Medicine and Health Sciences Commons^™

The Storytelling Cure: Medicine And Narrative From Galen To Shahrazad And Rousseau, Ryan A. Milov-Cordoba

Dissertations, Theses, and Capstone Projects

Are stories healing? This dissertation introduces and explores an idea that I call “the storytelling cure.” With this term I capture a set of related notions about the healing power of stories that span literary studies, intellectual history, philosophy, and medical practice. Through a comparative study I make the case for “the storytelling cure” as a cross-cultural, multiconfessional, and multilingual phenomenon of great age, complexity, and power, worthy of the most sustained attention by the contemporary field of Comparative Literature. Concretely, this dissertation presents three extended case studies of “storytelling cures” from three different kinds of texts (case history, frame …

The Differential Effects Of Acoustic Discriminations On Operant Learning Performance And Neurogenesis In Male And Female Zebra Finches, Kristena L. Newman

Dissertations, Theses, and Capstone Projects

Adult neurogenesis, the creation of new neurons, occurs throughout the lifespan in most organisms. However, though neuronal proliferation occurs daily, most of these neurons do not survive to become incorporated into preexisting neural circuitry and become fully functioning neurons. In the mammalian brain, adult neurogenesis occurs within the hippocampus, a brain region known to be important in learning and memory. In rats, successful acquisition of certain learning tasks increased new neuron numbers when the learning was sufficiently challenging (Curlik and Shors, 2011). It has also been demonstrated that a spatial discrimination task requires new neurons when the discrimination is more …

Biomarker, Treatment, And Socio-Demographic Factors Affecting Opioid Use Disorder Treatment Retention, Fernand A. De Los Reyes

Dissertations, Theses, and Capstone Projects

ABSTRACT

Biomarker, Treatment, and Socio-Demographic Factors

Affecting Opioid Use Disorder Treatment Retention

by

Fernand A. De Los Reyes

Advisor: Martha Velasco-Whetsell

Increasing mortality from opioid overdose and low treatment engagement are significant public health concerns. Along with increasing health care and criminal justice enforcement costs, there is an urgent need to study the factors associated with treatment retention in opioid use disorder. The study investigated the relative impact of the biomarker cholesterol on treatment retention in an opioid treatment program (OTP) clinic. Further, it examined the medical comorbidities, treatment, and socio-demographic variables that impact opioid use disorder treatment retention. This …

Prenatal Choline Supplementation During Maternal Obesity Alters Offspring Response To Western Diets, Hunter W. Korsmo

Dissertations, Theses, and Capstone Projects

Maternal obesity has led to an increase in adverse offspring developmental outcomes and a greater risk for long-term metabolic diseases. Choline, a semi-essential nutrient, can be incorporated into phosphatidylcholine (PC) as well as sphingomyelin (SM) and donate its labile methyl group for the remethylation of homocysteine after choline is oxidized to betaine. Prenatal choline insufficiency has been related to maternal obesity and metabolic diseases, such as metabolic associated fatty liver disease (MAFLD). Choline may interact with maternal obesity to influence the programming offspring.

Chapter 1 presents an introduction of choline and the various clinical outcomes associated with choline supplementation during …

A Survey Study Of Speech-Language Therapists’ Experiences With Teletherapy At The Onset Of The Covid-19 Crisis, Jason A. Rosas

Dissertations, Theses, and Capstone Projects

The present study aimed to understand how delivering pediatric treatment services via ‘teletherapy’ affected speech-language therapists (SLTs) during the initial outbreak of the COVID-19 pandemic crisis in 2020. SLTs reported on their experiences with the change from in-person to remote service delivery via two national surveys distributed at the start of the pandemic between April 2020 and July 2020. To explain SLTs’ survey responses, this dissertation introduced the Professional Adaptation Model (PA Model). The PA Model facilitated evaluation of the SLTs’ professional environment and the psychological constructs of their professional identity believed to influence the transition to speech-language teletherapy. Specifically, …

The Impossible Situation? Impasse As Psychotherapeutic Paralysis, Possibility, And Progress, Leo Cancelmo

Dissertations, Theses, and Capstone Projects

Psychotherapeutic impasse has long been understood in the clinical literature as treatment stagnation and even failure, both from one-person and two-person psychodynamic perspectives. However, there is a dearth of empirical research that delves deeper to understand this complex and rich phenomenon. Using semi-structured interviews with nine psychodynamic therapists speaking about individual adult patients, this study examined experiences of impasse to better understand treatments that become embroiled in a kind of paralysis. Qualitative analyses revealed dyads where patients were conceptualized as struggling chronically with negative feelings about themselves and others, and who experienced traumatic personal histories. Impasse in and of itself …

