Mental and Social Health Commons^™

Reduction In Opioid Requirements Following Changes To Regional Anesthesia For Patients Undergoing Total Knee Arthroplasty, Jeffrey Mauras, Michael Mcmahon, Jaudé Petrie, Ryan Roubion, Amy Bronstone, Claudia Leonardi, Vinod Dasa

School of Medicine Faculty Publications

Background: Newer analgesic techniques to reduce opioid use and pain after total knee arthroplasty (TKA) include preoperative cryoneurolysis, adductor canal block (ACB), and local anesthetic infiltration between the popliteal artery and capsule of the knee (iPACK) block. The purpose of this study was to evaluate whether changing the regional analgesic from ropivacaine to liposomal bupivacaine would provide superior pain relief and reduce opioid requirements at 2 and 12 weeks following TKA. Methods: We conducted a retrospective medical records review of 140 consecutive patients who underwent primary TKA at a single site and received ACB with ropivacaine (multimodal-ropivacaine [MM-R] group, n …

Understanding And Addressing Mental Health Challenges Of Families Admitted To The Neonatal Intensive Care Unit., Ashley D. Osborne, Daphna Yasova Barbeau, Tiffany Gladdis, Kara Hansen, Tonia Branche, Emily R. Miller, Christine C. Pazandak, Margaret K. Hoge, Michelle Spencer, Diana Montoya-Williams, Ryan Barbeau, Heather Padratzik, Stephen Lassen

Manuscripts, Articles, Book Chapters and Other Papers

This article reviews the psychological distress experienced by NICU families, including anxiety, postpartum depression (PPD), and post-traumatic stress disorder (PTSD), in addition to providing recommendations for clinicians at the individual, institutional, and national level. Currently, mental health screenings, specialized evaluations, and treatment options are not routinely offered to NICU families and are frequently under-utilized when offered. Here we provide expert opinion recommendations to address challenges in supporting universal screening, offering bedside interventions, including trained mental health professionals in care plans, updating neonatology training competencies, and advocating for policies that support the mental health of NICU families. We advocate that mental …

Assessing The Relationship Between Combat Exposure, Wartime Service, And Barriers To Substance Use Disorder Treatment In Post 9/11 Veterans., Robert Near

Dissertations

Substance use disorders (SUDs) represent a critical public health concern, particularly within military and veteran populations. The complex interplay of mental health challenges, combat exposure, and the unique stressors associated with military service contribute to a heightened vulnerability among veterans. Research from the United States Department of Veterans Affairs (USDVA) underscores the prevalence of these issues, indicating that approximately 1 in 10 veterans from the Iraq or Afghanistan wars treated by the VA are diagnosed with a SUD (Veterans Affairs, 2023). Additionally, veterans from all eras show a higher propensity for binge drinking when compared to the general population, further …

The Rose That Grew From Concrete: Exploring The Romantic Experiences Of Black Men With Histories Of Childhood Sexual Abuse, Tatyana Nichelle Smith

Dissertations

Contemporary research typically characterizes Black heterosexual relationships by dismal marriage and divorce rates, largely ignoring the reality of how Black men develop attachments with their romantic partners and therefore continuing to perpetuate deficit perspectives of Black men (e.g., the cause of conflictual romantic relationships and “broken” Black families). What may be less understood about these relationships is the influence of childhood trauma, such as childhood sexual abuse, and Black men’s experiences of gender role conflict. Research shows that Black men’s experiences of childhood sexual abuse and socialization about masculinity have important implications for how they come to view themselves and …

The Impact Of Nicu Death On Bereaved Mothers, Jennie Terranova

University Honors Theses

Infant loss in the United States occurs 5.6 per 1,000 live births. This paper examines risk factors that contribute to neonatal death. Prematurity is a risk factor for NICU admission. A portion of premature babies receiving care in the NICU will die. The stressful nature of the NICU has been studied widely in journals. The impact of NICU death on hospital staff and bereaved parents has been studied less. Mortality studies suggest that bereaved mothers are at a high risk of dying within the first 5 years after their child has died. Despite the frequency of maternal death post-child loss, …

