Browsing by Subject "Psychiatric and Mental Health"
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Item Autism: Association Between Autism and Parenting Stress(2009-12-01) Banini, Simon D.; Bae, SejongAutism is a developmental disorder, whose etiology is still an active research. Objectives of this study are to identify: risk factors of parenting stress; statistical tools for analysis and interpretations of data to ascertain and reinforce risk factors; and recommendations to mitigate parenting stress of autistic children. Data: National Survey of Children with Special Care Needs (NS-CSHCN), 2005-06. Analysis was performed on NS-CSHCN (n=40,723). Among parents with autistic children (n=2,123), the highest adjusted odds of stress were reported associated with primary language (OR= 9.44), insurance (OR=0.34), and Respite care (OR=3.71). Parents with non-autistic children (n=38,133) was the reference population with 467 missing values. Recommendations: Re-evaluation to improve provider language services especially for CSHCN; Family centered public health delivery rather than patient-provider interactive approach.Item Behavioral Disturbances, Chronic Pain, and Cognitive Impairment in Long-Term Care Centers(2004-07-01) Ambavaram, Sukanya; Cipher, Daisha J.; Bayona, Manuel; Coggin, ClaudiaAmbavaram, Sukanya. Behavioral Disturbances, Chronic Pain, and Cognitive Impairment in Long-Term Care. Master of Public Health, July 2004, 45 pp., 8 tables, references. Background- There is increasing interest in finding the relationship between pain, depression, behavioral disturbances and cognitive impairment in patients living in long-term care centers and predicting behavioral disturbances using chronic pain, depression and cognitive impairment as predictors. To date this is the first study identifying the relationship between pain and behavioral problems. Methods- The study population consisted of 412 residents living in 16 long-term care centers in Dallas, TX. Pearson product-moment Correlation was done to find the association between behavioral disturbances and pain, depression and cognitive factors. Multiple regression analysis was performed to obtain best predictors of behavioral disturbances and forward selection procedure to find out best fit model. Conclusion- Statistically significant correlation was achieved between behavioral excess and overall pain. The correlation was statistically significant between behavioral deficit and overall pain, activity interference and depression. Overall pain, activity interference and depression are significantly inter-correlated with each other. Over all pain and activity interference were found to be statistically significant predictors of behavioral excess. Overall pain was found to be statistically significant predictor of behavioral deficit.Item Body Image, Depressed Mood, Weight Concerns, and Risky Sexual Behaviors Among Female Adolescents(2006-05-01) Marshall, Khiya J.Marshall, Khiya J., Body Image, Depressed Mood, Weight Concerns, and Risky Sexual Behaviors among Female Adolescents. Doctor of Public Health (Social and Behavioral Sciences), May 2006, 75 pp., 17 tables, bibliography, 90 titles. Adolescence is a time of self-discovery and growth, both emotionally and physically, particularly for adolescent females. The literature lacks specific research pertaining to female adolescent females. The literature lacks specific research pertaining to female adolescent’s body image and other concerns and their association with risky sexual behaviors. Using secondary data from the 2003 Dallas Youth Risk Behavior Survey (YRBS; 9th-12th grade), this study explored the relationship between body image, having a depressed mood, and weight control behaviors and how these may translate into risky sexual behaviors among Dallas Independent School District (DISD) adolescent females. Most respondents were African American and Hispanic. The main hypotheses were: a) African American and Hispanic adolescent females will be more likely to have a depressed mood, an unrealistic body image, or weight control behaviors compared to Caucasian adolescent females; and b) Adolescents with unrealistic body image, depressed mood, and weight control behaviors will be more likely to engage in risky sexual behaviors, regardless of race or ethnicity. As hypothesized, more African American and Hispanic adolescents had a depressed mood, and more Hispanics had an unrealistic body image compared to Caucasians. The hypothesis that depressed mood and unrealistic body image would be significant predictors of engaging in risky sexual behaviors was corroborated only for depressed mood. Engaging in weight control, although hypothesized as not a significant predictor, was a significant predictor for using alcohol/drugs before his last sexual intercourse. School-based sexual education programs that target adolescent females in DISD should focus on abstinence or consistent condom use if sexually active, weight control behaviors, and depressed mood and its implications.Item Differences in Risk of Injury Between Stimulant-Treated and Untreated ADHD Patients(2006-08-01) Segars, Larry W.; Raghbir Sandhu; Krisine LykensSegars, Larry W., Differences in Risk of Injury between Stimulant-Treated and Untreated ADHD Patients. Doctor of Public Health (Epidemiology), August 2006, 63 pp, 7 tables, 0 illustrations, references, 78 titles. ADHD is a common psychiatric disorder of childhood and adolescence that also occurs in adults and spans the life of the patient. ADHD is characterized by lack of focus, distractibility, and poor concentration. Limited data have been generated focusing on ADHD patients and the association with an increased risk of injury. Unfortunately, no study has been published evaluating the effect of stimulant treatment for ADHD on the risk of injury requiring ambulatory medical care. This research utilized four concatenated years, specifically 1998-2001, of the National Ambulatory Medical Care Survey (NAMCS). This dissertation