<p> This case study evaluated the effects of differential reinforcement of other behavior (DRO) on scripting in a four year-old child with Autism Spectrum Disorder, Obsessive Compulsive Disorder and Celiac Disease. The overall goal was to show that DRO as the only independent variable could reduce scripting in a child with autism. A vibrator was set to vibrate every six minutes to indicate the end of each interval during intervention and the behavior was measured using a partial-interval time sampling method during the two hour in-home private Applied Behavior Analysis session over a two month period. An A-BC-C design demonstrated that DRO successfully decreased scripting behavior in the child with autism. A dependent paired samples t-test was used to compare the rates of scripting during the first three days of baseline and last three days of intervention. Results demonstrated a 29% decrease in scripting behavior. This result extends previous research that showed DRO, within a combined intervention, could be effective in decreasing scripting of adolescents with autism.</p>

<p> The current study examined how parental underestimations of child&rsquo;s weight status, parental worry, and the Theory of Planned Behavior variables (attitudes, subjective norms, and perceived behavioral control) predict intentions to adhere to the American Academy of Pediatrics&rsquo; (AAP) recommendations of four childhood health behaviors. These behaviors include: 1) eating five fruits and/or vegetables per day; 2) spending two hours or less on screen time (television, computer, and video games) per day; 3) engaging in at least one hour of physical activity per day; and 4) limiting (having zero) sugarsweetened beverages. Parents (N = 78) of overweight and obese children, ages six to 13 years old, were recruited from pediatric medical clinics and participated in an online study, where they were exposed to these AAP behavioral recommendations for children and completed online measures. Attitudes predicted of behavioral intentions for all recommendations except fruit and vegetable consumption. Subjective norms marginally predicted behavioral intentions for physical activity and sugar-sweetened beverage consumption. Perceived behavioral control predicted behavioral intentions for the four recommendations. Parental worry predicted behavioral intentions for fruit and vegetable consumption. Additional theoretical and practical implications of this research are also discussed.</p>

<p>Adults with intellectual disabilities (ID) are at risk for negative health conditions due to high levels of sedentary behavior. Walking and cycling are the most common forms of physical activity engaged in by adults with ID. Research is limited in evaluating physical activity interventions for this population. The purpose of this study will be to evaluate the effectiveness of a token reinforcement intervention to increase distance walked for adults with mild to moderate ID at adult day training centers. </p>

<p> This dissertation focused on how the affiliation and engagement practices that contribute to social cohesiveness result in changes to conversation for three individuals with aphasia that were part of group therapy that targeted improved communication through conversation. It revealed how those changes were made manifest by employing a qualitative research design which allowed the researcher to discover how social cohesiveness is demonstrated in conversation. This design included the administration of aphasia batteries that are widely used in the area of aphasiology and were administered prior to and subsequent to the period of conversation treatment. The design further included medical and clinic records that informed the researcher of the participant's physical and communicative abilities. The primary research tool was Conversation Analysis which by virtue of its dual characteristics of being context-sensitive yet context-free allowed the researcher to examine behaviors in an authentic context and observe patterns within and across participants. Additionally, post-semester interviews served as a lamination tool that, along with the primary and other secondary data sources, would verify or refute the patterns of conversation changes. </p><p> The resulting data were then analyzed for patterns of conversation change and formed three areas of interest; patterns of conversation changes that revealed the member's growing orientation toward group cohesiveness, patterns of changing compensatory strategy use, and changing patterns of turn-taking. The results of this study demonstrate the importance of social cohesiveness as an integral part of group conversation treatment and its effect, as a catalyst, upon improving conversation ability. Additionally, it illustrates group cohesiveness as a multi-dimensional construct that involves an orientation to task and interpersonal cohesiveness. Further, it explicates the relationship between an individual's functioning, personal factors, and context as influencers of the aphasic's demonstration of social cohesiveness. This study proffers important implications concerning the value of a qualitative research design for studying communication changes in aphasia and the essential employment of constructivist approaches to communication therapy for individuals with aphasia. These clinical implications shape the assessment and intervention practices of clinicians who recognize the transformative power of a constructivist approach that requires the situation of treatment in an authentic context. </p>

