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A Systematic Review of Multisystemic Therapy Efficacy in Youths 21 Years and Younger
No full textAbstractObjective: This review aimed to synthesize existing evidence on the effectiveness of multisystemic therapy compared to treatment as usual in reducing disruptive behaviors in youths 21 years and younger.
Introduction: Multisystemic therapy (MST), a holistic, highly individualized, goal-oriented, evidence-based approach, has been shown to effectively reduce disruptive behaviors in youths by addressing various systems influencing the youth's behavior, including the family, school, peer group, community, and individual factors. Disruptive Behavior Disorders, highly prevalent in childhood, are linked to negative outcomes, including substance abuse, psychiatric hospitalization, violent behavior, and criminal convictions. The estimated criminal justice costs for a typical offender aged 24 range between 3.7 million. It remains imperative to determine MST's efficacy to make evidence-based recommendations for clinical practice.
Inclusion Criteria: This review included full reports of randomized controlled trials (RCTs) and quasi-experimental study designs that investigated the effects of MST in children and adolescents aged 21 years and younger.
Methods: Five databases were searched to find published and unpublished literature. Eligible articles were assessed by two independent reviewers for relevancy, duplicates were removed, and full-text articles were appraised. Studies results were synthesized narratively due to significant heterogeneity between studies.
Results: 12 RCTs and 4 Quasi-experimental studies were included. The total number of participants was 3,671. Compared to usual care, MST was more effective in reducing poor family functioning and in improving psychiatric symptomatology, externalizing, and antisocial behaviors, which include aggression and criminality. The impact of MST on adolescent peer relations was less consistent across different studies.
Conclusion: MST effectively reduces disruptive behaviors in youths while improving family, parenting, psychiatric symptoms, and externalizing behaviors. Practitioners should consider MST as a treatment option for disruptive behaviors in children and adolescents. Keywords: Multisystemic therapy, disruptive behavior, systematic reviewD.N.P.Includes bibliographical referencesIncludes vit
Siegel integration on flags
No full textWe use the Maass-Selberg relations for the Borel Eisenstein series to study covol-
umes of primitive sublattices within partial flags of random lattices. This work can
be seen as a generalization of Siegel’s integration formula which says that a function
on Rn, n > 1 can be integrated by taking the expected value of the sum of the function
over the non-zero lattice points of a random covolume one lattice in Rn. A similar
result to our main integration theorem in the SL(n, R) case was discovered previously
by Kim in [3] with the use of Rogers’ integration theorems from [7]. While Rogers’
theorem can be more powerful than the Maass-Selberg relations, it only applies to
the SL(n, R) case with some recent efforts to extend the methods to Sp(n, R) as well.
Since the Maass-Selberg relations hold for Eisenstein series on Chevalley groups for
any root system, the proof of our main theorem in the SL(n, R) case works just as
well for G any Chevalley group. This leads to the main contribution of the thesis:
a formula for an integral over a truncated subset of G(Z)G(R) of a certain Borel
Eisenstein series which is induced from a constant function on a parabolic.Ph.D.Includes bibliographical referencesIncludes vit
“It Makes Me Feel Like the World Hasn't Changed a Lot” exploring early perspectives on law enforcement among pre-adolescent youth in Newark, New Jersey
No full textThis dissertation explores the development of legal attitudes and perceptions of police among pre-adolescent youth of color in Newark, New Jersey. Through in-depth qualitative interviews with 40 Black and Latinx children aged 9-11, the study examines how family socialization, neighborhood context, school experiences, and media exposure shape early orientations toward law enforcement.
Key findings reveal that distressing childhood socialization processes can cultivate legal cynicism and erode legitimacy views from a young age. Parental warnings emphasizing compliance without parallel expectations for police accountability lay a problematic foundation. Involuntary exposure to police violence imagery in digital spaces further breeds trauma and skepticism. Personal encounters with discriminatory policing create lasting vulnerabilities. Age differences emerge, with 11-year-olds displaying more critical perspectives shaped by broader societal narratives.
The study introduces a theory of Early Childhood Legal Estrangement to explain how marginalizing experiences across social domains can foster alienation from legal institutions before adolescence. Implications for policy and practice are discussed, including the need for trauma-informed policing and community-based interventions to rebuild trust. This research provides valuable insights into the early roots of legal cynicism among urban minority youth and suggests opportunities for positive intervention.Ph.D.Includes bibliographical reference
Controlling the movement of protons and electrons with amine-functionalized CpN3 Ligands coordinated to iron
No full textDeveloping cost-effective and efficient catalysts for moving around protons and electrons is crucial for applications in chemical energy storage and organic synthesis. Therefore, there is a need to develop Earth-abundant transition metal electrocatalysts to replace rare and expensive precious metals in these domains. In this thesis, new iron electrocatalysts for H2 production are synthesized that contain an amine rich cyclopentadienyl ligand (CpN3) designed to regulate proton and electron transport at a molecular level. Classical Cp ligands are traditionally known for their ancillary role in stabilizing metal centers, however their active participation in electrocatalytic hydrogen (H₂) production has only been documented in rare cases. Despite the prevalence of Cp motifs in coordination chemistry and catalysis, the kinetics of Cp ring protonation, the intricacies of proton transfer between the ligand and metal, and the role of the solvent in these processes remain insufficiently explored.Chapters 2 and 3 encompasses in-depth experimental and computational mechanistic studies of Fe(CpN3) complexes for electrocatalytic H2 production. The amines behave as ancillary functional groups and endo-CpN3 ring protonation occurs after 1e- reduction, even though amines in the second coordination sphere are typically protonated during electrocatalytic reactions. Through state-of-the-art DFT calculations, it is shown that coordinated solvent molecules play a critical role in steering stereo- and regioselective proton transfers, leading to the formation of an endo-CpN3H isomer, while other protonation pathways are kinetically unfavorable. These findings underscore the critical role of Cp ligand activation, solvent effects, and metal-ligand cooperation in promoting efficient proton-coupled electron transfer (PCET) catalysis.
