Psychiatric and Mental Health Commons^™

Treating Substance Use Disorders: Enhancing Attendance At The Weekly Inpatient Medication Assisted Treatment Group, Devon Gillis, Jayne Weisberg, Dena Whitesell, Amy Mcauliffe, Amy Sparks, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

Operations Transformation

At a large academic tertiary medical center, an Integrated Medication Assisted Treatment (IMAT) program has been established for those medically stable inpatients with an addiction diagnosis. Over a four month period, this program had experienced a decline in attendance and a quality improvement project was initiated is to better understand the barriers to attendance and institute a process that would reverse the decline.

A goal was established to improve attendance by medically stable patients that have consented to participate to a minimum of 50%.

A root cause analysis outlined numerous causes for low attendance and several countermeasures were established to …

Impact Of Adverse Childhood Experiences On Mental Health Outcomes And Related Prescription Practices In A Psychiatric Inpatient Sample, Carrie Lemay

Electronic Theses and Dissertations

A definitive association between adverse childhood experiences (ACEs) and negative physical and mental health outcomes has been established. There is evidence that individuals in forensic psychiatric facilities are disproportionately exposed to ACEs, which may impact severity, prognosis, and age of onset of psychiatric symptoms, including behavioral concerns of institutional aggression, self-harm behaviors, and suicide attempts. Such psychiatric and behavioral concerns are often managed through multiple psychotropic prescriptions, leading to psychotropic polypharmacy. This study evaluated the relationship between ACEs, mental health and behavioral concerns, and psychotropic polypharmacy through analysis of archival data from a forensic inpatient psychiatric facility. A total of …

Implementation Of An Evidence-Based, Electronic Clinical Algorithm To Improve Screening, Evaluation, And Referral Of College Students For Depressive Symptoms And An Evaluation Of Differences Based On Sexual Orientation And Gender Identity Data, Chris Webb

Graduate Theses, Dissertations, and Capstones

The purpose of this project was to improve the screening, evaluation, and referral of college students (LGBTQ+/Heterosexual) for depressive symptoms through the implementation of an evidence-based, electronic clinical algorithm. There is evidence in the literature indicating that there are increased mental health disparities among college students and the LGBTQ+ population. The prevalence of depressive symptoms among university students is higher than the general population, requiring university student health centers to implement enhanced screenings for depressive symptoms and identification of depression predictors. Prior to implementation of this project, a student health clinic in the Southeastern part of the United States used …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Reimagining Medical Education In The Age Of Ai, Steven A. Wartman, C. Donald Combs

Computational Modeling & Simulation Engineering Faculty Publications

Available medical knowledge exceeds the organizing capacity of the human mind, yet medical education remains based on information acquisition and application. Complicating this information overload crisis among learners is the fact that physicians' skill sets now must include collaborating with and managing artificial intelligence (AI) applications that aggregate big data, generate diagnostic and treatment recommendations, and assign confidence ratings to those recommendations. Thus, an overhaul of medical school curricula is due and should focus on knowledge management (rather than information acquisition), effective use of AI, improved communication, and empathy cultivation.

As A Pediatrician, I Don’T Know The Second, Third, Or Fourth Thing To Do: A Qualitative Study Of Pediatric Residents’ Training And Experiences In Behavioral Health, Rachel Petts Phd, Jeffrey D. Shahidullah Phd, Paul W. Kettlewell Phd, Kathryn A. Dehart Md, Kris Rooney Md, Ilene G. Ladd Ms, Tyler Bogaczyk Bs, Sharon L. Larson Phd

International Journal of Health Sciences Education

Despite a mandated 1-month rotation in developmental-behavioral pediatrics (DBP), pediatric residents report inadequate training in behavioral health care. As a first step in much needed curriculum development in this area, this study sought to assess learner experiences regarding the management of behavioral health problems during residency. Four focus groups were conducted for residents in years 1-3 of training in 2 residency programs in a northeastern state. Transcripts were analyzed and coded by researchers through qualitative classical content analysis. The exploratory analysis revealed 9 key themes: time requirements, rapport building, resources and referrals for behavioral health, psychiatric medications, diagnosis vs. treatment, …