<p> Several demographers and scholars have dubbed the baby boomers&rsquo; transition to retirement as the <i>graying society</i>. Therefore, and recognizing its importance, the main objectives of this study were to learn about the transition to retirement process and its related meanings for baby boomers in the public sector. Using a mixed methodology, 382 retirees shared their perceptions on the subjects via questionnaire and 6 via interviews. This study concluded with a validation of previous authors on the importance of being prepared prior to retirement especially in the case of those with disability retirement.</p>

<p> The inhibitory reflex, also known as the cutaneous silent period (CSP), is a spinal reflex mediated by small diameter A-&delta; fibers, serving to protect the body from harmful stimuli (Leis et al., 1992; Kofler, 2003). Previous investigations have suggested that the inhibitory effects of this reflex only occur within extensor muscles. The present study sought to determine the influence of the inhibitory reflex within both flexor and extensor muscles of the upper limb thereby providing further insight into the spinal organization of this reflex. Two subsets of data were collected. 22 subjects had the inhibitory reflex evoked with three different stimulation conditions (digit II, V and II+III stimulation at 10x perceptual threshold). 14 subjects returned to have transcranial magnetic stimulation (TMS) paired with digit II stimulation. Within both datasets subjects performed isometric contractions with each of the following upper limb muscles: abductor pollicis brevis (APB), flexor carpi radialis (FCR), extensor carpi radialis (ECR), biceps brachii long head (BIC), triceps brachii lateral head (TRI), anterior deltoid (AD), and posterior deltoid (PD). All stimulations were applied randomly during the isometric contractions. The first dataset included 20 stimulations in each condition within each muscle of the right arm. The second dataset included 10 stimulations of digit II only (CSP), TMS only (TMS), and a inhibitory reflex conditioned TMS (TMS+) within each muscle of the right arm. Distal muscle demonstrated the greatest influence for both the inhibitory reflex response and motor evoked potentials. A distal to proximal relationship was determined for the inhibitory response with a level of differential control occurring between the distal and proximal muscles. These results demonstrate evidence of the CSP in both flexor and extensor muscles of the upper limb, with the greatest effect taking place within the distal muscles. I hypothesize that this distal--proximal organization of cutaneous inhibitory reflexes may be influenced by the number of direct cortico-motoneuronal connections within the corticospinal tract. Thus, the cutaneous feedback plays a larger role in modulating direct descending input in distal muscles involved in grasping and manipulation, versus proximal muscles coordinating reaching.</p>

<p> Body image disturbances are associated with a variety of health compromising behaviors; however, less is known about their impact on health maintenance behaviors. The present study investigated the relationship between body image disturbances and the frequency of a specific body-focused health maintenance behavior: breast self-examination (BSE). It was hypothesized that two manifestations of body image disturbance, body shame and body avoidance, would be negatively associated with frequency of BSE in the past year and intended frequency of BSE in the coming year. Furthermore, it was hypothesized that health anxiety and risk perception for breast cancer would moderate the relationship between body image disturbance and frequency of BSE in the past year. As a secondary research question, the impact of body image disturbance on the self-reported level of negative affect experienced during BSE was investigated. </p><p> Participants were 120 women between the ages of 21 and 40 (M age = 24.14, SD = 4.78; M BMI = 24.73, SD = 5.75) recruited from a large public university. Following informed consent, participants completed a battery of self-report questionnaires assessing demographic variables, body image disturbances, BSE behaviors and intentions, health anxiety, and risk perception. Participants were also encouraged to complete follow-up questionnaires for three months assessing frequency of BSE and associated negative affect. </p><p> Results showed that when the entire sample was considered, neither body shame nor body avoidance were significantly associated with past year BSE or BSE intentions and neither health anxiety nor risk perception emerged as moderators. However, when only women ages 22 to 40 years old were considered in post hoc analyses, body shame significantly predicted past year BSE and both body shame and body avoidance significantly predicted BSE intentions. Additionally, risk perception emerged as a predictor of past year BSE. An additional post hoc analysis revealed that age moderated the relationship between risk perception and past year BSE when the entire sample was considered. Follow-up data revealed that neither body avoidance nor body shame significantly predicted affect during BSE after controlling for physical discomfort. These findings have important implications for health promotion among women of all ages.</p>