Chapter 4 describes the installation of a piperazine moiety onto the CpN3 framework, transforming the system into an electron-proton transfer mediator (EPTM) that catalyzes the transfer of hydrogen atoms to organic substrates. Experimental and computational aspects of the mechanism for H-atom transfer will be described. This chapter highlights the importance of exploring a broad range of H⁺/e⁻ addition mechanisms in designing catalysts for sustainable energy applications. Collectively, advances in the development of Earth-abundant iron-based electrocatalysts with amine-rich CpN3 ligands as promising alternatives to expensive precious metals in energy storage and organic synthesis are discussed.
Chapter 5 discusses the conclusion and future outlook, addressing the limitations and offering potential improvements to the CpN3Fe electrocatalysts system for hydrogen production. Future work is outlined for CpN3Fe complex featuring a piperazine moiety, focusing on investigating its N-H bond thermochemistry and PCET mechanisms to further understand its catalytic behavior.Ph.D.Includes bibliographical reference
Analytical approaches to information processing and risk assessment: from cybersecurity disclosures to medical audits
No full textThis dissertation consists of three essays using emerging technologies such as textmining and machine learning to explore information processing and risk assessment
in cybersecurity disclosures and medical audits. These three essays are distributed in
Chapters 2-4, respectively. The first chapter explains the background and motivation
of these research works. Chapter 2 discusses the first essay, proposing a framework
for text mining. It introduces a new methodology that employs sentiment analysis for
textual extraction in cybersecurity disclosures and evaluates this methodology to
verify its accuracy and reasonability. Chapter 3 implements the proposed method to
evaluate the informativeness of cybersecurity disclosure using sentiment analysis in
comparison to traditional methods of volume. Chapter 4 introduces a machine
learning methodology and risk assessment approach to audit medical assessment
using psychiatric data.Ph.D.Includes bibliographical reference
Facilitating school immunization compliance
No full textPurpose of Project: This project aims to investigate the pivotal role of the school nurse in enhancing immunization compliance amongst students and the benefits derived from the collaborative efforts of the local health departments to maintain high compliance rates. The primary objectives include identifying, tracking, and addressing immunization non-compliance by ensuring adherence to state-mandated requirements within a public primary educational setting. The project also seeks to highlight the significance of information management systems, such as the New Jersey Immunization Information System (NJIIS) a comprehensive vaccine administration database with shared access across various healthcare entities. MethodologyThe project employs a multifaceted approach, with the school nurse acting as the key facilitator in implementing immunization compliance. The data collection involves health record review and coordination with NJIIS to identify students still in need of mandated vaccinations. Additionally, the project emphasizes the importance of the role the local health department plays in providing primary care services. The health department serves as an accessible hub for students and families, mitigating barriers like lack of health insurance, transportation issues, or inability to obtain an appointment. The collaborative model involves organized communication between the school nurse, parents and guardians, and local health department to create a streamlined process contributing to increased compliance rates. ResultsThe collective efforts between the school nurse and local health departments demonstrate a synergistic approach, significantly enhancing the reach and impact of immunization initiatives. Offering more than just a referral to be vaccinated but the actual information to a place administering vaccines proved to be effective in increasing compliance rates amongst students. Post-intervention, 98.03% of students became compliant by completing all the necessary immunizations identified as missing. The data collection through NJIIS was helping in the identification of immunizations or lack thereof however, there was a trend of inconsistency use and accuracy of the database when compared to health records submitted directly to the school. An apparent trend that a lot of healthcare providers do not participate or update NJIIS, as 39.2% of the students were compliant before the intervention, but the inconsistent utilization of the state immunization registry by healthcare providers has the unintended consequence of creating inconsistencies in immunization records, often giving the appearance of non-compliance among individuals. Implications for PracticeThe findings of this project show the effectiveness of the collaborative model in addressing immunization gaps and fostering a culture of preventative health practices amongst parents and guardians. The organized approach not only contributes to a safer and healthier educational environment but also has broader implications for positive public health outcomes. The project highlights the ongoing need for partnership and communication between school health services and local health departments, emphasizing the shared goal of achieving optimal immunization coverage within school communities. The success of this project suggests its potential applicability in other regions, serving as a valuable framework for enhancing immunization initiatives in educational settings.D.N.P.Includes bibliographical reference
Implementation of SBAR into nurse-to-nurse shift report: a quality improvement initiative