is comprised of five chapters beginning with a description of ADHD, its characteristics, diagnosis, and treatment. This overview chapter is followed by a complete review of the literature describing the publication’s which assessed the association between ADHD and the risk of injury. The next chapter is a thorough review of the NAMCS and its methodology. The concatenated dataset captured 889 office visits associated with a diagnosis of ADHD, 666 of which were also related to the prescription of a stimulant for the management of ADHD. Using NAMCS’s weight variable these values produced a national estimate of 21,223,391 office visits associated with the ADHD diagnosis and 15,604,329 office visits associated with the prescription of a stimulant for ADHD. This research determined that there was a borderline statistically significant increased association with the prescription of a stimulant for the treatment of ADHD and the risk of injury requiring treatment in an ambulatory medical care setting. Interestingly, compared to patient’s who recorded their race as Caucasian, patients who recorded their race as “Other”; representing the races of Asian, Native Hawaiian/Other Pacific Islander, or American Indian/Alaska Native, and individuals indicating more than one race, had a statistically significant increased risk of injury necessitating treatment in an ambulatory medical care setting. Potential theories for this unique finding, along with the limitations of this research, are provided in the final discussion chapter.Item Evaluation of Mental Health Association of Tarrant County's School Based Mental Health Curriculum: Focus Group and Results(2005-04-01) Nanji-Bhai, Anila K.; Sue Lurie; Claudia S. Coggin; Kristine LykensNanji-Bhai, Anila K., Evaluation of Mental Health Association of Tarrant County’s School Based Mental Health Curriculum: Focus Group and Results. Master of Public Health (Community Health), April 2005, 31 pp., references. There are presently numerous research findings that indicate the need for mental health education among the adolescent population within the United States. In the last decade, tragedies such as the Columbine school shooting, and most recently the Red Lake school shootings in Minnesota point to the fact that adolescents are facing mental pressures and need assistance. In this study, a mental health curriculum, developed by the Mental Health Association of Tarrant County, was examined through the use of focus groups. The group was asked to analyze and comment on the curriculum, as to the age-appropriateness, the “appeal,” and to suggest improvements or revisions. The qualitative data that was gathered was analyzed using NVivo. Results showed a strong opposition to this type of program being brought into the school setting. As the focus group sessions continued however, the curriculum was adapted based on the participants’ comments and suggestions. In the end, the curriculum was accepted by the participants as a program that would be welcomed in schools. Conclusions were that when the proposed curriculum was modified according to the focus group participants’ comments and suggestions; particularly concerning TEKS objectives, the curriculum became more acceptable and a viable opportunity for the school districts.Item Maternal Depression as Predictor of Repeat Child Unintentional Injury(2004-12-01) Webster Krause, Lisa Ruth; Lurie, Sue; Gonzalez, AdelaWebster Krause, Lisa Ruth, Maternal Depression as Predictor of Repeat Child Unintentional Injury. Master of Public Health (Community Health), December 2004, 39 pp., 4 tables, references 28 titles. Current literature supports maternal depression as a predictor of child unintentional injury. There have been conflicting results concerning mediating and other risk factors. This study aims to reexamine the link between maternal depression and the occurrence of repeat child unintentional injury in the home. Using the NHIS 2002 data maternal depression was found to predict child repeat unintentional injury in this national sample. It was found that the most predictive model of repeat unintentional injury in this national sample. It was found that the most predictive model of repeat child unintentional injury consisted of maternal depression and low-income. Since maternal depression and low-income have been identified as underlying determinants of child unintentional injury, they should be a priority in prevention efforts so as to more effectively reduce the occurrence of repeat unintentional injury among children in the home.Item Nutrition, Dementia and Depression in an Ambulatory Geriatric Care Center(2005-05-01) Birmingham, John F.; Daisha Cipher; Douglas A. Mains; Thomas J. FairchildBirmingham, John F., Nutritional Risk, Dementia Factors and Depression in an Ambulatory Geriatric Care Center. Master’s of Public Health (Clinical Research), May 2005, 60pp., 7 tables, 2 figures, reference list, 56 titles. Dementia is a major public health problem in the aging population. Depression, nutritional risk and declining self-efficacy are broadly listed risk factors for dementia. Cross-sectional patient data was obtained by chart review of ambulatory community-dwelling elderly patients screened for depression, dementia factors, levels of independence in activities associated with daily living and nutritional risk. The statistical coefficients of the correlational relationships between nutritional risks, dementia factors, depression levels and levels of functional capacity were examined using path analysis. Two models depicted the composite of instrumental activities of daily living items (IADLs), as they related to the dependent variables models, nutritional risk, dementia factors, and depression levels. The model which regressed the IADLs composite variable against depression and dementia factors indicated a good fit (X2=0.00, p=0.01). Attempts to match screening data with diagnostic follow-up data were unsuccessful. Only 12 matches occurred between the GAP and CARE databases (N=256, N=1470).Item Psychiatric Emergency Services Utilization in Tarrant County, Texas, 2000-2007(2009-08-01) Brown, Sarah; Karan SinghOBJECTIVE: This study explores the utilization of psychiatric emergency services in Tarrant County Texas, which has a dedicated Psychiatric Emergency Center (PEC). There were three specific research questions: 1) Who uses the PEC and how do they use it? 2) How are clinical and socio-demographic characteristics related to single and repeat visits? 