Leadership And Peer Support Of Surgeons Post-Adverse Event: A Phenomenological Study, Maxine E. Trent

Electronic Theses and Dissertations

Abstract Surgeons are leaving the active practice of surgery and fewer physicians are pursuing surgical training, as a result the United States is predicted to have a shortage of surgeons until 2050. Surgery hosts a multitude of occupational stressors, one of which is interoperative adverse events and the subsequent experience of second victims. The literature indicates surgeons prefer psychological/emotional support from peers after interoperative adverse events. However, best practices for how to deliver peer and leadership support responses when surgeons experience second victims have not been established. This was a phenomenological qualitative study targeting practicing surgeons across the United States. …

The Effectiveness Of Digital Tools In Physical Activity Interventions For Individuals With Severe Mental Illness: A Scoping Review, Shannon Aisling Forde, Tara Coppinger, Susan Rea, Sinéad Hanrahan

Publications

Purpose: Severe mental illness (SMi) encompasses a mental, behavioural, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits an individual’s life activities. SMi can include disorders such as personality, psychotic, bipolar and major depression. incorporating physical activity (PA) into the daily lives of individuals with SMi offers increasing health benefits. Despite the acknowledged benefits of PA, there are barriers to engagement and participation rates remain low. Digital tools in PA interventions are rapidly increasing amongst this cohort and can mitigate these barriers. However, the broader implications of how a digital PA intervention can impact this …

Residential Factors Associated With Mental Health In United States Veterans, Air Force Military, And Air Force Employees, Andrew J. Hoisington, Christopher A. Stamper, Molly Penzenik, Meredith Reitter, Elizabeth J. Kovacs, Nazanin H. Bahraini, Lisa A. Brenner

Faculty Publications

Individuals in Westernized countries spend most of their time indoors. However, exploration of residential building factors that may influence occupants’ mental health is limited in scientific literature. The purpose of this study was to explore investigator's perceived areas of importance in residences to mental health via survey methods. To that end, we administered the Housing, Occupancy, Materials, and Environment (HOME) survey to assess factors that may influence mental health to those working in the United States (US) Air Force (n = 230) or past military members, US Veterans (n = 180). Self-reported mental health surveys were also administered to the …

Assessment Of Contextualized Reinforcement Pathology In A Community Sample Of Young Adult Substance Users, Ángel García-Pérez, Alba González-Roz, Roberto Secades-Villa, Gema Aonso-Diego, Sara Weidberg, Jin H Yoon

Faculty, Staff and Student Publications

Background: Alcohol, tobacco, and cannabis are the most commonly used substances among young populations, often leading to polysubstance use, which correlates with problematic consumption and adverse health outcomes. The contextualized reinforcer pathology (CRP) model explains addictive behaviors through several constructs, including the following: drug demand, delay discounting (DD), and substance-free and substance-related reinforcement. Most previous studies have focused on a single CRP construct and the couse of only two substances. This study aimed to characterize three subgroups of young adults reporting past month use of alcohol only, alcohol + tobacco or cannabis, and alcohol + tobacco + cannabis, in terms …

Home-Based Transcranial Direct Current Stimulation For Major Depressive Disorder: 6-Month Follow-Up From Randomised Sham-Controlled Trial And Open-Label Treatment Phases, Rachel D Woodham, Sudhakar Selvaraj, Nahed Lajmi, Harriet Hobday, Gabrielle Sheehan, Ali-Reza Ghazi-Noori, Peter J Lagerberg, Rodrigo Machado-Vieira, Jair C Soares, Allan H Young, Cynthia H Y Fu

