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 …

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 …

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 …

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 …

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. …

Assessing The Association Among Hospital Ownership Penalties Assessed Under The Hospital Readmissions Reduction Program And 30-Day Risk Standardized Mortality Rates For Selected Conditions, 2016-2018, Jennifer Carmona

Dissertations and Theses

Background: The Hospital Readmissions Reduction Program (HRRP) is an aspect of Patient Protection and Affordable Care Act (ACA) of 2010. HRRP requires Medicare to reduce payments to hospitals with relatively high readmission rates. While the implementation of the program has been accompanied by reductions in readmission rates, some have expressed concerns about unintended consequences, including harm to patient care and even death. Under HRRP, hospitals serving a high proportion of socioeconomically disadvantaged patients, like public hospitals, have been more likely to receive financial penalties, potentially impeding their ability to invest resources in improving patient outcomes. There is previous research …

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 …

Challenges To Career As A Source Of Meaning And Satisfaction Among Certified Athletic Trainers In The United States Of America, Nicole Marie Glasgow

Dissertations and Theses

There is a high prevalence of burnout in the athletic training profession. Similar to what has been found in other healthcare professions, burnout is correlated with lack of job satisfaction, high turnover, and decreased productivity. In phase one of this study, the purpose was to investigate whether there was a relationship between perceived career meaning and burnout among certified athletic trainers. In phase two, the purpose of the study was to explore the lived experiences of meaningfulness and purposefulness by certified athletic trainers. The overall objective of the research was to generate an understanding of factors associated with burnout in …

Contraceptive Use And Sterilization Among People With Disabilities, Gabrielle Y. Defiebre

Dissertations and Theses

Background

Approximately 20% of individuals in the United States (US) have a disability, with 1 in 4 adult women above the age of 18 having a disability. People with disabilities include individuals who may experience difficulties with mobility, cognition, independent living, vision, hearing, and/or self-care. Disabled people face physical/environmental barriers, provider-level barriers, and system-level barriers in accessing health care, including sexual and reproductive health care, and are more likely than people without disabilities to have unmet medical needs. Four recent studies have indicated that those with disabilities are more likely to have received female sterilization as a family planning service …

Psychedelic Use And Psychological Flexibility: The Role Of Decentering, Mystical Experiences, Ego-Dissolution, And Insight, William M. Campo

Dissertations and Theses

The purpose of this study was to investigate potential associations between psychological flexibility (PF) and characteristics of the psychedelic experience: self-perceived meaningful intention, feelings of comfort and safety, decentering, mystical experiences, ego-dissolution, and insight. The first hypothesis was that perceived meaningful intention and feelings of comfort/safety during the psychedelic experience were expected to be associated with PF, decentering, mystical experiences, ego-dissolution, and insight. The second hypothesis was that decentering, mystical experiences, ego-dissolution, and insight were expected to be associated with greater PF. Participants who used classic psychedelic substances prior to this study were recruited from social media. The sample after …

User Experience In The Visual Notifications On Smart Devices, Young Ae Kim

Dissertations and Theses

Notifications on smart devices have a crucial role for the end-users to help decide their action to the information. Despite the flexible customization of notifications for the intuitive user experience, users feel overwhelmed by the number of notifications they receive daily. The nature of notifications is short-lived, but they are extremely intrusive and disengaging. While user experience and user interface are advanced, notifications have remained broken despite their complexity. In fact, the notifications have the poorest usability that users may struggle to customize notifications in their smart devices and choose to ignore them. Irrelevant notifications not only get ignored, but …

Andragogy And Leadership Development In Entry-Level Doctoral Occupational Therapy Education, Tracey Elaine Recigno

Dissertations and Theses

Leadership development is critical for occupational therapy practitioners to be effective in their varied roles and ultimately is necessary for the sustainability of the occupational therapy profession. Occupational therapy education needs to be the starting point for developing a leadership identity. Best practices in leadership development require that experiences are contextualized and provide opportunities for active learning and reflective practices, yet there is minimal research to understand how occupational therapy educators teach this concept. This dissertation sought to first describe leadership development in occupational therapy and then describe how occupational therapy educators approach leadership education using adult learning principles. The …

Ego-Feeling And Ego-Boundaries: An Examination Of The Work And Legacy Of Paul Federn, Samuel Selinger

