Medicine and Health Sciences Commons^™

Exploring Opportunities To Expand And Improve Prep Uptake In Vulnerable Us Communities., Pedro B. Carneiro

Dissertations and Theses

The implementation of preexposure prophylaxis (PrEP) in the United States has fallen short of meeting both 2020 and projected 2030 milestones, with less than one-third of those who would benefit most from PrEP choosing to initiate it. High discontinuation rates and persistently elevated HIV incidence underscore the need for improvement. However, opportunities exist to enhance PrEP uptake, supported by a growing pipeline of PrEP innovations. To achieve this, effective implementation of available tools to combat HIV and the inclusion of all communities as stakeholders are essential. One such tool is event-driven (ED) PrEP, also known as PrEP 2-1-1, which is …

Recursive Functional Learning In Nonfluent Aphasia, Gerald C. Imaezue

Dissertations, Theses, and Capstone Projects

People with nonfluent aphasia (PWNA) require feedback from an external agent as well self-feedback to facilitate performance of language production tasks. The extent to which PWNA can use self-feedback alone to improve their task performance is unknown. In addition, it is argued that self-feedback may reinforce or minimize performance errors over time. To test whether either is the case, we introduce an original learning mechanism, recursive functional learning, which uses self-feedback loops to optimize recursively multiple subsystems (cognitive and linguistic subsystems) that PWNA engage during task performance. We used this mechanism to underpin a novel automated procedure we developed, recursive …

Nursing Perspectives On Intimate Partner Violence Screening In The Emergency Department, Justin Cabrera

Dissertations, Theses, and Capstone Projects

Using descriptive and quality descriptive (QD) analysis, emergency department nurses from around the country completed a modified version of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool to gain insight on their attitudes, knowledge, and preparedness about working with patient survivors of intimate partner violence (IPV) regarding their willingness to and comfort in engaging in IPV screening practices. In total, 1,523 responses were received from emergency department nurses currently or formerly in practice.

Findings show that there was no correlation between emergency department nurses’ education and training on IPV and willingness and comfort with IPV screening with …

Social And Cultural Processes That Impact Physical Activity Among South Asian Americans Managing Hypertension: A Mixed Methods Study, Sugandha Gupta

Dissertations, Theses, and Capstone Projects

Cardiovascular disease (CVD), the number one cause of death in the U.S., disproportionately affects South Asian Americans (SAAs). Physical activity is a modifiable health behavior that can reduce cardiovascular risk. Health behaviors, such as physical activity, occur within specific social and cultural contexts and are influenced by multiple factors at multiple levels of the social ecological model. This dissertation aimed to provide a rich, culturally-informed understanding of the factors at multiple levels – individual, interpersonal, and cultural –associated with physical activity among SAAs at risk for CVD. A sequential exploratory mixed methods approach was employed to examine social and cultural …

Understanding Influenza Vaccine Hesitancy And Uptake Among U.S. Hispanic Adults During The Covid-19 Pandemic, Helen J. Arteaga

Dissertations and Theses

The health burden caused by seasonal flu is substantial in the general population and each season targeted efforts are needed to decrease the risk of flu illness, hospitalization, and death. Flu risks and the disease burden are disproportionately higher among Hispanic adults, yet little is known about the factors influencing flu vaccine hesitancy and uptake among this marginalized population. This cross-sectional quantitative study used national survey data from the Understanding America Study (UAS) and logistic regression to address three research aims. Aim 1 was to examine the most significant demographic factors associated with flu vaccine uptake among the Hispanic community. …

The Health Impacts Of The Trump Administration Among California Immigrants, Claudia M. Calhoon

Dissertations and Theses

Immigration policy was a marquee issue in the US presidential administration of Donald Trump. Trump’s administration employed both policy and rhetoric related to immigrants to mobilize voters, alter immigration policies and practices, and sustain a narrative of a nation under attack by immigrants. Administration officials were able to undertake these approaches because of existing immigration law, but they did so in more explicitly punitive ways than in recent administrations. The goal of this dissertation is to explore the health impacts of the administration’s practices and their effects. Paper 1 analyzes the immigration rhetoric and policies of US president Donald Trump …