<p> The Bureau of Substance Abuse Treatment Recovery and Prevention, which oversees drug intervention services for Detroit residents, has found the city's illegal drug use among teens to mirror national rates. Illegal drug use is associated with addiction, major health problems, and stigma. Incorporating evidence-based screening during all teen health care visits would decrease missed opportunities to identify at-risk behaviors, the number of teens that do not receive intervention, and the stigma associated with screening. The purpose of this project was to develop evidence-based policy and practice guidelines for teen screening services for illegal drug use. The Plan-Do-Study-Act (PDSA) model was used to guide the project. An interdisciplinary team of direct service and administrative staff selected questions based on 6 key words&mdash;car, relax, alone, forget, friends, and trouble (CRAFFT)&mdash;to screen teens for illegal drug use. The interdisciplinary team also developed a teen screening policy along with practice guidelines for the screening policy, implementation plan, and project evaluation. A review of the literature provided support for the project methods. Two experts in the field of substance abuse provided content validity for the policy and practice guidelines, and concluded that the CRAFFT screening questions were valid for evidence-based screening for illegal drug use among teens, that the PDSA model was effective to guide the project, and that an interdisciplinary team approach was effective to address the issue. These findings may improve identification of at-risk teens, decrease missed screening opportunities, decrease stigma, and align the Bureau with current trends in substance abuse treatment.</p>

<p> Understanding the processes involved in retaining nurses in the Emergency Department is essential for future hiring and retention; turnover rates are currently at approximately 16% in the emergency department. Using Grounded Theory Methods (Glaser &amp; Strauss, 1967) and the conceptual framework of symbolic interaction, the process of becoming and remaining as an ED nurse was explored.</p><p> Data were collected through semi-structured, open ended interviews until data saturation occurred. The seven participants' ages ranged from 29-56 with ED nursing experience ranging from 1-17 years and nursing experience from 2-18 years. Five phases emerged from data analysis using constant comparative analysis of 183 pages of transcripts, through coding phrases, categorizing, and conceptualizing them. These phases, each with sub-categories, explained a process identified as <i>Seeking Status.</i> The five phases were: <i> joining the troops, working in the trenches, passing muster, earning stripes, </i> and <i>looking ahead.</i> <i>Passing Muster</i> emerged as the core category, the one that best explained the process and connected the other conceptual categories in this process.</p><p> The theory, <i>Seeking Status</i>, was compared to and contrasted with theories from nursing, sociology and anthropology such as socialization, rites of passage, adaptation, role identity, and reality shock. The theory overlapped with some of the theories explored; however it was unique in the finding regarding the significance of a two-tiered hierarchy of roles in the ED.</p><p> Implications for recruitment strategies, longer orientations and the need for preceptors for new nurses were described. Senior nurses, on the other hand, would benefit from increasing knowledge and skills regarding leadership and management strategies in their role.</p>

<p> Although Carl Jung and Joseph Campbell were both avid athletes, research and theory around engaging in sports as a valuable psychological process is quite rare. Athletic experience has hardly been looked at through the lens of the archetypal hero's journey, or the path of the warrior, in spite of the fact that mythology and literature are filled with stories of such characters and they are often the primary subject of contents of dreams, reverie, and active imagination. Given that martial arts is steeped in rich cultural traditions, and intertwined with political history as well as mythology, this lack of study creates a gap in Jungian literature, particularly with regard to the archetypes of initiation and individuation. </p><p> This phenomenological hermeneutic study explores the lives of five Brazilian jiu-jitsu black belt professors. The Literature Review was framed around historical perspectives of Brazilian jiu-jitsu, Jungian psychology and somatics, sports philosophy, phenomenology, and hermeneutics. It provides an in-depth perspective of lived experience of a very popular martial art used for self-defense. Brazilian jiu-jitsu was chosen for a variety of reasons, including the ability to teach highly dangerous techniques to a wide range of participants, and because the rapid growth of jiu-jitsu may indicate places where collective energy is moving. This raises the questions, Why Brazilian jiu-jitsu? Why Brazilian Jiu-Jitsu right now? </p><p> The implications of this study and the qualitative data gleaned from the interviews show that the practice of Brazilian jiu-jitsu can offer a great deal to individuals and communities, and can impact either, depending on intention. The practice, as lived by five interviewees and many other practitioners who were consulted, offers a safe environment for personal transformation, coupled with a spirited playful atmosphere, an emphasis on social values, and teamwork. With these structures in place, Brazilian jiu-jitsu schools frequently become places to improve quality of life and to inadvertently address a wide variety of maladaptive and clinical issues. </p><p> Key Words: martial arts, Jungian psychology, jiu-jitsu, phenomenology, sports, archetypal.</p>