Mobility safety, especially fall prevention, plays a significant role in successful aging for older adults. Fall preventive programs aim to reduce risks for mortality from fall-related injuries among older adults. However, the covariation between personal perceptions of falls and factors and confidence of self-management in falls (CSMoF) is still under-studied despite its importance to fall prevention. Using the International Classification of Functioning, Disability, and Health (ICF) model, this dissertation aimed to investigate the relative contribution of CSMoF in relation to fall risk self-perceptions while controlling for demographics and self-reported health and functioning. Participants were 691 older adults recruited from Area Agency on Aging at Arlington, Texas. They completed measures of physical functioning, CSMoF, fall risk perceptions and fear of falls. Regression analyses indicated that fear of falls was the most predictive factor of CSMoF among older persons. Physical function measures of age, chronic illnesses of metabolism, sensory impairment, and health status were also significant predictors of the CSMoF. The interaction of perception of falls and fall experience attenuated CSMoF, with physical functioning limitations. Fear of falls served as a mediator through which demographic predictors influence CSMoF. The joint effects of perception of falls and fear of falls likely explain CSMoF among older adults more than physical functional indicators. Fall prevention programs for older adults should prioritize to address modifiable subjective factors of fall perceptions, fear of falls, and CSMoF across health and functioning statuses. Fear of falls should be the center of CSMoF enhancement.

The objective of this thesis is to assess the prevalence of low quality of life in adult cancer survivors and predictors for these low scores, separately for physical and mental quality of life. Possible predictors can include sociodemographic, clinical, and behavioral factors. The data source for this thesis is the National Health and Nutrition Examination Survey (NHANES) 2005-2012. The sample population included 1244 cancer survivors 20 years or older that answered “yes” to the question “have you ever been told by a doctor or other health professional that had cancer or malignancy of any kind?” Mental and physical health scores were determined based on the number of days physical and mental health was not good and dichotomized according to mean value. The four groups identified were low mental health and low physical health (n=148, 11.9%), low mental health and high physical health (n=239, 19.2%), high mental health and low physical health (n=143, 11.5%), and high mental health and high physical health (n=714, 57.4%). The diet quality was calculated using the Healthy Eating Index 2015, which measures adherence to the Dietary Guidelines for Americans 2015-2020. The SAS Survey Analysis Procedures was used to account for the random multi-stage sampling of NHANES. Also, ANOVA and chi-square tests were used to determine the possible predictors of low quality of life while multivariable logistic regression analysis was performed to examine the independent predictors of low physical and mental health. Statistical significance was set at a two-sided p-value of

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With the increase of students applying to pharmacy programs, it is imperative that admissions committees choose appropriate measures to analyze student readiness. The purpose of this research was to identify significant factors that predict the academic performance, defined as grade point average (GPA) at the end of the first professional year, of pharmacy students. The population consisted of 466 students enrolled in a Doctor of Pharmacy Program in northeast Tennessee over a 5-year period. Statistical procedures included bivariate correlations, t-tests for independent samples, and multiple regression. Analysis of the data revealed that the majority of the students in the population were between 21 and 24 years of age, female, and White, non-Hispanic. Most were from the surrounding region, attended a 4-year undergraduate institution, and earned a bachelor’s degree prior to pharmacy school. Average PCAT scores were: 68 (Composite), 67 (Biology), 64 (Chemistry), 64 (Reading), 60 (Quantitative Ability), and 68 (Verbal Ability). The average undergraduate GPAs were 3.43 (cumulative) and 3.32 (math and science), whereas the average first-year pharmacy school GPA for the population was 3.33. Younger students tended to have higher first-year pharmacy GPAs than did older students. Students with higher PCAT Composite, Biology, Chemistry, or Verbal Ability scores also tended to have higher first-year pharmacy GPAs. Students in the population under study with high undergraduate math and science GPA or undergraduate cumulative GPA also tended to have a high first-year pharmacy GPA. Female students had higher first-year pharmacy GPAs than male students, and White, non-Hispanic students had higher first-year pharmacy GPAs than students of other races or ethnicities. Predictors of first-year performance differed based on gender and race or ethnicity, but cumulative and math and science undergraduate GPAs were consistently significant predictors. No significant difference in first-year pharmacy GPA was observed based on regional status, undergraduate institution type or location, or bachelor’s degree status. The linear combination of preadmission factors was significantly related to first-year pharmacy GPA using a multiple regression model, and the cumulative undergraduate GPA variable accounted for 25% of the variance in the first-year pharmacy GPA.