Efficacy, Acceptance, And Feasibility Of Virtual Reality For Chronic Pain Relief In Older Adult Veterans Residing In Long Term Care, Valicia Philibert

Dissertations, Theses, and Capstone Projects

Older adults residing in Long-Term Care (LTC) have a high prevalence of chronic pain. Pain management strategies have primarily focused on pharmacological approaches, but with physiological changes associated with aging, this population is at an increased risk for adverse effects from prescribed medications. More research is needed on innovative non-pharmacological interventions in the LTC setting. This study examined the feasibility, acceptance, and preliminary efficacy of Virtual Reality (VR) for chronic pain among older adult veterans in LTC. In this quasi-experimental, 12 older adult participants living with chronic pain in a long-term care facility received two sessions of VR. Pain intensity …

Neuroanatomy In Mild Cognitive Impairment: Relationship To Functional Skills, Treatment Expectancy, And Comorbid Depression, Sara Rushia

Dissertations, Theses, and Capstone Projects

Mild cognitive impairment (MCI) is a neurocognitive disorder defined by cognitive decline in older adults. Although MCI has been studied for decades, there remain important areas to be explored in order to adequately characterize aspects of this disorder that provide information valuable for possible interventions and disease progression to dementia, including a better understanding of the neuroanatomical variables relevant to this disorder. Such neuroanatomical variables include cortical thickness, hippocampal volume, and white matter hyperintensities (WMHs). This dissertation consists of three separate studies aimed at addressing gaps in the literature on MCI in relation to brain morphometrics and under-studied characteristics involved …

Effects Of Telesimulation On The Health Literacy Knowledge, Confidence And Application Of Nursing Students, Susan Patton

Dissertations, Theses, and Capstone Projects

Background: Assessing and addressing health literacy (HL) in patients is an essential role of the nurse and a critical component of nursing student education. Yet, large gaps exist within nursing school curricula with regard to the development of HL knowledge and skills, and the confidence to implement practices that target HL. Furthermore, effective training modalities that examine the transformation of nursing students’ knowledge into practice through the development of confidence during experiential learning have not been well explored.

Purpose: Evaluate the effectiveness of a HL information and a HL telesimulation intervention on the HL Knowledge, Application and Confidence of first-semester …

A Polypharmacological Approach To Relapse Prevention In An Animal Model Of Heroin Addiction, Scott T. Ewing

Dissertations, Theses, and Capstone Projects

Chemical compounds that target dopamine (DA) D1 or D3 receptors have shown promise as potential interventions in animal models of cue-induced relapse. However, undesirable side effects or pharmacodynamic profiles have limited the advancement of new compounds in preclinical studies when administered as independent treatments. In this series of experiments, we explored the effects of co-administration of a D1-recepter partial agonist (SKF 77434) and a D3-receptor antagonist (NGB 2904) in heroin-seeking rats within a ‘conflict’ model of abstinence and cue-induced relapse. Rats were first trained to press a lever to self-administer heroin and drug delivery was paired contingently with cues (e.g., …

Role Of The G Protein Beta Gamma Subunits In Serotonin Transporter Dynamics, Nora Awadallah

Dissertations, Theses, and Capstone Projects

Serotonin is a vital neurotransmitter and hormone with significant roles in almost every organ system. In the central nervous system, serotonin mediates physiological functions that in turn guide behavior and mood. Here, serotonin is released from serotonergic neurons and exerts its effects through serotonin receptors. Regulation of serotonin neurotransmission is important for the maintenance of its physiological functions; thus, extracellular serotonin must be sequestered to limit the intensity and duration of serotonin transmission. Disproportionate transmission is strongly linked with neurological and psychiatric ailments.

