Behavior and Behavior Mechanisms Commons^™

The Impact Of The Human Papillomavirus Vaccine On High-Grade Cervical Lesions In Urban And Rural Areas: An Age–Period–Cohort Analysis, Jaimie Z. Shing, Alicia Beeghly-Fadiel, Marie R. Griffin, Rachel S. Chang, Staci L. Sudenga, James C. Slaughter, Manideepthi Pemmaraju, Edward F. Mitchel, Pamela C. Hull

Behavioral Science Faculty Publications

Disparities in human papillomavirus (HPV) vaccination exist between urban (metropolitan statistical areas (MSAs)) and rural (non-MSAs) regions. To address whether the HPV vaccine’s impact differs by urbanicity, we examined trends in cervical intraepithelial neoplasia grades 2 or 3 and adenocarcinoma in situ (collectively, CIN2+) incidence in MSAs and non-MSAs among Tennessee Medicaid (TennCare)-enrolled women aged 18–39 years and among the subset screened for cervical cancer in Tennessee, United States. Using TennCare claims data, we identified annual age-group-specific (18–20, 21–24, 25–29, 30–34, and 35–39 years) CIN2+ incidence (2008–2018). Joinpoint regression was used to identify trends over time. Age–period–cohort Poisson regression models …

Physician Burnout Among West Virginia Primary Care Providers, Kevin S. Mccann, Adam Baus, Joanna Bailey, Laura Boone, Jennifer Boyd, Martha Cook-Carter, Dan Doyle

Marshall Journal of Medicine

Introduction

Work related burnout is highly prevalent in US physicians and linked to adverse effects on patients, providers and organizations. This study measures burnout in West Virginia (WV) primary care providers, allowing for comparison of results to a similar, recent study of US physicians.

Methods

Anonymous survey through email that included Maslach Burnout Inventory, demographic, workload, and practice characteristics. Responses were analyzed using JMP Pro 13. Analysis used JMP Pro 13 for descriptive statistics, chi-square and regression modeling.

Results

Subjects = 110, female/male ratio 1.4, all primary care physicians (PCP), or advanced practice registered nurses or physician assistants (APRN/PA). PCP …

Bmi And Associated Variables In A Pediatric Gender Clinic Sample, Mirae J. Fornander

Research Days

Background: Studies of transgender/gender diverse (TGD) youth indicate a high prevalence of overweight/obesity and concern for unhealthy weight control behavior.

Objectives/Goal: Describe BMI and the association of medication use, well-being, and recreational activities in treatmentnaïve pediatric TGD patients.

Methods/Design: Chart review of 302 patients (age 3-19, 73.5% sex assigned at birth (SAB) female; 85.8% white) from 2017-20. BMI was calculated by age and SAB using CDC growth charts. Parents reported medication use. Parent and self-reported Pediatric Quality of Life (PEDS-QL) Well-Being and activities were surveyed electronically.

Results: By BMI category, 3.3% were underweight (BMI85% and 29.5% fell >95%. Overweight and …

Psychosocial Factors Affecting Quality Of Life In Patients With Anorectal Malformations And Hirschsprung’S Disease – A Qualitative Systematic Review, Wendy Jo Svetanoff

Research Days

Background: While great strides have been made in surgical techniques and bowel management therapies for patients with anorectal malformations (ARM) and Hirschsprung’s disease (HSCR), little is known about psychosocial and behavioral factors that impact the quality of life at each stage of development.

Objectives/Goal: We aimed to perform a qualitative literature review to highlight the psychosocial, emotional, and behavioral themes that affect the quality of life as patients born with congenital colorectal disease.

Methods/Design: A systematic literature review of all articles published between 1980-2019 was performed in the PubMed and CINAHL databases. Inclusion criteria included articles that reported on the …

Impact Of Covid-19 On Families With A Child In Cancer Treatment, Mirae J. Fornander

Research Days

Background: A new diagnosis of pediatric cancer diagnosis is a sudden and tremendous stressor to families (Long & Marsland, 2011). The COVID-19 pandemic presented an acute, universal stressor that impacted daily life around the world (Brooks et al., 2020). The impact of the COVID-19 pandemic on children with cancer and their families is not yet known.

