Social and Behavioral Sciences Commons^™

Exposure To Violence And Sleep Inadequacies Among Men And Women Living In A Shelter Setting, Pooja Agrawal, Julie Neisler, Michael S. Businelle Phd, Darla E. Kendzor Phd, Daphne C. Hernandez, Chisom Odoh, Lorraine R. Reitzel

Health Behavior Research

Exposure to violence may explain sleep inadequacies reported by homeless adults, with women being potentially more susceptible to violence and sleep disturbances than men. This study examined the association between violence and sleep inadequacies among homeless adults and explored differences by sex. Adult participants were recruited from a shelter (n = 194; 71.1% men, M_age = 43.8+12.2). Participants self-reported victimization and/or witnessing violence (mugging, fight, and/or sexual assault) at the shelter, sleep duration (over an average 24 hours), insufficient sleep (days without sufficient rest/sleep), and unintentional daytime sleep (days with unintentional sleep) in the past month. Linear regressions …

What Determines Young Adults’ Attitudes, Perceived Norms, And Perceived Behavioral Control Towards Healthy Sleep Behaviors? A Reasoned Action Approach, Paul Branscum, Katie Qualls Fay

Health Behavior Research

A common limitation to the design of public health sleep interventions is the overall lack of using theory. Previous researchers have utilized the theory of planned behavior and the reasoned action approach (RAA) to predict healthy sleep behaviors, however much of this research was done using reflective (or generalized) measures, which alone is likely inadequate to equip health practitioners with tangible information they can use to translate theory into practice. Therefore, the purpose of this study was to use formative (or belief-based) measures of the RAA to evaluate the determinants of attitudes, perceived norms, and perceived behavioral control (PBC) of …

Chronic Pain Acceptance: Optimism Mediates The Relation Between Dispositional Mindfulness And Pain Acceptance, Kelli Miles

Electronic Theses and Dissertations

ABSTRACT

Chronic pain is associated with many indicators of maladjustment. We expected that five individual components of dispositional mindfulness would be positively associated with pain willingness (Hypothesis 1) and activity engagement (Hypothesis 2). A mediational hypothesis was tested, whereby dispositional mindfulness would be positively associated with optimism and optimism would in turn be positively associated with both pain willingness and activity engagement (Hypothesis 3). Both Hypothesis 1 and 2 were partially supported. Acting with awareness and nonjudging were the only mindfulness components that were positively associated with pain willingness. Other components of mindfulness were either negatively associated with pain willingness …

Treading The Waters Of Chronic Illness, Janessa Mcquivey

Family Perspectives

No abstract provided.

Examining The Relationship Of Exercise And Sleep In Students Across Multiple Academic Disciplines, Taylor Zewe

Honors Projects

Students in college learn the importance of balancing their academic studies with their sleep and exercise habits. The amount of sleep and exercise a student recieves has been examined in previous research studies. In these studies it was found that exercise had a postive affect on the amount of sleep received. However, there is little research on the affect academic discipline has on sleep habits and/or exercise habits of students in college. The purpose of this study is to examine the sleep and exercise habits among students in multiple academic majors at Bowling Green State University.

Undergraduates And Stress, Mahra Crone

Honors Projects

America is facing a serious mental health crisis, which may be an effect of increased chronic stress. Students, in particular, are vulnerable to this hazard as most face a moderate to extreme amount of stress. The programs which colleges and universities have put into place are outdated. Ineffective treatment of mental health crises leads to disastrous consequences. The present study analyzed the effects of major and grade level on stress level and sources of stress for undergraduate universities at both a large, public university and a small, private college. The author found that a student’s grade level and choice of …

Pediatric Postoperative Pain Medication: Demographic Predictors And Parent Medication Attitudes, Vivian Luong

Student Scholar Symposium Abstracts and Posters

Over 85% of children experience significant pain after surgery. Despite this presence of pain, research suggests that a quarter of these children receive very little pain medication at home. Such poor pain management in children can have harmful long-term consequences. Previous research indicates that the amount of pain medication administered to children in the home may be significantly impacted by the attitudes parents have regarding analgesics. Given this, the purpose of the present study is to identify how demographic factors such as child sex and ethnicity predict certain parent analgesic attitudes and, in turn, the amount of pain medication their …