3) Is admission status useful in defining distinct PEC user groups? This research is a novel approach to analyzing process characteristics of the PEC using available data and statistical techniques that maximize the potential of these data. METHODS: This study used existing patient data from the PEC information system. Data included eight years of consecutive admissions, with over 42,000 patient records and 79,000 admission events. This study employed statistical methods suitable for this type of data, and approaches unique to each of the three research questions, including univariate analysis of group differences, and binary and multinomial logistic regressions to examine relationships between PEC utilization groups and multiple independent variables. RESULTS: Increased PEC use is not a direct function of county population growth, and admission rates are not uniform across patients. Generally, repeat users were younger, admitted voluntarily, and had diagnoses of schizophrenia or bipolar disorder rather than depression. Examining repeat PEC users as two distinct groups, occasional users and frequent users, detected significant differences between them. The findings also supported the dual role of the PEC in serving both voluntary and involuntary patients. Patients admitted involuntarily were more likely to present with suicidality and aggression. CONCLUSIONS: A small proportion of patients utilize a disproportionate amount of resources and the PEC serves patients with fundamentally different treatment needs. This analysis of existing data has elucidated factors critical in planning and sustaining coordinated and accessible psychiatric services for Tarrant County residents.Item Synergy 2011: Annual Research Report(2011-01-01)Item The Effects of Media Exposure on Alcohol Consumption Patters within the African American Population(2005-05-01) Miller, Vanessa G.; Lykens, Kristine; Quinn, James; Cipher, DaishaMiller, Vanessa G., The Effects of Media Exposure on Alcohol Consumption Patterns within the African American Population. Doctor of Public Health (Health Management and Policy), May 2005, 206 pp., 62 tables, 8 illustrations, references, 77 titles. Objectives- The study examined the role of media exposure on alcohol consumption patterns in the African American population. In studying the role of media exposure, the study also examined the role of ethnicity, mood/affect, socio-demographic factors and religion on alcohol consumption patterns in this population. Methods- Secondary analysis of the General Social Survey (GSS), 1972-2002 cumulative data file was used to provide quantitative estimates of the relationship between media exposure, ethnicity, mood/affect, socio-demographic factors, and religiosity as predictors of alcohol consumption. Path analysis was used to determine the direct and indirect effects of these concepts on alcohol consumption patterns. Results- Watching television and reading the newspaper were significant predictors of alcohol use. Watching television had a positive effect on alcohol use; but only in the absence of religiosity. When religiosity was present, as indicated by religious affiliation and attendance at religious services, watching television had a significant negative effect on alcohol use. Reading the newspaper had a negative effect on alcohol use; but this effect was not very significant. Watching TV also had a significant positive effect on alcohol abuse. Reading the newspaper had an effect on alcohol abuse but this effect was not significant. IN the presence of religiosity, neither watching TV nor reading the newspaper had a significant effect on alcohol abuse. The effects of religiosity could also be seen on the relationships between alcohol consumption and socializing patterns, age, sex, ethnicity, and income. The year of the GSS survey had a significant positive effect of television viewing and a significant negative effect on reading the newspaper. Race did not have a significant effect on alcohol use or abuse. Conclusion- This research has significant policy implications, as it indicates that exposure to media, thus exposure to advertising, had an effect on alcohol consumption. Religiosity appeared to act as a protective mechanism against the adverse effects of media exposure, as they relate to alcohol consumption. This research provides support for the implementation of more faith-based initiatives to combat substance abuse (especially alcohol abuse). It also sets the foundation for additional research on the effects of advertising on alcohol consumption, looking at the media revolution of the 21st century.Item Women & Stress: Investigating the Female Stress Syndrome(2006-05-01) Oden, Melissa Standord; Sue LurieOden, Melissa Stanford, Women & Stress: Investigating the Female Stress Syndrome. Master of Public Health (Community Health), May 2006, 47 pp., bibliography. Research indicates that women experience long-term effects of stress that appear to be not only different from, but possibly more harmful than the long-term effects of stress in men. This situation creates the possibility of more chronic illness for women as well as the possibility for higher mortality rates. The purpose of this project is to investigate the effects of stress on professional women in Tarrant County based on meanings and interpretations women give to the stress they experience. It will also provide additional information about the effects of Female Stress Syndrome to contribute to the research literature on this topic.