An amplified emphasis on global competency and a projected demographic shift toward an increasingly diverse population necessitates that businesses and organizations prepare adequately to remain competitive and effective. Training to enhance employees' multicultural competence is often used by organizations to address these impending changes; however, there is little research documenting the degree to which these trainings are effective. Using archival training evaluation data, the purpose of this study was to examine participant estimations of the effectiveness of one such training and also to determine if participant demographic variables including gender, age, ethnicity, sexual orientation, and employee classification (faculty or staff) held any predictive value in relation to training ratings. The results indicated that overall most participants found the training effective. Staff, female, or non-White participants were significantly more likely to rate the training favorably. These results suggest that diversity training may be a viable method of addressing changing organizational demographics and provides some insight as to how training group demographics could be used during the training planning and implementation process to individualize the curriculum.

Individuals in the forensic mental health system who have experienced adverse childhood experiences (ACEs) are more likely to display suicidal ideation and engage in suicidal or non-suicidal self-injurious behavior. Additionally, prior research suggests that sex offender status may be disproportionately associated with increased suicidality. The current study explores risk correlates in those at heightened risk of suicidality and self-harm due to involvement with the criminal justice system, the presence of serious mental illness, and exposure to ACEs. Initial ACEs research explored the impact of self-reported physical, sexual, and emotional abuse, emotional and physical neglect, and household dysfunction on long term adult mental and physical health outcomes. While the ACE survey is a strong determinant of possible later adulthood adversity in samples with a range of exposure to adversity, it may be less helpful in criminal justice and forensic populations who experience disproportionate exposure to ACEs. Other risk correlates above and beyond those identified in the ACE survey may influence suicidality and self-harm and are yet to be explored. Here, outcomes included history of suicide attempts, age at first suicide attempt, and if 1st psychiatric hospitalization resulted from attempting suicide. Predictors included gender, total ACE score, out of home placements, status as a violent or sexual offender, mental health diagnoses, multiple sexual perpetrators against female participants, and cause of parental incarceration. Participants were 182 forensic inpatients in a maximum and intermediate security state hospital. The majority were male (81%; n = 147), with ethnicity nearly evenly distributed between Caucasian (56%; n = 101) and African-American (40%; n = 73), with few of Hispanic (2%; n = 4) or mixed ethnic (2%; n = 4) origins. Participants were, on average, 32.5 years of age (SD = 11.6, range 10-61). Most presented with a psychotic disorder (59.90%, n = 109), while other most frequent diagnoses included intellectual disability/cognitive developmental disorders (57.70%, n =1 05), a mood disorder (45.60%, n = 83), and impulse control disorders (22.5%, n = 41). Thirty-seven participants reported an ACE score of 0 (20.6%), 36 an ACE score of 1 (20. %), 32 an ACE score of 2 (17.8%), and 17 an ACE score of 3 (9.4%). Fifty-eight patients presented with an ACE score of 4+ (33%). Mean gender differences were significant (χ2 = 25.9, df = 8, p < .001), with the modal ACE score among female participants at 7, at a rate of nearly 23%. Of note, 29 (15.9%) had previous arrests for sexual offenses, and 79 (42.7%) were arrested for non-sexual violent offenses. Those remaining had engaged in these behaviors but were not arrested. In order to evaluate the impact of our predictor variables on the relationship between ACE score and likelihood of an individual making a suicide attempt, a single predictor logistic model will be fitted to the data. History of suicide attempts included 96 participants (52.7%) having made an attempt. Because it is likely that ACE score alone will not explain the relationship between suicide attempts in a sample with such elevated ACE scores, additional predictors will be included in a multiple predictor logistic model, including status as a sexual offender. Similar analyses will examine the impact of ACEs, sex offender status, and other related variables on the likelihood that first psychiatric hospitalization resulted from suicidality. A one-way between subjects ANOVA will be conducted to compare the effect of an ACE score of four or more on the age at first suicide attempt. We will additionally examine the impact of sex offender vs. violent vs. other offense status on age at first suicide attempt.

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The cost of health care continues to increase. Based on the biopsychosocial model of heath care, it has been shown that the treatment of psychological and social problems can have a cost offset effect on the cost of medical care. While this offset effect has been shown in an MFT population, there are no known studies that have looked at predictors of the change in medical use by those that receive marital and family therapy. This study looked at psychological and social measures of individuals who received marital and family therapy. These measures were evaluated based on the change from intake to one year post intake using best subsets multiple regression. The model for males showed variables that could be affected using a cognitive or cognitive-behavioral model of therapy. The model for females showed variables that could be affected using the emotionally focused model of therapy. The implications of this study are that a therapist could be the most effective in conjoint therapy if they apply concepts from both cognitive and emotionally focused therapeutic models.