Social and Behavioral Sciences Commons^™

Urban-Rural Divide In Inequality’S Impact On Substance Abuse, Jonathan E. Flores

Undergraduate Theses, Capstones, and Recitals

This thesis focuses on investigating the relationship between income inequality, measured through the Gini coefficient, and drug addiction, proxied through substance-related mortality. Specifically, this thesis focuses on how these dynamics vary across rural and urban counties in the United States, using population size as a proxy. County-level data from 2016 to 2020 were collected through both the CDC and the Census Bureau and subsequently analyzed using Stata, with crude death rates from drug and alcohol causes serving as a function of the Gini coefficient, labor force participation, racial composition, and other socioeconomic indicators. Through a quadratic version of the model, …

Intrapersonal And Interpersonal Factors Of Participation In Physical Activity And Resistance Training In Adolescent Girls: A Narrative Review, Ben Banse-Fay

University Honors Theses

Low rates of participation in physical activity and resistance training among adolescent girls are a concern due to increased health and injury risks. Adolescent girls participate in physical activity and resistance training at a lower rate than boys, which may explain higher rates of injury. Research examining physical activity of adolescent girls often utilizes an ecological framework, identifying intrapersonal, interpersonal, and environmental factors. Of these ecological levels, intrapersonal and interpersonal factors are modifiable without large costs.

Therefore, this review aimed to identify and summarize recent research that explores the intrapersonal and interpersonal factors associated with participation in physical activity and …

Analysis Of The Characteristics Of Lower Limb Muscle Synergy Controlistic Patterns During Unilateral Load-Bearing Walking, Jinwei Zhao, Luyao Chen, Fuyong Liu, Piotr Aschenbrenner, Tomasz Grzywacz, Jan Strawiński

Baltic Journal of Health and Physical Activity

Background: This study aims to investigate how unilateral load-bearing conditions influence lower limb muscle synergistic control patterns during walking. Understanding these patterns is crucial for elucidating the biomechanics of gait under loaded conditions. Materials and Methods: Sixteen healthy adults participated in the study. The Qualisys 600 series motion capture system was used to collect kinematic data, and the Delsys 16-channel wireless surface EMG system to record muscle activity. Four unilateral loading conditions (LL10, LR10, LL20, LR20) were tested, with normal walking as the control. Results: Load-bearing conditions significantly altered muscle contributions in different synergistic units. For example, in Synergistic Unit …

The Role Of Adolescent Depression Heterogeneity And Resilience Resources In Adulthood Cardiometabolic Health And Depressive Symptoms, Samantha R. Scott

Electronic Theses and Dissertations

Depression in adolescence is a major public health problem and is a risk factor for early-onset cardiometabolic disease. Although adolescent depression is a risk factor for poor cardiometabolic health, depression is heterogeneous and associations may differ by sex. Additionally, if risk factors such as depression can predict adulthood cardiometabolic health, resilience factors (e.g., social, school, neighborhood) that are protective for depression may also be protective for physical health, but this is an ongoing area of research. The goals of the current dissertation were to gain a better understanding of what depressive symptom presentations in adolescents are most concerning for adulthood …

Survival Guide For Queer Families In Heteronormative Healthcare: Liberatory Consciousness And The Paradox Of Dependent Healthcare, A Critical Policy Discourse Analysis, Dwenna A. Holden

Electronic Theses and Dissertations

In this study I explored and analyzed how the queer experiences of an anonymous higher education institution in the western United States’ self-identified queer faculty and staff intersected with the discursive framing of the college’s dependent healthcare structure and documents. Within a critical paradigm I designed research around a high-density theoretical approach to weaving various branches of queer theory together with critical theory around policy and law in relation to queer bodies and hostile heteronormative policy environments. I arrived at solutions based in complaint, survival, and transformation. I used critical policy discourse analyses to interrogate the college’s dependent healthcare documents …

Building Media Literacy In Adolescence: A Cognitive Behavioral Clinician's Manual To Combat Misinformation And Misdiagnosis During Sessions, Patricia Sacchetti

