Changing lifestyles in today's world have resulted in the evolution of many human activities. One of them is recreational drug use. The purpose of this study was to explore the association between drug usage, mental well-being and felony convictions among a sample of adult recreational drug users. The primary purpose of this analysis was to develop a set of predictor variables from the DRUGNET data set (i.e., lifestyle, drug usage, GWBS) that were able to account for the criterion variables (i.e., drug-related felony vs. no drug- related felony and non-drug felony vs. no felony ). The analyses attempted to differentiate the smaller portion of drug users who have experienced felony offenses (i.e., cases) from the majority of users who have not been convicted of these offenses (i.e., controls). Epidemiological case-control analyses (discriminant analyses) were performed by drawing a matched sample of cases and controls using their gender and age (+/- 2 yrs.). Drug laws and policies differ from country to country. Therefore the present study was limited to the United States citizens of age 18 yrs. or older. The study results support the hypothesis that there is a subgroup of the drug consuming population (i.e., recreational drug users) who lead productive and successful lives. The results found suggest that punishing a relatively small portion of drug users for their personal habits of using/possessing drugs may be counter productive rather than focusing on controlling abuse. The implication is that drug use should be perceived as a public health problem, not a criminal activity. The national policy targets should focus on education, public health, treatment and rehabilitation rather than incarceration.

Along with the numerous physical benefits of exercise, past research has shown that physical activity can alleviate symptoms of anxiety and depression in both clinical and non-clinical populations. Yet, it has been suggested less than half of American adults exercise at public health recommended levels. Therefore, it is important to identify factors that may lead to an increase in physical activity and, subsequently, improvements in mental health. Previous research, for the most part, has neglected to investigate how preference for attentional focus strategy during exercise influences mood. In addition, previous studies that involved attentional focus and exercise have focused more on participant’s resulting performance than affect. Therefore, the purpose of this study was to determine whether or not preference for attentional focus strategy would moderate the amount of affective change and enjoyment experienced during and after exercise. Participants (N=100) were recruited from psychology courses at Western Kentucky University. They were asked to run on a treadmill for 20 minutes on two separate days, one week apart. On one of the days they were asked to engage in their most preferred attentional focus strategy and another day their least preferred attentional focus strategy. The order of these sessions was counterbalanced. Participant’s preference for attentional focus strategies was used as an independent variable. The first dependent variable of interest was changes in affect, measured by the Activation-Deactivation Adjective Checklist (AD-ACL). The second dependent variable of interest was enjoyment, measured by the interest/enjoyment subscale of the Intrinsic Motivation Inventory (IMI). A 2 (Preference Condition) X 4 (Time) ANOVA was conducted for affect. There were no significant main effects and no significant interactions for preference. Yet, there was a significant change in affect across time. A one way ANOVA was conducted on enjoyment and autonomy levels. There were no significant main effects for preference. Results of the study indicated preference for attentional focus strategy does not influence the level of affective benefits typically associated with exercise, nor does it influence perceived enjoyment and autonomy. In addition, the study indicated individuals acquire affective benefits from engaging in moderate intensity exercise regardless of attentional focus strategy. Following from the findings of the current study, it is suggested that researchers continue to identify factors of the exercise experience that may lead to an increase in physical activity and, subsequently, improvements in mental health.

Depressive symptoms are common in patients with heart failure (HF) and adversely affect mortality, morbidity, and health-related quality of life. Cognitive therapy (CT) has been proposed as a non-pharmacological treatment for depressive symptoms in patients with HF. However, there is currently little evidence to support use of CT in patients with HF. The purpose of this dissertation was to develop and test a brief, nurse-delivered CT intervention for the treatment of depressive symptoms in patients with HF. Prior to testing the intervention, preliminary work was conducted resulting in four manuscripts: 1) a review of the evidence for CT in treating depressive symptoms in patients with cardiovascular conditions, 2) a description of living with depressive symptoms in patients with HF and strategies that could be used to manage these symptoms, 3) a review of measures of negative thinking and the identification of a measure of negative thinking that can be used in patients with HF, and 4) an evaluation of the psychometric properties of this measure. Based on information from these manuscripts, a randomized, controlled pilot study was conducted to test the effects of a brief CT intervention on outcomes of hospitalized patients with HF who report depressive symptoms. Forty-two hospitalized patients with HF with mild-moderate depressive symptoms were randomized to a brief CT intervention focused on reducing negative thoughts with thought-stopping and affirmations, or to usual care control. Both groups experienced improvements in depressive symptoms, health-related quality of life, and negative thinking at one week and three months. However, the intervention group experienced longer cardiac event-free survival and fewer cardiovascular hospitalizations and emergency department visits at three months when compared to the control group. This dissertation has fulfilled an important gap in the evidence base for depression treatment in patients with HF by demonstrating that a nurse-delivered, brief CT intervention may improve cardiac event-free survival in patients with HF. This brief CT intervention is replicable, practical, can be delivered by acute care nurses, and may improve clinical outcomes in patients with HF. Additional research is needed to determine the effects of the intervention on long-term outcomes in patients with HF.

Purpose: The purpose of this interpretive phenomenological study is to explore the lived experience of Haitian immigrant women living in Massachusetts with PPD. Specific Aims: Aim 1: To explore the lived experience of PPD among Haitian immigrant women. Aim 2: To explore how the experience of being Haitian influences Haitian immigrant women in their response to PPD. Framework: Leininger's Theory of Cultural Care (1988) guided the phenomenological approach and data collection. The Transcultural Care Decision & Action model contains three predictive modes for guiding nursing care judgments, decisions, or actions to provide care. Design: Interpretive phenomenology guided this qualitative study. Individual face-to-face interviews were conducted. The data from each interview were transcribed into a written document and analyzed using the Crist and Tanner five-step process. Results: This study yielded two themes; each theme has three dimensions. The first theme is “Feeling Disconnected” with three dimensions: (a) lack of support; (b) partner conflict; and, (c) nostalgia of Haiti. The second theme is “Feeling Reconnected” with three dimensions: (a) realization of needed help; (b) spirituality; and, (c) resilience. Conclusion: This study provides insight into the lived experience of Haitian women with PPD. Awareness of Haitian women’s actual experiences with PPD will help health care providers to identify and provide culturally appropriate care to this population.

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Guided inquiry is a teaching practice gaining popularity in the college setting, particularly within STEM classes, although it is a strategy that can be used across a broad spectrum of disciplines. Increasingly, courses are being offered online (asynchronously), which can present challenges for instructors seeking to help students become intellectually engaged, reaching deeper understandings of course concepts and the relationships among them. Guided inquiry may be one tool instructors can use to encourage students’ deeper exploration of course material. The purpose of this practice session is to explore how guided inquiry can be applied in an online setting, with discussion regarding its benefits and challenges. Examples from social science classes will be provided.

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