic Brain Injury, Linda Ewing-Cobbs, Janelle J Montroy, Amy E Clark, Richard Holubkov, Charles S Cox, Heather T Keenan

Faculty, Staff and Student Publications

Objective: To model pre-injury child and family factors associated with the trajectory of internalizing and externalizing behavior problems across the first 3 years in children with pediatric traumatic brain injury (TBI) relative to children with orthopedic injuries (OI). Parent-reported emotional symptoms and conduct problems were expected to have unique and shared predictors. We hypothesized that TBI, female sex, greater pre-injury executive dysfunction, adjustment problems, lower income, and family dysfunction would be associated with less favorable outcomes.

Methods: In a prospective longitudinal cohort study, we examined the level of behavior problems at 12 months after injury and rate of change from …

Prevalence And Correlates Of Sex Selling And Sex Purchasing Among Adults Seeking Treatment For Cocaine Use Disorder, Emma C Lathan, Judy H Hong, Angela M Heads, Nicholas C Borgogna, Joy M Schmitz

Faculty, Staff and Student Publications

Exchange sex places individuals with cocaine use disorder (CUD) at particularly high risk for deleterious safety and health outcomes. A substance use treatment provider who is aware of a patient's exchange sex behavior is better able to provide appropriate screening, care, and/or referral to risk reduction services. However, little is known about exchange sex, especially purchasing, among treatment-seeking adults with CUD. The current study examined the prevalence and correlates of sex selling and sex purchasing among treatment-seeking men and women with CUD (

The Effect Of Quality Of Life On Cardiometabolic Risk Factors In Postmenopausal Women, Chavela Lynn Riotutar

Cal Poly Humboldt theses and projects

Background: The emergence of cardiometabolic (CMD) indicators for Metabolic Syndrome (MetS) coincides with the decline in estrogen production during menopause and substantially increases development of cardiovascular disease (CVD) in women. Quality of life (QOL) encompasses physical, material, and social well-being. Research reveals a correlation between low QOL scores and CMD disease. Menopause significantly increases CMD risk, and may also lower QOL scores. Objective: To investigate the relationship between QOL and CMD risk in postmenopausal women. Method: Cisgender, postmenopausal women (age > 45 years) were recruited through emails to complete the online survey. Data collection included demographics, physical characteristics and activity level, …

A Multivariable Model Of Parent Satisfaction, Pain, And Opioid Administration In A Pediatric Emergency Department, Candice D. Donaldson, Thomas W. Heyming, Louis Ehwerhemuepha, Brooke N. Jenkins, Michelle A. Fortier, William Feaster, Zeev N. Kain

Psychology Faculty Articles and Research

Introduction: Children and adolescents are not impervious to the unprecedented epidemic of opioid misuse in the United States. In 2016 more than 88,000 adolescents between the ages of 12–17 reported misusing opioid medication, and evidence suggests that there has been a rise in opioid-related mortality for pediatric patients. A major source of prescribed opioids for the treatment of pain is the emergency department (ED). The current study sought to assess the complex relationship between opioid administration, pain severity, and parent satisfaction with children’s care in a pediatric ED.

Methods: We examined data from a tertiary pediatric care facility. A health …

X-Linked Serotonin 2c Receptor Is Associated With A Non-Canonical Pathway For Sudden Unexpected Death In Epilepsy, Cory A Massey, Samantha J Thompson, Ryan W Ostrom, Janice Drabek, Olafur A Sveinsson, Torbjörn Tomson, Elisabeth A Haas, Othon J Mena, Alica M Goldman, Jeffrey L Noebels

Faculty, Staff and Students Publications

Sudden Unexpected Death in Epilepsy is a leading cause of epilepsy-related mortality, and the analysis of mouse Sudden Unexpected Death in Epilepsy models is steadily revealing a spectrum of inherited risk phenotypes based on distinct genetic mechanisms. Serotonin (5-HT) signalling enhances post-ictal cardiorespiratory drive and, when elevated in the brain, reduces death following evoked audiogenic brainstem seizures in inbred mouse models. However, no gene in this pathway has yet been linked to a spontaneous epilepsy phenotype, the defining criterion of Sudden Unexpected Death in Epilepsy. Most monogenic models of Sudden Unexpected Death in Epilepsy invoke a failure of inhibitory synaptic …

Assessment Of The Impact Of Tardive Dyskinesia In Clinical Practice: Consensus Panel Recommendations, Richard Jackson, Matthew N Brams, Leslie Citrome, Amber R Hoberg, Stuart H Isaacson, John M Kane, Rajeev Kumar

Faculty, Staff and Students Publications

PURPOSE: Tardive dyskinesia (TD) is a hyperkinetic movement disorder in which patients experience abnormal involuntary movements that can have profound negative impacts on physical, cognitive, and psychosocial functioning. Use of measures to assess the functional impact of TD in routine clinical practice is lacking. To address this gap, an advisory panel of experts in psychiatry and movement disorder neurology was convened to develop consensus recommendations on assessment of the impact of TD on patients' functioning that can be used in clinical practice.