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper examines the role of Cognitive Behavioral Therapy (CBT) in countering misinformation that youth encounter on social media and other informal sources, with the goal of creating a manual for mental health clinicians. The use of CBT by clinicians working with adolescents to combat the issue of misinformation and misdiagnosis has received little attention in the literature. Mental health clinicians’ knowledge of media literacy as a psychological construct can foster an effective treatment style by building upon the foundation of well-established theory and practice, such as CBT. CBT is a multifaceted treatment that can help guide mental health clinicians …

Overcoming Barriers To Connection Between People With Schizophrenia And Their Caregivers, Sarah G. Fernandez

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The purpose of this doctoral project is to bring together existing literature on relational barriers between patients and caregivers, and strategies for overcoming them, for one reason: to help clinicians facilitate connection within families and households where one person has schizophrenia. It is therefore comprised of two parts: this paper containing a three-part literature review on barriers to connection including social skill deficits characteristic of the disease of schizophrenia, environmental factors, and caregiver burden and expressed emotion within families, as well as protective factors and strategies for overcoming them. The second component of this project is a psychoeducational module geared …

Comparative Effects Of Combustible Cigarette Versus Electronic Cigarette Exposures On Kras Mutant Lung Cancer Promotion, Walter V Velasco, Maria T Grimaldo, Nastaran Karimi, Michael J Clowers, Avantika Krishna, Ranran Wu, Rahmah Ejaz, Bo Yuan, Segundo Del Aguila, Iman Bouchelkia, Javier Eduardo Moreno Barragan, Katherine E Larsen, Yasmina Rezai, Farbod Khalaj, Kyler Mitra, Carlos Reyna Rodriguez, Ricardo Millares, Angelica Baca De Anda, Susana Castro-Pando, Umesh C Karandikar, Joseph F Petrosino, Florencia Mcallister, Humam Kadara, Edwin J Ostrin, Johannes F Fahrmann, Kristi Louise Hoffman, Seyed Javad Moghaddam

Center for Medical Ethics and Health Policy Staff Publications

Despite the emerging public health concern related to the use of electronic cigarette vapors (ECV), its impact on lung cancer is poorly understood. We assessed the effect of ECV on lung tumorigenesis in a mouse model of lung adenocarcinoma. Mice were exposed to either room air, combustible cigarette smoke (CCS), or ECV 2 hours daily for 8 weeks at which lung samples were harvested and studied for different outcomes. We found that CCS, but not ECV, led to a significant increase in tumor burden. Immunophenotyping of both CCS- and ECV-exposed lungs displayed pronounced pro-tumor immunosuppressive phenotypes, characterized by significantly decreased …

Attitudes Toward Pig Islet Xenotransplantation For Type 1 Diabetes: A Scoping Review, Daniel J Hurst, Daniel Rodger, Luz A Padilla, Fernando Ovalle

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Over 8 million people globally have type 1 diabetes. Islet allotransplantation offers an alternative to insulin therapy but is constrained by donor availability. Genetically modified pig islet transplantation presents a potential solution, yet understanding stakeholder attitudes is crucial before clinical adoption.

METHODS: This scoping review followed Joanna Briggs Institute methodology and PRISMA guidelines. CINAHL, EMBASE, PubMed, PsychINFO, and SCOPUS were searched for studies examining attitudes toward pig islet xenotransplantation among patients, healthcare workers, and other stakeholders.

RESULTS: From 199 sources, 16 met eligibility criteria, spanning ten countries from 2003 to 2023. The 23,780 participants included 1,535 (6.5%) patients/family members, …

Revising And Consolidating The Dsm-5 And Icd-11 Post-Traumatic Stress Disorders Into A Dimensional Spectrum-Based Disorder: A Literature Review, Samuel Milton Shatsky

University Honors Theses

This thesis investigates the clinical, cultural, and theoretical implications of replacing the current DSM-5 and ICD-11 categorical diagnoses of posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD) with a unified dimensional framework: trauma spectrum disorder (TSD). The proposed TSD model addresses ongoing concerns around diagnostic inflation, treatment misalignment, and clinical confusion stemming from binary trauma categorizations. This thesis explores whether adopting a dimensional diagnostic model to replace DSM-5 and ICD-11's current PTSD and CPTSD designations could lead to improved treatment outcomes and diagnostic clarity.

