TCU Digital Repository (Texas Christian Univ.)
Not a member yet
54550 research outputs found
Sort by
The Most Wonderful Sort of Harmony: A Duo Recital
No full textWithin the world of classical music, many forms of collaboration and ensemble exist, with different demands, repertoire, challenges, and triumphs. For this honors project, my colleague and I have embarked on a journey to learn, rehearse, and perform a recital of duets for violin and cello, learning about the specific challenges of such an instrumentation and an intimate collaborative process along the way. Alongside our end goal of a performance on May 4, 2024, we also intend to learn about the composers who wrote the pieces we chose to learn and the ways in which we must interact with these composers and their works in order to perform as effectively as possible. Our recital program, a link to the recital livestream, and my own program notes, along with a bibliography, are submitted as my thesis
Stigma as a Barrier to Care Among Justice-Involved Individuals Living With or At-Risk for HIV and Substance Use Disorder
No full textResearch Question: Do the sociodemographics among justice-involved individuals living with or at risk for HIV and substance use disorder impact baseline stigma scores?Background and Significance: It is vital to provide justice-involved (JI) individuals living with HIV and/or substance use disorder (SUD) with linkage to care upon community re-entry. There are endless barriers preventing this population from receiving proper care after release. A less examined barrier is stigma and its impact on health service engagement. This study aims to investigate the differences in types of stigma as a barrier to care among a population of JI individuals randomized to two health delivery models.Materials and Methods: 356 individuals with recent involvement with the criminal justice system, history of opioid/stimulant use and HIV risk behavior in 2 regions of Texas and 2 regions of Connecticut were identified. Participants¿ baseline Anticipated Stigma and Internalized Stigma were examined using the ACTION Stigma Scale. A combination of correlation analyses and independent samples t-tests were used to explore whether stigma scores varied as a function of participants¿ sociodemographic information.Results: Women (M = 3.06, SD = 1.00; M = 3.27, SD = 1.03) reported significantly more Anticipated Stigma and Internalized Stigma when compared to men (M = 2.67, SD = 1.01; M = 2.86, SD = 1.08), t(352) = ?3.02, p = ?0.001. Those in a controlled setting (M = 2.61, SD = 0.94; M = 2.80, SD = 1.04) reported experiencing more Anticipated Stigma and Internalized Stigma as compared to participants in the community setting (M = 2.91, SD = 1.08; M = 3.10, SD = 1.09), t(350) = ?2.61, p = ?0.005.Conclusion: The baseline data reveal both Anticipated Stigma and Internalized Stigma are significantly higher (1) among women compared to men and (2) among those in a controlled setting compared to those under community supervision (probation or parole). Although the study's health service delivery models will bridge many gaps to care, it is unclear how stigma plays a role. By identifying how stigma impacts care within these models, interventions can be implemented to lessen stigma and improve overall health outcomes for this unique population who experience three different layers of stigma: HIV, substance use, and justice involvement
Oral health literacy, knowledge, practice and beliefs among Asian Americans: A scoping review
No full textObjectives The Asian American (AsA) population is at high risk for poor oral health outcomes and remains an underserved and understudied community. Low oral health literacy could explain poor oral health behaviours, practices and outcomes in this population. The aims were as follows: (i) provide a scoping review of oral health literacy, knowledge, practice and beliefs among AsA individuals residing in the United States; (ii) identify any instruments or tools translated into participants' language and (iii) determine whether the translated instruments had been assessed for validity and reliability. Methods The current study used a scoping review framework based on PRISMA-ScR that included rigorous eligibility criteria, search strategy, independent selection process with adjudication, and standardized reporting of outcomes. The search was conducted on March 14, 2022, and updated on February 25, 2023 and February 13, 2024, in the following databases: Ovid MEDLINE, Embase, Web of Science and CINAHL. Peer-reviewed original research on oral health literacy, knowledge, awareness, practice, and beliefs related to oral health care in AsA subgroups published in English were included. Two reviewers independently assessed whether titles and abstracts should be included for review, with discrepancies adjudicated by a third reviewer. Data extracted from articles used a standard template that included study design, and measurement tools of oral health, knowledge, awareness, practice and beliefs, as well as results and conclusions of the publication. In addition, the template captured whether the translated and original measurement tools were assessed for reliability and validity. Results Of the 367 papers identified, 10 studies that met eligibility criteria were included in the final review. Of these, four studies used previously validated tools to assess oral health measurements in AsA. Only five of the studies translated the tools into the participants' native language. Although AsA exhibited lower oral health literacy than Whites but higher than Hispanics and African Americans, none of the translated tools were assessed for reliability and validity. Acculturation and country of birth were factors influencing oral health behaviours related to good oral health practice and utilization, with AsA born in the United States exhibiting higher oral health utilization than those born in their country of origin. Oral health beliefs played a significant role in dental care utilization among AsA populations. Conclusions The scoping review on oral health in Asian American communities identifies a significant research gap, particularly in the lack of validated tools for assessing oral health literacy, which varies across ethnic groups. It notes that AsA generally have lower oral health literacy compared to Whites, but higher than Hispanics and African Americans. AsA born in the United States shows better oral health practices, influenced by acculturation and birth country. The findings emphasize the need for more thorough and culturally adapted research methods to address oral health disparities in this diverse group
