Research Model Applications In The Investigation Of Vascular Disease Treatments, Alex Anthony Dangler

Dissertations and Theses

Cardiovascular disease (CVD) is a pressing global health issue with significant socioeconomic consequences. Within the spectrum of CVDs, peripheral artery disease (PAD) and aortic disease necessitate the development of effective and safe treatments. To achieve this, various research models are employed to investigate molecular mechanisms of cells, understand cellular interactions in vascular diseases, assess biocompatibility, and test and evaluate medical devices. This dissertation examines research models and their applications in the advancement of treatments for vascular diseases. For the evaluation of liposome delivery systems in PAD, an ApoE-/- cellular mouse model was employed to investigate the cellular uptake of liposomes …

Patient Frailty: A Review, Lakshmi Sailaja Kodavati

Dissertations and Theses

According to Geriator (2011), frailty is a common clinical syndrome in older adults that carries an increased risk for poor health outcomes such as falls, incident disability, hospitalization, and mortality. An operational definition of frailty is the existence of at least three out of five observable criteria indicating compromised energetics: low grip strength; low energy; slowed walking speed; low physical activity; and unintentional weight loss (Fried, et al. 2001).

According to Dubois and Charpillet (2017), most transitions into frailty are due to unintentional weight loss which, in turn, impacts gait performance and subsequent general mobility. In this literature review, the …

Adaptation To Sport Retirement In Division I Student-Athletes, Andrea Cota Powell

Dissertations and Theses

This dissertation utilizes a mixed-methods design to explore adaptation to sport retirement among Division I student-athletes. Sport retirement is a major life transition that can elicit changes in support systems, identity crises, and feelings of loss, failure, and grief. Transitioning out of sport is a phenomenon that over 90% of collegiate student-athletes experience when their four years of NCAA eligibility expires. It is a phenomenon that all athletes experience at some point in their lives. To transition out of sports, one must adapt to post-sport life. Study one of this dissertation explored the phenomenon of occupational retirement through concept analysis …

Promoting Well-Being Among Intercollegiate Student-Athletes: A Gratitude Intervention Using Positive Psychology, Laura Kruger

Dissertations and Theses

Intercollegiate student-athletes face rising stress and pressures which challenge their well-being and mental health, and sometimes with alarming concerns. Over the years, supportive services and resources specifically available to student-athletes have not evolved at the same pace as student-athlete needs. Also, barriers and stigmas hinder student-athletes from readily accessing supportive mental health services. The high stress of student-athletes can contribute to the development of negative mental health symptoms and impairs positive well-being. Evidence supports how outreach initiatives help student-athletes. Positive psychology, including gratitude as a positive psychological state, has shown benefits to well-being. This experimental study design researched if the …

Intentional Misdiagnosis And Ethical Considerations Of Mental Health Counselors Working With Managed Care, Emily Lake

Dissertations and Theses

Abstract Research has discussed ethical dilemmas for professional counselors working with managed care. Professional counselors are faced with the implications of providing a diagnosis to clients to receive reimbursement by managed care and to assist clients in receiving care. The purpose of the study is to better understand the counselor’s role in intentional misdiagnosis due to billing requirements from insurance companies. Furthermore, the researcher is interested in the personal and professional characteristics of counselors predictive of the decision to engage in intentional misdiagnosis. Participants in this study were asked to complete the Marlowe-Crowne Social Desirability Scale and a researcher-created survey. …

Working Conditions, Type 2 Diabetes Mellitus, And Health Behaviors In Latino And Other Minoritized Groups Living In The United States, Tailisha M. Gonzalez

Dissertations and Theses

Background: Type 2 Diabetes Mellitus (T2DM or ‘diabetes’) poses a significant public health challenge to the healthcare system, economy, and well-being of communities in the United States (U.S.). There are also substantial racial/ethnic and social disparities in diabetes incidence and control that have persisted for decades. For Latinos and other minoritized groups in the U.S., diabetes disparities may be linked to working conditions. Globally, work is considered a major determinant of health and yet studies in the U.S. tend to focus on legacy hazards, such as chemical, biological, and environmental factors. In recent years, occupational health scholars have argued …

The Makings Of Creativity And Empathy: Maps Of Maternal Representations, Anielle M. Fredman

Dissertations and Theses

ABSTRACT

The Makings of Creativity and Empathy: Maps of Maternal Representations

by

Anielle M. Fredman

Advisor: Sasha Rudenstine, Ph.D.