Objectives/Goal: The current study is a pilot investigation of COVID-19 exposure and impact among a sample of families with a child being treated for cancer.

Methods/Design: Primary caregivers (N=22) of a child (M age=7.4, SD=4.6) who was diagnosed with cancer within the last 18 …

Intracranial Vcam1 At Time Of Mechanical Thrombectomy Predicts Ischemic Stroke Severity, Benton Maglinger, Madison Sands, Jacqueline A. Frank, Christopher J. Mclouth, Amanda L. Trout, Jill M. Roberts, Stephen Grupke, Jadwiga Turchan-Cholewo, Ann M. Stowe, Justin F. Fraser, Keith R. Pennypacker

Behavioral Science Faculty Publications

BACKGROUND: Emergent large vessel occlusion (ELVO) strokes are devastating ischemic vascular events for which novel treatment options are needed. Using vascular cell adhesion molecule 1 (VCAM1) as a prototype, the objective of this study was to identify proteomic biomarkers and network signaling functions that are potential therapeutic targets for adjuvant treatment for mechanical thrombectomy.

METHODS: The blood and clot thrombectomy and collaboration (BACTRAC) study is a continually enrolling tissue bank and registry from stroke patients undergoing mechanical thrombectomy. Plasma proteins from intracranial (distal to clot) and systemic arterial blood (carotid) were analyzed by Olink Proteomics for N=42 subjects. Statistical …

Consequence Of Patient Education On Health Habits, Esha M. Patel, Adarsh Gupta

Rowan-Virtua Research Day

Hypothesis: Patients who participate in an specific health habit do so due to a lack of knowledge about the consequences of that choice.

Goal: Correlate patient participation in specific health habits with their knowledge of the consequences of these choices. Understand why patients continue to participate in specific habits and what influences their decision. The end goal of my project is to provide insight to encourage physicians to evaluate patient’s health education and get physicians to try to apply consequences of these habits on the patient’s life to help them understand health outcomes.

Conclusion: This study showed more correlations between …

Case Of New Onset Alice In Wonderland Syndrome In Adolescent After Prolonged Hospitalization, Michaela Margolis, Timothy Wong, Richard Hadi

Rowan-Virtua Research Day

Alice in wonderland syndrome (AIWS) has been described as body image illusions involving distortions of the size, mass, or shape of the patient’s own body or its position in space, often occurring with depersonalization and derealization. Most cases typically affect young children.

Common distortions are micropsia, macropsia, metamorphopsia, and pelopsia.

The term was adopted from the book by Lewis Carroll, wherein the main character perceived her size and shape to change in different scenarios.

These distortions are often expressed as sensory perceptions rather than illusions or hallucinations, and are often distressing to the patient.

AIWS onset has been found to …

Building Community-Engaged Multidisciplinary Partnerships To Improve Medication Management In Elderly Patients With Multiple Chronic Conditions, Ivy O. Poon, Felicia Skelton, Lena R. Bean, Dominique Guinn, Terica L. Jemerson, Ngozi D. Mbue, Creaque V. Charles, Uche Anadu Ndefo

Journal of Patient-Centered Research and Reviews

Purpose: Many studies in preventing adverse drug events have been researcher-driven, yet few have engaged patients in the development of a project. This project aims to engage minority elderly patients with multiple chronic conditions in the development of research questions and strategies to improve medication safety.

Methods: Elderly patients (≥ 65 years old) who were prescribed 7 or more chronic medications were recruited through a university-based aging resource network in a historically African American community in Houston, Texas. Patients and a caregiver participated in a multidisciplinary workgroup comprised of a physician, pharmacists, a nurse, health educators, and a social worker. …

Healthcare Altruism And Dysconscious Healthism In The Delivery Of Integrated Healthcare Services To Individuals Who Are Deaf, Hard Of Hearing, And Deafblind, Jaime A.B. Wilson, Michael John Gournaris

JADARA

Healthcare altruism and dysconscious healthism are terms proposed to recognize the barriers to healthcare access faced by not only individuals with hearing loss but also all minority populations. The implications of an integrated healthcare model to provide services to individuals who are d/Deaf, hard of hearing, or DeafBlind (D/HH/DB) are explored. Unique insights are then offered regarding existing barriers to healthcare access and the next steps.