Extracellular serotonin levels are primarily mediated by the serotonin transporter (SERT), a critically important plasma membrane protein …

Neurocardiovascular Instability (Ncvi) Risk As A Predictor Of Cognitive Function In The Long Life Family Study, Rebecca Abraham

Dissertations, Theses, and Capstone Projects

In aging populations, the abnormal neural control of the cardiovascular system has been examined within the construct of neurocardiovascular instability (NCVI). The main research aim addressed whether baseline features of NCVI could predict cognitive function (i.e., decline) at follow-up within long-lived families. Across 941 subjects, baseline NCVI risk was indexed by two features: (1) self-reported syncopal or fall events and (2) average seated BP. The Low NCVI risk group included those who were normotensive (e.g., within normal BP range) and reported no NCVI features (n=379). The Moderate NCVI risk group included those who elicited pre-hypertensive (elevated BP) or hypertensive (high …

Creating An Interactive Virtual-Reality Game As A Method For Vestibular Rehabilitation, Jessica Kaganskiy

Dissertations, Theses, and Capstone Projects

Virtual reality is an innovative form of technology that has been used more and more in vestibular rehabilitation therapy programs for individuals with chronic balance problems. Blender and Unity game engines were used to create a 3D interactive virtual reality video game intended for Oculus devices in order for individuals to utilize the game to perform vestibular rehabilitation exercises. The activities in the video game are based on the Cawthorne-Cooksey exercises commonly used in vestibular rehabilitation. The exercises target eye movement, head movement, stretch movement, and bilateral coordination; repetitive motion is used to help train and treat the individual’s vestibular …

Gobernar Es Prever: Health Management Self-Efficacy Among A National Sample Of Latinx Adults, Giselle Gerardi

Dissertations, Theses, and Capstone Projects

Background: Minority populations, such as Latinx people, are more likely to develop chronic diseases and increased complications related to disease severity when compared to Non Latinx Whites (NLW). Furthermore, Latinx 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. Despite interventions and resources aimed at supporting Latinx populations, often, there are low participation and high attrition rates.

Methods: This research explores the relative impact of aspects of health, built environment and key demographic domains on HMSE of a national sample of Latinx adults through …

Effect Of The Virtual Simulation Paired Prebriefing-Debriefing Strategy On Nursing Students’ Self-Efficacy Perceptions And Virtual Simulation Performance In The Care Of Patients Experiencing A Myocardial Infarction, Laura M. Penalo

Dissertations, Theses, and Capstone Projects

Through the use of virtual simulations (VS) in nursing education, nursing students are exposed to a variety of clinical scenarios that may potentially improve their learning of competencies, increase their self-efficacy, and enhance their future clinical performance. Despite limited quantitative research incorporating evidence-based strategies such as prebriefing and debriefing as part of the VS experience, this educational technology continues to gain popularity. In 2020, the use of VS in the nursing curriculum exponentially increased when the global COVID-19 pandemic impacted traditional in-person clinicals, laboratory, and human patient simulation (HPS) experiences. Associate Degree Nursing (ADN) programs have benefited from the use …

A Diagnostic Pocket Guide For Audiologists: Outer, Middle, And Inner Ear Disorders And Chronic Diseases, Ashley Andino

Dissertations, Theses, and Capstone Projects

Given the Scope of Practice for Audiologists as outlined by the American Speech-Language-Hearing Association (ASHA), the diverse occupational settings audiologists belong to, and the varied multidisciplinary collaboration necessary, audiologists are tasked with needing, at minimum, a baseline understanding of a wide range of disorders. This includes not only otological diseases, but multisystem disorders that affect the auditory system. While an abundance of diagnostic audiological information on various disorders and their impacts are available, there exists a gap in the availability of condensed and accessible diagnostic information for everyday use. The goal of the resulting diagnostic pocket guide is to provide …

A Guide To Pharmacology For Audiologists, Lauren E. Pasko

Dissertations, Theses, and Capstone Projects

Objective:The purpose of this research is to develop a pharmacology guide for Audiologists and Audiology students to promote patient-centered care in audiology.

Introduction: Clinical audiology doctoral (Au.D.) graduate programs provide little education to audiology students on the topic of pharmacology. In order to provide optimal, patient-centered care, the Audiologist must be familiar with commonly prescribed medications, the conditions that they are used to treat, and their effects on the body. Knowledge of patient medication use can help the Audiologist orient their practice to the present health condition of the patient. An evidence-based guide for audiologists and audiology students on …

Effects Of Chronic Stress On Safety Processing And Physiology In The Medial Prefrontal-Amygdala-Basal Forebrain Circuit, Itamar S. Grunfeld