Do Healthcare Students Endorsing Stigma Of Mental Illness Screen For Suicidal Ideation? An Evaluation Of Knowledge, Attitudes, And Behaviors, Dannel K. Petgrave

Electronic Theses and Dissertations

The stigma of mental illness endorsed by healthcare professionals has been linked to adverse outcomes. This issue underscores the need for early anti-stigma interventions in the context of professional training. The present study measured stigma change and suicide screening behaviors among medical, nursing, and pharmacy students enrolled in an interprofessional Communication Skills for Healthcare Professionals course. The Mental Health Knowledge Schedule (MAKS; Evans-Lacko et al., 2010), Opening Minds Scale for Health Care Providers (OMS-HC; Modgill, Patten, Knaak, Kassam, & Szeto, 2014), and the Marlowe-Crowne Social Desirability Scale Form C (M-C SDS Form C; Reynolds, 1982) was administered at baseline (T …

Multinational Comparative Cross-Sectional Survey Of Views Of Medical Students About Acceptable Terminology And Subgroups In Schizophrenia, Shanaya Rathod, Muhammad Irfan, Rachna Bhargava, Narsimha Pinninti, Joseph Scott, Haifa Mohammad Algahtani, Zhihua Guo, Rishab Gupta, Pallavi Nadkarni, Farooq Naeem, Fleur Howells, Katherine Sorsdahi, Kerensa Thorne, Victoria Osman-Hicks, Sasee Pallikadavath, Peter Phiri, Hannah Carr, Lizi Graves, David Kingdon

Rowan-Virtua School of Osteopathic Medicine Departmental Research

AIM: The aim of this study was to inform thinking around the terminology for 'schizophrenia' in different countries.

OBJECTIVES: The objective of this study was to investigate: (1) whether medical students view alternative terminology (psychosis subgroups), derived from vulnerability-stress models of schizophrenia, as acceptable and less stigmatising than the term schizophrenia; (2) if there are differences in attitudes to the different terminology across countries with different cultures and (3) whether clinical training has an impact in reducing stigma.

DESIGN: This is a cross-sectional survey that examined the attitudes of medical students towards schizophrenia and the alternative subgroups.

SETTING: The study …

Individualizing Care For Pediatric Patients With Autism Spectrum Disorder In Perioperative Services, Erin Scheller

Master's Theses

This research explores solutions for individualizing and improving care for pediatric patients with Autism Spectrum Disorder in the Perioperative Setting of an Outpatient Surgery Center. Specifically, it seeks to determine if providing parent and staff resources on Autism Spectrum Disorder is significantly helpful in increasing confidence in the staff by the parents and the staff themselves. Participants included thirty-five surveyed families who had pediatric patients visiting perioperative services and staff who work on the unit. Methods used include information dissemination with the use of printable and online evidence-based resources, an in-person education event for staff, and a pilot study of …

The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer

Dissertations

Purpose: The purpose of this descriptive, qualitative study was to identify and describe the importance of the predictors of juvenile recidivism and the effectiveness of efforts to prevent/avoid juvenile recidivism as perceived by previously detained, arrested, convicted, and/or incarcerated adult students 18 years of age and older exiting from alternative education in Northern California. A second purpose was to explore the types of support provided by alternative schools and the perceived importance of the support to avoid recidivism according to adult students 18 years of age and older exiting from alternative education.

Methodology: This qualitative, descriptive research design identified …

Assessment Of The Need For Provider Education On Screening For Depression In Patients With Select Dermatologic Problems, Sarah B. Zerhusen

DNP Projects

PURPOSE: The purpose of this project is to evaluate the knowledge, attitudes, perceptions, skills, and self-efficacy of dermatology providers’ assessment of depression in patients with chronic skin disease to determine the need for continuing education programs.