Methodology consisted of an extensive literature review of the field's current research. Using the …

No Evidence For Pape-Induced Jumping Performance Enhancement Following Isometric And Treadmill Warm-Ups In Team Sport Athletes, Artur Terbalyan, Adam Maszczyk, Robert Krzysztof Roczniok

Baltic Journal of Health and Physical Activity

Background: This study aimed to determine whether an isometric PAPE‐based warm-up could enhance jumping performance compared to a traditional treadmill jogging warm-up in team sport athletes. The primary focus was on assessing neuromuscular activation and performance indicators such as jump height and force asymmetry. Materials and Methods: Fifty-three athletes from basketball, volleyball, handball, and soccer participated in a controlled, parallel-group experiment. Participants performed either a unilateral isometric warm-up protocol – comprising two sets of four exercises per leg– or a 5‐minute treadmill jogging session, with jump performance assessed via countermovement jump tests on dual force plates. A split-plot ANOVA was …

Teaching Students To Provide Effective Feedback With The Situation-Behavior-Impact (Sbi) Framework, Steve Garwood

Rowan-Virtua SOM Faculty Teaching & Learning Seminar

We often ask medical students to provide feedback to each other and the faculty. However, we do not necessarily teach them to provide effective, actionable feedback. This research focused on the impact of providing students with a 1-hour session training them to utilize the Situation-Behavior-Impact (SBI) feedback model.

Enhancing Mental Health Through Mind-Body Exercises In Sedentary Students: A Systematic Review With An Indonesian Perspective, Izmi Alya Khairunnisa, Aditya Denny Pratama

Jurnal Sosial Humaniora Terapan

Sedentary Behavior (SB) among students is associated with increased risks of depression, anxiety, stress, and weakened immune function. According to the WHO, SB contributes to approximately two million deaths each year. This systematic literature review aims to evaluate the effectiveness of mind-body exercises in improving mental health outcomes—specifically stress reduction, anxiety management, and emotional regulation—among students with sedentary lifestyles. Using the PRISMA framework, 2,201 articles were identified from databases including Scopus, PubMed, and ProQuest, with six studies meeting the inclusion criteria. The review found that mind-body exercises such as yoga, tai chi, and pilates significantly reduce stress and anxiety, enhance …

Exploring The Connection Between Mental Health Stigma, Social-Emotional Risk, And Help-Seeking Behaviors Among High School Students, Dorie Ross

USF Tampa Graduate Theses and Dissertations

Throughout the United States, the rate of adolescents experiencing mental health-related challenges continues to rise, impacting their social-emotional well-being. Despite increasing concerns, the majority of adolescents do not seek treatment for mental health problems. One barrier contributing to a lack of help-seeking behaviors is mental health stigma. Furthermore, for students who have sought help for such concerns, there is a lack of consensus on whom high school students turn to for support when seeking help. The current study utilized quantitative methodology in the form of Structural Equation Modeling to examine the complex relationship between social-emotional risk, perceptions of mental health …

Evaluating The Use Of Repetitive Transcranial Magnetic Stimulation In A Patient With Treatment Resistant Depression, Autism Spectrum Disorder, And Post-Traumatic Stress Disorder: A Case Report, Luke Fritsch Ba, Mba, Msiv, Oluwafunke O. Ogunremi Bs, Msiv, Alexandra R. Job Bs, Msiv, James Hellekson Md

Aesculapius Journal (Health Sciences & Medicine)

Despite a wide array of therapeutic modalities, many patients with Major Depressive Disorder (MDD) experience no significant improvement in symptoms with traditional treatment. Given the prevalence of Treatment Resistant Depression (TRD), other alternative therapeutic modalities for MDD are being researched. Repetitive Transcranial Magnetic Stimulation (rTMS) is one modality that continues to show successful therapeutic outcomes for those with TRD. The aim of this study is to highlight a case of rTMS being used on a patient with TRD, autism spectrum disorder (ASD), post-traumatic stress disorder (PTSD), and substance use.