Memory-Related Frontal Brainwaves Predict Transition To Mild Cognitive Impairment In Healthy Older Individuals Five Years Before Diagnosis, Yang Jiang, Juan Li, Frederick A. Schmitt, Gregory A. Jicha, Nancy B. Munro, Xiaopeng Zhao, Charles D. Smith, Richard J. Kryscio, Erin L. Abner

Behavioral Science Faculty Publications

BACKGROUND: Early prognosis of high-risk older adults for amnestic mild cognitive impairment (aMCI), using noninvasive and sensitive neuromarkers, is key for early prevention of Alzheimer's disease. We have developed individualized measures in electrophysiological brain signals during working memory that distinguish patients with aMCI from age-matched cognitively intact older individuals.

OBJECTIVE: Here we test longitudinally the prognosis of the baseline neuromarkers for aMCI risk. We hypothesized that the older individuals diagnosed with incident aMCI already have aMCI-like brain signatures years before diagnosis.

METHODS: Electroencephalogram (EEG) and memory performance were recorded during a working memory task at baseline. The individualized baseline neuromarkers, …

In Patients With Mild To Moderate Alzheimer’S, Does Music Therapy Help To Decrease Mood Disturbances When Compared To Those Not Participating In Music Therapy?, Lauren Bauer

Capstone Showcase

Abstract:

Introduction: Affecting both memory and cognitive abilities, Alzheimer’s disease is a growing problem as the baby boomer population ages. Clinical trials for new medications fail or are slow going, researchers have sought alternatives to alleviate symptoms for patients of this disease. This paper will address the effect of music therapy on mood disturbance in patients with Alzheimer’s disease.

Method: A literature search was completed in November of 2019 using PubMed, EBSCO Search, ScienceDirect, and Google Scholar. Six articles were chosen based on relevance to the research question, study design, outcome, and results.

Results: Based on review, music …

The Effects Of Psychological Intervention On Pregnant Women With Elevated Cortisol Levels And Adverse Birth Events, Megan Mellon

Capstone Showcase

Elevated levels of stress, anxiety, and depression during pregnancy are thought to influence cortisol levels. Dysregulations in cortisol, as a byproduct of the hypothalamic-pituitary axis, have been associated with preterm birth and adverse birth outcomes. Studies have demonstrated poorer long-term effects of antenatal stress on child neurodevelopment, temperament, and cognition. Psychological interventions of cognitive behavioral therapy (CBT), mindfulness, and gratitude have shown to have a positive effect on psychological wellbeing across various populations. The purpose of this literature review was to analyze a collection of randomized-controlled trials to conclude if psychological interventions during pregnancy for women with elevated levels of …

Identification Of Infant Feeding Practices In Eastern Kentucky And Southern West Virginia That Correlate With High Weight-For-Length, Havilah R. Adkins

DNP Projects

Background: Approximately 20% of children in the United States are obese. West Virginia and Kentucky rank in the top 10 for obesity rates in children as young as 2-4 years old. Obesity increases the risk for numerous short-term health problems and impacts long-term health, development, quality of life, and life expectancy. Research indicates that obesogenic behaviors can be addressed prior to the development of obesity or significant health problems to prevent, rather than treat. Interventions targeting caregivers of infants younger than 2-years can promote early development of healthy feeding habits that persist through the developmental stages of nutrition. Before a …

How Duty Rosters And Stress Relate To Sleep Problems And Fatigue Of International Pilots, Marion Venus, Martin Grosse Holtforth