METHODS: This is a single practice, multi site, quantitative correlational design study to assess provider use, comfort, and proficiency of screening and discussion of depression in patients suffering from plaque psoriasis and atopic dermatitis. Data was collected through the use of a questionnaire dispensed in January of 2018. The sample consisted of 23 dermatology providers in a dermatology practice with clinics in Louisville, Lebanon, …

An Empirical Approach To Assessing Pediatric Residents' Attitudes, Knowledge And Skills In Primary Care Behavioral Health, Jeffrey D. Shahidullah Phd, Paul W. Kettlewell Phd, Kathryn Dehart Md, Kris Rooney Md, Ilene Ladd Ma, Tyler Bogaczyk Bs, Amy Signore Phd, Sharon L. Larson Phd

International Journal of Health Sciences Education

This paper describes an empirical approach to assessing pediatric residents' attitudes, knowledge and skills in primary care behavioral health. Outcomes from that assessment approach are presented from two pediatric residency training programs in the northeastern United States. Thirty-six pediatric residents completed attitudes, knowledge and skills surveys. The survey was developed to align with the American Academy of Pediatrics’ Policy Statement in 2009 citing aspirational competencies for pediatricians in primary care behavioral health. This alignment addressed both learner variables (attitudes, knowledge, and skills) as well as clinical presentations (ADHD, anxiety, depression, and suicide) highlighted in the policy statement. The survey specifically …

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples

Dissertations

Abstract

Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …

Musical Ear Syndrome: What Do We Know?, Cara D. Pestel

Rehabilitation, Human Resources and Communication Disorders Undergraduate Honors Theses

The purpose of this study was to review the existing literature regarding Musical Ear Syndrome and other related auditory hallucinations. While the existence of auditory hallucinations is evident, their cause is unclear and widely understudied. There was a need for existing information to be compiled for use in the healthcare field. This review of existing literature will aid speech-language pathologists, audiologists, nurses, psychologists, and physicians in understanding this condition and what differentiates it from other various disorders. This will allow these professionals to better understand the experiences and needs of those with Musical Ear Syndrome.

Effects Of Training On Suicide Assessment And Intervention, Vanessa Phillips Bosshart

Steeplechase: An ORCA Student Journal

The rate of suicide is increasing in America. Healthcare professionals are an instrumental part of suicide prevention. The APNA has acknowledged that there are serious gaps in nursing education, specifically in the area of suicide risk assessment, prevention, and intervention, and there have been continued efforts to increase competencies in these areas among behavioral healthcare workers. Evidence shows that suicide specific training programs have a positive impact on healthcare professionals. Training programs such as the RRSR training program and the GSAP for nursing personnel improves nurses' confidence and abilities to assess for and intervene with suicidal patients. These programs also …

Linezolid Induced Delirium In The Absence Of Serotonin Syndrome: A Psychiatric Consultation/Liaison Case Report, Hani Nazha, Md, Nathan T. Harrington, Md

Marshall Journal of Medicine

Delirium is one of the most common mental illnesses that can affect elderly patients and patients with advanced medical problems. Because these patients are frequently on multiple medications and/or are more sensitive to medications secondary to their age, interactions with current medications, or existing medical problems; medication toxicity is frequently the etiology behind their delirium. This is a case report of a patient admitted for cellulitis that developed delirium from Linezolid however did not develop any other signs or symptoms of Serotonin Syndrome; a known side effect of Linezolid. This distinctive case highlights the importance of a careful analysis of …

Addressing Health Disparities Among Homeless In Alachua County Through Community-Based Participatory Research., Meron Hirpa, Omar Iqbal, Haider Ali, Sama I. Ilyas, Nabeel Iqbal, Jeena A. Kar, Tiffany Splatt, Brendan Shortley, Nancy Hardt

Journal of Health Disparities Research and Practice

Introduction. In states such as Florida that did not expand Medicaid, a large number of economically disadvantaged individuals do not qualify for subsidies to buy health insurance through the Affordable Care Act (ACA) ². This leaves the health needs of Florida’s homeless population largely unaddressed. Nearly 48.1% of Alachua County’s homeless population has disabling conditions ¹⁶. This confirms a pressing need to understand the homeless population's healthcare needs, knowledge, and barriers in accessing healthcare. Methods. We used a Community-Based Participatory Research model in conducting health fairs and needs assessment surveys, incentivizing participation, and providing education about existing resources. …

Facilitating Effective Communication Between First Responders And Older Adults During Fall Incidents: An Educational Intervention, Krystin M. Beeman, Erica L. Berger, Isabel A. Cabezas, Nicole M. Mathews

Dissertations, Masters Theses, Capstones, and Culminating Projects

PURPOSE. The purpose of this project was to provide first responders with communication strategies for older adults that may help when responding to fall- related calls. General information was also provided to First Responders on working with older adults with a focus on the aging process, fall risk factors, and communications strategies.

