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2025

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Full-Text Articles in Behavior and Behavior Mechanisms

Mental Health And Beliefs About Abortion Access Following Changes To Reproductive Healthcare Laws In 2022: Findings From Oklahoma, Munjireen Sifat, Laili K. Boozary, Tina N. Le, Julia Mcquoid, Brittany Zaring-Hinkle, Sarah Tonkin, Lizbeth Benson, Bingjing Mao, Motolani Ogunsanya, Ruosi Shao, Amy M. Cohn, Allyson Shortle, Darla E. Kendzor Dec 2025

Mental Health And Beliefs About Abortion Access Following Changes To Reproductive Healthcare Laws In 2022: Findings From Oklahoma, Munjireen Sifat, Laili K. Boozary, Tina N. Le, Julia Mcquoid, Brittany Zaring-Hinkle, Sarah Tonkin, Lizbeth Benson, Bingjing Mao, Motolani Ogunsanya, Ruosi Shao, Amy M. Cohn, Allyson Shortle, Darla E. Kendzor

Department of Medical Oncology Faculty Papers

INTRODUCTION: A secondary analysis of cross-sectional survey data was conducted to characterize beliefs about abortion access in Oklahoma, measure stress associated with the overturn of Roe vs. Wade (2022), and evaluate the potential relationship between post-Roe stress (PR stress) and mental health.

METHODS: From August through September 2022, adult Oklahomans (N = 1793) were surveyed about their sociodemographic characteristics, beliefs about abortion access, frequency of past-month stress related to the overturn of Roe vs. Wade, and mental health. Beliefs about abortion access were characterized overall and within sociodemographic groups. The relationship between PR stress and mental health was evaluated, and …


Exploring The Impact Of Inpatient Mental Health Care On Adolescents, Alexandria M. Mckahan Dec 2025

Exploring The Impact Of Inpatient Mental Health Care On Adolescents, Alexandria M. Mckahan

2025 Fall Honors Capstones Projects - Archive

Adolescent psychiatric hospitalizations continue to rise, yet there is limited research on which daily practices inside inpatient units genuinely support engagement and recovery. This project examined how structure, staff tone, and therapeutic programming influence adolescents’ participation and emotional stability within a real inpatient setting. The study focused on three questions: how structured routines affect recovery, what challenges staff face when supporting adolescents with complex needs, and how adolescents’ engagement patterns reflect their perception of care. Using a mixed-methods case study at Mesa Springs Behavioral Health Hospital, I conducted approximately twenty field observations, semi-structured staff interviews, and descriptive engagement tracking across …


Are E-Cigarettes A Safer Alternative? Revisiting The Cardiovascular Cost Of Nicotine Delivery, Jason D. Gardner Dec 2025

Are E-Cigarettes A Safer Alternative? Revisiting The Cardiovascular Cost Of Nicotine Delivery, Jason D. Gardner

School of Graduate Studies Faculty Publications

No abstract provided.


Influence And Excess: A Study Of Alcohol’S Governmental, Societal, Biochemical, And Enzymatic Impact In The U.S And Other Countries Around The World, Thomas W. Snider Dec 2025

Influence And Excess: A Study Of Alcohol’S Governmental, Societal, Biochemical, And Enzymatic Impact In The U.S And Other Countries Around The World, Thomas W. Snider

Senior Honors Theses

The conduct of the thesis is to explore the intricacies of alcohol consumption. The thesis will outline the history of alcohol and the societal pressures and conduct of drinking with relation to the government. After the history of alcohol has been defined, the thesis will move into the chemistry portion, delineating the absorption, digestion, metabolism, and excretion of alcohol. This is the portion of the thesis that will contain the quantitative data and source material as much research has already been conducted regarding these components of alcohol consumption. The condition of the research is that the data will be collected …


Per Se Driving Under The Influence Of Cannabis Statutes And Blood Delta-9-Tetrahydrocannabinol Concentrations Following Short-Term Cannabis Abstinence, Robert L. Fitzgerald, Anya Umlauf, Raymond T. Suhandynata, David J. Grelotti, Marilyn A. Huestis, Kyle F. Mastropietro, Igor Grant, Thomas D. Marcotte Dec 2025