Methods:

Our patient is a 53-year-old female who first presented to …

One Health Integration To Control And Prevent Zoonoses: Application Of Organizational Theory Literature, Lisset M. Dumet Poma, Sherril Gelmon, Julia M. Goodman, Seth E. O’Neal

Hatfield Graduate Journal of Public Affairs

Zoonoses are infectious diseases transmitted between animals and people that disproportionately affect low- and middle-income countries (LMICs). The One Health (OH) approach aims to integrate systems, incentivizing collaboration among animal, human, and environmental systems to address zoonoses and improve health. Innovative solutions for effectively and sustainably achieving systems integration are needed. Organizational theories can facilitate the study of the context of OH implementation, applying comprehensive approaches that recognize the interconnections among organisms, the environment, and social systems, including the diverse entities needing integration (e.g., policy, community, public organizations). This narrative review examines organization and systems literature to provide recommendations for …

Adolescent Preventive Care Outcomes Before And After Covid-19 Onset: What Is The Role Of Telehealth?, Sarah Hayden Knipper

Dissertations and Theses

Adolescents are a developmentally distinctive population with unique primary health care needs; they comprise about 10% of Oregon's population and more than half are covered by the Oregon Health Plan (OHP). This dissertation investigated significant declines in preventive care utilization (well visits and HPV immunizations) among adolescents enrolled in OHP during the COVID-19 pandemic and the relationship between the decline in utilization and the rise in telehealth availability. The study focused specifically on the role of race/ethnicity, geography, and access to health systems in mitigating or exacerbating decreases in preventive care. A mixed methods approach was employed to understand not …

Support Beyond Services: Examining The Role Of Neighbor Relationships, Housing Staff, And Place In Mental Health Recovery, Kenna Estell Dickard

Dissertations and Theses

This dissertation explores the role of non-clinical support for individuals with serious mental illness (SMI). Through three interconnected manuscripts, this dissertation highlights the importance of housing staff support, places in the community, and neighbor relationships in fostering recovery for individuals with SMI. The first manuscript analyzes how housing staff support influences residents' well-being through an ecological lens. This study found that staff support is associated with reduced loneliness, higher residential satisfaction, and increased sense of community. This study also considers the role of self-determination as a moderator, demonstrating the importance of resident agency in maximizing well-being outcomes. The second manuscript …

Etchings Of The Exiled, Jan A. Wozniak

Ought: The Journal of Autistic Culture

No abstract provided.

Self-Collection For Cervical Cancer Screening In A Safety-Net Setting: The Prestis Randomized Clinical Trial, Jane R Montealegre, Susan G Hilsenbeck, Shaun Bulsara, Susan L Parker, Trisha L Amboree, Matthew L Anderson, Maria Daheri, Maria L Jibaja-Weiss, Kathleen M Schmeler, Ashish A Deshmukh, Elizabeth Y Chiao, Michael E Scheurer

Center for Medical Ethics and Health Policy Staff Publications

Importance: There are limited data on the effectiveness of mailed self-collection to increase cervical cancer screening (CCS) participation in underresourced health care settings.

Objective: To compare the effectiveness of mailed self-collection kits, with and without patient navigation, to telephone reminders to increase CCS in a safety-net health system.

Design, setting, and participants: This pragmatic, parallel, single-blinded, randomized clinical trial within a publicly funded safety-net health system in Houston, Texas, compared (1) telephone reminder (TR) for clinic-based screening, (2) TR with mailed self-collection (SC), and (3) TR with mailed SC and patient navigation among a random sample of CCS-eligible patients not …

The Effect Of Birthweight And Gestational Age On Cognitive Function In Midlife: The Bogalusa Heart Study, Eunsun Gill, David J Libon, Soo Jung Kang, Ileana De Anda-Duran, Lydia A Bazzano, Wei Chen, Camilo Fernandez-Alonso, Emily W Harville

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Although the relationships between birthweight, gestational age (GA), and cognitive function (CF) before midlife have been demonstrated, the relationships after midlife and potential racial disparities remain inconclusive. This study examined the association between birthweight, GA, and midlife CF stratified by race.

