Behavior and Behavior Mechanisms Commons^™

Gender Disparities And Burnout Among Emergency Physicians: A Systematic Review By The World Academic Council Of Emergency Medicine-Female Leadership Academy For Medical Excellence., Suman Thakur, Vivek Chauhan, Sagar Galwankar, Fatimah Lateef, Pia Daniel, Zeynep Cakir, Katia M. Lugo, Samjhana Basnet, Busra Bildik, Siham Azahaf, Sevilay Vural, Busra H. Difyeli, Lisa Moreno-Walton

School of Medicine Faculty Publications

Background: The Female Leadership Academy for Medical Excellence, members of the World Academic Council of Emergency Medicine, conducted this systematic review, which explores gender disparities in burnout among emergency physicians (EP) using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Burnout is a critical issue in healthcare, particularly in emergency medicine where high stress and demanding work environments prevail. Methods: Following PRISMA guidelines, we searched PubMed and Epistemonikos for studies using MBI-HSS to measure burnout in EPs. Inclusion criteria encompassed peer-reviewed, English-language articles reporting burnout by sex. Data extraction focused on proportions of burnout and its subcomponents, mean scores, and odds …

Improved Adherence To Lipid Screening In The Pediatric Cardiology Clinic: A Quality Improvement Project, Rachel Magnan, Thomas Murphy, Lauren Rosenthal, Aparna Prasad, Anjali Chelliah, Stuart Kaufman, Donna Timchak, Lindsey Mcphillips, Saira Siddiqui

Department of Pediatrics Faculty Papers

INTRODUCTION: Lipid screening identifies at-risk patients to facilitate cardiovascular risk reduction. National pediatric guidelines recommend universal lipid screening between 9-11 and 17-21 years of age. We aimed to improve adherence to lipid screening for all age-appropriate outpatient pediatric cardiology visits from a baseline of 35% to 90% between November 2021 and July 2023.

METHODS: All outpatient visits for patients 9-11 and 17-21 years were included. Chart review and an Epic electronic health record report identified patients screened, lipid test results, and need for further testing. A P-chart was generated. After establishing a baseline for 8 weeks, interventions, including an Epic …

Womb, Gravity, And Space: Shifting Towards The Cerebellum-Basal Ganglia Paradigm In Dystonia, Diego Iacono

Department of Neurology Faculty Papers

No abstract provided.

Factors Associated With Cognitive Flexibility In People With Opioid-Use Disorder: A Pilot Study, Paul S. Regier, Thais Costa Macedo De Arruda, Laura Sinko, Anne M. Teitelman, Anna Rose Childress

College of Nursing Faculty Papers & Presentations

The ability to adapt to changing circumstances has strong survival value. Individuals with substance use disorders tend to get "stuck" over-responding to drug-reward signals and pursuing drugs despite negative consequences. A lack of flexibility may be tied to impairments in neurocognition, including learning, memory, and executive function. However, results are often mixed, potentially due to heterogeneity in factors such as mental health, personality traits, or prior adversity. This study aimed to identify which factors influence neurocognitive variations within the opioid use disorder (OUD) population. Based on prior literature, we hypothesized that individuals with OUD would show deficits (vs. controls) in …

Mild Traumatic Brain Injuries In Justice-Involved Individuals And Executive Function Consequences On Transition And Reentry Into The Community ​, Alaina L. Randerson, Michael Sutcliffe, Cassandra Nelson, Ariana Gonzalez

Fall 2024 OTD Capstone Symposium

The United States has the highest documented incarceration rate in the world (Carson, 2022), with an increasing number of justice-involved individuals (JII) potentially affected by mild traumatic brain injury (mTBI). Despite the high prevalence of mTBIs in the general population, limited research exists on the prevalence and impact of mTBIs in JII. Preliminary evidence suggests that the prevalence of mTBIs in incarcerated individuals is 50 times higher than in the general public (Siegler et al., 2017). This study aimed to explore the lived experiences of JII with mTBI, focusing on the origin of mTBIs, executive dysfunction, and the occupational barriers …

The Level Of Anxiety Associated With Coping Mechanisms In First Year Physician Assistant Students, Julianna Paczewski, Heidi Uvodich

Physician Assistant Capstones, 2020-current

No abstract provided.