METHODS. A series of educational sessions to first responders at a local fire district were developed and presented by occupational therapy students. Materials were developed by presenters from evidence-based resources and tailored to the target population. Each presentation focused on statistics about older adults, the aging process, fall …

Perceptions And Attitudes Of A Sample Of Primary Care Patients Receiving Psychological Care From Their Pcp, Nadine Henzes Gowarty

PCOM Psychology Dissertations

With millions of Americans suffering from a mental health disorder and slightly more than half receiving treatment, the demand for psychological services far outweighs the number of practitioners available to provide direct care. Therefore, the majority of all primary-care visits are based on psychosocial factors; one third of a PCP’s caseloads consist of patients with mental-health problems. Given the fact that PCPs provide comprehensive psychosocial care, it is important to determine the beliefs and perceptions of their patients. Results from this study identified numerous factors that influence the relationship between patients receiving mental health care from their PCP. Specifically, if …

Positive Psychiatry, Amresh Srivastava

Data and Test Instruments

Revolutionary advances in understanding mental disorders and in providing novel treatments have enhanced the expectations of patients and relatives. There is a growing demand on newer research in providing interventions that allow patients to live a normal life. Of late, concept of the illness itself has undergone significant change. It is now proposed that expected outcome from treatment of mental disorder is to achieve a state of ‚ ‘wellness.’ Positive psychiatry is a newer branch of psychological medicine that seeks to promote understanding of wellness and examines its application in intervention and prevention of mental disorders. The concept of positive …

Substance Abuse Among The Elderly: What Works In Treatment, Sophia Morelli

Electronic Theses, Projects, and Dissertations

Social workers are trained during the course of their education to work with the elderly and to understand the various dynamics of aging. These professionals also receive education on substance abuse and how to assess clients as well as link them to appropriate supportive services. How can social workers be more inclined to effectively treat the elderly substance abuser? What are, if any, special considerations a social worker should be aware of when working with the geriatric population? What treatment modalities seem to be more effective with the elderly client? This study utilized a qualitative analysis consisting of interviews with …

The Capus Project-Innovative Solutions For Hiv/Aids Linkage To Care, Melanie Gwynn, Jamila Ealey, Kate Racoff Musgrove

9th Annual Rural HIV Research & Training Conference (2014-2019) (Archived)

“The CAPUS Project-Innovative Solutions for HIV/AIDS Linkage to Care”

Objectives: 1) Expand knowledge of the current linkage to care landscape within Georgia; 2) Identify essential components of the Resource Hub to enhance linkage to care efforts throughout Georgia; and 3)Promote effective use of the Resource Hub to facilitate HIV/AIDS linkage to care within highly impacted communities

Dimensions Of Suicidality: Analyzing The Domains Of The Sis-Map Suicide Risk Assessment Instrument And The Development Of A Brief Screener, Megan Johnston, Charles Nelson, Amresh Shrivastava

Data and Test Instruments

This study aimed at validating the domains of suicidality assessed by the Scale for Impact of Suicidality—Management, Assessment and Planning of Care (SISMAP) and creating a brief screener based on the full scale. A total of 50 individuals with suicidal ideation were given the SIS-MAP interview. Support was found for these domains of suicide risk; in particular, the subscales of ideation and protective factors for suicide risk were highly reliable. For each domain of suicidality, items most predictive of total risk index scores were selected to create a brief screener aimed at expediting the assessment process. The screener was reliable, …