METHODS: An advisory panel provided recommendations using an iterative process, beginning with a narrative literature review regarding current …

Anxiety Screening In Children & Adolescents With Type 1 Diabetes Using The Gad-7 Tool, Allison B. Reynolds

DNP Projects

BACKGROUND: Children and adolescents with type 1 diabetes (T1DM) can encounter a variety of factors that affect proper management of their diabetes, including mental health. Youth with diabetes have significantly higher rates of depression, anxiety, and mental health problems compared to the general population. Anxiety is especially prevalent. PURPOSE: The objective of this project was to evaluate anxiety screening of children and adolescents with T1DM during their routine diabetes visits. Specifically, to assess for any trends in anxiety levels and patient characteristics including demographics, insulin regimen and A1C levels. METHODS: A cross- sectional, retrospective review of ambulatory electronic health records …

Positive Reflective Journaling As A Tool For Managing Stress And Promoting A Healthy Work Environment In Nursing Academia, Roxanne Gall

DNP Projects

Abstract

Background: Teaching and nursing are consistently cited as the two occupations that work under the highest levels of occupational stress. Positive Reflective Journaling may be a tool that helps to manage stress and influence a healthy work environment in academic nursing settings.

Purpose: The purpose of this study was to investigate whether Positive Reflective Journaling could be used as an adjunct to reduce stress and support a healthy working environment in

nursing academia.

Methodology: Eighty-six faculty and staff from a University based School of Nursing were invited to participate in the study. A positive reflective journaling exercise was evaluated …

Buprenorphine For Chronic Pain: A Safer Alternative To Traditional Opioids, Suhani Dalal, Ahish Chitneni, Amnon A Berger, Vwaire Orhurhu, Bilal Dar, Bennett Kramer, Anvinh Nguyen, John Pruit, Charles Halsted, Alan D Kaye, Jamal Hasoon

Faculty, Staff and Students Publications

With the ongoing public health crisis with prescription opioids, there is a need for safer alternatives for medication management in chronic pain patients. Buprenorphine is a partial mu-opioid agonist which is commonly utilized to treat patients with opioid-use disorders. The purpose of this review is to discuss the potential use of this medication for the treatment of chronic pain instead of resorting to more traditional Schedule II opioids. Buprenorphine offers a safer alternative for patients who require opioids to manage chronic pain, given the unique pharmacological properties that allow it to provide adequate analgesia with less abuse potential.

A Pharmacokinetic Analysis Of Hemodialysis For Metformin-Associated Lactic Acidosis, Stephen A Harding, Rana Biary, Robert S Hoffman, Mark K Su, Mary Ann Howland

Faculty, Staff and Students Publications

OBJECTIVE: Although hemodialysis is recommended for patients with severe metformin-associated lactic acidosis (MALA), the amount of metformin removed by hemodialysis is poorly documented. We analyzed endogenous clearance and hemodialysis clearance in a patient with MALA.

METHODS: A 62-year-old man with a history of type II diabetes mellitus presented after several days of vomiting and diarrhea and was found to have acute kidney injury (AKI) and severe acidemia. Initial serum metformin concentration was 315.34 μmol/L (40.73 μg/mL) (typical therapeutic concentrations 1-2 μg/mL). He underwent 6 h of hemodialysis. We collected hourly whole blood, serum, urine, and dialysate metformin concentrations. Blood, urine, …

How Does Direct Volunteering Affect The Onset Of Alzheimer’S Dementia In Elderly Patients With Preexisting Cardiac Comorbidities?, Sneha R. Gade

Undergraduate Research Posters

Alzheimer's Dementia is a disease that affects memory, thinking, and behavior. The Alzheimer's Association reported Alzheimer's as the sixth-leading cause of death in the United States, and a cure does not exist. Donepezil, a cholinesterase inhibitor drug, is frequently prescribed to treat Alzheimer's disease. Still, patients must continuously take the medication for years to receive any measurable improvement in quality of life after developing Alzheimer's Dementia. Further, research shows prolonged use of Donepezil can lead to other health problems, such as QTc prolongation, for cardiac disease patients. Therefore, the effectiveness of non-drug interventions, such as volunteering to prevent the disease's …

Long-Term Mental Health And Quality Of Life Outcomes Of Neonatal Insults In Kilifi, Kenya, Dorcas N. Magai, Hans M. Koot, Charles R. Newton, Amina Abubakar

Institute for Human Development, East Africa

We examined the mental health and quality of life (QoL) outcomes and their correlates of school-aged survivors of neonatal jaundice (NNJ), hypoxic-ischemic encephalopathy (HIE), and a comparison group. The Child Behavior Checklist and the Pediatric Quality of Life Inventory were administered to assess the mental health and QoL of 375 children (134 with NNJ, 107 with HIE, and 134 comparison group) aged 6 to 12 years [Median age 9 (interquartile range 7 to 11)]. The results showed that survivors of NNJ and HIE have mental health problems and QoL similar to the comparison group. Maternal mental health was the predominant …