Per Se Driving Under The Influence Of Cannabis Statutes And Blood Delta-9-Tetrahydrocannabinol Concentrations Following Short-Term Cannabis Abstinence, Robert L. Fitzgerald, Anya Umlauf, Raymond T. Suhandynata, David J. Grelotti, Marilyn A. Huestis, Kyle F. Mastropietro, Igor Grant, Thomas D. Marcotte

Institute of Emerging Health Professions Faculty Papers

BACKGROUND: Several US states have per se laws using 2 or 5 ng/mL of delta-9-tetrahydrocannabinol (THC) as cutpoints for driving under the influence of cannabis, while some have zero-tolerance statutes. These cutpoints are considered prima facia evidence of driving impairment.

METHODS: In a cohort of people who regularly use cannabis (N = 190) we measured baseline concentrations of THC after instructing participants to abstain from cannabis for at least 48 hours. Baseline driving performance was evaluated using a driving simulator. We also measured blood THC concentrations serially following a smoking session (placebo or active cannabis).

RESULTS: Forty-three percent of the …


Engaging Ukrainian Tf-Cbt Therapists In A Practice Skills Course To Support Their Wellbeing, Elisabeth Pollio, Esther Deblinger, Beth Cooper, Maike Garbade, Julie P Harrison, Elisa Pfeiffer Dec 2025

Engaging Ukrainian Tf-Cbt Therapists In A Practice Skills Course To Support Their Wellbeing, Elisabeth Pollio, Esther Deblinger, Beth Cooper, Maike Garbade, Julie P Harrison, Elisa Pfeiffer

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Background: Burnout and secondary traumatic stress (STS) are common among therapists working with trauma-exposed clients, which can negatively impact them professionally and personally. The shared trauma of war exposure may put therapists at greater risk. To help support their wellbeing, an eight-session course was offered to Ukrainian therapists following training in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). This course involves therapists personally utilizing the PRACTICE skills taught to clients in TF-CBT for professional and personal benefit.

Objective: The objective was to gather preliminary evidence on the potential impact of implementing the course with Ukrainian therapists providing TF-CBT during a period of …


Implementation Of An Information Sheet For Pediatric Patients With Autism Spectrum Disorder In An Inpatient Setting To De-Escalate Aggressive Behaviors And Reduce Seclusion Rates, Megan R. Castro Dec 2025

Implementation Of An Information Sheet For Pediatric Patients With Autism Spectrum Disorder In An Inpatient Setting To De-Escalate Aggressive Behaviors And Reduce Seclusion Rates, Megan R. Castro

Doctor of Nursing Practice

Introduction: Research shows that most seclusion events in pediatric psychiatric settings involve pediatric patients with neurodevelopmental disorders, particularly autism spectrum disorder (ASD). A lack of provider expertise contributes to elevated seclusion rates, highlighting the need for evidence-based, ASD-informed care.
Purpose: To reduce seclusion events within a pediatric psychiatric facility in South Texas, by implementing an evidence-based intervention upon admission that could decrease aggressive behaviors and the likelihood of requiring seclusion. Evidence summary: Literature and guidelines underscore the importance of identifying sensory triggers and calming strategies at admission. Collaborative care and personalized interventions, such as a patient information sheet that identifies …


Host-Intrinsic Factors Determine Anti-Tumor Efficacy Of Exercise In Pancreatic Ductal Adenocarcinoma, Sumedha Pareek Dec 2025

Host-Intrinsic Factors Determine Anti-Tumor Efficacy Of Exercise In Pancreatic Ductal Adenocarcinoma, Sumedha Pareek

Dissertations and Theses (Open Access)

Pancreatic Ductal Adenocarcinoma (PDAC) is the third leading cause of cancer-related deaths with a low 5-year relative survival rate of approximately 13.3% for all stages combined. We have previously shown that exercise can improve quality of life and enhance functional capacity among patients with PDAC. Exercise induces a variety of changes in the tumor microenvironment with beneficial effects in several tumor types. However, our understanding of the clinical effects of exercise and the mechanisms that mediate anti-tumor effects are limited in pancreatic cancer.