Factors Associated With Receipt Of Tobacco Treatment Integrated With Nurse Navigation In A Centralized Lung Cancer Screening Program At An Urban Academic Medical Center, Christine S. Shusted, Sarah Mukhtar, James Lee, Brooke Ruane, Emily Muse, Lawrence Emeigh-Mcbride, Eboni Gatson-Anderson, Gregory C. Kane, Kuang-Yi Wen, Hee-Soon Juon, Julie A. Barta

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

PURPOSE: Optimal approaches for tobacco treatment counseling among individuals who currently smoke and are undergoing shared decision-making (SDM) and lung cancer screening (LCS) are unknown. The objective of this cross-sectional study was to determine the rate of reported interest in tobacco treatment counseling and pharmacotherapy among individuals who currently smoke and are receiving integrated nurse navigation for LCS and tobacco treatment in a centralized LCS Program.

METHODS: We identified individuals undergoing SDM through our centralized LCS Program between March 2021 and March 2022. The LCS Program tobacco treatment protocol includes counseling both in-person and via telephone during SDM, LCS results …

A Review Of The Association Between Dietary Intake And Brain Iron Levels In Older Adults: Preliminary Findings And Future Directions., Valentinos Zachariou, Christopher E. Bauer, Colleen A. Pappas, Brian T. Gold

Behavioral Science Faculty Publications

Background/Objectives: Non-heme iron is essential for critical neuronal functions such as ATP generation, synaptogenesis, neurotransmitter synthesis, and myelin formation. However, as non-heme iron accumulates with age, excessive levels can contribute to oxidative stress, potentially disrupting neuronal integrity and contributing to cognitive decline. Despite growing evidence linking high brain iron with poorer cognitive performance, there are currently no proven methods to reduce brain iron accumulation in aging or to protect cognitive function from iron’s negative effects. Recent studies suggest that nutrition may influence brain iron levels, though the evidence remains limited and mixed. Methods: In this review, we explore recent findings, …

The Contributions Of Motor Skill Proficiency To Cognitive And Social Development In Early Childhood, Catherine M. Capio, Norman B. Mendoza, Rachel A. Jones, Rich S.W. Masters, Kerry Lee

Health Sciences Faculty Publications

With limited evidence from intervention studies, causal relationships between motor competence and cognitive and social development have yet to be clearly established. In this research, we investigated whether a targeted training programme to improve fundamental movement skills (i.e., object control, locomotor) in young children would also lead to improvements in the cognitive (i.e., executive function) and social (i.e., socioemotional competence) domains. Using a two-arm group randomised intervention design, 185 children aged 36 to 60 months (mean 47.51, SD 8.11 months) were allocated to a motor skill intervention group or an active control group. The intervention was implemented over one school …

Investigating The Effects Of Workload Management Strategies On Nurse Practitioner Burnout And Job Satisfaction, Erica G. Smith

Doctoral Projects

Burnout is a critical issue among psychiatric mental health nurse practitioners (PMHNPs), worsened by excessive workloads, productivity demands, and the emotional intensity of patient care (Chi et al., 2024). The negative effects of burnout included diminished job satisfaction, reduced quality of care, and increased turnover (Chi et al., 2024). As the demand for Psychiatric Mental Health Nurse Practitioners (PMHNPs) grew, addressing these challenges was essential for maintaining a sustainable workforce and ensuring quality patient care.