Healing Through Creativity And Creation: Drama Therapy As Treatment For Individuals With Eating Disorders, Hayley Werner

Student Scholar Symposium Abstracts and Posters

For those living with eating disorders, intervention and effective treatment can mean the difference between life and death. Conventional treatments, such as Cognitive Behavioral Therapy and Dialectical Behavioral Therapy, forms of talk therapy, and Nutritional Counseling, focus solely on the psychological patterns or nutritional science of eating disorders. Though these treatments are effective for some individuals, there is a gap in treatment options that address both the mind and body as one and appeal to the humanity of patients outside of their disorder(s). Herein lies the power and potential of integrating drama therapy as a widely available treatment. Drama therapy …

Cholesterol Efflux Capacity And Its Association With Metabolic Syndrome In A Multi-Ethnic Population (Dallas Heart Study): A Cross-Sectional Study, Oludamilola Akinmolayemi

Dissertations & Theses (Open Access)

Metabolic syndrome (MetS) is a multi-component risk factor for cardiovascular disease (CVD) and type 2 diabetes. MetS has been found to be associated with increased risk of incident CVD, cardiovascular morbidity and mortality, and prevalence atherosclerosis. Cholesterol efflux capacity (CEC) is a measure of the functional property of high-density lipoprotein cholesterol (HDL-C). In addition, it characterizes the ability of HDL-C to accept cholesterol from extra-hepatic cells in the periphery to the liver and has been shown in clinical studies to be inversely associated with atherosclerosis cardiovascular disease (ASCVD) and incident cardiovascular disease (CVD) . Low HDL-C is one of the …

Factors Affecting Antiretroviral Treatment Entrance, Adherence And Retention Among Hiv Patients In Nigeria And Uganda, Nnenna Ananaba

Dissertations & Theses (Open Access)

Introduction: The maximum benefits of antiretroviral therapy (ART) are achieved when HIV patients follow through the HIV Care Continuum. Understanding the factors that impact the Care Continuum are key in minimizing late ART uptake while increasing treatment retention and adherence in sub-Saharan Africa. Objectives: To explore factors that impact the various phases of the HIV Care Continuum, we review trends in median CD4 cells count and presentation with HIV advanced disease stage between 2013 and 2017. We also examined treatment retention rates and the impact of food security on ART adherence. Methods: Two datasets were reviewed. One dataset consists of …

Association Between Childhood Maltreatment And Type 2 Diabetes Mellitus: A Retrospective Cohort Study In The United States, Diep N. Poulos

Dissertations & Theses (Open Access)

This retrospective cohort study analyzed self-reported and biological data collected from MIDUS in 2004-2006 to understand the association between the types of childhood maltreatment (CM) and Type 2 Diabetes Mellitus (T2DM). The central hypothesis of this study is that childhood maltreatment is positively associated with adult onset diabetes (T2DM). CM has been associated with lifelong morbidity and an increased risk in chronic diseases such as diabetes and heart disease (Bernstein RE, 2013). In this study, CM was defined by the Childhood Trauma Questionnaire (CTQ). The CTQ has three types of abuse: physical, sexual, emotional, and two types of neglect: physical …

Studying The Properties Of Seamless Phase Ii/Phase Iii Clinical Trials Under Covariate Adaptive Randomization, Garrett Miller

Dissertations & Theses (Open Access)

Covariate adaptive randomization is an allocation procedure used in clinical trials that seeks to balance treatment groups. While this method has been shown to reduce bias due to imbalanced treatment groups, the effects of covariate adaptive randomization have not been studied under seamless Phase II/Phase III clinical trials that incorporate short-term endpoint information and treatment selection. Therefore, this analysis sought to determine whether these adaptive randomization methods can be applied to seamless Phase II/Phase III trials while preserving Type I error. In addition, this analysis sought to create R-packages that employ seamless Phase II/Phase III techniques to provide analysis tools …

Quantifying The Financial & Clinical Impact Of Annual Vs. Biennial Mammography Screening, Danmeng Huang

Dissertations & Theses (Open Access)