The Lived Experience Of Using Opiates Among Young Adults, Catherine Mbewe

Dissertations, Theses, and Capstone Projects

The purpose of this research study is to explore the lived experience of using opiates, as described by young adults aged 18 to 25 years. Over the last 2 decades, opioid use disorders (OUDs) and opiate overdose deaths have increased dramatically in the United States. What used to be a problem primarily contained to minority groups in poor inner-city areas is now increasingly common in all races, genders, ages, and classes. There has also been an alarming increase in opiate use—including fentanyl, both legal and illegal—among young adults. While much of the literature has been focused on the opiate use …

Social Identities And Campus Belonging As Predictors Of Flourishing Among College Students, Christine Gilchrist

Dissertations, Theses, and Capstone Projects

Annual data since 2012 shows college students’ flourishing (a measure of psychological well-being) in continuous decline, with 2022 showing the largest decrease. Since the knowledge base of the predictors of flourishing is limited, how college executives can best address this issue is unclear. Variations in flourishing have been observed in studies that examined the relationship between food insecurity (DeBate et al., 2021), race/ethnicity (Lipson et al., 2018, 2022; Nyunt et al., 2022; Parr, 2022), immigration status (Cadenas & Nienhusser, 2021), as well as gender identity and sexual orientation (Parr, 2022). The intersectional impact of demographic and social identities has not …

Practices And Attitudes Towards Infant Hearing Protection At Orthodox Jewish Weddings, Rebecca Weiss

Dissertations, Theses, and Capstone Projects

Previous research has shown that prolonged exposure to noise can cause permanent hearing loss no matter what age, including infants. The impact of noise at orthodox Jewish weddings, where infants are frequently in attendance, can reach extremely high and damaging levels of sound intensity. Because the hearing conservation behaviors and attitudes towards child hearing protection in this population are unknown, the objective of this study is to identify the attitudes and behaviors of orthodox Jewish wedding attendees toward child hearing conservation. A survey was developed and administered electronically to congregants of orthodox Jewish synagogues in the New York City area. …

Barriers To Optimal Audiological Care For Members Of The Deaf Community, Joyce Orenshein

Dissertations, Theses, and Capstone Projects

Background:

The purpose of this study was to identify the barriers to optimal audiological care for members of the Deaf community from the perspectives of Deaf individuals compared to audiologists. The goal is to help bridge the clinical communication barriers that lie between audiologists and the Deaf community by identifying the perceived gaps in care specifically and by gathering suggestions for improvement. A survey was administered to both audiologists and members of the Deaf community, making the present study unique and essential in that responses from both communities are compared and suggestions for bridging the gap are made.

Methods …

The Impact Of Semantics And Syntax On Lexical Retrieval In Individuals With Aphasia, Marta M. Korytkowska

Dissertations, Theses, and Capstone Projects

Nearly all people with aphasia (PWA) report difficulty with lexical retrieval (i.e., anomia). While there are several tasks used to measure lexical retrieval, each poses different degrees and types of challenges. For example, some studies have found that PWA performance varies depending on the type of lexical retrieval task. The tasks that have been used include lexical retrieval in isolation tasks (such as picture-naming), lexical retrieval in sentence level tasks (such as narration tasks), and lexical retrieval in sentence-completion tasks. Some studies have found no differences between the accuracy of lexical retrieval in isolation and at the sentence level (e.g., …

Gender Role Conflict, Campus Climate, And Satisfaction Among Male Undergraduate Nursing Students, Randelle Sasa

Dissertations, Theses, and Capstone Projects

Background. Gender role conflict (GRC) has been identified in the literature as a contributing factor to male undergraduate students’ dissatisfaction with the nursing program. Utilizing Bandura’s social cognitive theory as guiding framework, this study examined the relationships between GRC, campus climate (CC), satisfaction with the nursing program (SS), and demographic factors among male undergraduate nursing students. Understanding the associations between these variables may inform success initiatives for these at-risk students.