The present study investigates the relationship between maternal fantasy of the child and their relationship, and children’s unconscious processes. In addition, the study aims to ascertain the link between maternal representations and aspects of the child’s intrapsychic world, including ego functioning, object relations, and processes of separation-individuation.

Maternal fantasy was measured in an original way with a tripartite typology of Positive, Mixed-Complex, and Contradictory Representations, applied to the Parent Development Interview-Revised Short (Slade et al., 2004), adapted from the Working Model …

Use Of Bioheat Modeling To Characterize And Optimize Implantable Medical Devices And Neuromodulation Technologies, Adantchede Louis Zannou

Dissertations and Theses

Medical device development includes prototyping, benchtop characterization, preclinical studies, and clinical trials. Understanding the limitations and potential adverse effects of medical devices prior to their administration in humans is a crucial first step. Optimizing medical devices is essential to employing technology and improving patients care. Computational modeling is widely adopted as a powerful tool to predict stimulation/recording parameter optimization, rapid electrode/device prototyping, investigating novel mechanism of action, and testing working principles of any medical devices. Many implantable neuromodulation technologies including Spinal Cord Stimulation (SCS), which provide substantial therapeutic benefit for patient population with lower back pain, produces heat via the …

Mechanically Driven In Vivo Osteocyte Ca2+ Signaling: Aging And Pharmacologic Effects, James Padgett

Dissertations and Theses

Bone’s ability to respond and adapt to mechanical loading declines significantly with age which is a major contributor to bone fragility. It is widely accepted that osteocytes are the key cells responsible for orchestrating the development of the “ideal” skeleton. This ability is attributed to osteocyte’s role as the primary mechanosensing cell that is responsible for maintaining the skeleton’s integrity throughout life. Recent work from our laboratory has shed light into how osteocytes respond to mechanical loading in vivo. The breakthrough approaches that enabled these discoveries were development of: (1) the first ever reporter mouse model with a genetically encoded …

The Impact Of Resilience And Professional Practice Demographics On The Professional Quality Of Life Of Recreational Therapists, Kelley Mccubbin

Dissertations and Theses

Compassion fatigue can worsen recreational therapists’ quality of life, leaving lasting impacts on a professional’s a professionals' work, home, and social environments. There is little to no research that discusses the impact of resilience and professional practice demographics on compassion satisfaction and compassion fatigue among recreational therapists. This nonexperimental correlational dissertation study examined the impact of resilience and professional practice demographics on the professional quality life (compassion satisfaction and compassion fatigue) in a group of recreational therapists. A total of 677 recreational therapists were analyzed after responding to an online survey that included a professional practice demographic questionnaire, the Professional …

An Assessment Model Of The Healthcare Entrepreneurship Ecosystem To Foster Solutions For Underserved Communities, Abdalilah Saleh Owaishiz

Dissertations and Theses

There are significant disparities in access to healthcare treatment and this study investigates the healthcare entrepreneurship ecosystem and the challenges and considerations associated within. There is a lack of research on how to evaluate and assess the healthcare entrepreneurship ecosystem especially when applying multi-criteria decision-making (MCDM) methods. The Hierarchical Decision Model (HDM) has been utilized to identify several perspectives and factors grouped under them by the expert’s quantification. This research concentrates on underserved communities because that is where the biggest needs and impact can be made to support achieving health equity and universal health coverage. The findings of this research …

Effect Of Body Mass Index, Testosterone, And Insulin On Breast Cancer: A Mendelian Randomization Study And Investigation Of Selection Bias, Kezhen Fei

Dissertations and Theses

BACKGROUND: Female breast cancer is the most studied cancer, and the second leading cause of cancer death in women, whose aetiology is still not completely clear. The parallel increase of incident obesity and breast cancer in women worldwide raises the question of the role of adiposity, measured by body mass index (BMI), and of major anabolic hormones, such as insulin and testosterone, on breast cancer. Observational studies are open to confounding making it difficult to clearly demonstrate causal effects. Several mendelian randomization (MR) studies have shown inverse association of BMI with breast cancer. To assess selection bias in MR …