METHOD: 1,032 subjects from the Bogalusa Heart Study (67% Whites, 33% Blacks, mean age 48.1 ± 5.3 years) were studied. Cognition was assessed with tests measuring verbal episodic memory, working memory, attention, graphomotor information processing speed, and global CF. Each test was standardized by sex and age, then averaged. The global CF was computed by averaging all cognitive …

Changes In Insulin, Leptin, Resistin And Irisin Levels And Their Associations With Blood Pressure After An 8-Week Supervised, Online “Hiit Mama” Program Vs. Self-Performed Moderate-To-Vigorous Physical Activity During Pregnancy - A Randomized Controlled Trial, Anna Szumilewicz, Junjiang Sun, Rita Santos-Rocha, Jan Mieszkowski, Andrzej Kochanowicz

Baltic Journal of Health and Physical Activity

We aimed to determine changes in insulin, leptin, resistin, and irisin levels and their associations with blood pressure (BP) during pregnancy, following an 8-week high-intensity interval training (HIIT) or a self-performed moderate-to-vigorous physical activity (MVPA). The study involved 54 Caucasian women in uncomplicated, singleton pregnancy (age 32 ± 4 years, week of gestation 24 ± 4, mean ± SD). They were randomly allocated to the 8-week supervised, online “HIIT Mama” program (HIIT group, n = 34) or educational intervention and self-performed MVPA (EDU group, n = 20). All participants maintained normotension throughout the study. The HIIT program in-duced a statistically …

Current Practice In The Provision Of Psychological Assessment, Catherine R. Hanigan, Linda J. Baum, Anderson B. Rowan

Archives of Assessment Psychology

Understanding the assessment practices of psychologists has been a focus of research since the mid-twentieth century. Previous studies focused on the types of tests utilized as well as the amount of time spent on assessment. This updated research examined professional psychologists’ current practice and use of assessment, such as specific test usage, time spent on assessment, and feedback practices. A survey instrument was created, piloted, and administered to a sample of 293 currently practicing licensed psychologists. Results indicated that current assessment practices are largely consistent with previous surveys of psychologists. The tests identified as most frequently used were the Wechsler …

Reading Patients' Personalities The Sentence Completion Way, Stephen P. Joy, Lawrence Mccloskey, Wilson Mcdermut

Archives of Assessment Psychology

Previous research has shown that reliable, valid measures of major personality traits can be derived from a sentence completion test, the Rotter Incomplete Sentences Blank (RISB). However, all previous samples consisted of undergraduates. Here, we report findings for two clinical samples (N = 120) to whom a variety of self-report inventories and structured clinical interviews were also administered. RISB-based ratings of Extraversion and Neuroticism were consistently correlated with relevant variables in both samples and displayed convergent and discriminant validity vis a vis self-reported traits. RISB-based ratings of Psychoticism were clearly associated with relevant variables in one sample with mixed but …

Prediction Of Methotrexate Neurotoxicity Using Clinical, Sociodemographic, And Area-Based Information In Children With Acute Lymphoblastic Leukemia, Rachel D Harris, Olga A Taylor, Maria Monica Gramatges, Amy E Hughes, Mark Zobeck, Sandi Pruitt, M Brooke Bernhardt, Ashley Chavana, Van Huynh, Kathleen Ludwig, Laura Klesse, Kenneth Heym, Timothy Griffin, Rodrigo Erana, Juan Carlos Bernini, Ashley Choi, Yuu Ohno, Melissa A Richard, Alanna C Morrison, Han Chen, Bing Yu, Philip J Lupo, Karen R Rabin, Michael E Scheurer, Austin L Brown

Center for Medical Ethics and Health Policy Staff Publications

Background: Methotrexate is a critical component of pediatric acute lymphoblastic leukemia (ALL) therapy that can result in neurotoxicity which has been associated with an increased risk of relapse. We leveraged machine learning to develop a neurotoxicity risk prediction model in a diverse cohort of children with ALL.