Methods. A cross-sectional survey was developed from valid and reliable instruments. The Gender Role Conflict Scale – Short Form measured GRC; the adapted Inventory of Male Friendliness in Nursing Programs …

Examining The Effect Of Talker Familiarity Using Familiar And Unfamiliar Talkers On Noise-Vocoded Speech Perception In Normal-Hearing Listeners: A Training Study, Daria N. Collins

Dissertations, Theses, and Capstone Projects

Auditory training studies utilizing stimuli that are applicable to real-world processing of speech have been shown to improve speech perception abilities in normal hearing populations, those with hearing loss, and cochlear implant wearers. In particular, exposing normal hearing adults to noise-vocoded speech via auditory training studies has been shown to not only simulate the perceptual experience of a cochlear implant wearer, but have demonstrated promising improvements on speech perceptual abilities via the training paradigm. Additionally, studies have highlighted various variables that impact speech perception, including, talker familiarity. Talker familiarity has been shown to enhance speech perception both in listeners with …

The Effects Of Music Therapy On Elderly Adults With Dementia, Jeante J. Jackson

Dissertations, Theses, and Capstone Projects

As people age, the brain is more susceptible to changes that diminish cognitive function. In recent years neuroscience has found convergent evidence between music therapy and brain architecture, as it has shown the generation of new connections in the brain or a reorganization and possible strengthening of existing connections already in the brain. However, the literature regarding music training’s effects on executive control, selective attention, and speech processing is lacking particularly when it comes to older populations.

This study investigated Verbal Working Memory, Visuospatial Attention and Task Initiation, and Auditory Selective Attention in a 91-year-old adult (B.P.) diagnosed with dementia. …

Belief And Success Health Management Self-Efficacy: A National Survey Of Black Adults, Stephanie Y. Store

Dissertations, Theses, and Capstone Projects

Minority populations, such as Black adults of non-Latinx descent, are more likely to develop chronic diseases and complications related to disease severity when compared to Non-Latinx Whites (NLW). Furthermore, Black adults of non-Latinx descent people are less likely to engage and maintain health promoting behaviors (HPB) to prevent disease development. HPB are effective in preventing or delaying chronic disease. This research explores the relative impact of aspects of health, built environment and key demographic domains on HMSE of a national sample of Black adults. Methods: Hierarchical regression modeling was performed utilizing data from the 2018 National Survey of Health Attitudes …

Exploring The Potential Of Hearing Screening Smartphone Applications To Enhance Access To Hearing Healthcare: A Literature Review, Adam Sulaiman

Dissertations, Theses, and Capstone Projects

In 2016, the National Academies of Sciences (NAS) published a landmark consensus report with several recommendations to enhance the availability and affordability of hearing healthcare in the United States. Among the most notable of the recommendations was the creation of a new category of FDA-approved Over-the-Counter (OTC) hearing aids. Unlike the traditional hearing aid model, which requires a comprehensive hearing test by a hearing health professional prior to purchase, OTC hearing aids would be directly available for sale to any American adult with a self-perceived mild-to-moderate degree of hearing loss. This proposal has now become reality with the passage of …

"I Stayed There The Whole Night": Exploring Caregivers' Experiences With The Healthcare System When Caring For A Parent At The End Of Life, Lillian Mehran

Dissertations and Theses

Background: In the United States, there are nearly 53 million individuals serving as caregivers to a loved one. Half of all caregivers are caring for a parent or parent-in-law, and 79% of caregivers are caring for a person aged 50 or older. In New York State, there are an estimated 4.1 million caregivers who collectively provide over 2.6 billion hours of unpaid care, with those caring for a person at the end of life providing twice as many hours of caregiving per week compared to other caregivers. The number of individuals requiring caregiving is expected to increase as a significant …

Reviews Of Applications For Smartphone-Connected Hearing Aids And Implications On Counseling, Rebecca Strong

Dissertations, Theses, and Capstone Projects

With the recent rise of smartphone ownership, more applications have been created that connect user’s hearing aids to their smartphone. One type of application that has become popular is one that allows the user to control hearing aids using a smartphone. While these applications have many benefits for the user, there has been very little research on the experiences of individuals using these applications. In order for audiologists to best help their patients troubleshoot and prepare reasonable expectations for using smartphone-connected hearing aids, they need to understand the patient experience to create effective solutions. One technique that can be used …

Examining The Effect Of Training Using Natural And Noise-Vocoded Sentences On Noise-Vocoded Speech Perception In Normal-Hearing Listeners, Alexis Leiderman