Current guidelines for screening mammography recommend different start ages and intervals for women with average cancer risk. Longer intervals between mammograms allow more time for a tumor to grow, to become symptomatic and clinically detectable, and more likely to be at advanced stage. Existing literature on the associations between mammography screening frequency and risk of more advanced breast cancer have mixed results. Studies have showed that advanced breast cancer costs more to treat, but real-world cost estimates following different mammography screening frequencies are unavailable. To fill the gaps, this dissertation aimed to quantify the clinical and financial impact following annual …

Physical Activity Among Preschool-Aged Children: Considerations For Waking Activity Patterns And Health, Erin Dooley

Dissertations & Theses (Open Access)

With nearly one-quarter (23%) of U.S. preschool children (ages 3-5 years) having overweight or obesity, supporting healthy growth and development is paramount. Hispanic children have the highest prevalence within this age group (15.6%) and a large projected population growth. Energy expenditure through physical activity is one way to combat excess development of obesity and poor health outcomes. Yet there is limited evidence about the correlates associated with physical activity and health within this population. The three studies of this dissertation examined sociodemographic-, cultural-, and context-related factors related to waking activity patterns and the subsequent impact on health indicators. The overall …

Examining The Relation Between Social Capital And Physical Activity Across Life Stages, Leigh Ann Ganzar

Dissertations & Theses (Open Access)

Physical inactivity in adults increases the risk for adverse health outcomes, including non-communicable diseases and premature death. Children who are not sufficiently physically active face increased risk for non-communicable disease risk factors, mental health issues, and poor academic performance. Despite these risks, the majority of people do not achieve sufficient physical activity levels. Social capital is an aspect of the social environment that can shape physical activity behavior throughout different life stages. The three studies of this dissertation sought to assess the association between social capital, from both the cohesion and network perspectives, and physical activity behavior in different life …

Epidemiological Evaluation Of The National Sickle Cell Screening Program In The Republic Of Uganda, Arielle G. Hernandez

Dissertations & Theses (Open Access)

Sickle cell anemia contributes substantially to childhood morbidity and mortality in sub-Saharan Africa, where there are scarce health resources and inadequate awareness among healthcare providers and the community. Without early diagnosis and initiation of preventive treatments, most infants will die of acute complications before their fifth birthday. Information on the mortality associated with sickle cell anemia is excluded from global statistical summaries due to the lack of accurate data, making sickle cell anemia an invisible killer of children on the African continent. Information from long-term large-scale sickle cell screening efforts is not yet available in Africa; therefore, a mixed-methods study …

The Associations Between Fat And Clinical Outcomes Among Lung Cancer Patients: Dietary Intake And Genetic Determinants, Fang Yu Lin

Dissertations & Theses (Open Access)

Higher dietary fat intake and alterations in fatty acid metabolism may affect cancer development and progression. This dissertation conducted a series of studies examining whether dietary fat intake and genetic variants in fatty acid metabolism genes have an impact on clinical outcomes among non-Hispanic whites newly diagnosed with non-small cell lung cancer (NSCLC). First, a cohort of 2,262 NSCLC patients was prospectively examined for intakes of total, saturated, monounsaturated, and polyunsaturated fat in relation to overall survival and recurrence. Dietary fat intake at diagnosis was assessed with a previously validated food frequency questionnaire and categorized by Dietary Reference Intakes. Multivariable …

External Environmental Dimensions And Financial Performance Of Major Teaching Hospitals In The U.S, Karima Lalani

Dissertations & Theses (Open Access)

Background: Teaching hospitals have a unique mission to not only deliver graduate medical education, but to also provide both inpatient and ambulatory care, and to conduct clinical and medical research; therefore, they are under constant financial pressure, and it is important to find out what types of external environmental components affect their financial performance. No recent studies have been comprehensively conducted for all major teaching hospitals in the U.S. to examine if there is an association between the external environmental dimensions based upon Resource Dependence Theory (Munificence, Uncertainty, Complexity) and the short-term financial performance, measured by days cash on hand …

Examining Differences In Physical Activity By Socio-Demographics, Employment, And Social Support Among U.S. Adolescents, Ashleigh Marie Johnson