Methods: We included children (age 2-20 years) diagnosed with ALL (2005-2019) and treated in Texas without pre-existing neurologic disease. Clinical information was obtained by medical record review. Neurotoxicity occurring post-induction and prior to maintenance therapy was defined as neurologic episodes occurring within 21 days of methotrexate. Suspected cases were independently confirmed by 2 …

The Effect Of Ex-Ante Government Responsibility For Health On Public Health Financing In Post Pandemic Budgets, Denis Granados, Rylee Roman, Hallie Sidman

Working Papers Series

This paper investigates how pre-pandemic levels of government responsibility for public health financing influenced post-pandemic health spending across selected OECD countries. Using a combination of descriptive analysis and regression modeling, the study examines changes in public health expenditure per capita between 2019 and 2022, focusing on key variables such as the government’s share of health financing, the Total Pandemic Policy Intensity (PPI) index, and GDP per capita. Findings suggest that while all countries increased health spending post-COVID-19, the scale of change varied significantly based on economic capacity, institutional readiness, and political will. Notably, countries with higher pre-pandemic public health investment …

Co-Designing A Digital Nutrition Intervention For Individuals With Severe Mental Illness Using The Behaviour Change Wheel, Ciara O'Sullivan, Tara Coppinger, Indika Dhanapala, Alison Merrotsy

Publications

Title: Co-Designing a Digital Nutrition Intervention for Individuals with Severe Mental Illness Using the Behaviour Change Wheel

Purpose: This study aims to develop a digital nutrition intervention for individuals with severe mental illness (SMI) residing in high-support mental health hostels, using a theoretically informed co-design approach.

Design/methodology/approach: This study will employ a participatory, mixed-methods approach, incorporating Public and Patient Involvement (PPI) to ensure user-centred intervention design. The Behaviour Change Wheel (BCW) guides the selection of intervention functions, Behaviour Change Techniques (BCTs) and delivery methods. The study will consist of three phases: (1) Preparation, (2) Co-Design, and (3) Finalisation.

Findings: Data …

Functional Resilience Of Healthcare In The Critical Juncture Of The Covid-19 Pandemic, Avner Kronisch, Christian Bongiorno, Kerane Smith, John Baker

Working Papers Series

This paper offers a comparative analysis of eight national healthcare systems—spanning democracies, autocracies, and various institutional models—to evaluate resilience during the COVID-19 pandemic. Drawing on Shvetsova et al.’s framework of informational and authority redundancies, and Parker & Klein’s “choke point” theory of healthcare rationing, we examine how institutional structure shaped pandemic response, system adaptability, and continuity of non-COVID services. Using indicators like life expectancy, under-five mortality, hospital capacity, cancer survival, and excess mortality, we explore how systems absorbed shock and maintained essential care. We find that decentralized and polycentric governance structures, when paired with coordination and resource adequacy, enhanced resilience—exemplified …

Covid-19 & Healthcare (Re)Privatization? A Comparative Analysis Of High And Medium Per Capita Gdp Countries, Kristina Donders, Kaitlyn Matthews, Brittany Reyes, Frank. H. Rizzo

Working Papers Series

This paper examines whether the COVID-19 pandemic accelerated healthcare privatization in high- and medium-GDP countries. Drawing on political economy theories of path dependence and privatization, we analyze changes in public and private healthcare expenditures in eight countries: Canada, Chile, Denmark, Georgia, Luxembourg, Norway, the Philippines, and South Korea—comparing data from 2019 and 2022. Using World Bank indicators on healthcare financing, GDP, aging populations, and food insecurity, we find that although healthcare expenditures generally increased during the pandemic, this increase was primarily in public, not private, spending. Case studies of Georgia and South Korea reveal that local economic and demographic pressures, …

Institutional Change In Healthcare As Brought About By The Critical Juncture Of The Covid-19 Pandemic, Olga Shvetsova

Working Papers Series

This introduction to the 2025 capstone symposium lays the conceptual groundwork for a new approach to analyzing institutional change in healthcare systems triggered by the COVID-19 pandemic. Departing from conventional legal-institutional perspectives, it extends the decision space framework developed by Bossert (1998) to capture both formal authority and the de-facto responsibilities exercised by public and non-public actors. By disaggregating health responsibilities across levels of government and sectors—public, private, and hybrid—and operationalizing these as quantifiable indicators over time, the framework allows for real-time and comparative assessment of institutional transformation. The pandemic is treated as a critical juncture that exposed and reconfigured …