Suicidal Ideation In Callers To A Crisis Hotline In Mumbai,, Amresh Srivastava, Megan Johnston, Larry Stitt, Meghana Thanksr, Sunita Iyer, Nilesh Shah, David Lester

Data and Test Instruments

Suicidal ideation in callers to a crisis hotline in Mumbai, India Amresh K. Shrivastava1,2, Megan Johnston3, Larry Stitt4, Meghana Thakar5, Sunita Iyer6, Nilesh Shah7 and David Lester8* 1Silver Mind Hospital and Mental Health Foundation of India, (PRERANA Charitable Trust) Mumbai. 2Department of Psychiatry, University of Western Ontario, London, Canada. 3Department of Psychology, University of Toronto, 100 St. George St., Toronto, Ontario, Canada, M5S 2M2. 4Biostatistical Support Unit, Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada. 5Silver mind Hospital, Mumbai, Currently, Child and Adolescent Mental Health Practitioner, Lambeth CAMHS Early Intervention Team, South London and Maudsley …

Cannabis And Psychosis: Transition To Psychosis, Amresh Srivastava, Kristen , Terpstra, Yves Bureau

Data and Test Instruments

Cannabis has been implicated as a risk factor for the development of schizophrenia, however, but the pathway of cannabis causing psychosis is not well understood. It appears that cannabis does not cause any structural changes per say but deficits in areas of the brain responsible for memory and emotion do show some changes. Recent studies suggest that cannabinoids such as CB1 have a pharmacological profile similar to that of atypical antipsychotic drugs. This mechanisms may involve dopamine, GABA, and glutamate neurotransmission; It is still not known if these changes are transitory or permanent, and whether or not they contribute to …

Measurement Of Clinical Risk Of Stigma And Discrimination Of Mental Illnesses, Amresh Srivastava, Yves Bureau, Nitika Rewari, Megan Johnston, Arman Panday, Nilesh Shah

Data and Test Instruments

Abstract Background: Stigma and discrimination continue to be a reality in the lives of people suffering from mental illness, particularly schizophrenia, and prove to be some of the greatest barriers to access care, continue to remain under care, and regain a normal lifestyle and health. Research advances have defined stigma, assessed its implications and have even examined intervention strategies for dealing with stigma. The delay in treatment due to stigma causes potential complications like suicide, violence, harm to others and deterioration in capacity to look after one’s physical health. These are preventable clinical complications. In order to deal with the …

Study Of Negatives Symptoms In First Episode Schizophrenia*, Vivek Bambole, Nilesh, Shah, Shushma Sonavane, Megan , Johnston, Amresh Srivastava

Data and Test Instruments

Background: Prevalence of negative symptoms in the early phase of schizophrenia remains uncertain. Ne- gative symptoms are the primary cause of long term disability and poor functional outcome. The purpose of this study is to examine the presence of negative symptoms in patients with fist episode psychosis in schizophrenia who were hospitalized. Methods: Nega- tive symptoms were measured in 72 patients present- ing with FEP using the scale for assessment of nega- tive symptoms (SANS) and ascertained diagnosis us- ing DSM-IV. Prevalence of SANS items and sub- scales were examined for both schizophrenia and bi- polar disorder. Results: This study …

The Closure Of New Orleans' Charity Hospital After Hurricane Katrina: A Case Of Disaster Capitalism, Kenneth Brad Ott

LSU New Orleans Theses and Dissertations

Abstract

Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, …

Coping As A Mediator Between Proximity To Violence In Juarez, And Ptsd Symptoms Among College Students Attending A University On The Texas - Mexico Border, Francis Javier Reyes

Open Access Theses & Dissertations

The present study directly examined whether proximity to ongoing violence might lead to symptoms of Post-Traumatic Stress Disorder (PTSD) in a sample of students attending a border university less than a mile from the US Mexico border. Exposure to violence is a common cause of PTSD symptomology. Prior research in the region suggests that ongoing traumatic stress due to the violence in Juarez is associated with increased PTSD symptomology. Because coping skills are thought to protect individuals from PTSD the Transactional Model of Stress and Coping (Lazarus & Folkman, 1984) guided the study. The purpose of this study was to …