Dissertations, Theses, and Capstone Projects

Auditory training has been shown to be an intervention strategy that may improve speech perception abilities in individuals with and without hearing loss. Within the cohort of individuals with hearing loss, auditory training has also been shown to have an improvement on speech perception in cochlear implant users. In several training studies, normal-hearing listeners have been exposed to noise-vocoded speech using auditory training paradigms to mimic how cochlear implant users may in turn be affected by these paradigms. These studies have highlighted certain areas for improvement in speech perception abilities based off of the training paradigms put in place. Several …

Multi-Target Ligand-Guided Selection (Ligs) Against B-Cell Specific Antigens Expressed In A Single Lymphoma Cell Population, Nicole B. Williams

Dissertations, Theses, and Capstone Projects

Nucleic acid ligands called aptamers are single-stranded DNA or RNA molecules which fold into functional three-dimensional structures to facilitate their target binding with high affinity and specificity. The method used to generate aptamers is an in vitro process called Systematic Evolution of Ligands by Exponential enrichment (SELEX). A variant of SELEX, cell-SELEX has been used to select aptamers against cell-surface proteins in their native state. We recently introduced a novel method called Ligand-Guided Selection (LIGS) to identify aptamers against cell-surface markers. Herein, we expanded LIGS method into a multiplexing platform to partition multiple aptamers against B-cell-specific antigens, CD19 and CD20, …

Reimagining The Inner Ear: A Morphometric Modeling Approach For Establishing Shape Change In The Evolution Of The Human Otolith System, Christopher M. Smith

Dissertations, Theses, and Capstone Projects

Our sense of balance is among the most central of our sensory systems, particularly in the evolution of human positional behavior. The peripheral vestibular system of the inner ear comprises the organs responsible for this sense; the semicircular canals (detecting angular acceleration) and otolith organs (utricle and saccule; detecting linear acceleration, vibration, and head tilt relative to gravity). The vestibular organs are often considered a single system, with most research focusing on the semicircular canals. The otolith organs, by comparison, remain largely unexplored despite their central role in balance. Consequently, this lack of knowledge limits understanding of vestibular functional morphology …

Caring For Individuals Who Are Experiencing Homelessness: An Audiologist’S Toolkit, Jenna Marie Sparacio

Dissertations, Theses, and Capstone Projects

National-level counts for individuals experiencing homelessness have been steadily on the rise. People experiencing homelessness face extraordinary barriers and challenges in accessing health care services, including hearing healthcare. Additionally, there is a high prevalence of self- reported hearing difficulties and hearing handicap among people experiencing homelessness. Hearing loss status and management is often not prioritized in healthcare settings, and treatment plans are not typically modified to best address the hearing needs of individuals who are homeless. This evidence-based toolbox for audiologists was developed to help understand and mediate healthcare barriers that people experiencing homelessness face, as well as to help …

Evidence-Based Practice In The Management Of Tinnitus In Children And Adolescents: A Systematic Review Of The Literature, Rivka Deutsch

Dissertations, Theses, and Capstone Projects

Objective: The purpose of this investigation is to conduct a systematic review of the literature to compile and evaluate the known research on the management of tinnitus in children/ The specific aims of this paper are to determine what approaches can be considered best practice for the management of tinnitus in this population, what aspects of adult management (if any) can be adapted for children, and whether the literature supports one management approach over another.

Methods and Results: A comprehensive search utilizing the Medline and Cumulated Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar databases, accessible via …

Never-Ending Parenting: Challenges Experienced By Caregivers Of Adults With Severe Autism, Andrea Palerino

Dissertations, Theses, and Capstone Projects

Despite the large number of children with autism spectrum disorder (ASD) who are annually aging out of the school-based systems in the United States, much of the academic literature has been focused on the concerns and challenges of preschool or school-aged children with ASD. As a result, there lacks a clear understanding of how primary caregivers of adult children with severe autism spectrum disorder (SASD) utilize various forms of capital to navigate care.

