Mental and Social Health Commons^™

A Brief But Comprehensive Three-Item Social Connectedness Screener For Use In Social Risk Assessment Tools, Nancy P Gordon, Matthiew C Stiefel

Faculty, Staff and Student Publications

BACKGROUND: The 2014 IOM report "Capturing Social and Behavioral Domains and Measures in Electronic Health Records" described three subdomains of social relationships that affect patient health and well-being. However, most social risk screeners currently assess only one subdomain, frequency of social connections. We are proposing a three-item Brief Social Connectedness (SC) screener that additionally assesses risks in social/emotional support and loneliness/social isolation subdomains.

METHODS: For this cross-sectional study, we used data from a 2021 Kaiser Permanente Northern California (KPNC) social risk survey for 2244 members ages 35-85 years. The survey included three validated questions that covered the SC subdomains (frequencies …

Geriatric Trauma Triage: Optimizing Systems For Older Adults-A Publication Of The American Association For The Surgery Of Trauma Geriatric Trauma Committee, Tanya Egodage, Vanessa P Ho, Tasce Bongiovanni, Jennifer Knight-Davis, Sasha D Adams, Jody Digiacomo, Elisabeth Swezey, Joseph Posluszny, Nasim Ahmed, Kartik Prabhakaran, Asanthi Ratnasekera, Adin Tyler Putnam, Milad Behbahaninia, Melissa Hornor, Caitlin Cohan, Bellal Joseph

Faculty, Staff and Student Publications

BACKGROUND: Geriatric trauma patients are an increasing population of the United States (US), sustaining a high incidence of falls, and suffer greater morbidity and mortality to their younger counterparts. Significant variation and challenges exist to optimize outcomes for this cohort, while being mindful of available resources. This manuscript provides concise summary of locoregional and national practices, including relevant updates in the triage of geriatric trauma in an effort to synthesize the results and provide guidance for further investigation.

METHODS: We conducted a review of geriatric triage in the United States (US) at multiple stages in the care of the older …

Victory Out Of Tragedy: Organ Donation, Ali Salim, Bryan A Cotton

Faculty, Staff and Student Publications

Major improvements in trauma care during the last decade have improved survival rates in the severely injured. The unintended consequence is the presentation of patients with non-survivable injuries in a time frame in which intervention is considered and often employed due to prognostic uncertainty. In light of this, discerning survivability in these patients remains increasingly problematic. Evidence-based cut-points of futility can guide early decisions for discontinuing aggressive treatment and use of precious resources in severely injured patients arriving in extremis.

Postsurgical Pyoderma Gangrenosum After Penile Inversion Vaginoplasty: Case With Review Of Diagnostic And Management Strategies, Michael M Talanker, Jessica R Nye, David T Mitchell, Daniel J Freet

Faculty, Staff and Student Publications

BACKGROUND: Postsurgical pyoderma gangrenosum (PSPG) is a highly uncommon and unpredictable wound healing complication. Rapid progression of ulcers at incisions can cause unfettered dehiscence. Most commonly, PSPG involves breast procedures; however, in this work, we detail a case of a patient who developed PSPG 10 days postoperatively after penile inversion vaginoplasty.

METHODS: The patient in this case underwent a penile inversion vaginoplasty with orchiectomy in the standard fashion. She had no risk factors for PSPG. Following an uncomplicated hospital stay, the patient developed difficulty with pain control and increasing serous drainage on the 10th postoperative day. On readmission, the patient …

Alopecia As An Early Clinical Marker For Azathioprine Induced Myelosuppression: A Case Report, Nilanjana Dutta , Final Year Mbbs, Dr. M Suresh Babu , Professor, Dr. Subramanian Ramaswamy , Professor, Dr. Mahabaleshwar Mamadapur , Assistant Professor

Digital Journal of Clinical Medicine

Azathioprine is a pro-drug and is metabolized by the TPMT enzyme in the body. In South Asians, Azathioprine is known to cause alopecia and bone marrow suppression in patients with TPMT enzyme deficiency. In India, the prevalence of TPMT mutation varies from 1.2- 10%. A new mutation was detected in 2014, NUDT15 whose incidence varies from 8.5-16%. Patients with mutation in both TPMT and NUDT15 develop myelosuppression faster. In our case, alopecia manifested as the first clinical feature of Azathioprine myelosuppression. Physicians need to recognize early clinical clues (alopecia) to avoid the impending development of myelosuppression and to look for …

Scope And Limitations Of Chatgpt In Research And Academic Writing, Shyam Pyare Singh, Imran Ahmed Khan, Shaila Kumari Mitra

Digital Journal of Clinical Medicine

Background: ChatGPT has proven to be an invaluable tool, enabling human-like interactions, and facilitating knowledge exchange. It possesses the ability to generate coherent and contextually relevant responses based on the input it receives. In essence, ChatGPT responds to anything in a conversational manner and provides an output that looks like human writing. However, with the rapid advancement of medical research, there is an increasing concern that ChatGPT may be abused to create articles devoid of clinical reasoning and critical thinking.