Understanding Distruptive Change In Health Care: Perspectives From The Front Lines Of Covid, Wendy Vaughon

Dissertations and Theses

COVID-19 dramatically stressed an already overburdened healthcare system. Physicians, susceptible to burnout, bore the brunt of this threat as frontline providers. Limited data are available describing how the pandemic may have affected physician perceptions and beliefs, including experiences of burnout and plans to exit the field. Reddit, a social media website, allows physicians the ability to interact with their peers pseudonymously on a purpose-driven, publicly viewable subreddit (r/medicine). By providing a space for “physicians and other medical professionals” to interact, it is possible to observe unfiltered discourse.

This dissertation explores physician-peer discourse on Reddit prior to and during the COVID-19 …

Health Literacy And People Diagnosed With Mental Illness, Beckie Child

Dissertations and Theses

Health literacy is a well-studied concept that has a large literature base. Yet, little is known about health literacy and people diagnosed with mental illnesses, and even less health literacy research speaks to people diagnosed with mental illness. I used a framework and approach of lived experience of psychiatric diagnosis and psychiatric survivor research to conceptualize and inform the study. It explores health literacy with people diagnosed with mental and physical health diagnoses using a small quantitative survey, focus groups, and an individual interview. The findings suggest that health literacy is a dynamic and complex construct that interacts with the …

Examining Demographic And Environmental Factors In Predicting The Perceived Impact Of Cancer On Childhood And Adolescent Cancer Survivors, Nazan Cetin

Dissertations and Theses

Cancer survivors' perceptions on how cancer has impacted their lives has been identified as a "critical predictor" of psychosocial well-being and quality of life outcomes. Given the dramatic increase in survival rates and the long-term health and psychosocial challenges, as well as survivorship care barriers, this study focuses special attention on childhood and adolescent cancer survivors and is guided by Tedeschi and Calhoun's theory of posttraumatic growth and Hammond's theory of distinctiveness. This study aims to examine the influence of demographic (i.e., age at diagnosis, biological sex, race/ethnicity, type of cancer) and environmental factors (i.e., geographical location and insurance type), …

Treatment Disparities In Emergency Medical Services: The Influence Of Race/Ethnicity, Obesity, And English Proficiency, Jamie Kennel

Dissertations and Theses

Different treatment in healthcare settings provided to different social groups of people may lead to disparities in health, quality of life, and life span. Despite the critical role among healthcare services that Emergency Medical Services (EMS) provides disproportionately for marginalized communities, it remains unclear if and to what extent treatment disparities take place in the pre-hospital setting. Guided by the theoretical frameworks of social worth, aversive racism, and stigma, this study utilizes medical chart data from three different public and private datasets to investigate treatment disparities by Emergency Medical Service providers for racial minority, obese, and limited English proficiency patients. …

The Effects Of Language Proficiency On Narrative Macrostructure In Spanish-English Bilinguals, Jenny Magallon

Dissertations and Theses

Bilingual children of the same age may have different narrative skills depending on the quantity and quality of their experiences in the two languages. Thus, children's storytelling skills can vary depending on children's oral proficiency in each language. The present study examined the effects of oral proficiency on story structure in forty 5- to 7-year-old Spanish-English speaking children using Spanish and English samples from story retelling tasks. Language proficiency was measured as continuum of performance using the Spanish-English Language Proficiency Scale (SELPS; Smyk et al., 2013). To estimate the effects of Spanish and English proficiency on story structure, linear regressions …

Radiation Isolation And The Impact Of Care: Nursing Knowledge And Perception Of Radiation Risks, Bae P. Chu

Dissertations and Theses

Background: The safety challenges encountered when employing ionizing radiation to treat patients and manage radiation exposure and contamination have been well established in previous research. However, little is known about nurses’ understanding of the risks associated with ionizing radiation and how they respond to their own perceptions of risk. Although a wealth of literature shows an association between radiation treatment and negative patient experiences, there remains a lack of understanding of the basis of these perceptions among nurses. Increased ionizing radiation diagnoses and treatment means that nurses are at a higher risk of radiation exposure today than thirty years ago. …

Assessment Of Spatial And Temporal Trends Of Exposure To Ambient Fine Particulate Matter And Ozone In New York/New Jersey Metropolitan Area, Subraham Singh