International Journal of Aviation, Aeronautics, and Aerospace

While previous research focused on pilots’ fatigue, rosters, potential performance-impairment and aviation-safety, this research investigates, how pilots’ work-related and psychosocial stress and rosters can affect their sleep and fatigue. A cross-sectional online survey was completed by 192 pilots flying for European operators, 180 Australian pilots and 34 pilots from UAE, Turkey and Asia Pacific. Pilots reported their actual duty- and flight-hours, flown sectors, standby, rest, vacation days, number of early starts, night-flights and sports-hours for the last two months. Schedule-related data, way to work, age, flight-hours on the present type of aircraft, subjective job-security and psychosocial stress were used as …

Nonsuicidal Self-Injury, Suicide Planning, And Suicide Attempt Among High-Risk Adolescents Prior To Psychiatric Hospitalization, Christina M. Sellers, Antonia Díaz-Valdés, Andrew C. Porter, Catherine R. Glenn, Adam Bryant Miller, Adeline Wyman Battalen, Kimberly H. Mcmanama O'Brien

Psychology Faculty Publications

The purpose of this study was to understand the trajectories of nonsuicidal self-injury (NSSI) and suicide plans (SP) in the 90 days prior to inpatient hospitalization, understand the role of NSSI and SP in predicting suicide attempts (SA) on a given day, and to test the interaction between NSSI and SP in predicting same-day SA. Participants included 69 adolescents (77% female, 65% white, 77% Non-Hispanic/Latinx, Mage = 15.77 SDage = 1.00) from an inpatient psychiatric unit. Past 90 day NSSI, SP, and SA were measured using the Columbia Suicide Severity Rating Scale and Timeline Follow Back. First, mixed effect models …

The Use Of Life-Like Robotic Animals In The Acute Care Setting To Assist In The Care Of Patients With Dementia, Abby Denby

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The purpose of this pilot project was to describe the effect of life-like robotic animals on the nurses’ ability to provide care, patients’ level of agitation, use of antipsychotic medications, restraint and sitter use for patients with dementia in an acute care setting. Nurses report challenges and feelings of helplessness while caring for patients with dementia. Dementia may cause depression, agitation, aggression (physical or verbal) and a decrease quality of life. Animal Assisted Therapy (ATT) is a growing therapy in many healthcare settings but there is a lack of literature specifically related to the use of AAT in the acute …

Historical Trauma Response Scores As A Function Of Unresolved Grief And Substance Use Disorder In American Indian Populations, Andrew R. Saunders

Undergraduate Research Symposium

Abstract

Researchers are interested in the outcomes of interventions, specifically, measuring historical trauma (HT) among American Indian/Alaska Native communities and the long-term distress and substance abuse as a result of historical trauma response (HTR). Previous literature has implicated limitations in the clinical conceptualization of the relationship between intergenerational transfer of HTR and substance abuse. The aim of the current study is to examine treatment efficacy of 50 homosexual, American Indian males randomized to a culturally-adapted juxtaposition of (1) Group Interpersonal Psychotherapy (IPT), (2) Cognitive Processing Therapy (CPT), and (3) Historical Trauma and Unresolved Grief Intervention (HTUG), or (4) waitlisted on …

When Patients Die: Patient Memorials And Group Reflection In An Internal Medicine Residency Program, Nicole Oakman, Jonathan Lim, Christine Bui, Holland Kaplan, Stephanie Sherman

Faculty, Staff and Students Publications

Patient death is a formative and emotional experience for physicians. Medical trainees are particularly susceptible to the emotional impact of patient death. However, few studies have examined how trainees process patient death. This study describes annual patient memorials organized at a large multisite academic graduate medical education program. Peer-led, 1-hour patient memorial services were organized for internal medicine residents, including large and small group reflection, a moment of silence, and collective art projects. At the conclusion of each memorial, participants completed a 10-question survey regarding their experience during the memorial and their prior experiences with patient death. Ninety-nine surveys were …

Caregiver Perspective On Sensory Diet And Therapeutic Listening For Children With Autism Spectrum Disorder And/Or Sensory Processing Disorder, Mikayla M. Brett, Lynette Zulquairnain, Katlyn Ribant