This doctoral project aimed to assess the impact of a workload management strategy on reducing burnout and improving job satisfaction among PMHNPs in a hospital …

Parenting With Grace, Eva Nelson Cole

Capstone Projects and Master's Theses

Parents are often caught off guard by the upheaval of adding children to their lives. Feelings of guilt, shame, isolation, and depression can arise when parents are faced with the demands and stressors that come along with having children. Studies have shown that children who have distressed parents endure lasting negative outcomes that can extend into the primary school years (Mihelic et al., 2018). Educating parents and giving them some awareness about what to expect can make a real difference. To have these conversations, I created a two-part parenting workshop for new parents at Parents’ Place in Pacific Grove, CA. …

Effectiveness Of Interventions To Address Nursing Students' Mental Health: An Integrative Review, Aimee Dickson, Shelby Carter

Master's Projects

Background:

The rigors of the nursing school curriculum are associated with higher levels of stress, anxiety, and depression, resulting in unhealthy habits and ineffective coping strategies that lead to initial difficulties in the academic environment and burnout as professional nurses advance into their careers. This phenomenon further burdens the already taxed workforce, leading to ongoing turnover and compromising care. This integrative review aims to look at what coping strategies have proven most successful in fostering nursing students' well-being, leading to lifelong practices that promote strength while addressing the rigors of academia and, later, the workforce.

Methods:

The literature review search …

Exploring Mental Health Providers' Willingness To Integrate Digital Applications For Gen-Z Students, Chanlinee Karawek

Undergraduate Research Symposium Lightning Talks

Mental health services have expanded significantly throughout recent years, alongside the virtualization of said services since the COVID-19 pandemic. As a result, digital mental health applications (DMHAs) are now widely available. Generation-Z college students are a demographic that both grew up with this technology and is associated with a high risk of mental illness development during their time in higher education. Integration of familiar technology and necessary mental health services could potentially help address their unique psychological needs. This study explores mental healthcare providers’ perspectives on incorporating DMHAs into their therapy services to Gen-Z college students. An anonymous survey was …

Improving Healthcare Utilization Models And Uncovering Health Behavior Patterns In Asian Americans Through Data Disaggregation, Luke Cho

Undergraduate Research Symposium Podium Presentations

Although Asian Americans are made up of 20+ distinct ethnicities with unique health outcomes, previous healthcare research has treated them as a monolithic group, covering up many important disparities in health outcomes and healthcare utilization patterns. This study examines how disaggregating Asian American health data by ethnicity improves models analyzing healthcare utilization patterns, focusing on routine physicals, dental checkups, alternative medicine consultations, and preference for ethnic concordance.

Using data from the 2015 Asian American Quality of Life survey (2,609 adults in Austin, Texas), binomial generalized linear models (GLMs) analyzed the impact of income, age, gender, insurance status, and ethnicity on …

The Influence Of Sociodemographic, Tobacco Use, And Mental Health Characteristics On Treatment Adherence Among Adults Enrolled In A Community-Based Tobacco Cessation Program, Motolani E. Ogunsanya, Summer G. Frank-Pearce, Sixia Chen, Munjireen Sifat, Amy M. Cohn, Michael S. Businelle, Darla E. Kendzor

Kimmel Cancer Center Faculty Papers

BACKGROUND: While counseling and pharmacological interventions are known to facilitate smoking cessation, poor adherence can impact their effectiveness. Therefore, this study aimed to identify personal and clinical factors that influenced adherence to smoking cessation treatment among socioeconomically disadvantaged adult Oklahomans enrolled in a publicly available tobacco treatment program and observational research study.

METHODS: Adult participants (N = 442) were enrolled in a community-based tobacco treatment program. Logistic regression models identified sociodemographic, mental health, and substance use characteristics associated with treatment adherence. Adherence was measured by counseling session attendance and weeks of moderate/high medication adherence assessed via the Medication …

Identifying Barriers To Hepatitis B And Delta Screening, Prevention, And Linkage To Care Among People Who Use Drugs In Philadelphia, Pennsylvania, Usa, Beatrice Zovich, Catherine Freeland, Holly Moore, Kara Sapp, Anousha Qureshi, Amy Jessop, Rachel Holbert, Fiona Borondy-Jenkins, Quinn Plunkett, Chari Cohen

Student Papers, Posters & Projects

BACKGROUND: People who use drugs (PWUD) are at increased risk for blood-borne viruses, including hepatitis B (HBV) and delta (HDV). Despite the public health threats both viruses present, awareness remains low among at-risk communities and providers who serve them. This study assessed barriers to HBV and HDV prevention, diagnosis, and linkage to care, evaluated existing levels of knowledge, and identified educational needs and preferences among both PWUD and service providers.

