This thesis focuses on the complex landscape of depression prevalence and the depression treatment disparities within vulnerable populations. By examining the underlying factors contributing to the rise in depression prevalence and understanding the challenges faced by vulnerable communities we can…
This thesis focuses on the complex landscape of depression prevalence and the depression treatment disparities within vulnerable populations. By examining the underlying factors contributing to the rise in depression prevalence and understanding the challenges faced by vulnerable communities we can focus future research on the critical need for novel and equitable depression treatments.
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In the western medicine, there are many forms of medicines and therapies that have not yet been formally recognized by major government health organizations like the Food and Drug Administration (FDA). These therapies are also considered quite controversial by health-care…
In the western medicine, there are many forms of medicines and therapies that have not yet been formally recognized by major government health organizations like the Food and Drug Administration (FDA). These therapies are also considered quite controversial by health-care workers within our western society. As such, the implications of these medicines from a health/economics view show that insurance agencies have not formally added them to policies. In this documentary, we will explain and analyze the function and purpose of stem cell therapy (STT) injections and the use of biologics, which is defined as the medication produced from our own blood and proteins. We will fill in the gaps with knowledge regarding regenerative medicine, such as the functions and properties of stem cells and its lack of standardization in therapeutics. After providing further knowledge on these topics, we will transition into the health/economic perspective encompassing insurance coverage, government funding, FDA regulation and its potential future.
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In the western medicine, there are many forms of medicines and therapies that have not yet been formally recognized by major government health organizations like the Food and Drug Administration (FDA). These therapies are also considered quite controversial by health-care…
In the western medicine, there are many forms of medicines and therapies that have not yet been formally recognized by major government health organizations like the Food and Drug Administration (FDA). These therapies are also considered quite controversial by health-care workers within our western society. As such, the implications of these medicines from a health/economics view show that insurance agencies have not formally added them to policies. In this documentary, we will explain and analyze the function and purpose of stem cell therapy (STT) injections and the use of biologics, which is defined as the medication produced from our own blood and proteins. We will fill in the gaps with knowledge regarding regenerative medicine, such as the functions and properties of stem cells and its lack of standardization in therapeutics. After providing further knowledge on these topics, we will transition into the health/economic perspective encompassing insurance coverage, government funding, FDA regulation and its potential future.
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Poor medication adherence is a widespread healthcare issue that directly impacts the effectiveness of the medication and the overall health of the patient. Wellth is a smartphone application offered to users challenged with managing chronic conditions to improve medication adherence…
Poor medication adherence is a widespread healthcare issue that directly impacts the effectiveness of the medication and the overall health of the patient. Wellth is a smartphone application offered to users challenged with managing chronic conditions to improve medication adherence through daily reminders and monthly financial incentives to help members form healthy habits. The study examined the effects of financial incentives on the medication adherence of members according to their characteristics including their age, gender, and location of residence in addition to the health conditions they were battling during a 5-month Wellth program. In this study, adherence was defined as the percent of days the users checked in all their medications within a ±3-hour task window while timely adherence was when check-ins were submitted in a narrower window of ±1-hour. Wellth demonstrated both positive and negative relationships between specific patients and adherence. By comparing the findings with the existing literature, patterns were evaluated, and hypotheses were made. The severity of the member’s illness and vulnerability to consequences seemed to go be joint factors. The complexities of medication regimens, side effects, and symptoms associated with their health condition affected patient motivation. Economic factors including financial status, healthcare access, and level of knowledge could also be used as an explanation. This study is important because it helps develop and implement effective adherence programs for different kinds of patients by examining what type of patients for whom incentives work best using a mobile app. Essentially, this helps target features and design new programs for those who did not respond well to financial incentives.
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Autistic adults face heightened risk of psychiatric disorders, with depression occurrence estimated at quadruple the rate of the general population. Mindfulness Based Stress Reduction (MBSR), an intensive 8-week in-person intervention, reduces depressive symptoms in adults with autism spectrum disorder (ASD).…
Autistic adults face heightened risk of psychiatric disorders, with depression occurrence estimated at quadruple the rate of the general population. Mindfulness Based Stress Reduction (MBSR), an intensive 8-week in-person intervention, reduces depressive symptoms in adults with autism spectrum disorder (ASD). However, access to these programs is restricted due to financial, geographic, and scheduling limitations. Additionally, lapses in practice post-intervention cause these effects to be short-lived. This study examines antidepressant effects of an 8-week app-delivered mindfulness meditation intervention using Ten Percent Happier in adults with ASD and explores whether anchoring meditation practice to a preexisting behavior will improve therapy compliance and depression-related efficacy. Ninety-seven participants were randomly assigned to either App Only (n=30), App + Habit training (n=27) or Waitlist Control (n=40). App Only and App + Habit groups were requested to meditate a minimum of 10 minutes per day, 5 days per week for 8 consecutive weeks using the mobile application. The App + Habit group received additional instruction to anchor leaving the bathroom each morning with meditation; The App Only group was only provided with education on habit formation. Participants completed the Beck Depression Inventory-II (BDI-II) at pre- and post-intervention. All groups received weekly ecological momentary assessments (EMAs) to assess frequency and length of practice. The App + Habit group was additionally assessed for cue-initiated meditation frequency. Data were analyzed using repeated measures analysis of variance (ANOVA). Pre-to-post changes on BDI-II scores indicated a group by time interaction (p=0.04) and a main effect of time (p <0.001). Post-hoc analysis revealed the App + Habit group exclusively showed significant decline in depressive symptoms (p<0.001). The App + Habit group showed greater number of days meditated, average minutes per day of meditating, and continuation of meditation practice 8-weeks after the intervention period, compared to the App Only group.