Pediatrics

Due to the high prevalence of Autism Spectrum Disorder (ASD) and Sensory Processing Disorder (SPD), there is a high demand for more research on effective interventions in order to improve quality of life and engagement in meaningful occupations for individuals with ASD and/or SPD. Sensory Diet (SD) and Therapeutic Listening © (TL) are interventions commonly utilized with individuals with ASD and/or SPD, however, there is limited research on their combined use. The purpose of this study is to determine the effectiveness of the combined occupational therapy (OT) interventions of SD and TL on the occupational performance of children with ASD …

A Case For Delirium Risk Prediction Models To Aid In Triaging Resources To Those Most At Risk An Integrative Literature Review, Tammy Perttula

Nursing Masters Papers

Abstract

Delirium is a complex syndrome resulting from compounding effects of acute illness, comorbidities, and the environment. It results in adverse outcomes: elevated mortality rates, length of stay, readmissions, institutionalization, long-term cognitive changes, and diminished quality of life. The rate of iatrogenic delirium is astounding, ranging from 10%-89%. There are no curative treatments; thus, primary prevention is the key. The purpose of this literature review is to identify and critique the research for the accuracy of risk stratification and feasibility in practice. Support for interventions that prevent delirium is mounting; however, interventions are resource-intensive and often not implemented. Researchers have …

Fecal Microbiota Transplantation And Gut Microbiome Effects On Psychiatric Illnesses, Mona Seresht

Physician Assistant Studies | Student Authored Articles

Despite the medical advances that have been made in regards to mental health, psychiatric medications, and alternative therapies, many patients continue to suffer day in and day out, unable to live the type of life they desire. Many times, the medication route includes many episodes of trial and error, side effects, and no significant improvement in actual symptoms. Therapy, although effective, typically necessitates a supplemental medication for the best results. Fecal microbiota transplantation (FMT) is a method where feces from a healthy donor is transferred to an affected patient, typically via colonoscopy. Theoretically, this alters the gut microbiome in a …

Initial Evaluation Of A Wellness Game, Bing Parkinson, Bruce St. Amour

Capital Division GME Virtual Research Day 2020

Physician wellness has recently been a topic of significant national interest.^1-8 The term “wellness” has many definitions, and was best defined by Around et al. ¹ as “one’s personal recipe for thriving and not just surviving.” Wellness refers to interconnected dimensions of physical, mental, and social well-being that extend beyond the absence of illness. Wellness has traditionally been measured in the negative sense by assessing rates of burnout, emotional exhaustion, and depersonalization. It is known that physician burnout is at its highest point during residency^{1, 4, 5} and burnout is linked to many negative outcomes including: substance abuse …

Scope Of Attention Variation As A Function Of Anxiety And Depression, Kathleen Anne O'Donnell

Electronic Theses, Projects, and Dissertations

As a social species, correct emotional perception is so vital, that the human brain has evolved a mechanism to control attentional choices by exerting a narrowed field of perception during danger, called the scope of attention (SoA). The SoA determines what information will be focused on or ignored by blocking the perception of non-relevant items and increasing selective focus on danger; even if danger is merely a sad-face. The emotional items blocked from perception cannot be remembered because they were never perceived. But, attention-control to emotional stimuli also varies with mood, as seen in mood-disorders. A mood-disorder’s effect upon the …

A Web-Based, Positive Emotion Skills Intervention For Enhancing Posttreatment Psychological Well-Being In Young Adult Cancer Survivors (Empower): Protocol For A Single-Arm Feasibility Trial, John M. Salsman, Laurie E. Mclouth, Michael Cohn, Janet A. Tooze, Mia Sorkin, Judith T. Moskowitz

Behavioral Science Faculty Publications

BACKGROUND: Adolescent and young adult cancer survivors (AYAs) experience clinically significant distress and have limited access to supportive care services. Interventions to enhance psychological well-being have improved positive affect and reduced depression in clinical and healthy populations but have not been routinely tested in AYAs.