METHODS: For this mixed-methods study, data were collected through an anonymous online provider-focused survey, and interviews with PWUD, non-medical staff, and healthcare providers at a harm reduction organization in Philadelphia, …

Driving Healthy Behaviors Through Social Support: The Role Of Co-Responsibility In Weight Loss And Maintenance, Melanie Knufinke-Meyfroyt, Carlo Lancia, Yentl Lodewijks, Simon Nienhuijs, Eva Deckers

Patient Experience Journal

Objective: The effectiveness of out of hospital lifestyle interventions in healthcare is likely co-dependent on social support from involved one's. We sought to investigate the interrelationships between patient-partner Co-responsibility, Spousal Support, and Self-efficacy and the mechanisms through which they contribute to health behaviors and outcomes relevant to weight loss and maintenance. Methods: Co-responsibility, Spousal Support, self-efficacy, health outcomes and health behaviors like total weight loss, physical activity, OBESI-Q, and health satisfaction were assessed through a questionnaire among 868 individuals attempting to lose weight. Full and semi-partial correlations were used to understand the association between Co-responsibility, Spousal Support, Self-efficacy …

Convergence Of Alcohol Consumption And Dietary Quality In Us Adults Who Currently Drink Alcohol: An Analysis Of Two Core Risk Factors Of Liver Disease, Peng-Sheng Ting, Wei-Ting Lin, Suthat Liangpunsakul, Madeline Novack, Chiung-Kuei Huang, Hui-Yi Lin, Tung-Sung Tseng, Po-Hung Chen

School of Public Health Faculty Publications

BACKGROUND/OBJECTIVES: Alcohol consumption and poor dietary habits are on the rise in the United States, posing significant challenges to public health due to their contribution to chronic diseases such as liver failure. While associations between alcohol consumption patterns and diet quality have been explored, the relationship between specific alcoholic beverage types and diet quality remains underexamined. This study aims to compare diet quality among consumers of different alcoholic beverage types. METHODS: We conducted a cross-sectional analysis of 1917 current alcohol drinkers from the National Health and Nutrition Examination Survey (NHANES) who completed a 24 h dietary recall survey. Diet quality …

‘Foundations Of The Mind, Brain, And Behavioral Relationships’: A Combined Faculty And Student’S Perspective Of A New Textbook On Clinical Neuroscience, Richard J. Addante, Jahdiel Perez Caban, Sarah E. Smith

Psychology Faculty Publications

The textbook, ‘Foundations of the Mind, Brain, and Behavioral Relationships’ (Moini et al., Citation2023), is one of the newest textbooks in neuroscience to arrive. The market for textbooks in the field of neuroscience is competitive among several excellent comparators, but critical market gaps still remain to be filled, notably the area of clinical neuroscience that is both advanced in content but accessible to students. One of the reasons that this gap has existed in the field is precisely because it can be a very difficult a mark to hit: how does one present neurobiological content that is …

Nepali Oral Microbiomes Reflect A Gradient Of Lifestyles From Traditional To Industrialized, Erica Ryu, Yoshina Gautam, Diana Proctor, Dinesh Bhandari, Sarmila Tandukar, Meera Gupta, Guru Prasad Gautam, David Relman, Ahmed Shibl, Jeevan Bahadur Sherchand, Aashish Jha, Emily Davenport

SKMC Student Presentations and Publications

BACKGROUND: Lifestyle plays an important role in shaping the gut microbiome. However, its contributions to the oral microbiome remain less clear, due to the confounding effects of geography and methodology in investigations of populations studied to date. Furthermore, while the oral microbiome seems to differ between foraging and industrialized populations, we lack insight into whether transitions to and away from agrarian lifestyles shape the oral microbiota. Given the growing interest in so-called "vanishing microbiomes" potentially being a risk factor for increased disease prevalence in industrialized populations, it is important that we distinguish lifestyle from geography in the study of microbiomes …

The Association Of Migration-Related Stress With Poor Mental Health Among Recently Resettled Afghan Refugees, Munjireen Sifat, Sarah Kenney, Venera Bekteshi, Shawn Chiang, Motolani Ogunsanya, Laili Boozary, Adam Alexander, Darla Kendzor

Department of Medical Oncology Faculty Papers

BACKGROUND: The resettlement of Afghan refugees in Oklahoma City, OK, provides a critical context for examining the mental health challenges faced by this population due to post-migration stressors.