Dissertations & Theses (Open Access)

The overall decline in physical activity levels during adolescence supports the examination of intrapersonal-, interpersonal-, and behavior-level factors that may influence physical activity behavior among this population. The three papers within this dissertation aimed to examine associations of socio-demographics and socio-environmental factors with physical activity among U.S. adolescents. Papers 1 and 3 used data from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study. Paper 1 examined differences in adolescent physical activity by gender and race/ethnicity, and examined modification by grade and socioeconomic status (SES). Paper 3 examined the association of parent- and adolescent-reported parental social support with adolescent …

Characterizing Risk & Burden Of Lower Cranial Neuropathy (Lcnp) As Late Effect Among Oropharyngeal Cancer Survivors, Puja Aggarwal

Dissertations & Theses (Open Access)

Background: Lower cranial neuropathy (LCNP) is a rare but potentially disabling late effect of radiotherapy (RT) and other head and neck cancer therapies. Survivors who develop late LCNP may experience profound functional impairment with deficits in swallowing, speech, and voice. The aims of this research were: 1) to quantify the cumulative incidence of late LCNP and identify clinical predictors of late LCNP; 2) to investigate the impact of late LCNP on severity of cancer treatment-related symptoms, general functional impairment (GFI), and single item scores of the most severe symptoms; and 3) to quantify the association of late LCNP with swallowing-related …

Insuring The Integrity Of Global Registries, Aardhra Meenakshi Venkatachalam

Dissertations & Theses (Open Access)

Data quality is a priority in public health because it is used for public health program planning and implementation, research, as well as policy. The information gleaned from the data allows us to assess health status, and improve health needs. This paper evaluated methods for cleaning, managing and addressing missing data in the Lagos State Ambulance Service registry. The techniques included screening, data organization, diagnostic phase, treatment phase and a missing data phase to holistically handle the data. The percentage of systemic errors was reduced through the use of the 5-step method. Missing data was informative for state of origin, …

Hiv-Related Discriminatlon And Cervical Cancer Screening In Zambia, Crystal J. Cazier

Dissertations & Theses (Open Access)

Background: The Republic of Zambia has the third-highest incidence of cervical cancer in the world, where approximately 700,000 women over age 15 are living with HIV. Women living with HIV (WLHIV) are at increased risk for cervical cancer. While literature suggests that discrimination is a barrier to HIV care, no studies have explored if discrimination experienced in HIV clinics is related to cervical cancer screening using nationally representative datasets. Objective: The primary objective of this study was to examine whether perceived discrimination by healthcare workers due to HIV status is related to having been screened for cervical cancer among WLHIV. …

Childhood Abuse, Religiosity, And Opioid Use: Findings From The National Epidemiologic Survey On Alcohol And Related Conditions Data, James E. Lewis

Electronic Theses and Dissertations

Religiosity is adopting a belief system surrounding concepts of purpose, meaning, and value through an institution that has already defined these concepts prior to the individual member attending and that member’s degree of participation. Religiosity does have protective factors against negative health outcomes. This protective influence was evaluated in this study. Data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were examined to learn about the relationship between protective effects of religious participation on substance abuse, and whether this association weakened for individuals who have experienced higher levels of childhood abuse. A binary logistic regression …

Help-Seeking For Cognitive Impairment By The Patient : The Role Of Self-Compassion., Allison J. Midden

Electronic Theses and Dissertations

Older adults represent one of the fastest growing population groups with estimates predicting global growth from 617 million in 2015 to 1.6 billion in 2050. As the aged population increases, incidence of Alzheimer’s disease (AD) and other dementias will also increase. Professionals agree that early intervention is essential for therapeutic and quality of life purposes. However, many older adults wait several months or years to seek medical help after first noticing signs of cognitive impairment. The present study seeks to identify the predictors of help-seeking for cognitive impairment by an individual for him/herself and the role that self-compassion may play …

We All Need Somebody To Lean On: Social Support As A Protective Factor For Individuals With Childhood Adversity, Rachel Clingensmith