In this project, using C57BL/6 mice from Taconic Biosciences (Tac) and Jackson Laboratories (Jax), we established a …


Physician Peer Review: Just Culture And Practical Implementation In An Emergency Department, Christian Fromm, Monica Colicino, Merle A. Carter, Elizabeth M. Datner Nov 2025

Physician Peer Review: Just Culture And Practical Implementation In An Emergency Department, Christian Fromm, Monica Colicino, Merle A. Carter, Elizabeth M. Datner

Einstein Health Papers

BACKGROUND: Although regulatory agencies require hospitals to engage in peer review to maintain accreditation, quality assurance review processes are not standardized, and well-structured peer review of clinical cases involving medical errors and adverse events governed by Just Culture principles is not widespread. We implemented such an emergency department (ED) physician peer review process and performed an analysis of cases that underwent review.

METHODS: We formed an ED physician peer review committee at our institution guided by Just Culture principles, including promotion of a culture of safety to encourage open reporting of errors and near misses, and top-down leadership commitment to …


Stigma And Barriers To Seeking Mental Health Care Among Emergency Department Providers – A Mixed Methods Study, Shannon C. White, Charlotte H. Harris, Ravindra Gopaul, Joshua M. Smyth Nov 2025

Stigma And Barriers To Seeking Mental Health Care Among Emergency Department Providers – A Mixed Methods Study, Shannon C. White, Charlotte H. Harris, Ravindra Gopaul, Joshua M. Smyth

Student Papers, Posters & Projects

High levels of psychological distress and depression are common among clinicians working in US emergency departments [ED], yet treatment-seeking remains rare, contributing to burnout and negative well-being. Reluctance to seek care often reflects concerns about negative consequences (e.g., stigma, negative professional impact). We sought to characterize the availability of mental health resource availability, beliefs about seeking care, and barriers faced by emergency department healthcare providers. A sequential mixed-method design was employed. Phase 1 included a survey of ED physicians, advanced practice providers (APPs; i.e., nurse practitioners and physician assistants) and medical residents at an academic medical center. The survey assessed …


What Are The Barriers And Facilitators To The Acceptance Of Information And Communication Technology-Based Interventions For Improving Resilience And Mental Health Of Healthcare Workers: A Scoping Review Protocol, Elisabete Alves, Ricardo Rodrigues, César Fonseca, Manuel Lopes, Inês Faria, Nina Dalkner, Paul Barach, Frans Folkvord, Jim Ingebretsen Carlson, Eva Reininghaus, Michele Wessa, Yvonne Prinzellner, Vanessa Leung, Eva Turk, Lara Guedes De Pinho Nov 2025

What Are The Barriers And Facilitators To The Acceptance Of Information And Communication Technology-Based Interventions For Improving Resilience And Mental Health Of Healthcare Workers: A Scoping Review Protocol, Elisabete Alves, Ricardo Rodrigues, César Fonseca, Manuel Lopes, Inês Faria, Nina Dalkner, Paul Barach, Frans Folkvord, Jim Ingebretsen Carlson, Eva Reininghaus, Michele Wessa, Yvonne Prinzellner, Vanessa Leung, Eva Turk, Lara Guedes De Pinho

College of Population Health Faculty Papers

INTRODUCTION: Healthcare workers (HCWs) report overwhelming demands and experience crisis levels of burnout and unique challenges that further impair their mental health. Promotion of mental health among HCWs using information and communication technology (ICT) has received little empirical research attention and interventions for improving mental health resilience in HCWs are not well established.

DESIGN: Scoping review to map existing evidence and identify gaps for future research regarding the main barriers and facilitators of the acceptance of ICT-based interventions for improving resilience and mental health among HCWs working in all healthcare settings.