Findings support app-delivered mindfulness interventions as an accessible and cost-effective alternative to traditional in-person mindfulness training for Autistic adults. However, results suggest app-based mindfulness tools may only be effective when delivered with specific habit formation instruction. Additionally, habit formation instruction led to greater adherence to meditation practice after the study period ended.
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Meditation app usage is associated with decreases in stress, anxiety, and depression symptoms. Many meditation app subscribers, however, quickly abandon or reduce their app usage. This dissertation presents three manuscripts which 1) determined the behavioral, demographic, and socioeconomic factors associated…
Meditation app usage is associated with decreases in stress, anxiety, and depression symptoms. Many meditation app subscribers, however, quickly abandon or reduce their app usage. This dissertation presents three manuscripts which 1) determined the behavioral, demographic, and socioeconomic factors associated with the abandonment of a meditation app, Calm, during the COVID-19 pandemic, 2) determined which participant characteristics predicted meditation app usage in the first eight weeks after subscribing, and 3) determined if changes in stress, anxiety, and depressive symptoms from baseline to Week 8 predicted meditation app usage from Weeks 8-16. In Manuscript 1, a survey was distributed to Calm subscribers in March 2020 that assessed meditation app behavior and meditation habit strength, and demographic information. Cox proportional hazards regression models were estimated to assess time to app abandonment. In Manuscript 2, new Calm subscribers completed a baseline survey on participants’ demographic and baseline mental health information and app usage data were collected over 8 weeks. In Manuscript 3, new Calm subscribers completed a baseline and Week 8 survey on demographic and mental health information. App usage data were collected over 16 weeks. Regression models were used to assess app usage for Manuscripts 2 and 3. Findings from Manuscript 1 suggest meditating after an existing routine decreased risk of app abandonment for pre-pandemic subscribers and for pandemic subscribers. Additionally, meditating “whenever I can” decreased risk of abandonment among pandemic subscribers. No behavioral factors were significant predictors of app abandonment among the long-term subscribers. Findings from Manuscript 2 suggest men had more days of meditation than women. Mental health diagnosis increased average daily meditation minutes. Intrinsic motivation for meditation increased the likelihood of completing any meditation session, more days with meditation sessions, and more average daily meditation minutes. Findings from Manuscript 3 suggest improvements in stress increased average daily meditation minutes. Improvements in depressive symptoms decreased daily meditation minutes. Evidence from this three-manuscript dissertation suggests meditation cue, time of day, motivation, symptom changes, and demographic and socioeconomic variables may be used to predict meditation app usage.
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The purpose of this study was to examine the demographic and geographic disparities in the incidence of newborn babies with Neonatal Abstinence Syndrome (NAS) in the United States from 2012 to 2015. Specifically, I examined the prevalence of NAS according…
The purpose of this study was to examine the demographic and geographic disparities in the incidence of newborn babies with Neonatal Abstinence Syndrome (NAS) in the United States from 2012 to 2015. Specifically, I examined the prevalence of NAS according to geographic location (i.e. urban versus rural) and race while also controlling for mother’s insurance type, median household income, and trends over time. Additional analyses explored the relationship between NAS and delivery method, birth weight, and neonatal candidiasis that causes sepsis. Understanding the disparities in NAS and birth outcomes during this period (2012-2015) can help better target interventions for combating the health and economic burdens of NAS since maternal opioid use has continued to rise since 2015. Additionally, existing research into geographic disparities in NAS have only been region-specific. This study expands the scope of this literature by considering urban versus rural disparities across the country.
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Despite the benefits of prehabilitation before surgery, many patients do not participate in these programs. Research has shown that prehab reduces the duration of hospital stays, thus the cost of hospitalization, and improves the recovery process from surgery. This paper…
Despite the benefits of prehabilitation before surgery, many patients do not participate in these programs. Research has shown that prehab reduces the duration of hospital stays, thus the cost of hospitalization, and improves the recovery process from surgery. This paper aims to determine why prehab is not as common as rehab by evaluating its accessibility issues related to the amount of information accessible to patients, and the cost and insurance policies related to prehab. Telemedicine is also presented as a possible solution to the accessibility issues, and viewed as an alternative that can increase the number of prehab participants. Literature review and analysis of clinic websites indicates that information availability and cost presents accessibility issues to prehab. Although cost and information availability of prehab presents an accessibility problem, and telemedicine has the potential to increase the number of participants in prehab, it is found that many people still might not consider prehab as an option. Studying prehab is interesting and it presents a unique case study of the benefits of preventative medicine. Preventative medicine is often not promoted because of the difficulty of measuring the benefits. But in the case of prehab, both the physical benefits and cost-savings are easily measurable. This paper presents an interesting and clear case study about the effectiveness of preventative medicine, and contributes important data in favor of shifting greater resources and attention to preventative medicine.
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