Faculty, Staff and Student Publications

Transcranial direct current stimulation (tDCS) is a potential home-based treatment for major depressive disorder (MDD). In our double-blind randomised controlled trial (RCT) (n = 174; UK and USA), a 10-week course of home-based tDCS demonstrated clinical efficacy (clinical response: 58.3 % active treatment arm and 37.8 % sham (p = 0.017). tDCS was delivered in a bifrontal montage, with anode over left dorsolateral prefrontal cortex (DLPFC) and cathode over right DLPFC. Each session was 30 min, with active stimulation at 2 mA and sham at 0 mA, incorporating brief ramp-up and ramp-down phased. Following the 10-week RCT, all participants were …

Intersecting Inequities: Latinx Access To Mental Health Services, Melissa Thorson

Dissertations

This study examined barriers to mental health service utilization among Latinx populations using data from the 2022 National Survey on Drug Use and Health (NSDUH). Through the theoretical frameworks of Minority Stress Theory and Toxic Stress Theory, the study investigated the relationships between age, language proficiency, socioeconomic status, and mental health service access among different Latinx subgroups. Statistical analyses included chi-square tests, multiple regression, and mediation analyses on a sample of Latinx adults (N = 9,852). Results indicated associations between age and English proficiency (χ² = 145.23, p < .001, Cramer's V = 0.38), with 45% of adults aged 50 and older reporting limited English proficiency. Socioeconomic analysis revealed that 32% of older Latinx adults reported family incomes below $20,000, with insurance status partially mediating the relationship between income and service utilization (indirect effect = 0.15, 95% CI [0.08, 0.23]). differences in utilization rates emerged among Latinx subgroups (F(6, 1243) = 8.76, p < .001, η² = 0.12), with Mexican-origin individuals showing higher utilization (10%) compared to Puerto Rican individuals (2-3%). Age and socioeconomic status demonstrated interaction effects (β = 0.18, p < .01), while language proficiency moderated the relationship between age and service utilization (β = 0.24, p < .001). These findings suggest that barriers to mental health service utilization among Latinx populations are complex and interconnected, requiring multilevel interventions that address linguistic, cultural, and socioeconomic factors simultaneously. Implications for healthcare policy and service delivery are discussed, emphasizing the need for culturally responsive and linguistically appropriate mental health services.

Assessment Of Mental Wellbeing Programs In The Construction Industry, Evan James Olszak

Construction Management

Mental health problems are very prevalent within the construction industry, and there is not enough attention put towards the mental wellbeing of employees in the industry. The construction industry is ranked #2 for deaths by suicide, and #1 when mining and extraction are included (CDC, 2021). Previous research has been done to understand the severity of the issue, and some programs have been started to spread awareness and train employees. The issue arises in a lack of analysis of these programs. The programs that are being used are still in their infancy and require a comprehensive review to understand the …

Interacting Immediate And Long-Term Action Regulation In Suicidal Behavior, Nicholas Murphy, George Kypriotakis, Marijn Lijffijt, Sidra Iqbal, Tabish Iqbal, Dania Amarneh, Brittany O'Brien, Amanda Tamman, Ynhi Thomas, Nidal Moukaddam, Thomas R Kosten, Lynnette A Averill, Sanjay Mathew, Alan C Swann

Staff and Researcher Publications

Background: Suicide is a prominent cause of death across the lifespan, especially between 10 and 34 years old. Most suicides are first attempts, during crises with unpredictably fluctuating risk, arising insidiously from mechanisms related to long-term exposure to psycho-bio-social risk factors. Identifying susceptibility from interacting immediate and long-term mechanisms of action regulation could prevent suicidal crises.

Methods: We investigated interacting immediate and long-term regulation of action in risk for suicide. Immediate processes were assessed through affective and behavioral symptoms and a computer measure of impaired action-regulation, the Immediate Memory Task (IMT). Long-term processes included history of trauma, stress, and addictive …

Fda Approves Lecanemab-Irmb Maintenance Dosing For Early Alzheimer’S Disease Treatment, Jordyn Linfield, Giang Nguyen, Ashley Jacob, Andrew Johnson, Maria Nguyen, Sara Ha, Joshua Honaker, Samantha Mccord, Kelly Kroustos