METHODS AND ANALYSIS: This protocol was developed in accordance …


Learning And Satisfaction, Ainsley Smith Nov 2025

Learning And Satisfaction, Ainsley Smith

Scholars Week

Learning and Satisfaction

Motivation, especially in the world of psychology, is quite the broad and overarching term that relates to various aspects of life. Whether it be motivation in the workplace, classroom, sports, or relationships, our intrinsic and extrinsic motivations drive us to do our best on what we set forth to accomplish. Although there is extensive research on methods of learning in correlation to motivation as well as levels of satisfaction impacting these levels, there has yet to be much exploration into the impact an emotional component or personal connection may have on these factors. The purpose of this …


Effects Of Tpa023b, An Α2/3/5gabaa Subtype-Selective Partial Allosteric Modulator, On Fentanyl-Induced Respiratory Depression In Male Rats: Comparison With The Non-Selective Benzodiazepine Midazolam, Loc M. Pham, Andria B. Nanney, Jordan Hasting, Daniela Rüedi-Bettschen, Kevin B. Freeman, James K. Rowlett Nov 2025

Effects Of Tpa023b, An Α2/3/5gabaa Subtype-Selective Partial Allosteric Modulator, On Fentanyl-Induced Respiratory Depression In Male Rats: Comparison With The Non-Selective Benzodiazepine Midazolam, Loc M. Pham, Andria B. Nanney, Jordan Hasting, Daniela Rüedi-Bettschen, Kevin B. Freeman, James K. Rowlett

Psychiatry Publications

Rationale

Opioid-related overdose deaths involving benzodiazepines have increased in recent years, and prior studies have reported that clinically used benzodiazepines can enhance the respiratory-depressant effects of mu opioid receptor (MOR) agonists. TPA023B is an α1-sparing GABAA positive allosteric modulator developed as a potential anxiolytic with fewer benzodiazepine-typical side effects. However, it is unknown if and to what degree TPA023B can affect MOR-agonist induced respiratory depression.

Objectives

The current study compared the effects of either TPA023B or midazolam, alone and combined with fentanyl, on respiratory depression in rats, using whole-body plethysmography.

Methods

Male Sprague-Dawley rats were implanted with chronic indwelling intravenous …


Art Therapy In Social Work Practice, Laura Gebur Oct 2025

Art Therapy In Social Work Practice, Laura Gebur

Journal of Undergraduate Research at Minnesota State University, Mankato

Art therapy is an emerging practice among mental health professionals looking for new ways to engage with their clients and encourage nonverbal communication. Creativity is a means of processing memories, improving relationships, and strengthening the mind-body connection across a variety of age groups and practice settings. The efficacy of art therapy has led to its integration into social work practice, benefitting a diverse range of client populations within the field. While a lack of macro-level research studies has prevented the implementation of standardized art therapy techniques in social work, clinical research trials have examined art therapy across several areas of …


Patient Satisfaction Among Opioid Use Disorder Treatment Sample In An Opioid Treatment Program: A Mixed Method Research Study, Stanley Nkemjika Oct 2025

Patient Satisfaction Among Opioid Use Disorder Treatment Sample In An Opioid Treatment Program: A Mixed Method Research Study, Stanley Nkemjika

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND/OBJECTIVES: Patient satisfaction is increasingly recognized as a key indicator of the effectiveness of substance use disorder (SUD) treatment. While some studies suggest disparities in satisfaction across treatment settings, there remains limited research examining these differences, particularly among vulnerable populations. This study aimed to assess patient perceptions of satisfaction with opioid use treatment services and explore how demographic and socioeconomic factors influence these experiences.

METHODS: Conducted between 1 February and 31 March 2025, the study took place at a longstanding Opioid Treatment Program in Philadelphia. A total of 217 participants receiving treatment were recruited through convenience sampling during routine clinic …


Adherence To Integrative Care, Oncology Healthcare Utilization, Opioid Use And Hospitalization, Eran Ben-Arye, Dan Greenberg, Noah Samuels, Ana Maria Lopez, Tzahit Simon-Tuval Oct 2025

Adherence To Integrative Care, Oncology Healthcare Utilization, Opioid Use And Hospitalization, Eran Ben-Arye, Dan Greenberg, Noah Samuels, Ana Maria Lopez, Tzahit Simon-Tuval