Dissertations and Theses

Paul Federn was an important figure in the early development of psychoanalysis. He was, besides Sigmund Freud himself, the only founding member of the Vienna Psychoanalytic Society who was still a member when the society was disbanded by the Nazis in 1938. He was also an early pioneer in the use of psychoanalysis toward the understanding and treatment of psychosis, and was among the very first to consider the importance of the ego to psychoanalytic understanding of the mind and mental illness. This dissertation examines Federn’s key ideas-- ego-feeling and ego-boundaries-- their influence on later psychoanalytic formulations by Winnicott, Lewin, …

The Role Of Rna Helicase Rhau In Immunoglobulin Class Switch Recombination, Sabine Jean Guillaume

Dissertations and Theses

B cells alter the expression of immunoglobulin isotypes through a process known as class switch recombination (CSR). In these cells, activation induced cytidine deaminase (AID) binds Gquadruplex (G4) switch transcripts, which serve as guide RNAs to target AID to the immunoglobulin heavy chain switch (S) regions in the DNA for CSR. Sequence alignment revealed homology between the AID G4 binding domain and the RNA helicase associated with AU-rich element (RHAU) specific motif (RSM), which allows RHAU binding to G4 RNAs and subsequent unwinding of G4 RNA into single-stranded transcripts. We hypothesize that RHAU functions in CSR by binding G4 S …

Identification Of Adhd And Comorbid Disorders In Children: The Potential Role Of Minority Group Membership, Rachel H. Tayler

Dissertations and Theses

Identification of ADHD and Comorbid Disorders in Children: The potential role of minority group membership

by

Rachel Tayler, MSc, MA

Advisor: Sarah O’Neill, PhD

Attention-Deficit/Hyperactivity Disorder (ADHD) affects six million US children. Females, Latinx, and possibly Black children have lower rates of diagnosis than their Male and White non-Latinx peers. ADHD is behaviorally defined, and as such, clinicians' perceptions of symptoms and determination of diagnoses may be influenced by demographic factors such as race, ethnicity and sex.

This vignette study examined whether clinicians' implicit ethnic, racial, and sex biases affect diagnosis of ADHD and comorbid conditions. Psychiatry trainees and pediatricians …

Exosome- And Microrna-Based Therapeutic Approach For Tendinopathy, Angela Wang Ilaltdinov

Dissertations and Theses

Tendinopathy, characterized by degeneration and chronic inflammation, is a significant clinical burden. Current treatments focus on symptom management but do not sufficiently address its underlying pathology; however, stem cell-based approaches aimed at repairing diseased tissues may overcome this limitation. Therapeutic effects of stem cells may be due in part to paracrine actions, including some mediated by exosomes – extracellular vesicles secreted by cells that play a role in cell communication. MicroRNA (miRNA), small non-coding RNA carried by exosomes, are likely responsible for many exosome effects. Exosomes and miRNA therapies show promise in treating diseases such as cancer and arthritis, but …

Youtube, Cyberbullying And Covid-19, Ani Shavliashvili

Dissertations and Theses

The purpose of this research is to uncover how people discuss bullying or cyberbullying experiences via YouTube videos before and after the start of the COVID-19 pandemic. Since people were indoors during the pandemic, individuals took to social media and left comments on YouTube about bullying. Since people could not discuss bullying in-person, it was interesting to see how people shared their views on bullying and cyberbullying via YouTube, as well as how that might have changed after the start of COVID-19. The purpose of this study is to demonstrate how social media platforms like YouTube provide a safe space …

Investigating The Role Of Phonological Awareness In The Training Of Phonetic Transcription With Slp Students, Jennifer Kay Binkley

Dissertations and Theses

A dissertation study was developed and completed to further explore the relationship between phonological awareness (PA) and phonetic transcription skills in undergraduate speech-language pathology students. A review of the literature provides gaps in knowledge which the proposal seeks to address. Based upon this literature review, the researcher compared PA skills of undergraduate students of various majors, to determine if there was a change in PA by taking a traditional phonetics course, and to explore phonetic transcription outcomes as the result of direct PA intervention with undergraduate SLP students. Quantitative analysis was used to answer three research questions, which were organized …

Effective Mental Health Accommodations For Occupational Therapy Students And Practitioners, Allison Jo Naber

Dissertations and Theses

The process of transitioning from high school to higher education and from academic programs outside of the health sciences to the workplace is documented; however, the transitional experiences of those in the health professions and occupational therapy specifically are less understood. This dissertation research aimed to identify the formal accommodations and informal adaptations occupational therapy students and entry-level practitioners have employed to address their mental health needs as they transition from the classroom to fieldwork or capstone and entry-level practice. The link between empirical literature, theories surrounding transitions, and the Occupational Adaptation Model provided the foundation for this research. This …