METHODS: A through literature search was conducted on PubMed and Google scholar to find relevant article according to objective.

RESULTS: …

A Real World Study Of Adherence To Insulin In Diabetic Humans-Stadium Study, Dipsanker Chatterjee, Subham Das

Digital Journal of Clinical Medicine

Background:

With an ever-increasing prevalence of diabetes, lack of adherence to insulin treatment in even a small percentage of patients is a major issue and can lead to significant burden on the healthcare system. This survey analysis seeks to investigate the insulin adherence patterns to identify the factors associated with medication adherence.

Methodology:

The current cross-sectional survey was conducted among diabetes patients on insulin treatment. A list of questions about insulin adherence was provided to the participants in the study and the responses were recorded. The data was analysed using Graph Pad Prism.

Results:

Around 23.2 and 18.6 % of …

Internet Addiction: A Growing Threat: A Cross-Sectional Among The Undergraduate Medical Students Of Tertiary Care Hospital, Mysuru, Rakesh M, Diksha Goswami, Sunil Kumar D, Shwethashree M

Digital Journal of Clinical Medicine

Background: The internet has quickly become a part of our lives, impacting every part of our existence. Its use has expanded beyond simply being a communication tool and a source of information. The objective of the study is to assess the prevalence of Internet addiction among the Undergraduate medical students of Mysuru.

Methods: This cross-sectional study was conducted among 255 medical students of a Tertiary care Hospital, Mysuru for three months from September 1^st to November 30^th,2023. Data was collected using a semi-structured questionnaire. The semi-structured questionnaire covered details of demographic data and twenty questions of the …

Placenta Accreta Spectrum Disorder As First Trimester Pregnancy Termination Complication; Case Series, Sindhu Kumari, Poornima M

Digital Journal of Clinical Medicine

Placenta Accreta Spectrum (PAS) disorder is rare (2% according to ACOG) condition of pregnancy when the placenta grows deeply into myometrium. This leads to failure of placenta to separate normally from myometrium after delivery and leads to massive hemorrhage. The PAS is classified as PA (Placenta Accreta), PI (Placenta Increta) and PP ( Placenta Percreta), on basis of depth of trophoblastic invasion. Increase in no. of cesarean sections, increasing the incidence of PAS. Cesarean scar on uterus promotes placental tissue to invade deeply in subsequent pregnancy. Antenatal scanning and color imaging can detect PAS, at a very early stage. Here …

Gender Equality– A Sustainable Development Goal In Progress At A Medical College And Hospital In South India, Mr. Manoj S M, Kusuma Kasapura Shivashankar, Suma M. Natraj, Praveen Kulkarni

Digital Journal of Clinical Medicine

Background: Gender Equality is one of the most important SDG and attaining it will ensure a peaceful, prosperous and a balanced world with equal opportunities for both women and men. The Indian scenario in the field of women education has changed with mindset of most parents undergoing a paradigm shift and many girls are encouraged to attend schools, colleges and women are allowed to work. Considering the above shift, our study intended to find out if the same was true and SDG-5, Gender Equality was attained or in progress at our medical college and hospital and hence the study.

Methods: …

The Balm Framework Of Clinical Excellence: An Adoptable Model For Sub-Saharan Africa., Taoreed Adegoke Azeez

Digital Journal of Clinical Medicine

Clinical excellence is the ability to provide rigorous, evidence-based, and rewarding care to the right patients. The BALM (brilliance, attitude, leadership, and materials) framework is a novel model for adjudicating clinical excellence. There are a few models and frameworks for evaluating clinical excellence, but each has its flaws and does not consider the peculiarities of economically-challenged regions such as sub-Saharan Africa. Coincidentally, such low-resource areas have an urgent need for a framework to assess clinical excellence because of their low health-related indices. The five-step mode of professional excellence is a well-recognised tool and was the model upon which the BALM …

Alkaptonuria Presenting With Back Pain: A Diagnostic Dilemma, Arnav Salar, Dyuksha Arora, Mahabaleshwar Mamadapur

