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Psychiatric Associations with Barriers to use of Mental Health Services in Medical Students
No full textIntroduction: Medical students experience stress, anxiety, and depression at rates greater than those of the general population. Medical students also underutilize mental health services. There exists a need for a comprehensive, multivariate analysis of the reasons medical students do not pursue mental health services, and the undesirable mental health outcomes that are associated with these barriers. This study associates psychiatric phenomena of stress, anxiety, and depression within the context of barriers to use of mental health services in medical students.
Methods: In this cross-sectional study, medical students (N = 128) from the University of South Florida engaged with an online survey on their degree of perceived stress, anxiety, and depression using the Perceived Stress Scale (PSS), Generalized Anxiety Disorder-7 scale (GAD-7), and Patient Health Questionnaire-9 (PHQ-9), respectively. They also provided responses to a study-specific measure designed to assess barriers to use of mental health services. Multiple regressions were performed to determine the weights of associated variables—barriers to use of services—relative to the aforementioned psychiatric phenomena.
Results: Stress, anxiety, and depression were significantly associated— F(13, 113) = 4.541, p \u3c 0.001; F(13, 113) = 3.976, p \u3c 0.001; F(13, 113) = 6.296 p \u3c 0.001, respectively—with lack of time, stigma of mental health care, feeling that “my problems are not that important,” cost, fear of unwanted intervention, and fear of documentation on academic record.
Conclusion: Future interventions by relevant stakeholders can target specific barriers to use of mental health services to reduce stress, anxiety, and depression among medical students
A New Look at Sex Offender Rehabilitation: Embracing Elective Chemical Castration
Full text linkThis essay analyzes the historical and modern use of castration efforts on sex offenders and advocates for federally supported, elective chemical castration as an effective means of rehabilitative treatment and relapse prevention post-incarceration
A Retrospective Study of Pulmonary Function Tests in Bronchiectasis: An Infectious Disease of the Respiratory System
Full text linkIntroduction: Bronchiectasis, currently being recognized worldwide, is an abnormal dilatation of the bronchi and bronchioles brought on by recurrent cycles of inflammation and airway infection. Impaired pulmonary function has a predictive significance in bronchiectasis. When treating patients with suspected or confirmed respiratory diseases, pulmonary function tests (PFT) are useful examinations. Very few studies have been done on PFTs in bronchiectasis. The main aim of this study is to study PFTs in bronchiectasis.
Method: This is a retrospective observational study done on 50 patients over two years at the tertiary care center. The previous records of patients were collected from the Pulmonary Function Lab. The spectrum of lung functions in patients with bronchiectasis was studied with the parameters in pulmonary function tests to see pre- and post-bronchodilator changes in the study population.
Results: After post-bronchodilator use, flow volume curve parameters were significantly increased. The mean responses were significant for both FEV1 (increased from 1.29 to 1.53) and FEV1/FVC (increased from 70.9 to 78.4) criteria. However, there was no significant change for the mean MMEF 25/75 (increased from 1.09 to 1.45) criteria after bronchodilator use. The most common pattern was an obstructive defect 24 (48%).
Conclusion: When diagnosing and treating bronchiectasis, lung function tests are a crucial evaluation tool. Objective information regarding the kind and severity of respiratory impairment is provided by lung function testing. An airflow obstruction is the most frequent ventilatory pattern associated with bronchiectasis. There is improvement in FEV1 and FVC following bronchodilator use in bronchiectasis
Between Breaths: Healing and Being
Full text linkBurnout among healthcare professionals is an increasingly recognized crisis, yet pathways to resilience remain underexplored. This narrative chronicles the author’s personal journey from profound exhaustion to self-discovery and renewal. Through the integration of contemplative practices, nature exposure, and mindful nourishment, the author navigated the challenges of residency and emerged with a deeper understanding of well-being. By incorporating Isha Kriya meditation, Surya Kriya yoga, and self-inquiry practices rooted in Advaita Vedanta, the experience evolved into a transformative path of inner resilience. This report highlights the necessity of prioritizing self-care within the medical profession and offers evidence-backed insights into holistic wellness practices, urging healthcare professionals to cultivate a foundation of well-being as essential to both personal and professional fulfillment
The impacts of management practices on industrial hemp chemistry, physiology, and microbiome ecology.