Dissertations, Theses, and Capstone Projects

Chronic stress increases generalization of fear to non-threatening cues, a key symptom in numerous psychiatric mood disorders. However, the mechanisms through which stress impacts safety learning remain poorly understood. To probe the relationship between stress and safety learning, this dissertation employed multiple behaviors, in conjunction with in-vivo multisite physiology during explicit safety and fear discrimination learning. In Chapter 1, I outline the role of chronic stress in driving neurological adaptations that result in generalized fear and highlight how this occurs because of impaired safety cue encoding. In Chapter 2, I show that chronic stress in the form of social defeat …

Biomimetic And Medical Applications Of Hollow Nanoscale Structures, Justin Fang

Dissertations, Theses, and Capstone Projects

Materials whose structure incorporates nanoscale void spaces have multiple possible uses, whether in a bulk form or as individual particles, due to the combination of high surface area ratios and nanoscale material properties. This thesis will explore a few of these possibilities, concentrating on potential biomimetic and biomedical applications, for two materials: metal- organic frameworks and superparamagnetic iron oxide nanocages.

Metal-organic frameworks consist of metal ions such as Cu2+ which have highly porous lattice structures allowing them to absorb and release guest molecules such as peptides like diphenylalanine; this stored chemical energy can be turned into kinetic energy and used …

Cvemp Frequency Tuning In Adults Aged 60 And Above: A Systematic Review, Kiersten P. Dudman

Dissertations, Theses, and Capstone Projects

Objective: This systematic review aims to evaluate if there is a significant difference in the frequency specificity of cVEMP amplitude responses in the older adult population, and if so how clinical protocols should reflect age related changes in the vestibular system to properly assess for vestibular pathology.

Methods: A comprehensive search was conducted using various databases through the Mina Rees Library of the City University of New York’s Graduate Center. This search identified articles relevant to this systematic review. Inclusion criteria encompassed quantified studies that utilized various frequency tone bursts to elicit VEMP responses among several age groups.

Results: Three …

Monolingual Versus Bilingual Use Of Context To Facilitate Speech Recognition In Background Noise: A Systematic Review, Rachel Abucasis

Dissertations, Theses, and Capstone Projects

Introduction: Previous literature has shown that bilingual listeners face more challenges than monolinguals during speech recognition in adverse listening conditions. As noisy environments degrade the acoustic stimuli and leave the listener with a partial or ambiguous signal to pair to a lexical representation, it is not possible to do so with the acoustic and phonological features alone. Bilinguals consistently use a significant amount of their cognitive resources during the early stages of speech processing, partially due to their need to navigate between the two languages. With exhaustion of most of their cognitive resources, there is limited capacity available to use …

Audiologists' Perspectives On Noise Induced Hearing Loss, Rachael L. Cleary

Dissertations, Theses, and Capstone Projects

Excessive noise has long been established in the literature as a prevalent workplace hazard. The high prevalence of occupational noise-induced hearing loss (NIHL) has led to high economic costs and has produced many physical and mental health effects on workers exposed to occupational noise. Standards set by OSHA are implemented in the workplace in order to protect employees. Despite these regulations set by OSHA, millions of workers in the United States are still exposed to excessive occupational noise, with limited use of hearing protection. The high prevalence of occupational NIHL and low use of hearing protective devices (HPDs) brings into …

The Arv Treatment Adherence Model: A Qualitative Study On Antiretroviral (Arv) Treatment Adherence For People Living With Hiv, Danielle Strauss

Dissertations, Theses, and Capstone Projects

Adherence to antiretroviral (ARV) treatment improves life expectancy and other health outcomes for people living with HIV (PLWH). It also minimizes their risk of transmitting HIV through sexual contact and is therefore a form of HIV prevention. However, many PLWH, specifically low-income PLWH of color who have been disproportionately impacted by the virus, face a multitude of barriers to ARV treatment adherence, making it much harder for them to take their medication as prescribed and remain engaged in care. This qualitative study based on Constructivist Grounded Theory explored the process by which 14 virally suppressed, low-income PLWH of color overcame …

Exploring Social Identity Threat And Safety Cues For Lesbian, Gay, Bisexual, Pansexual, And Queer Cisgender Women In Ob/Gyn Care, Rachel Fikslin

Dissertations, Theses, and Capstone Projects

Lesbian, gay, bisexual, pansexual and queer (LGBPQ) cisgender women (CW) experience a number of health inequities compared to heterosexual cisgender women related to sexual and reproductive health. Heterosexist health care cultures may signal social identity threat for LGBPQ-CW that may undermine their health care engagement and outcomes. In three online studies, I examined the effects of two heterosexist cultures (i.e., gender essentialism and pronatalism) as well as two potentially identity-safe alternatives (i.e., gender diversity and reproductive/sexual autonomy) on the identity threat and health care engagement experiences of LGBPQ-CW in OB/GYN care.