Digital Journal of Clinical Medicine

Alkaptonuria is a rare inborn error of metabolism due to a deficiency of homogentisate 1,2 dioxygenase, resulting in homogentisic acid accumulation in tissues. It is characterised by homogentisic aciduria, ochronosis, and arthritis. We hereby discuss a 46-year-old male who presented with progressive lower back pain and polyarthralgia for ten years, initially diagnosed as ankylosing spondylitis. Characteristic skin pigmentation, ochronosis, and radiological findings led to the correct diagnosis of alkaptonuria. This case highlights the importance of considering alkaptonuria as a differential diagnosis for chronic back pain and arthritis, mainly when sacroiliac joints are spared, and ochronosis is present. While no cure …

Psychiatric Morbidity In Perinatal Women And Its Outcome In A Tertiary Care Hospital, Lakshmi Velayudam, Prathap Talwar, Kishor M, Harshitha Padmanabha

Digital Journal of Clinical Medicine

Background: Pregnancy and postpartum are a period of vulnerability in a women’s life for developing mental health problems. Perinatal psychiatric illness has various adverse outcome on maternal, neonatal and child health.

Objective: To study the prevalence of psychiatric disorders and its outcome among women in the perinatal period.

Method: It is a prospective study conducted at a tertiary care hospital where antenatal and postnatal women were screened for psychiatric disorder using patient health questionnaire-9 (PHQ-9) and Edinburgh Post Natal Depression Scale (EPDS) respectively. Total of 140 women diagnosed with psychiatric disorder were followed up for a year and outcome …

Exploring The Elective Experience: A Review Of The "Adult Psychiatry" Elective At A Medical College, Dyuksha Arora, Kishor M

Digital Journal of Clinical Medicine

This review delves into the motivations, experiences, and perceived advantages and disadvantages of undertaking the 'Adult Psychiatry' as an elective at JSS Medical College. Experiences from four students, two from the 2019 batch and two from the 2020 batch, provide a comprehensive overview of their elective.

Clozapine And Modified Electroconvulsive Therapy (M-Ect) In Treatment Resistant Schizophrenia (Trs) – A Case Report, Kareena Arora, Kishor M, Murali M R, Suhas K Mr

Digital Journal of Clinical Medicine

Schizophrenia is psychiatric disorder affecting less than 1% of population that can be devastating, characterized by positive, negative and cognitive symptoms. This can lead to significant functional impairment. Despite intensive and ongoing research, outcomes from best-practice treatment are often suboptimal. Unfortunately, not all the patients respond to antipsychotic medications. Overall estimates suggest that one-fifth to one-half of patients have treatment resistant schizophrenia (TRS).

TRS include failure sequential trial of two different antipsychotics with sufficient dose, duration and adherence as a minimum criterion. TRS represents major clinical challenge.

Clozapine is the only drug approved for TRS as it is the drug …

Internet Gaming Disorders Amongst Medical Undergraduates In Tamil Nadu, India - A Cross Sectional Study, Rejee Sneha Ebanezer, Sumedha K, Murugan V

Digital Journal of Clinical Medicine

Abstract

Background: Internet Gaming Disorder (IGD) or internet-related gaming addictions are characterized by severely impaired control over gaming affecting routine activities, followed by several psychological, physical and social issues. Budding medical undergraduates who are future health professionals might have positive effects on their studies and career goals when saved from internet gaming addictions. Hence, this study aimed to identify the proportion of medical undergraduate students and interns with internet gaming disorders studying in a private medical college and tertiary care hospital.

Setting: A tertiary care Hospital and Medical College, Tamil Nadu, India

Study design: Cross – sectional study.

Participants: Medical …

High Stakes And Hidden Risks: A Case Series On Pathological Gambling In Context With Affective Disorders And Substance Abuse, Avni Gupta, Namita Deka, Mahesh Kumar

Digital Journal of Clinical Medicine

Background: Pathological gambling is a non–substance-related addictive disorder, characterized by persistent preoccupation with gambling, impaired control, and continuation despite negative consequences. It is associated with financial losses, social and occupational dysfunction, and psychiatric comorbidities, including affective and substance use disorders. Although international prevalence estimates range from 1–2%, research in India remains limited, particularly with the rise of online gambling.