Acute Cross-over Effects of Lower Limb Muscle Fatigue on Movement Strategies of Young Adults During Upright Standing
No full textResearch Question: Are there acute cross-over effects of lower limb muscle fatigue on movement strategies of young adults during upright standing?Background and Significance: Our study made use of three major concepts: the cross-education phenomenon, muscle fatigue, and postural control. The crosseducation phenomenon pertained to the effects of training one side of the body to the untrained contralateral or opposite side. Muscle fatigue was the decrease in maximal force as a response to contractile activity. Lastly, postural control was the ability that allowed one to maintain upright standing. Looking at these three components¿the cross-education phenomenon, muscle fatigue, and postural control¿that have been studied over the last century, we developed a research idea that used the influence these three had on each other. Our research generated a quantitative analysis of the cross-educational phenomenon on postural control by observing contralateral muscle fatigue.Materials and Methods: Twenty individuals (17 males, 3 females) were enrolled in the study. Participants were healthy young adults, with no lower extremity injuries, normal or corrected-tonormal vision, no known balance disorder, and no neuromuscular disorder or impairment. Postural control data was collected with a force plate (OR6-7, AMTI, Advanced Mechanical Technology, Inc., Watertown, MA) that recorded forces and moment data. Participants performed pre- and post-fatigue balance assessments on a force plate, including single-legged standing with variations of the dominant and nondominant leg and stable and unstable surface types. Following the initial balance assessment, a fatigue task of single-leg standing calf raises was performed until exhaustion. Data from the pre-fatigue balance task and post-fatigue balance task were analyzed and compared.Results: The Coefficient of Variation in the Anterior-Posterior (CVAP) direction for the fatigued Dominant Leg exhibits steep variability, indicating significant sway during the post-fatigue balance task, as expected. The CVAP for the unfatigued Nondominant Leg also shows an increase in variability, though not as steep, which can be attributed to the crossover effect (p=0.043).Conclusion: Acute fatigability on one of the lower limbs in our subjects influenced contralateral postural stability and control during upright standing. This was supported objectively by measurements of the muscle activity from the force plate device. As for impact, we increased our understanding of postural control training through cross-education and provided additional evidence via objective data. Future work can include increased power, more diverse subjects, or, or other limbs. We hope that our study has provided valuable insights for various applications, such as physical rehabilitation or performance training
Heart Rate Variability Training in U.S. Military Veterans and their Caregivers¿The Power of Two
No full textResearch Question: In United States Armed Forces veterans with invisible wounds of war, such as posttraumatic stress (PTS) and traumatic brain injury (TBI), does training Heart Rate Variability (HRV) in sessions with a trusted companion going through the training with the participant lead to significant further improvement in self-reported executive cognitive function, and general mental and physical well-being for the veteran when compared to the improvements seen in veterans who are trained in one-on-one sessions with a licensed coach?Background and Significance: HRV, which is a measurement of how ¿in sync¿ our bodily systems are, is an important indicator of health, fitness, and stress resilience. Low variability can indicate that an individual is functioning below optimal physical, cognitive, or emotional levels. Conversely, optimal HRV reflects a healthy balance between both branches of the autonomic nervous system (ANS) and represents an individual¿s resilience and ability to adapt to physical and mental stress. Negative emotions such as stress, anger, and worry foster ANS imbalance. In contrast, sincere, positive feeling states result in balance, order, and stability that, when practiced regularly, with deep breathing, improve HRV. While there have been many studies that have illustrated the benefits of HRV training for those coping with emotional distress, there is a lack of robust research exploring the effects of simultaneously training close friends or family in HRV.Materials and Methods: A prospective cohort study was performed. Veterans enrolled in Boot Campaign's Stress and Resilience program and an identified trusted caregiver/companion underwent an individual, but simultaneous, interactive HRV-training program based upon a standardized, culturally competent curriculum for a period of 5 weeks. This program, led by a credentialed and experienced coach teaches evidence-based tools that can be used in real-time to help manage stress, build resilience capacity, and optimize performance. Outcomes were collected prior to the commencement of the coaching protocol and again at the conclusion of training. Standardized self-report outcome measures were then utilized to assess program efficacy. We compared pre and post intervention survey results to measure participant progress over the course of our study using both paired t-tests and nonparametric independent t-tests.Results: We found that veterans who have a trusted companion (caregiver or significant other) that simultaneously undergoes the HRV training had greater improvements in a reduction of stress, anxiety, fatigue, burnout, and depression and a greater improvement in executive cognitive function, and general mental and physical well-being when compared to their baseline values obtained before the simultaneous training began.Conclusion: We believe that these improvements were due to improvements in the HRV measures of the veterans. While these results can be used by Boot Campaign and similar veteran-centered organizations to drive treatment, other professional groups such as first responders and physicians, who deal with high rates of stress, including posttraumatic stress, could also benefit from the therapeutic implications of this study