METHODS: This study utilized online surveys to recently resettled Afghan refugees in Oklahoma City, with support provided by bilingual research assistants to accommodate low literacy rates. Surveys, initially in English, were professionally translated into Dari and Pashto and validated through back-translation.

RESULTS: Participants (N = 348) were majority of Pashtun ethnicity. High rates of mental health issues were evident, with 62.1 % of participants screening positive for depression and 20.1 % …

Borderline Personality Disorder: A Narrative Review On Effective Psychotherapies, Marina Neri, Antonino Reitano, Lavinia Rinnone, Antonio Bruno, Fabrizio Turiaco, Felicia Matilde Ferreri, Carmela Mento, Maria Rosaria Anna Muscatello, Fiammetta Iannuzzo

Journal of Mind and Medical Sciences

Borderline personality disorder (BPD) is a severe mental disorder characterized by pervasive patterns of relational instability, chronic feelings of emptiness, sense of abandonment, self-injurious and anticonservative attempts. Pharmacological treatment has been found useful only for the management of severe symptoms and management of comorbidities, while psychotherapy is the main treatment for BPD. Although the disorder has long been considered resistant to any treatment, in recent years research has not only shown that BPD can be treated but also provided several manualized and empirically validated psychotherapeutic treatments. This paper set out to examine the most effective current psychotherapies for the treatment …

The Recent History And Near Future Of Digital Health In The Field Of Behavioral Medicine: An Update On Progress From 2019 To 2024, Danielle Arigo, Danielle E Jake-Schoffman, Sherry L Pagoto

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The field of behavioral medicine has a long and successful history of leveraging digital health tools to promote health behavior change. Our 2019 summary of the history and future of digital health in behavioral medicine (Arigo in J Behav Med 8: 67-83, 2019) was one of the most highly cited articles in the Journal of Behavioral Medicine from 2010 to 2020; here, we provide an update on the opportunities and challenges we identified in 2019. We address the impact of the COVID-19 pandemic on behavioral medicine research and practice and highlight some of the digital health advances it prompted. We …

Digital, Social Micro-Interventions To Promote Physical Activity Among Midlife Adults With Elevated Cardiovascular Risk: An Ambulatory Feasibility Study With Momentary Randomization., Danielle Arigo, Leah M Schumacher, Kiri Baga, Jacqueline A Mogle

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Although regular physical activity (PA) mitigates the risk for cardiovascular disease (CVD) during midlife, existing PA interventions are minimally effective. Harnessing social influences in daily life shows promise: digital micro-interventions could effectively engage these influences on PA and require testing.

PURPOSE: This feasibility study employed ecological momentary assessment with embedded micro-randomization to activate two types of social influences (i.e., comparison, support; NCT04711512).

METHODS: Midlife adults (N = 30, MAge = 51, MBMI = 31.5 kg/m2, 43% racial/ethnic minority) with ≥1 CVD risk conditions completed four mobile surveys per day for 7 days while wearing PA monitors. After 3 days …

Demographic Characteristics, Perinatal Smoking Patterns, And Risk For Neonatal Health Complications Among Pregnant Smokers In The United States Who Begin Using Electronic Cigarettes During Pregnancy: A Descriptive Study Using Population-Based Surveillance Data., Hui Nian, Rachel Odland, Samantha Mindlin, Lin Ammar, Hilary Tindle, Angela M Miller, Kelli K Ryckman, Ethan Xie, Tina V Hartert, Brittney M Snyder, Steven M Brunwasser, Pingsheng Wu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Health agencies have called for research evaluating e-cigarette (EC) use in supporting prenatal smoking cessation. This study aimed to describe (1) the characteristics of smokers who begin using electronic cigarettes (ECs) during pregnancy, (2) how frequently smokers reduce or eliminate pre- and post-natal combustible cigarette (CC) use, and (3) the risk for neonatal health complications among smokers who initiate ECs during pregnancy.