Methods: We report a case series of three individuals presenting to a tertiary-care psychiatry outpatient department with pathological gambling. Clinical assessments included detailed psychiatric evaluation, mental status examination, and psychometric assessments using the Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory …

The Influence Of Flavor On The Abuse Liability Of A Heated Tobacco Product And Its Feasibility As A Menthol Cigarette Substitute, Augustus White

Theses and Dissertations

Heated Tobacco Products (HTPs) purport to expose people that use cigarettes to fewer of the harmful or potentially harmful constituents of tobacco while still delivering reinforcing amounts of nicotine (Auer, Concha-Lozano et al., 2017). An exemplar of the HTP class, IQOS, and its three varieties of “HeatSticks” have been authorized by the Food and Drug Administration (FDA) as “Modified Risk Tobacco Products” (MRTP). However, as the FDA is planning to ban menthol as a characterizing flavor in cigarettes, questions remain regarding whether characterizing flavors should be permitted in HTPs (FDA, 2022e). New evidence regarding HTP abuse liability (i.e., the likelihood …

Associations Between Childhood Trauma And Tobacco Dependence Among Latine Adults: Testing The Protective Effects Of Compassion For Self And Others, Camila Tirado

Theses and Dissertations

Tobacco dependence has posed a significant public health challenge in the United States and disproportionately affects Latine adults' risk of developing a variety of adverse health conditions. Childhood trauma is a recognized risk factor for dependence, overall health, and mental health concerns. Still, the influence of compassion for self or compassion for others in this context remains unclear. This cross-sectional study investigated the moderating effects of self-compassion and compassion for others on the relationship between childhood trauma and cigarette dependence among Latine adults. Data was collected through questionnaires assessing childhood trauma, self-compassion, cultural values and factors, compassion for others, and …

Acute Effects Of An Oral Nicotine Pouch In People Who Use Smokeless Tobacco, Alisha Eversole

Theses and Dissertations

People who use smokeless tobacco (SLT) are exposed to a variety of carcinogenic toxicants, yet, despite health risks, nearly 6 million people in the US use SLT. SLT contains and delivers nicotine, a psychostimulant that causes dependence and hinders cessation efforts. An orally-administered nicotine pouch marketed as “tobacco-free” recently has become available for purchase in the US. However, there are very few non-industry-sponsored studies regarding the effects of these oral nicotine pouches.

The current study used clinical laboratory methods to determine the acute effects of an oral nicotine pouch in people who use SLT. Participants completed four sessions (within subjects, …

Assessing Providers’ Readiness To Integrate Mat Services In A Primary Care Setting, Carmen Ingram-Thorpe

Theses and Dissertations

Opioid use disorder is a growing concern in the United States. Despite medication-assisted treatment (MAT) being a more effective treatment option than behavioral treatment alone, primary care providers’ rate of adoption and utilization of MAT has not matched the demand of the opioid crisis. The largest barrier facing our local community is the availability of organizations and providers that can and will actually provide MAT services. The purpose of this study was to identify factors that impact primary care providers’ readiness to treat individuals with opioid use disorder (OUD) using MAT. This study used the ADKAR model as framework, which …

Overcoming The Unseen: Understanding Diverse Canadian Workers’ Well-Being During The Beginning Of The Coronavirus Pandemic, Tyler M. Pacheco

Theses and Dissertations (Comprehensive)

Canadian workers were severely affected by the onset of the coronavirus (COVID-19) pandemic. The rapid spread of the pathogen across Canada resulted in several work-related consequences (e.g., temporary/indefinite layoffs and business closures, mandatory working-from-home) that could have impacted workers’ well-being during this turbulent period. Research available at the start of this dissertation process, and even more recently published studies, primarily explored general trends in workers’ negative well-being during COVID-19, not examining the distinct realities that diverse workers, including more marginalized ones, may have experienced. Across three manuscripts, several theories from diverse disciplines (positive, developmental, community, and industrial-organizational psychology, public health) …

Body-Map Storytelling: A Qualitative Exploration Of The Lived Experiences Of Hospital Care Amongst Street Involved Youth, Chelsey Fedchenko

Theses and Dissertations (Comprehensive)

This social work study explores the experiences of hospital care amongst street-involved (SI) youth. Given that SI youth are at a higher risk for health-related harms and experience significant barriers to health care services, they are at an increased likelihood of hospitalization. Yet, inadequate health care support for SI youth remains a critical problem in Canada. While hospital care amongst adult homeless populations has been well studied interdisciplinary, there is a scarcity of research investigating the hospital care experiences amongst SI youth. The aim of this qualitative, arts-based study was to explore how street-life contributes to hospitalization, how SI youth …

"Why Does This Have To Be So Hard?": Perinatal Experiences From An Ecological Systems Approach, Caitlin Senk