Kimmel Cancer Center Faculty Papers

Research on the relationship between integrative oncology (IO) programs and dispensing of chemotherapy agents and supportive care drugs, and hospitalization rates is limited. The present study examined these outcomes in chemotherapy-treated patients with cancer, comparing patients highly adherent to integrative care (high-AIC) to those with low adherence (low-AIC). Data from patients with cancer treated with taxane and/or platinum-based agents participating in an ongoing prospective, controlled pragmatic trial were examined retrospectively. Patients were referred to an IO consultation and weekly treatments at 3 medical centers in Northern Israel, with high-AIC defined as attending ≥4 sessions at 6 weeks; low-AIC, 0-3 sessions. …


Prevalence, Patterns, And Factors Influencing Decision To Sport Specialize During High School In Current Division-I And Sport Club Ice Hockey Athletes, Emily C. Srygler, Eric A. Caloud, Laura A. Zdziarski-Horodyski, Masaru Teramoto, Madison N. Renner, Stephanie N. Adler, David R. Bell Oct 2025

Prevalence, Patterns, And Factors Influencing Decision To Sport Specialize During High School In Current Division-I And Sport Club Ice Hockey Athletes, Emily C. Srygler, Eric A. Caloud, Laura A. Zdziarski-Horodyski, Masaru Teramoto, Madison N. Renner, Stephanie N. Adler, David R. Bell

Internet Journal of Allied Health Sciences and Practice

Purpose: Young athletes are continuing to choose high levels of sport specialization despite growing evidence of associations with chronic injury. Perceptions of specialization leading to greater athletic success have been found to be a motivator for these athletes and their parents, but little is known about its prevalence in ice hockey. Therefore, the purpose of this study was to analyze the prevalence, patterns, and factors influencing sport specialization during high school in current Division-I and sport club ice hockey athletes. This information can assist in filling in the knowledge gap in high school sport specialization in ice hockey athletes, specifically …


Factors In The Relationship Between Rural Cancer Patients And Mental Health, Jordan B. King Oct 2025

Factors In The Relationship Between Rural Cancer Patients And Mental Health, Jordan B. King

Theses and Graduate Projects

Cancer patients frequently experience psychological distress, yet many do not access mental health services, particularly those residing in rural areas. The present study examines what factors contribute to utilization of mental health services and attitudes toward seeking mental health services in rural cancer patients who are actively receiving cancer treatments. Participants (N = 102) completed a paper and pencil survey. A logistic regression was used to examine the relationship between five predictor variables (anxiety, depression, social support, geographic location, and number of barriers) on the outcome variable (utilization of services). The model was statistically significant, X2(4) = …


The Academic, Psychological, And Physical Impact Of Motor Skills Difficulties On College Students: A Scoping Review, David Gaul Phd, Suzanne Mccarthy Wolf Oct 2025

The Academic, Psychological, And Physical Impact Of Motor Skills Difficulties On College Students: A Scoping Review, David Gaul Phd, Suzanne Mccarthy Wolf

Articles

Purpose of Review

This scoping review examines the extent and quality of research literature to determine the impact of motor skills difficulties on college or university students. It assesses the adequacy of current institutional supports and identifies opportunities for more inclusive educational practices.

Recent Findings

Four databases (PubMed, SCOPUS, PsycINFO, and Web of Science) were searched for English-language studies published since 1970. Eighteen studies met inclusion criteria: 12 empirical, 4 descriptive, and 2 program evaluations. Six papers from the UK addressed support, social isolation, and academic confidence; six Israeli studies focused on handwriting, dysgraphia, and accommodations; three US studies examined …


Neighborhood Social Cohesion Associated With Chronic Liver Disease Prevalence And All-Cause Mortality, Tiange P. Zhang, Jennifer L. Dodge, Divya Ayyala-Somayajula, Norah A. Terrault Oct 2025

Neighborhood Social Cohesion Associated With Chronic Liver Disease Prevalence And All-Cause Mortality, Tiange P. Zhang, Jennifer L. Dodge, Divya Ayyala-Somayajula, Norah A. Terrault