Pharmacy and Wellness Review

Alzheimer’s disease (AD) is the most prevalent neurodegenerative disorder and is associated with progressive and irreversible cognitive decline that begins with memory lapses leading to physical and functional impairment. The conventional therapies that have been used for the treatment from Alzheimer's Disease include acetylcholinesterase inhibitors and memantine, but additional therapy options are being developed. Lecanemab, brand name Lequembi, is currently a Food and Drug Administration (FDA) approved humanized monoclonal antibody for the treatment of Alzheimer’s disease and indicated for mild cognitive impairment (MCI) or mild dementia. While there is impactful aid for treatment, lecanemab has three significant adverse reactions, which …

A Farewell Message, Misty L. Rhoads

Journal of Transformative Touch

No abstract provided.

Gradiance: A Mindfulness Intervention, Kip Geddes

Masters Theses

People in cities live life at a fast paced forward march that results in a mental state called ‘hurry sickness’. This prevents them from living in the moment, which often leads to a disconnection to those around them. Mindfulness techniques have been proven to increase people’s levels of happiness and openness to the people around them. However, many people are too busy to practice these methods. My thesis looks at ways for mindfulness to intervene into their established routines. Illumination has been shown to promote mental well-being, either in therapy lamps, or circadian rhythm based lighting; the liminal spaces that …

From Industrial Building To Affordable Senior Housing: An Idea Book Beyond Code, Weiyi Ma

Masters Theses

This thesis envisions a proposal to adaptively re-purpose Rhode Island’s extant industrial building stock into affordable housing tailored to the needs of its older and more vulnerable citizens. Architectural dignity, in terms of older citizens amidst this housing crisis, is the creation of living environments that honor their autonomy, comfort, and identity through design interventions that provide accessible, luminous, breathable, and socially enriching spaces, reaffirming their rightful place within the community. With humanistic care and logical rigor, it establishes a mathematical framework for assessment and execution, anchored in five criteria: light, air, space, accessibility, and livability, and presents itself in …

Piloting Trauma-Informed Workshops To Enhance Life Skills In Housing Transitions: Action Research, Negar Ghaderi

Critical and Creative Thinking Capstones Collection

This action research pilot project explores how trauma-informed, life skills workshops grounded in critical and creative thinking methods can support Housing First (HF) residents transitioning from homelessness to permanent housing. The study is based on the understanding that addressing homelessness requires more than housing provision—it demands attention to the cognitive and emotional impacts of trauma through co-created, resident-centered interventions. Using iterative cycles of planning, acting, observing, and reflecting, the project engages a small, fluctuating group of 4–5 participants from a diverse community of 60 HF residents. The pilot program includes six workshops, one focus group discussion, and individual interviews over …

Opioid Use Patterns After Nonsurgical Management Of Distal Radius Fractures: A Call For Opioid Stewardship, Sina Ramtin, Sara Khan, Vijay Chhabra, Wali Pirzada, Mohammad Khak, Asif M. Ilyas

Rothman Institute Papers

PURPOSE: While most opioid research focuses on postoperative use, limited data exist on prescribing patterns in nonsurgical management of common injuries such as distal radius fractures (DRFs). This study aimed to assess opioid prescribing trends and identify factors linked to prolonged use in nonsurgically treated DRFs.

METHODS: A retrospective cohort study of 591 patients aged 18-50 with nonsurgically managed DRFs between 2018 and 2024 was conducted. Opioid use was classified as prior opioid use (POU), fracture-related opioid use (FxOU), or delayed opioid use (DOU). Prescription data were obtained from the Prescription Drug Monitoring Program and analyzed for morphine milligram equivalents, …