Electronic Theses and Dissertations

Extensive research has shown that childhood adversity impacts development across the lifespan and has been linked to numerous negative health outcomes. Depression symptoms are one such outcome that has been associated with ACE exposure. The literature also indicates emotion regulation may be a mediator between ACEs and depression outcomes. The primary aim of this study (N = 766) is to investigate pathways leading from ACEs to depression and potential protective factors. It was hypothesized that difficulties in emotion regulation would mediate the link between ACEs and later depressive symptoms, social support would moderate the pathway between difficulties in emotion regulation …

Characterizing Risk & Burden Of Lower Cranial Neuropathy (Lcnp) As Late Effect Among Oropharyngeal Cancer Survivors, Puja Aggarwal

Dissertations & Theses (Open Access)

Background: Lower cranial neuropathy (LCNP) is a rare but potentially disabling late effect of radiotherapy (RT) and other head and neck cancer therapies. Survivors who develop late LCNP may experience profound functional impairment with deficits in swallowing, speech, and voice. The aims of this research were: 1) to quantify the cumulative incidence of late LCNP and identify clinical predictors of late LCNP; 2) to investigate the impact of late LCNP on severity of cancer treatment-related symptoms, general functional impairment (GFI), and single item scores of the most severe symptoms; and 3) to quantify the association of late LCNP with swallowing-related …

Coy Arjate Adrusted Response Adaptive Randomization Designs With Targeted Learning, Hai Zhu

Dissertations & Theses (Open Access)

Since Food and Drug Administration (FDA) issued the very first draft guidance in 2010, adaptive designs have been considered to be one of the most promising approaches to make drug development more efficient and less costly. Two approaches, covariate-adjusted response-adaptive (CARA) randomization and adaptive seamless phase II/III design (ASD) have garnered growing attention recently. However, most of the CARA designs are based on parametric models and suffered from model misspecification. The research of incorporating CARA into ASD is also limited and whether type I error rate can be controlled has not been answered. In this dissertation, a new family of …

Patient-Perceived Patient-Centered Medical Home Characteristics And Healthcare Utilization, Expenditure And Quality, Alissa Ratanatawan

Dissertations & Theses (Open Access)

The patient-centered medical home (PCMH) model is a care delivery model which patient treatment is coordinated through their primary care physician to ensure they receive the necessary care when and where they need it, in a manner they can understand with the aims to improve healthcare quality while keeping healthcare cost growth under control. The objective of this study was to analyze health service utilization, expenditure and quality of civilian noninstitutionalized US adult population in healthcare facilities that have 3 domains of PCMH features, which are comprehensive care, patient-centered care, and accessible care, using patient’s perspective from the 2016 Medical …

Clinical And Demographic Factors Associated With Peg-Asparaginase-Related Toxicities In Patients With Acute Lymphoblastic Leukemia, Priyadarshani Dharia

Dissertations & Theses (Open Access)

Introduction: Polyethylene glycol (PEG)-asparaginase is one of the first-line drugs in pediatric ALL treatment. Although a complete and prolonged treatment with PEGasparaginase has been instrumental in improving the survival of ALL patients, it is associated with four common toxicities: hypersensitivity, hyperbilirubinemia, pancreatitis, and venous thromboembolism (VTE). PEG-asparaginase-related toxicities may require modifications and delays in treatment, which often leads to poor treatment outcomes. Previous studies of PEG-asparaginase-related toxicities have mainly focused on individual toxicities. Further, these studies were conducted in study populations which were predominantly self-reported non-Hispanic whites. Therefore, there is a gap in the knowledge regarding the cumulative burden of …

Moving Beyond The Single Gene: Integrative Gene Set Analysis For Rna-Seq, Andrew Richard Aschenbrenner

Dissertations & Theses (Open Access)

RNA-seq is the next-generation sequencing technology for gene expression and while many tools have been developed to assess differential expression, most focus on gene-level statistics. Gene-level statistics implicitly ignore any dependence among genes. In order to directly incorporate correlation into testing for differential expression, genes are sorted into networks using Ingenuity Pathway Analysis (IPA) and the gene expression of each network is modeled using Generalized Estimating Equations (GEE). Since the gene network data often exhibits correlation structures containing positive and negative values, a new intermediate correlation structure is developed. This structure provides a compromise between an exchangeable (one parameter for …