Dissertations and Theses

Background. Exposures to fine particulate matter (PM_2.5; particles with diameter less than 2.5 μm) and ozone (O₃) affect premature respiratory and cardiovascular mortality, morbidity and contribute to the development and progression of sub-clinical and clinical disease. Climate change affects air quality directly by modifying the thermodynamic properties of formation mechanisms and transport patterns, and indirectly, through increased emissions of PM_2.5 and O₃ precursors. The resultant changes in air quality influence human health outcomes through mechanisms of varying scale, timing, and complexity. PM_2.5 and O₃ levels have been declining due to the implementation …

Factors Related To Contraceptive Use And Family Planning Decision-Making In The South Asian Community Residing In New York City, Nandini Shroff

Dissertations and Theses

Introduction: Currently, there are approximately 5.4 million South Asians residing in the United States (U.S.). The limited literature illustrates that contraceptive use is underutilized among Asians and Asian sub-groups, including South Asian Americans, compared to other racial and ethnic groups. Using Los Angeles County Health survey data, one study found that 22% of Asian Americans reported always using condom in the past 12 months compared to 37% of African Americans, 27% of Whites, and 27% of Hispanics. A study among New Jersey women revealed that compared to non-South Asian women, South Asians (SAs) were less likely to have used ever …

Investigation Of The Association Of Exposures To Fire-Related Hazards With Pulmonary Function Of Firefighters, David G. Goldfarb

Dissertations and Theses

Background. Firefighters are habitually exposed to hazardous toxicants which place them at an elevated risk for numerous adverse health outcomes. An example of this is the associations observed in other works between inhalation of combustion byproducts from urban structural fires and both acute and chronic pulmonary dysfunction. To-date, the characterization of firefighters’ exposures to dangerous chemicals in smoke from non-wildfire incidents, both directly through personal monitoring and indirectly from work-related records is scarce. Prior works investigating the association between routine firefighting and pulmonary function have relied on crude metrics such as years of service and numbers of responses to …

Neighborhood Predictors Of E-Cigarette Retailer Density In New York City, Laena Orkin-Prol

Dissertations and Theses

Background: The rampant expansion of the e-cigarette market over the last decade in the U.S. is a threat to the health of the public—due to the e-cigarette’s appeal to young people, addictiveness, and harms of consumption. It is vital to study the distribution of e-cigarette retailers of different types in major urban centers, such as New York City (NYC), to identify if certain neighborhoods are overburdened with retailers and if intervention is required. The current research on the e-cigarette retailer environment is limited in its scope and methods used.

Objective: To investigate neighborhood attributes associated with e-cigarette retailer density in …

The Global Implementation Of Dolutegravir For Hiv Treatment, Matthew L. Romo

Dissertations and Theses

Background
Dolutegravir, an integrase strand transfer inhibitor, is now recommended by international guidelines as part of preferred antiretroviral therapy (ART) regimens for people living with HIV. In low- and middle-income countries (LMICs), HIV treatment programs are transitioning from non-nucleoside reverse transcriptase inhibitors (NNRTIs) to dolutegravir because of its superior efficacy and tolerability, and high genetic barrier to HIV drug resistance. Along with the optimism surrounding widespread dolutegravir use, key questions regarding its implementation have emerged. In this dissertation, I sought to achieve the following specific aims: Aim 1: Characterize dolutegravir uptake in LMICs and identify potential disparities related to sex …

Assessing Psychosocial Factors That Influence Water, Sanitation, And Hygiene Behavior In The Amhara Region Of Ethiopia, Kimberly Kamara

Dissertations and Theses

Background: The absence of potable drinking water from an improved source combined with inadequate sanitation and hygiene contributed to an estimated 1.9% of the global burden of disease in 2016. The estimated number of diarrheal deaths in 2016 was 1.4 million, of which 829,000 could have been prevented through improved drinking water and sanitation services, and hand-washing with soap. Despite the clear link between poor water and sanitation access and hygiene practices, 785 million people do not have access to water and two million do not have access to basic sanitation services. However, access does not automatically result in increased …

Episode Based Payment Models And The Hospital Safety-Net: An Evaluation Of The Center For Medicare And Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program, John A. Gravina

Dissertations and Theses

Episode Based Payment Models and the Hospital Safety-net: An Evaluation of the Center for Medicare and Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program

By John Anthony Gravina

Advisor: Alexis Pozen, Ph.D.