The Portals: Jewelry As A Site Of Escape And Solace, Jung Ki Min

Masters Theses

This thesis investigates jewelry as a medium for emotional escape and psychological refuge, offering multisensory alternative forms of escapism. Rooted in personal experiences of continuous change and instability, the work explores how imagined spaces—constructed through AI-generated and digitally assisted visuals and layered material processes—can serve as intimate sanctuaries. Drawing from psychological theories, surrealism, and escapism, the study positions jewelry as a portable interface that enables temporary retreat without full detachment from reality. The series of work, which integrates transparent acrylic, visual layering, and subtle dimensionality, materializes these imagined spaces into wearable forms. These pieces invite reflective engagement, allowing wearers to …

The Dialectic Of Airless Space, Ophelia Arc

Masters Theses

The Dialectic of Airless Space is a cumulative, cross-disciplinary research project that explores ‘airless space’ as a somatic and psychological condition shaped by institutional environments. Unfolding over time through five interrelated books, the project weaves together writing, ephemera, textile sculpture, and drawing to archive the invisible architectures of bodily and mental experience.

Health Care In Women’S Carceral Spaces, Kate Gouveia Pereira

Culture, Society, and Praxis

Canada has had a long history of mistreating incarcerated women in their jails. The carceral system was built to fit around the needs of men, neglecting to consider the various health issues that only women face. For many years. federally imprisoned women were held in one deteriorated prison, the Prison for Women (P4W), and were held in abhorrent conditions and experienced many acts of violence. Despite the opening of five more prisons and funding for various programs for women, incarcerated women continue to experience violence and health crises, leaving imprisoned women extremely vulnerable to mental and physical distress. In particular, …

Development Of An Age-Appropriate Household Dysfunction Measure And Its Concurrent Validity With Multiple Outcomes Among Middle School Adolescents In Southeast Texas, Ross Shegog

Faculty, Staff and Student Publications

Existing adverse childhood experience (ACE) measures include a limited number of household dysfunction (HD) items and the use of adult-oriented language that is not always appropriate for middle schoolers. We developed an age-appropriate 10-item HD measure informed by previously validated ACE measures and tested its concurrent validity with dating violence (DV) perpetration, lifetime substance use, and mental health outcomes among middle schoolers in Southeast Texas. This cross-sectional study used the baseline data from a DV prevention intervention program for sixth graders (N = 126), Me & You Tech. Baseline data were collected from March 2023 to April 2023. To …

Optimizing Psychiatric Care Through Pharmacogenomics: An Evidence-Based Program To Increase Multi-Gene Pharmacogenomic Testing And Provider Competence In Mental Health Settings, Marc Boulanger

Doctor of Nursing Practice Final Manuscripts

Objective: This scholarly project aimed to enhance psychiatric providers' competency, confidence, and knowledge in the PHASER pharmacogenomic (PGx) testing program at the VA San Diego Healthcare System.

Background: PGx testing enhances psychiatric care by enabling precise medication management tailored to a patient’s genetic profile, improving treatment effectiveness and reducing adverse drug reactions. Despite demonstrated clinical utility, adoption of PGx remains limited due to provider knowledge gaps. This project addresses these gaps through targeted education.

Methods: Two educational modules, developed with input from the PHASER site-lead, aimed to enhance provider knowledge and confidence in PGx. Module one introduced the PHASER program …

Development And Pilot Testing Of An Addiction Clinic-Based Pre-Exposure Prophylaxis Uptake And Adherence Intervention For Women With Substance Use Disorders: Protocol For A Pilot Randomized Trial, Angela M Heads, Diane Santa Maria, Mandy J Hill, Robert Suchting, Kimberly N Evans, Zaneta Gaul, Luba Yammine, Constanza De Dios, Joy M Schmitz

Faculty, Staff and Student Publications

Background: Black and Hispanic women in the United States continue to bear disproportionate incidence of HIV related to sexual transmission and injection drug use. Specifically, women with substance use disorders (SUDs) are more likely to engage in vaginal or anal condomless sex associated with HIV transmission. Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention tool but is not widely used by racial or ethnic minority women. Effective interventions for engaging women with SUDs in HIV prevention interventions that are culturally appropriate and, therefore, more appealing to racial or ethnic minority women with SUDs are critically needed.