In Study 1 (n = 213), I used …

Lactating Justice: Constructing A Society Economically Focused On Optimizing Health Through Human Lactation, Shadley Hobour

Dissertations, Theses, and Capstone Projects

This paper uses a qualitative research method to answer if a Universal Base Income would be a good economic policy to adopt to optimize Black chestfeeding. The key idea this thesis aims to clarify is how anti Blackness is killing Black people and how one economic policy could improve health. In this essay, I will break down the significance and importance of human lactation for lifelong better health, and investment in a UBI would especially work as a preventative measure for several health issues Black people experiences.

Cochlear Implant Evaluations Of Spanish-Speaking Adults, Mariana Mejia Turnbull

Dissertations, Theses, and Capstone Projects

Background. As the Hispanic population in the U.S. continues to increase, audiologists need valid and reliable speech perception materials in Spanish to be able to offer evidence-based, high quality hearing health care to this population. The purpose of this study was to investigate current trends in CI evaluations of Spanish-speaking adults in clinics around the country, with a specific focus on sentence perception tests (Part 1). An additional goal was to analyze and compare the linguistical content of the Spanish sentence perception tests found to be the most commonly used among clinicians (Part 2).

Methods. A questionnaire was created and …

Usability Of Health-Related Websites By Filipino-American Adults And Nursing Informatics Experts, Kathleen Begonia

Dissertations, Theses, and Capstone Projects

Filipino-Americans are an understudied minority group with high prevalence and mortality from chronic conditions, such as cardiovascular disease and diabetes. Facing barriers to care and lack of culturally appropriate health resources, they frequently use the internet to obtain health information. It is unknown whether they perceive health-related websites to be useful or easy to use because there are no published usability studies involving this population. Using the Technology Acceptance Model as a theoretical framework, this study investigated the difference between website design ratings by experts and the perceptions of Filipino-American users to determine if usability guidelines influenced the perceived ease …

Reducing Fear Overgeneralization With Safety Learning: Attention Bias As A Moderator, Boyang Fan

Dissertations, Theses, and Capstone Projects

Anxiety disorders are the most prevalent mental health condition and affect one out of nine individuals around the world. Fear generalization is a neurocognitive mechanism thought to maintain and exacerbate anxiety, and thus is an important target of therapeutic interventions. Yet, intervention research and practice place relatively little emphasis on its importance. Given that a significant proportion of individuals do not respond to extant treatments of anxiety disorders, a strengthened focus on fear generalization may inform the development and personalization of new treatment approaches. Recent notions have linked fear generalization to failures in distinguishing between signals that predict the occurrence …

Educated There, But Employed Here: The Unique Experiences Of Internationally Educated Nurses, Nnenna Onuoha

Dissertations, Theses, and Capstone Projects

The educational background of nurses impacts their delivery of evidence-based, safe, quality, and patient-centered care. Obtaining a master’s degree can lead to patient benefits such as decreased lengths of hospital stay, reduced mortalities, reduced hospitalization costs, reduction in total patient falls, and nurse benefits such as increased job satisfaction and critical thinking skills. Internationally educated nurses (IENs) make up five percent of the 3.9 million nursing workforce, according to the National Sample Survey of Registered Nurses (NSSRN) data collected by the Bureau of Health Workforce. IENs obtain fewer master’s degrees than U.S-educated nurses, as the NSSRN data shows that 40% …

Maternal Wellness: Self, Matrescence, Obstetric Violence, And Self-Care, Vanessa V. Vales-Lewis

Dissertations, Theses, and Capstone Projects

In this dissertation, I engage in a self-study through an examination of my experience of matrescence (i.e., the transition to motherhood). I discuss my praxis in the development of a self-study on maternal wellness as it applies to my well-being as both a researcher and the researched. In Chapter 1, I preface this study by highlighting critical scholars and the bricoleurs who have been foundational in my undertaking of this work on a narrative study on maternal wellness. Using bricolage as part of a research methodological framework that involved key scholarly methodologies of authentic inquiry, emergence and contingence, and narratology, …