AIMS AND METHODS: Pregnant women using CCs exclusively during prepregnancy, who participated in a U.S. surveillance study, were classified by their reported late-pregnancy smoking behavior as CC-exclusive users, EC initiators, or quitters. EC initiators were further subclassified …

Why Do Early-Career Adult Reconstruction Surgeons Change Jobs? An American Association Of Hip And Knee Surgeons Young Arthroplasty Group Survey Study, Matan Ozery, Elizabeth G. Lieberman, Jenna A. Bernstein, Jesse I. Wolfstadt, David C. Landy, Claudia Leonardi, Anna Cohen-Rosenblum

School of Medicine Faculty Publications

Background: There are high reported rates of burnout and job turnover among orthopedic surgeons. The purpose of this study was to investigate the prevalence of job change among early-career adult reconstruction surgeons and to examine which demographic or practice factors influenced job change. Methods: An electronic survey was distributed to all practicing surgeon members of the American Association of Hip and Knee Surgeons Young Arthroplasty Group. The survey included questions about practice type, demographics, job change, and a validated burnout questionnaire. Survey responses were collected using a secure database. Statistical analysis was performed to examine relationships between respondent characteristics and …

Diagnostic Overshadowing: A Delayed Diagnosis Of Autism Spectrum Disorder In A Deaf Child, Quynh-Chi Dang, Michael Hoffman, Rachel St. John

Journal of Early Hearing Detection and Intervention

Diagnostic overshadowing occurs when a patient with a pre-existing diagnosis presents with symptoms that are attributed to the diagnosis, but actually reflect a separate issue. This diagnostic overshadowing can lead to delays in diagnosis, as well as disparities in health care and outcomes. The following case will provide an example in which diagnostic overshadowing contributed to the delay of an autism diagnosis in a child who is deaf. With at least 40 to 50% of children who are deaf or hard of hearing having at least one co-existing medical/developmental condition, and the current prevalence of autism at 1 in 36 …

Digital Education On Hospital Nutrition Diets: What Do Patients Want To Know?, Neha Gutta, Som Singh, Dharti Patel, Aleena Jamal, Fawad Qureshi

SKMC Student Presentations and Publications

INTRODUCTION: Therapeutic nutrition plays an imperative role during a patient's hospital course. There is a tremendous body of literature that emphasizes the systematic delivery of information regarding hospital nutrition diets. A major component of delivering healthcare information is the principle of providing quality healthcare information, but this has not yet been investigated on hospital nutrition diets. This study aimed to evaluate the comprehension and readability of patient education materials regarding therapeutic hospital diets.

METHODOLOGY: The methodology employed the use of publicly available questions regarding hospital nutrition diets and categorized them per Rothwell's Classification of Questions. Additionally, the questions were extracted …

Increasing The Frequency Of Behavior Assessment To Reduce Physical Restraint, Breanne N. Ford

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project was to implement a system that routinely assesses for behavior changes in psychiatric patients presenting to the emergency department to improve staff intervention of escalating behaviors and decrease physical restraint use.

Background: The project was implemented in a 45-bed emergency department in a community-based hospital affiliated with a large hospital system in Houston, Texas.

Methodology: The project utilizes the Behavioral Activity Rating Scale (BARS) to assess patients' behaviors at routine intervals throughout shifts and a comfort cart that houses several non-pharmacological intervention items to use to de-escalate adverse behaviors. The staff …

Emotional Display Rules Of Deaf Culture, Nicholas M. Gala, Lawrence Pick

JADARA

Emotional display rules refer to the expression of culturally prescribed and socially acceptable emotions across different people and situations (Wu & Schulz, 2020). The display rules among hearing adults across several cultures are well defined and depend on the type of emotion, the individuals involved in the exchange, and the situation. Regarding Deaf culture in the United States, this minoritized group may follow unique display rules (Hosie et al., 2000), but there has been almost no research conducted with this population and the existing studies have focused on youth. The present study explores perceived emotional expressions among a sample of …