Objective: This 3-phased …

Cultivating Workplace Wellness: An Evaluation Of Gratitude Card Interventions Among University Faculty, Jeffrey Druck, Patrick Ockerse, Jamal Jones

Journal of Wellness

Introduction: There has been a growing interest in understanding the role of gratitude in promoting well-being. Gratitude, defined as a feeling of thankfulness and appreciation in response to receiving a benefit from someone else, has been shown to improve mood, increase social support, and decrease symptoms of depression and anxiety. This research paper explores an innovative intervention using gratitude cards for faculty members and measures the emotional impact of this intervention.

Methods: The study involved 32 clinical physicians from the Department of Emergency Medicine at the University of Utah. Participants were invited to write a gratitude card to …

Policy Proposal For Integrating Pediatric Mental Health Into Nursing Practice In Uganda, Giselle S. Perez

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Mental health disorders affect over 1 in 7 individuals aged 10 to 19 globally. In low- and middle-income countries like Uganda, limited access to mental health specialists and pervasive stigma exacerbate the gap in care. Nurses, often the first point of contact, typically lack adequate pediatric mental health training. The proposal aims to address this gap by equipping nurses with the knowledge and competencies to identify, intervene, and support children with mental health disorders. Purpose: This proposal advocates for implementing targeted, continuing education in pediatric mental health for Ugandan nurses. The goal is to enhance the quality of …

From Fee For Service To Outcome Based Care: A Policy Proposal To Reduce Provider Burnout In Assertive Community Treatment, Amanda M. Thompson

Doctor of Nursing Practice Final Manuscripts

Purpose: This project examines the impact of the fee-for-service (FFS) reimbursement models on provider burnout within Assertive Community Treatment (ACT) programs and proposes a hybrid reimbursement framework that integrates case-rate and outcome-based payment structures. The goal is to enhance care quality, improve provider retention and optimize patient outcomes by addressing financial and administrative inefficiencies inherent in the current model.

Background: Mental illness affects over 59 million U.S. adults with serious mental illness (SMI) presenting significant challenges in healthcare delivery. ACT is an evidence-based, multidisciplinary approach designed to provide intensive, community-based psychiatric care to individuals with serious mental illness (SMI). However, …

Systematic Review On The Treatment Of Emotional Abuse Victimization In Women By An Intimate Partner, Günnur Karakurt, Rhea D’Silva, Çerağ Oğuztüzün, Ankita Choudhary, Keming Gao, Shari Bolen

Faculty Scholarship

Purpose: Emotional partner abuse, often closely intertwined with physical assault, involves persistent emotional mistreatment by an intimate partner. Despite its significance, research specifically focusing on emotional IPV is limited. This study systematically reviews the effectiveness of treatments for women victimized by emotional abuse from an intimate partner. Methods: Following the guidelines outlined in the Cochrane Handbook for Systematic Reviews of Interventions, we identified four relevant studies published between 2010 and 2019 with interventions designed for survivors of IPV. Results: The total sample size of 857 was included in the current study (I² = 95%). Our systematic review revealed two …

Intersection Of Alcohol Use, Pain Symptoms, And Negative Affect In Total Knee Arthroplasty Patients And People With Hiv, Taylor Fitzpatrick-Schmidt, Vinod Dasa, Claudia Leonardi, Tekeda F. Ferguson, David A. Welsh, Patricia E. Molina, Martin J.J. Ronis, Scott Edwards

School of Medicine Faculty Publications

Alcohol is a well-known analgesic, although excessive alcohol use can lead to hyperalgesia and heightened negative affect. This cross-sectional study examined associations between alcohol use, self-reported pain, and negative affective symptoms in two distinct cohorts of patients vulnerable to chronic pain: individuals undergoing total knee arthroplasty (TKA) surgery and a cohort of people with HIV (PWH). Participants were enrolled in two clinical studies: a retrospective study of patients undergoing TKA and a longitudinal study of PWH, the New Orleans Alcohol Use in HIV (NOAH) cohort. Based on the Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) score, participants in both …