Antioch University Dissertations & Theses

This study examines the lived experience of the perinatal population to understand how they can be supported from the lens of different ecological systems and what counselors can do to better serve people with uteruses during their perinatal experience. Furthermore, this study aims to utilize an inclusive framework for capturing the perinatal experience of people with uteruses and to explore barriers and facilitators to care through an ecological systems framework. Fifteen participants who have experienced infertility, conception, pregnancy, miscarriage, childbirth, stillbirth, and postpartum were recruited through various means throughout the United States. Thematic analysis was used, with semi-structured interviews and …

Understanding The Experience Of Mothers In Higher Education During The Covid-19 Era, Shannan L. Engel

Antioch University Dissertations & Theses

This exploratory study aimed to understand the experience of mothers in higher education both during the COVID-19 pandemic and toward the end of restrictions. The population included academic mothers with children at home during the pandemic. Data was analyzed thematically by a team of researchers. The results generated six themes: (a) life changed suddenly, (b) remote work, school, and life, (c) unsupported, (d) sense of control, (e) support, and (f) positive aspects of COVID. These findings are important to the field of mental health counseling profession, supervision, and higher education because of the circumstances exemplified by the pandemic that highlight …

Emotions, Self-Efficacy, And Accountability For Antiracism In White Women Counselors, Lisa Wenninger

Antioch University Dissertations & Theses

Supporting the development of an antiracist identity in counselors could facilitate change toward equity, justice, and opportunity within the counseling profession and increase awareness of white counselors in working with clients of color. Understanding obstacles to and enablers of antiracist attitudes in white women counselors holds the potential to bring change to the profession as a whole, given their position in the majority. This quantitative study used instruments to assess white racial affects of white fear, anger, and guilt along with antiracist self-efficacy as influencing antiracist accountability in a sample of white women counselors in the United States (N = …

Experiences Of Counselors Working With Adolescents, Allison Bradford Chow

Antioch University Dissertations & Theses

This qualitative study aimed to examine the lived experience of clinical mental health counselors working with adolescents. Participants included pre-licensed (associate) or licensed counselors who predominately work with and have a strong preference for working with adolescent clients. Data was collected through individual interviews and analyzed with a descriptive-interpretative approach. Ten domains were identified as part of data analysis: (a) Understanding Adolescent Culture and Building a Therapeutic Alliance, (b) The Intersection of Counselor and Adolescent Emotions, (c) Transference and Countertransference, (d) Clinical Challenges and Barriers, (e) The Multifaceted Role of Parents, (f) Nuances of Confidentiality, (g) Adolescent Development and Strengths, …

Emdr Gaming Recovery And Insight Protocol (E-Grip): An Approach For Treating Video Game Addiction, Manjit Bath

Antioch University Dissertations & Theses

The prevalence of video game addiction has escalated with the advancement of digital technologies, posing significant psychological and social challenges. This dissertation introduces the eye movement desensitization and reprocessing (EMDR) Gaming Recovery and Insight Protocol (E-GRIP), a novel therapeutic approach designed to address the complexities of video game addiction. Grounded in the principles of EMDR therapy and incorporating insights into video game culture, E-GRIP aims to treat individuals struggling with problematic gaming behaviors by integrating their gaming experiences and preferences into the therapeutic process. The E-GRIP methodology extends the conventional EMDR framework by including an in-depth exploration of the client’s …

Therapeutic Interventions For Adolescents With Non-Epileptic Seizures, Noah Trantel

Antioch University Dissertations & Theses

Although there have been some studies that explore the lived experiences of adults with non-epileptic seizures, there have been limited studies that examine the lived experiences of adolescents and emerging adults with non-epileptic seizures. This qualitative study explored the experiences of emerging adults who had been diagnosed with non-epileptic seizures during adolescence. The study focused on specific interventions utilized in therapy that they found helpful, highlighted what their experiences were throughout their daily lives, and what treatment recommendations were provided. The research will also help guide parents, clinicians, and individuals with NES towards treatment recommendations. Eight participants completed an in-depth, …

The Menstrual Cycle In Psychotherapy: Interventions, Therapist Engagement, And Blind Spots, Rozita Alaluf

Dissertations and Theses

There is a dearth of literature on psychotherapy and menstruation, except for the treatment and diagnosis of issues associated with premenstrual distress. This study aimed to bridge this gap by investigating the frequency and context of discussions about the menstrual cycle, the factors influencing therapists’ engagement with this topic, and the therapeutic approaches utilized to address the menstrual cycle within psychotherapy.

In phase 1, 118 psychotherapists from various theoretical backgrounds completed a survey on menstruation in clinical practice. The data was analyzed using descriptive statistics. In phase 2, semi-structured interviews were conducted with 7 psychotherapists, primarily identifying their theoretical orientation …