Hip Fracture Outcomes Dependent on Admission Day of the Week and Payer Source
No full textResearch Question: Is there a correlation between the hospital length of stay for hip fractures and the day of the week of admission or the source of payer?Background and Significance: Hip fractures pose a unique challenge due to the prevalence of pre-existing medical comorbidities and cognitive impairments among the geriatric population. Hip fractures also cause substantial financial burden on the healthcare system with an estimated annual cost exceedingly over 12 billion dollars. A significant contributing factor to these costs is prolonged hospitalizations, leading to longer lengths of stay and lower hospital reimbursements. We set to investigate whether the day of the week admission or payer source (Managed Medicaid vs Traditional Medicaid) impacted lengths of stays.Materials and Methods: A geriatric hip fracture database was constructed using patients aged at least 60 years old sustaining a hip fracture between January 1st, 2012, and December 31st, 2020, identified from Texas Harris Fort Worth. Data was analyzed using an analysis of variance (ANOVA), chi-squared test and t-test over SPSS.Results: Data showed a significant difference in the length of stay across the week, with a p-value of 0.04. There was no significant difference in the incidences of mortality, 30-day mortality, and one-year mortality when compared across the days of the week of admission. A comparison of Managed Medicare / Medicare Advantage with traditional Medicare showed statistically significant (p-value <0.05) longer length of stay on Thursdays for patients enrolled in Managed Medicare / Medicare AdvantageConclusion: The day of the week admission and payer source has a significant impact on the length of stay for geriatric hip fracture repairs may be attributable to limited weekend resources and increased burdens of coordination
Diagram driven computer generation of equation-of-motion coupled cluster equations for perturbed quantum oscillators
No full textWe consider a set of quantum harmonic oscillators subjected to perturbations expressible as a power series in position and momentum. A diagrammatic scheme is developed, by which to generate equation-of-motion coupled cluster (EoM-CC) equations for the calculation of the perturbed energy spectrum of the system. The diagrammatic scheme is then adapted into a Python code, capable of generating the necessary equations and computer code associated with any arbitrary order of the perturbation and coupled cluster excitation levels. The generated equations are made readily accessible for numerical evaluation, alongside convergence schemes and the application of iterative Bogoliubov transformations
Content validity assessment of items associated with CRNA turnover: an index development study
No full textObjective: To establish content validity for instrument items associated with occupational turnover for certified registered nurse anesthetists (CRNAs).
Methods: A panel of content experts in the field of nurse anesthesiology rated items as essential, useful but not essential, and not necessary. Items which displayed statistically significant agreement among experts were retained.
Results: In total, 49 items displayed statistically significant content validity.
Conclusion: This study suggests compensation, leadership, working conditions, and the clinical practice environment are important content domains associated with CRNAs choosing to quit their jobs
Primary Care: Its Pokemon Moment
No full textPrimary care in the United States is undergoing bursts of evolution in response to health system stresses, changing demographics, and expansion of risk and value-based reimbursement structures. The impact of primary care remains substantive and associated with improved population health. However, the spectrum of services, the nature of the physicians involved and new ways of including the patient in her, or his own care suggests that a new definition of primary care be considered, and patient expectations be heeded and understood. Evolutionary bursts yield new traits and in primary care, they are spawning new care models with significant implications for general internal medicine, internal medicine/pediatrics trained individuals and medicine subspecialties given the focus of these models on Medicare Advantage. Ultimately, changes in reimbursement and creative incentives will be two factors among many that will solidify the next stage of primary care in the (c) 2024 The Authors. Published by Elsevier Inc. This is an open access article under the CC BYicine (2024) 137:577-58
Room temperature luminescence of 1,N2-etheno-2-aminopurine in poly (vinyl alcohol) films.
No full textWe studied spectral properties of 1,N2-etheno-2-aminopurine after immobilization in poly (vinyl alcohol) films. The absorption spectrum of 1,N2-ε2APu consists of two peaks centered at 300 and 370 nm, and the fluorescence spectrum has maximum at about 460 nm. The fluorescence quantum efficiency is 62%. The fluorescence anisotropy reaches a value of 0.3 at longer wavelengths, while it is low at shorter wavelengths (corresponding to the second single excited state). The 1,N2-ε2APu has a relatively long fluorescence lifetime of about 16 ns and a noticeable room temperature phosphorescence with a lifetime of about 220 ms. A broad phosphorescence emission band (425-675 nm) is centered at about 530 nm and markedly overlaps with fluorescence at shorter wavelengths. Surprisingly, the phosphorescence excitation spectrum of 1,N2-ε2APu-doped poly (vinyl alcohol) film differs from the absorption and fluorescence excitation spectra. The strongest room temperature phosphorescence excitation is about 335 nm. At longer excitation wavelengths, above 450 nm, where fluorescence cannot be excited, a triplet excitation is still possible. The 1,N2-ε2APu phosphorescence anisotropy spectra confirm direct triplet state excitation. The ability to excite molecules at long wavelengths can find applications in the study of biological molecules that are unstable when excited at high energies