This qualitative descriptive study explored some of the challenges experienced by primary caregivers of adult children with SASD. Convenience sampling was used to conduct semi-structured interviews with …

Audiological Management Of Children With Down Syndrome: A Toolkit For Caregivers, Natalie Lisiewicz

Dissertations, Theses, and Capstone Projects

Children with Down syndrome may have multiple medical co-morbidities. This can result in an overwhelming number of medical appointments and information for caregivers to keep track of. Middle ear dysfunction, among other otologic abnormalities, is common in the Down syndrome population, and the presence of these conditions will result in referrals to an audiologist to monitor hearing sensitivity. While hearing may not be the most pressing concern as compared to a possible life-threatening condition such as a heart defect, it is still a crucial factor in a child’s overall development.

This toolkit is designed with the intention of educating caregivers …

Evaluation Of A Place-Based Asthma Reduction Initiative On Asthma-Related Morbidity Among Children In East Harlem And The Impact Of The Covid-19 Pandemic On Health Care Utilization And Medication Adherence Among Medicaid-Enrolled Children, Sarah C. Walters

Dissertations and Theses

Background: In New York City, asthma continues to be the leading cause of hospitalizations and emergency department (ED) visits among children, and disproportionally burdens Black and Latino children in low-income neighborhoods. Place-based, or geographically targeted, programs offer upstream strategies for addressing public health issues in these underserved neighborhoods, and given their targeted nature, quasi-experimental or other observational methods are needed to rigorously evaluate their impact. This dissertation uses multiple methodological approaches to assess the impact of the East Harlem Asthma Center of Excellence (EHACE) – an equity-focused, multi-faceted, place-based asthma mitigation initiative in the East Harlem neighborhood of a New …

Obesity Risk And Comorbidities Among Colombians In New York City And In Colombia, Carlos A. Devia

Dissertations and Theses

Introduction: The prevalence of obesity and overweight in adults and children continues to increase worldwide, accounting for the mortality and morbidity from several diseases. Obesity disproportionally impacts Latinos in the United States (U.S.), and despite their diversity in origins, ancestry, and culture, it is still unclear the burden of obesity by specific Latino groups. For example, little information is available about how obesity impacts Colombians in the U.S. (the largest South American population). New evidence also indicates that Latino immigrants may no longer be arriving with healthy weight status to the U.S. because Latin American countries are undergoing epidemiologic and …

Validating A New In Vivo Model To Study Als, Izabela J. Cimachowska

Student Theses and Dissertations

Buildup of oxidative stress and mitochondrial dysfunction are well known characteristics of both sporadic and hereditary amyotrophic lateral sclerosis (ALS). While both forms of the disease seem to arise from common cellular dysfunction, the genetic disease is studied to a much greater extent. Engineering novel animal models of the sporadic form of the disease is crucial for development of druggable targets to treat ALS and understand the underlying mechanisms. Interestingly, accumulation of oxidative stress by exacerbated emission of reactive oxygen species (ROS) from presynaptic mitochondria is a hallmark of both hereditary and sporadic ALS. Previous work by our laboratory showed …

Caring For Children With Mental Health Concerns: The Experience Of Being A School Nurse, Jeannine Kaskoun

Dissertations, Theses, and Capstone Projects

Mental health issues have for years been on the rise among our nation’s schoolchildren, and the COVID-19 pandemic has only served to aggravate what can now be called a crisis. Researchers agree that timely assessment, diagnosis, and treatment of mental health concerns in children are critical to maintaining their growth and development and could potentially aid in decreasing serious mental health events as they move into adulthood. While in an ideal world, each child would have a family medical provider, the fact is that for many children, the school nurse is the child’s sole provider of health care. Many times, …

Synthesis And Biomedical Applications Of Hollow Iron Oxide Nanoparticles, Aloka S. Paragoda Arachchilage

Dissertations, Theses, and Capstone Projects

Nano-scale materials have gained much attention during the past few decades due to the stark differences in their properties compared to bulk material. Thus, they are being studied for a myriad of applications ranging from harnessing solar energy to diagnostics. This thesis focuses on the synthesis of hollow iron oxide nanoparticles using Galvanic replacement reactions and their application in drug delivery. Moreover, the use of a peptide precursor for the enhancement of exosomes is also discussed.

Chapter 1 discusses a simple and economical Galvanic approach used for the synthesis of hollow one-dimensional iron oxide nanotubes. In the initial reaction, the …