No full textPurpose: Effective communication is crucial in healthcare. Delays in care in psychiatric settings lead to prolonged patient wait times for medication, causing mood instability and increasing the risk of treatment delays, sentinel events, and low nurse satisfaction. This project aims to enhance communication by implementing a standardized tool for nursing shift report to improve compliance rates of bloodwork and EKG completion within 24 hours of admission. Methodology: The Psych Specific SBAR tool was implemented over a 4-week period on two units in a behavioral health facility. Retrospective and prospective chart reviews were conducted to compare compliance rates for Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), Lipoprotein Profile (LP), and electrocardiogram (EKG). Pre- and post-implementation nursing surveys were administered to compare nurse satisfaction levels. Results: No improvement in completion of CBC (χ_((1))^2 = .002, p = .966), CMP (χ_((1))^2= .816, p = .366), LP (χ_((1)=)^2 .146, p = .703) and EKG (χ_((1))^2= .1.853, p = .173) was seen after Psych Specific SBAR Tool implementation, revealing no statistically significant relationship exists between standardizing nursing shift report and timely completion of lab work and EKG. The Psych Specific SBAR tool improved nurse satisfaction with report based on measures of accuracy, sufficiency, thoroughness, relevance, clarity, consistency, and omitted information. Implications for Practice: Timely completion of labs and EKG is not a nursing communication issue and is unaffected by the implementation of a standardized reporting method. The Psych Specific SBAR tool increased nursing satisfaction with nursing shift report.D.N.P.Includes bibliographical reference
Predictors of mental illness stigma in sonographers
No full textPurpose. People with mental illnesses (MI) and severe mental illnesses (SMI), as all people, deserve access to adequate healthcare. People with SMI have a life expectancy that is substantially shorter, about 9 – 25 years less, than the general population. Many of the health issues that people with MI face are considered manageable and treatable. Stigma toward people with MI, which may affect the health outcomes of this population, has been documented in healthcare professionals such as physicians, nurses, and dentists. Diagnostic medical sonographers are healthcare professionals involved in diagnosing many ailments that people with MI are battling. Therefore, it is necessary to examine the attitudes of these professionals as they may affect the healthcare outcomes of people with MI.
Methodology. A non-interventional, cross-sectional, attitudinal study utilizing demographic and professional information and two measures designed to detect stigma towards people with MI was conducted to understand the characteristics of diagnostic medical sonographers that may predict MI stigma. In addition to providing demographic and professional information, the sonographers in the study completed the Attribution Questionnaire (AQ-27) and the Mental Illness Clinician’s Attitude (MICA) Scale. This study aimed to identify the variables most likely to positively or negatively predict stigma. Multiple one-sample t-tests compared sonographer stigma with healthcare professionals from peer-reviewed, published studies that utilized the same stigma measures. Several multiple regression analyses were run to establish how characteristics of sonographers predicted stigma. A canonical correlation was utilized as an omnibus test of all predictor variables and all stigma variables to confirm the findings of the multiple regression analyses and establish how all variables were related.
Findings. Firstly, sonographers in this study demonstrated less MI stigma than most other health professionals with whom they were compared, with the exception of four subscales on the AQ-27: 1) dangerousness, 2) avoidance, 3) fear, and 4) coercion, suggesting that fear of violence from people with MI may affect sonographers’ stigmatizing attitudes. Secondly, as predicted by a substantial amount of literature, social contact (i.e., previous experience with people with MI) was the best predictor among those measured of lower stigma in sonographers.
Implications. The findings of this research can help guide future interventions in healthcare and educational settings to increase the likelihood that patients with MI will receive adequate diagnostic medical sonography examinations. These findings may also guide diagnostic medical sonographers' future scope of practice. A major strength of this study is that it used a more sophisticated statistical analysis than reported in most other healthcare MI stigma studies.Ph.D.Includes bibliographical reference
The evolution & inefficiency of grammar
No full textGrammar has long been considered a language in itself and has been known for its difficulty to learn, for both new language speakers, and native ones. But if grammar is the origin of our languages, then what are the origins of grammar? This research questions the enforcement of grammar on the collegiate level, regarding grammar as a suggestive foundation for communication and comprehension, not professionalism nor literary intelligence. This research paper not only explores the history of grammar, but provides an explanation for its evolution. Understanding the history of our linguistic foundations and the forefathers of its existence, allows us to utilize grammar to its fullest capacity, whilst acknowledging the leniency of its use. This research will analyze individual examples of grammatical evolution, alongside its controversial and religious past, explaining how modern grammar was born from the mistakes of our literary predecessors. It will dive into the history of our current English alphabet, punctuation, pronouns, and general grammar construction. Additionally, this research will examine prominent figures in literature, and their impact on the evolution of grammar. These findings argue that grammar is not fundamental in terms of writing and communication, and should thus be used as a suggestion for comprehensive communication, rather than a strict guide for formal writing.Presented at the annual Celebration of Undergraduate Research and Creative Activity while the author was an undergraduate student at Rutgers University-Camden