Division of Gastroenterology and Hepatology Faculty Papers

Background and Aims: Neighborhood social cohesion (NSC)—the degree of trust and solidarity within a community—may influence health through multiple pathways including shaping healthy norms, perception of safety, and stress. Whether NSC influences chronic liver disease (CLD) prevalence and associated mortality in the United States is unknown. Methods: Using 172,047 adults from the 2013–2018 National Health Interview Survey with linkage to National Death Index mortality data, NSC was measured using questions on help availability, accountability, trustworthiness, and connectedness among neighbors, with composite scores (4–16) categorized as minimal (4–7), low (8–10), moderate (11–13), and high (14–16). Logistic and Cox regression tested the …


Program For Teachers To Address The Needs Of Students With Adhd, Ashton R. Wagner, Wendy Tremaine, Dr. Mary Jan Greer, Phd, Otr Oct 2025

Program For Teachers To Address The Needs Of Students With Adhd, Ashton R. Wagner, Wendy Tremaine, Dr. Mary Jan Greer, Phd, Otr

Fall 2025 OTD Capstone Symposium

The capstone project focused on supporting teacher participants from Eden Gardens Fundamental Magnet Elementary by providing practical strategies to address students who struggle with attention, regulation, and daily classroom routines. After completing a needs assessment, it was clear that many teachers faced similar challenges, including difficulty with transitions, staying on task, and responding when students became overwhelmed. To address this, created an OT-led teacher-training program that uses the PEOP model and focuses on simple, practical strategies teachers can implement right away. This included visual cues, sensory and movement supports, and minor changes to the classroom setup. As teachers began using …


Opportunities And Barriers To Engaging Caregivers In Firearm Suicide Prevention: Findings From Focus Groups With Caregivers Of Veterans., Katherine Macwilliams, John Marmion, Dee Blascyk, Sharon Urbina, Rachel Moyers, Gala True Sep 2025

Opportunities And Barriers To Engaging Caregivers In Firearm Suicide Prevention: Findings From Focus Groups With Caregivers Of Veterans., Katherine Macwilliams, John Marmion, Dee Blascyk, Sharon Urbina, Rachel Moyers, Gala True

School of Medicine Faculty Publications

Background: Firearms are involved in more than 70% of U.S. Veteran suicides. Caregivers, defined as family members or concerned significant others, can play an important role in firearm suicide prevention through initiating conversations about secure firearm storage with Veterans. Our objective was to explore caregivers' experiences with lethal means safety (LMS) conversations and identify perceived barriers to caregivers discussing LMS with healthcare providers and with Veterans. Methods: We conducted focus groups with 32 caregivers with experience caring for a Veteran at risk for suicide. Qualitative data were analyzed using thematic analysis. Results: We identified three primary themes: 1) caregivers recognize …


Prevalence Of Helmet Use In Skateboarders: A Systematic Review And Narrative Synthesis, Katherine Hunzinger, Ricker Adkins, Stevie Chen, Thomas Li, Lujie Chen Sep 2025

Prevalence Of Helmet Use In Skateboarders: A Systematic Review And Narrative Synthesis, Katherine Hunzinger, Ricker Adkins, Stevie Chen, Thomas Li, Lujie Chen

Department of Exercise Science Faculty Papers

Introduction: Helmet adoption remains low among skateboarders, but the specific prevalence remains unclear. The purpose of this study was to summarize available evidence on helmet-use prevalence among skateboarders. Methods: A systematic search of PubMed and Web of Science was conducted using the search terms: skateboard, skateboarding, protective gear, protective equipment, pads, or helmet. Articles were included if they were in English with specific data on helmet use among skateboarders. Articles excluded were those representing reviews or conference abstracts/presentations; or if helmet use prevalence for skateboarders could not be ascertained. Data extraction and quality assessment were performed independently by two reviewers, …


Association Between Climate Change Awareness And Depression & Anxiety: Findings From A U.S. Sample, Stanley Nkemjika, Colvette Brown, Henry Onyeaka, Srikanta Banerjee, Jennifer Oliphant Sep 2025

Association Between Climate Change Awareness And Depression & Anxiety: Findings From A U.S. Sample, Stanley Nkemjika, Colvette Brown, Henry Onyeaka, Srikanta Banerjee, Jennifer Oliphant

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND: Exploring the connection between climate change awareness and overall well-being is crucial, particularly in how it impacts both the environment and mental health. The mental health consequences of climate change and its awareness have not been thoroughly examined, especially in the U.S. In this study, the relationship between awareness of climate change and depression or anxiety among U.S. adults was explored. Similarly, the role of climate change awareness has not been explored in relation to mental health concerns.