OBJECTIVE: The aim of this protocol is to (1) test the feasibility and acceptability of a Web-based positive emotion skills intervention for posttreatment AYAs called Enhancing Management of Psychological Outcomes With Emotion Regulation (EMPOWER) and (2) examine proof of concept for reducing psychological distress and enhancing psychological well-being.

METHODS: The intervention development and testing are …

Promoting Resilience In Self-Management (Prism): Adverse Childhood Experiences And Impacts On Emotion Regulation, Kasey Ann Macedo

Honors Scholar Theses

PRISM (Promoting Resilience in Self-Management) is a mindfulness-based intervention that aims to strengthen emotion regulation skills among individuals by employing cognitive behavioral therapy components. The purpose of the current study is to identify the relationship between adverse childhood experiences (ACEs) and depression, as well as to examine the changes in emotion regulation strategies of participants by comparing pre and post test data. The participants were voluntarily recruited from the Cornerstone Foundation, a homeless shelter, food pantry, and community center in Vernon, CT. The 13 participants completed PRISM through four weeks of two-hour workshop sessions in a small-group format. Results indicate …

Supporting Self-Regulation Of Children With Adhd Using Wearables: Tensions And Design Challenges, Franceli L. Cibrian, Kimberley D. Lakes, Arya Tavakoulnia, Kayla Guzman, Sabrina Schuck, Gillian R. Hayes

Engineering Faculty Articles and Research

The design of wearable applications supporting children with Attention Deficit Hyperactivity Disorders (ADHD) requires a deep understanding not only of what is possible from a clinical standpoint but also how the children might understand and orient towards wearable technologies, such as a smartwatch. Through a series of participatory design workshops with children with ADHD and their caregivers, we identified tensions and challenges in designing wearable applications supporting the self-regulation of children with ADHD. In this paper, we describe the specific challenges of smartwatches for this population, the balance between self-regulation and co-regulation, and tensions when receiving notifications on a smartwatch …

Development And Psychometrics Of The English Version Of The Itch Cognitions Questionnaire, Carolyn J. Heckman, Christina Schut, Mary Riley, Anke Ehlers, Rodrigo Valdes-Rodriguez, Jörg Kupfer, Uwe Gieler, Jerod L. Stapleton

Health, Behavior & Society Faculty Publications

BACKGROUND: The aim of this study was to validate the English version of the Itch Cognition Questionnaire in a sample of patients with chronic itch due to psoriasis or atopic dermatitis. An English-language version of an instrument assessing itch-related cognitions is needed since cognitions can contribute to a worsening of itch, and chronic itch is prevalent in English-speaking counties and internationally.

METHODS: The German Itch Cognitions Questionnaire was translated into English, and cognitive interviewing was conducted to finalize item wording. Internal and test-retest reliability, item discrimination, responsiveness to change, and construct, convergent, and discriminant validity were assessed in a national …

Using Education To Increase Compliance With Heart Failure Medications, Kara Stout Do, Isaac Navarro Dmd

Internal Medicine

• Approximately 5.7 million adults in the United States have heart failure.
• 25% of individuals die within one year of diagnosis and more than 80% die within 8 years.
• Full adherence to medications may be as low as 30% in heart failure patients.
• Non-compliant patients are two times more likely to be readmitted to the hospital and have a three times higher mortality rate.

Somatic Symptom And Related Disorders: A Case Of Illness Anxiety Disorder In A Young Relatively Treatment Naive African American Male, Linda Zhang, Richard P. Leggett, Harrison Ross Galicki, William B. Dehart

Psychiatry

Somatic symptom and related disorders (including illness anxiety disorder and somatic symptom disorder) is a diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) replacing somatoform and related disorders in the DSM-4 Text Revision. This classification eliminated the requirement that somatic symptoms must be nonorganic in nature, in an effort to reliably detect more cases of significant health anxiety than previously with DSM-4 criteria. Illness anxiety disorder is a primary anxiety disorder characterized by persistent preoccupation or excessive concern about having or developing an undiagnosed disease despite medical evaluation and reassurance. It is considered a …