Introduction: Payments for Healthcare services are increasingly being tied to clinical quality, patient experience, health outcomes, and efficiency through value-based payment arrangements (VBP). VBP presents a potential opportunity to reduce healthcare expenditures by requiring providers to take on financial risk associated with the cost and quality of care, therefore aligning payment incentives with the goals of providing higher quality and efficient care. As of 2020, 80 percent of …

Augmentative And Alternative Communication Use, Service Delivery Experiences, And Communicative Participation For People With Amyotrophic Lateral Sclerosis, Betts Peters

Dissertations and Theses

People with amyotrophic lateral sclerosis (ALS) often experience changes to their speech, and may use augmentative and alternative communication (AAC) devices and techniques to maintain the ability to communicate. The use of AAC may facilitate the participation of people with ALS in various life situations involving communication. There is limited data in the literature about the AAC approaches currently used by people with ALS, the professional services they receive to support communication, or the effects of AAC on their communicative participation. This dissertation involved a nationwide online survey of people with ALS, and comprises three papers intended to add to …

The Associations Between Diabetes, Cardiovascular Disease And Occupational Hearing Loss In A Cross-Sectional Analysis Of Department Of Energy Nuclear Workers, With A Mendelian Randomization Of Publicly Available Data To Enhance Observational Findings, Jonathan Corbin

Dissertations and Theses

Title: The Associations between Diabetes, Cardiovascular Disease and Occupational Hearing Loss in a Cross-sectional analysis of Department of Energy Nuclear Workers, with a Mendelian Randomization of Publicly Available Data to Enhance Observational Findings

Author: Jonathan Corbin

Advisor: Ghada Soliman, MD, PhD, R.D., CDN

Introduction: Occupational Hearing Loss (OHL) is the most common workplace health condition, and the overall impact of hearing loss (HL) on health is underappreciated. Diabetes and cardiovascular disease (CVD) are two of the most common causes of death and are largely preventable and treatable. Previous research has evaluated associations between OHL and …

Fortunate People In A Fortunate Land: Dwelling And Residential Alienation In Santa Monica's Rent-Controlled Housing, Lauren E.M. Everett

Dissertations and Theses

The importance of safe and stable housing for individual and community wellbeing is widely acknowledged. However, for the one third of Americans who rent their homes, housing-related stress and precarity (residential alienation) may undermine stability and a sense of home. Rent control is perhaps the most well-known tenant protection policy in the United States, but it remains highly controversial and its efficacy has been debated for decades. This research is the first academic inquiry to examine the policy through the experience of residents of rent-controlled housing. In academic discourse dominated by quantitative inquiry from the discipline of economics, this study …

Factors Associated With Racial And Ethnic Disparities In Cesarean Delivery Among Women With Low-Risk Pregnancies At New York City Hospitals, 2012-2017, Ellen Brazier

Dissertations and Theses

BACKGROUND: While Cesarean delivery is a life-saving procedure when certain complications arise, it is associated with increased risks of maternal mortality and morbidity, as well as neonatal and childhood morbidities, and increased risks for women during subsequent pregnancies. Stark and persistent racial/ethnic disparities in Cesarean delivery that are not explained by clinical risks raise concerns about overuse of the procedure, as well as the contribution of potentially avoidable Cesareans to disparities in maternal mortality and morbidity. Understanding the extent to which disparities in Cesarean delivery may be attributable to differences in care during labor is critical for addressing these disparities. …

A Mixed Methods Approach To Understanding Participant Perspectives On Return Of Individual Research Results, Jyoti Angal

Dissertations and Theses

Provision of individual research results to participants is a critical component of the research process. While there is general interest amongst researchers in returning individual research results, a lack of understanding of the personal value of results for participants has hindered the return of individual results. This is especially true for non-genomic research results such as surveys, laboratory test results, or imaging results. This study examined the participant perspectives on the return of individual research results in a diverse cohort of 1587 mothers currently enrolled in the Environmental Child Health Outcomes (ECHO) program. A mixed-methods approach was used to delineate …