METHODS: Based on the HINTS-6 dataset, a nationally representative, cross-sectional survey conducted by the National Cancer Institute, a variety of statistical …


Mechanisms Of Sleep Regulation In Drosophila Melanogaster, Anfal A. Abuhilal Sep 2025

Mechanisms Of Sleep Regulation In Drosophila Melanogaster, Anfal A. Abuhilal

Dissertations, Theses, and Capstone Projects

Sleep is a fundamental biological need, and sufficient sleep is required for physical and mental well-being. Sleep is regulated by two biological mechanisms: sleep-wake homeostasis and circadian rhythm. Circadian rhythms are near 24-h rhythms in behavior and physiology that are generated by endogenous mechanisms. In mammals, the suprachiasmatic nucleus (SCN) is the central circadian pacemaker, which is known to receive a significant amount of serotonergic input that likely modulates sleep rhythms. In addition to circadian modulation, sleep is subject to homeostatic regulation. Several neuromodulators have been proposed as mediators of sleep homeostasis. Serotonin has been implicated in sleep drive and …


Medication Adherence Among Partnered, Sexual Minority Men Living With Hiv: What’S Love, Interdependence And Comorbidities Got To Do With It?, Kendell M. Doyle Sep 2025

Medication Adherence Among Partnered, Sexual Minority Men Living With Hiv: What’S Love, Interdependence And Comorbidities Got To Do With It?, Kendell M. Doyle

Dissertations, Theses, and Capstone Projects

Sexual minority men (SMM) report higher incidence and prevalence rates of HIV infection relative to their heterosexual counterparts. The burden of HIV infection has garnered research attention focused on HIV risk reduction and HIV disease management (such as medication adherence). More recently, attention has been paid to the association of comorbid chronic health conditions and ART adherence among people living with HIV (PLWH) more broadly. Yet, limited attention has been paid to the association of comorbidities among SMM living with HIV specifically, despite the high rates of HIV among this population and various other risk factors that put SMM at …


Institutionalized Bullying In Tertiary Institutions In Nigeria And Perceived Mental Health Impacts: A Phenomenological Qualitative Study, Chika Bosah, Casey Mace Firebaugh, Tara R. Zolnikov Aug 2025

Institutionalized Bullying In Tertiary Institutions In Nigeria And Perceived Mental Health Impacts: A Phenomenological Qualitative Study, Chika Bosah, Casey Mace Firebaugh, Tara R. Zolnikov

The Qualitative Report

Institutionalized bullying is when bullying moves beyond individual instances of bullying and is culturally embedded in an institution, such as a school or workplace. This type of bullying has not been thoroughly examined in tertiary school settings in Nigeria. This phenomenological qualitative study examined the experiences of tertiary students (from four different institutions in Nigeria) and their experiences of institutionalized bullying to determine if and to what extent this practice is occurring. There were (n=48) tertiary students engaged in open-ended, semi-structured interviews in Nigeria in 2022. Interviews were transcribed, coded, and thematically analyzed. Overall, this study found that institutionalized bullying …


Understanding And Predicting Flossing Behavior In A Rural Appalachian Community Using The Multi-Theory Model, Rahib K. Islam, Manoj Sharma, Amanda H. Wilkerson, Bradford Layman, Clyde Dunn, Shamima A. Somi, Ratnesh Sharma, Karen Gruszynski, Syed S. Quadri, Vinayak K. Nahar, Robert E. Davis Aug 2025

Understanding And Predicting Flossing Behavior In A Rural Appalachian Community Using The Multi-Theory Model, Rahib K. Islam, Manoj Sharma, Amanda H. Wilkerson, Bradford Layman, Clyde Dunn, Shamima A. Somi, Ratnesh Sharma, Karen Gruszynski, Syed S. Quadri, Vinayak K. Nahar, Robert E. Davis