No full textAgroecology incorporates ecology and agronomy to inform crop management. Industrial hemp (Cannabis sativa L.) is a prime system to investigate agroecological questions because it has only recently been authorized for commercial cultivation and its sensitivity to biotic and abiotic stressors is unresolved. Here, I investigate how some conventional management choices, including the application of fungicide, plastic mulch, and irrigation, impact the physiology, chemistry, and microbial ecology of industrial hemp. Overall, I found that industrial hemp can be both resilient and resistant to these stressors, an important development for the industry. In Chapter II, I tested the impacts of fungicide application and fungal pathogen inoculation on the non-target leaf endophyte community. Fungal endophytes are ubiquitous plant symbionts and appreciated for their role in modulating stress response in plants, making them of interest for agroecological applications. Fungicide application not only reduced pathogen abundance but also altered fungal endophyte community composition. Chapter III investigated the impact of irrigation applied in a plastic mulch system on hemp chemistry, physiology, and endophyte community, and Chapter IV examined the effects of insufficient and excess vi water on hemp chemistry and physiology. In both chapters, I found that water availability did not cause changes in plant physiology and had only minor impacts on hemp chemistry. As part of developing agroecological solutions for hemp management, I also utilized hemp-isolated fungal endophytes to test their potential to mitigate impacts from insect predation and water stress. In Chapter II, I inoculated diet with a potentially entomopathogenic endophyte to test its effects on the larvae of a hemp pest and found that fungal inoculation had no negative impacts. In Chapter IV, I inoculated plants with two fungal endophytes to test if they modulated stress response to water availability. Endophyte inoculation only had minor effects on the concentration of two cannabinoids. While endophytes did not elicit the target effects, they still have potential to be implemented in management for other purposes, such as a biological control against microbial pathogens. This dissertation contributes to the growing knowledge of industrial hemp and can be used to inform future agroecological investigations in this emerging crop
A causal model of performance shaping factors for human reliability analysis in manufacturing.
No full textHuman reliability analysis is a critical component of probabilistic risk assessment, aimed at predicting and mitigating human errors in complex systems. This dissertation develops a novel approach to human reliability analysis in manufacturing by integrating structural equation modeling and Bayesian networks to improve the estimation of human error probabilities. Traditional human reliability assessment methods, such as the Standardized Plant Analysis Risk-Human Reliability Analysis (SPAR-H) and the Technique for Human Error Rate Prediction (THERP), provide structured techniques for estimating human error probabilities. However, these methods often fail to capture the complex interdependencies among performance shaping factors (PSFs), limiting their applicability in dynamic manufacturing environments. To address this limitation, this study constructs a hierarchical causal model of PSFs, categorizing them into internal factors—such as stress, experience and training, and physical and cognitive abilities—and external factors, including task complexity, human-machine interface, and work processes. The research begins by identifying inconsistencies in existing PSF taxonomies and proposes an improved framework that captures the interrelationships among PSFs. A survey-based data collection process was conducted to validate the framework and gather expert assessments. Structural equation modeling, using a multiple indicators multiple causes (MIMIC) approach, is applied to confirm causal relationships within the PSF model, demonstrating that external factors significantly influence internal factors, which subsequently affect human reliability. A Bayesian network model is developed to estimate human error probabilities and is validated through a case study in ceramic filter manufacturing. The analytic hierarchy process is used to derive expert-based weightings, while sensitivity analysis identifies the most influential PSFs. Comparative evaluation with SPAR-H illustrates the enhanced predictive accuracy of the Bayesian model, especially for complex tasks involving multiple interacting factors. The findings provide valuable insights for improving human reliability in manufacturing and bridge theoretical contributions with practical applications. The proposed Bayesian model supports a probabilistic, data-driven approach to error estimation, making it adaptable to evolving industrial contexts. Future research directions include the integration of real-time operational data, the incorporation of artificial intelligence and machine learning for adaptive modeling, and broader validation across diverse industrial sectors
The impact of consensus decision making on creating conditions for psychological safety in SBDM councils.
No full textThis study reflects an examination of the forces and factors that impact effective decision-making on a Site-Based Decision Making council (SBDM) in Kentucky. It explores the relationship between consensus decision-making, the leader of a school, and the stakeholders who sit on an SBDM council as it relates to members’ feelings of inclusion, value, and belonging. A qualitative case study was designed to capture observational data gathered during SBDM meetings, as well as data gathered during member interviews. This data was analyzed through a relativist theoretical lens, which revealed that when open, trusting relationships are established among council members, decision-making flourishes. The findings and conclusions of this research have the potential to impact future SBDM councils in the future as they seek to embed inclusive decision-making practices that acknowledge cultural dynamics and cognitive inputs in a multicultural society
CNS-specific HIV reservoir characterization in humans: advancing our understanding through novel genomics methods.
No full textThe persistence of the human immunodeficiency virus (HIV) reservoir despite years of suppressive antiretroviral therapy (ART) represents the principal obstacle to achieving a functional cure. Because the intact, replication-competent portion of the reservoir drives viral rebound after treatment interruption, HIV cure strategies must specifically identify and target cells harboring these proviruses. Conventional reservoir‐characterization techniques typically require separate assays to capture integration sites, assess proviral integrity, and quantify clonal proliferation and they rely on short‐read sequencing. These limitations hinder our ability to understand how integration landscapes, the integrity of the HIV genome, and cell‐division dynamics intersect to maintain viral persistence in diverse tissues. We developed HIV SMRTcap, a single‐molecule, real‐time capture method that unifies long‐read sequencing with a customized bioinformatics pipeline. The assay employs targeted enrichment of HIV proviral DNA, followed by long read sequencing to recover contiguous proviral genomes and their flanking host sequences. We first validated SMRTcap’s sensitivity and performance across subtypes A, B, C, D, and A/D recombinants. We then applied the method to postmortem tissues—frontal lobe and spleen—from ART-suppressed, viremic, and HIV-associated encephalitis (HIVE) donors vii to characterize the HIV reservoir in tissues during different stages of infection. HIV SMRTcap effectively captured comprehensive reservoir characteristics across multiple HIV subtypes and tissue types. In the frontal lobe of ART-suppressed individuals, proviral integration predominantly found in intergenic regions, consisting of heavily truncated proviruses. In the other hand, the encephalitic donors exhibited variable cellular reservoir characteristics, reflecting different representation of disease severity. Notably, proviral populations in brain and spleen tissues primarily consisted of unique integration events or small clones, suggesting minimal clonal expansion. Integration site distributions varied among the groups but showed no preferential integration into zinc finger genes; however, these integrations persisted post-viral suppression. Together HIV SMRTcap is a sensitive, robust, and comprehensive tool capable of characterizing HIV reservoirs across various subtypes and tissues. Despite its current methodological limitations—such as distinguishing episomal from sheared genomic DNA and capturing hypermutated sequences—the assay significantly advances the understanding of tissue-specific HIV reservoirs. Further research with expanded cohorts and improved bioinformatic analysis will enhance reservoir characterization, guiding future HIV cure strategies
Healthcare access and agency in material culture: a specialized analysis of pharmaceutical artifacts from Louisville’s West End.
No full textThe American Victorian Period of the 1870s to 1920s was a time of significant transitions in medicine. In Louisville, Kentucky, this period saw an influx of Black healthcare professionals and the founding of Louisville National Medical College, the state’s first medical school open to people of color. A number of these professionals lived and/or practiced in the Beecher Terrace study area, which was excavated between 2017 and 2020. Patent medicine brands and archival records were examined qualitatively in order to understand neighborhood and case study household health concerns and consumer choice. Statistical analyses of the medicine bottles recovered during the archaeological investigation and of city mortality rates were employed in order to understand diachronic changes in healthcare access and outcomes for neighborhood residents. The findings suggest that, while marginalization negatively impacted Black Louisvillians, health outcomes improved significantly after the establishment of Black professionals and institutions