School of Medicine Faculty Publications

Effective flossing is essential for preventing periodontal disease. However, in a rural Appalachian community, adherence to flossing routines remains low, contributing to significant oral health disparities. The purpose of this study was to conceptualize intention of initiation and sustenance of flossing behaviors using the multi-theory model (MTM) of health behavior change. A cross-sectional survey was administered to individuals recruited from a shopping mall in rural Appalachia. The MTM constructs were measured and data were analyzed using multiple linear regression models. Of the 228 participants, 55% did not floss daily. Behavioral confidence (β = 0.571, p < 0.001) was a significant predictor for the intention of initiation of flossing among non-daily flossers, while emotional transformation (β = 0.377, p = 0.836) significantly explained sustenance among non-daily flossers. For daily flossers, changes in the physical environment (β = 0.432, p = 0.003) significantly predicted the intention of initiation of flossing, whereas emotional transformation (β = 0.344, p = 0.008) and practice for change (β = 0.594, p < 0.001) significantly predicted sustenance of flossing behavior. The MTM appears to be a robust framework for understanding and predicting flossing behaviors in rural Appalachian populations. Interventions designed to enhance behavioral confidence, physical environment changes, emotional transformation, and practice for change could improve flossing adherence. Further research should explore these constructs to develop targeted public health strategies.


Dissatisfaction And Residual Symptoms In Younger And Older Adult Patients After Total Knee Arthroplasty, Nicholas Pohl, Parker Brush, Adrian Santana, Sebastian Fras, Eleanor Jenkins, Arjun Saxena Aug 2025

Dissatisfaction And Residual Symptoms In Younger And Older Adult Patients After Total Knee Arthroplasty, Nicholas Pohl, Parker Brush, Adrian Santana, Sebastian Fras, Eleanor Jenkins, Arjun Saxena

Department of Orthopaedic Surgery Faculty Papers

INTRODUCTION: Total knee arthroplasty (TKA) is an increasingly used treatment option for younger patients with osteoarthritis. Previous research has found only 66% patients < 60 years who underwent TKA postoperatively reported that their knees felt normal. However, the prior studies did not compare underlying causes for dissatisfaction based on age. This study compared the satisfaction and residual symptom rates between patients ages < 60 and ≥60 years and identified specific reasons for their dissatisfaction between the age groups.

METHODS: Patients who underwent unilateral TKA for osteoarthritis from 2014 to 2016 were electronically sent a 15-question survey pertaining to surgery satisfaction. Following patient identification and survey completion, patient demographics, medical history, surgical time, and length of stay were collected through manual review of medical records. Patients who completed surveys were grouped by age (< 60 years or ≥60 years) for analysis.

RESULTS: In total, 1189 ≥ 60-year-old patients and 388 < 60-year-old patients were included. Most patients in both cohorts reported satisfaction with overall knee function (< 60: 68.6%; ≥60: 71.8%; P = 0.175). Fewer < 60-year patients reported normal knee function (66.5% vs. 75.2%; P < 0.001). The most common residual symptom in both cohorts was continued pain.

CONCLUSION: Patients younger than 60 years reported less satisfaction with performing normal activities …


Prior Adolescent Oxycodone Exposure Enhances Pain Sensitivity Following Chronic Intermittent Ethanol In Adult Female Mice, Lisa L. Wilson, Lucas Albrechet-Souza, Linh Ha, Nicholas W. Gilpin, Tiffany A. Wills Aug 2025

Prior Adolescent Oxycodone Exposure Enhances Pain Sensitivity Following Chronic Intermittent Ethanol In Adult Female Mice, Lisa L. Wilson, Lucas Albrechet-Souza, Linh Ha, Nicholas W. Gilpin, Tiffany A. Wills

School of Graduate Studies Faculty Publications

The opioid crisis remains a critical public health concern, with rising rates of overdose and opioid use disorder. While opioids are effective for managing pain, both chronic use and withdrawal are associated with increased pain sensitivity. Although most prior research has focused on adults, opioid use during adolescence is common and linked to a heightened risk for developing alcohol use disorder and other forms of substance misuse. Like opioids, acute alcohol use can be analgesic, but chronic alcohol exposure and withdrawal lead to increased pain sensitivity. However, the interactive effects of adolescent opioid and adult alcohol exposure on pain remain …