Medicine and Health Sciences Commons^™

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 …

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. …

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., …

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 …

Analysis Of Electrophysiological Markers And Correlated Components Of Neural Responses To Discourse Coherence, Kurt M. Masiello

Dissertations, Theses, and Capstone Projects

Constructing meaning from spoken language is invaluable for learning, social interaction, and communication. In clinical populations with developmental disorders of speech comprehension, the severity of disruption can persist and vary from limiting occupational opportunities to lower performance outcomes. Previous research has reported an event-related potential (ERP) neural positivity over right hemisphere lateral anterior sites in response to semantic and discourse processing. Although useful as a marker for clinical populations of autism spectrum disorder (ASD) and developmental language disorder (DLD), little is understood about the dynamics and neural sources of this biological marker. In addition to traditional methods of ERP analysis, …

Race, Gender, Physical Activity, And Cancer: A Quantitative Investigation, Shawna A. Townsend

Dissertations, Theses, and Capstone Projects

Black women are more likely to die from cancer than any other population in the United States. Physical activity is known to be associated with preventing and reducing cancer burden. However, Black women are less physically active than their White counterparts and have a higher prevalence of diseases related to lack of physical activity than any other female group. To better understand these issues, this study employed the self-and-family management framework and intersectionality as theoretical frameworks through a secondary analysis of the Health Information National Trends Survey (HINTS) dataset and hierarchical regression modeling to examine the relative impact of (a.) …

Sit Less, Move More: A National Study Of Physical-Activity Behavior And Cancer, Stella O. Nwogugu

Dissertations, Theses, and Capstone Projects

Background: Physical activity is associated with lower risks of cancer, the second leading cause of death among Americans. Yet, sedentary behavior is the prevailing lifestyle for about 80% of American adults. Additionally, cancer survivors remain significantly inactive, even though physical activity has been shown to decrease risk of cancer and cancer recurrence, improve tolerance of cancer therapy, and reduce mortality. This research explores the relative impact of personal agency, social support, and key demographic variables on physical-activity behavior for a national sample of adults as well as how these relationships differ for cancer survivors and their counterparts.

Methods: Using the …

Factors Associated With Technology Adoption By Community-Dwelling Older Adults During The Covid-19 Pandemic, Elizabeth A. Sutton

Dissertations, Theses, and Capstone Projects

The COVID-19 pandemic brought to the forefront the disparity between older and younger Americans in the utilization of information and communication technologies (ICT) when measures such as the COVID vaccine rollout were dependent on technology use. Technology adoption has implications for overall health and the continuation of disparities in technology adoption is associated with poor aging outcomes. The aim of this study was to understand factors associated with technology adoption by community-dwelling older adults during the COVID-19 pandemic. A nationally representative sample of 2,954 community-dwelling older adults who completed the National Health and Aging Trends Study (NHATS) COVID-19 Questionnaire was …

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 …

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 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 …

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 …

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 …

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 …

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 …

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.

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 …

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 …

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, …

Informed Consent: Foundations And Applications, Joanna Smolenski

Dissertations, Theses, and Capstone Projects

Since its advent in the 20th century, informed consent has become a cornerstone of ethical healthcare, and obtaining it a core obligation in medical contexts. In my dissertation, I aim to examine the theoretical underpinnings of informed consent and identify what values it is taken to protect. I will suggest that the fundamental motivation behind informed consent rests in something I’ll call bodily self-sovereignty, which I argue involves a coupling of two groups of values: autonomy and non-domination on the one hand, and self-ownership and personal integrity on the other. I will then go on to consider two 'case …

Food-As-Medicine: An Everyday Strategy Of Health, Rachel Rebecca Bogan

Dissertations, Theses, and Capstone Projects

Using food-as-medicine, a valuable strategy of health, as its focus, this dissertation examines why and how New Yorkers use food to negotiate their health. I argue that while using food medicinally is a common health practice, food-as-medicine operates unequally among different groups of New Yorkers. I attribute this inequity, in part, to how those in power, including public health experts, biomedical doctors, and the food industry, operationalize food-as-medicine as a health remedy and to a neoliberal, healthist context that ties people’s morally “correct” uses of food-as-medicine to their abilities to access “good” citizenship and optimal health.

I chose to write …

Cross-Linguistic Morphosyntactic Influence In Bilingual Speakers Of Jamaican Creole And Jamaican English, Taryn R. Malcolm

Dissertations, Theses, and Capstone Projects

Bilingualism in Jamaica is of considerable consequence, as most individuals are early bilinguals, speaking both a variety of Jamaican Creole (JC) from birth and having standardized English (sE) as the language of instruction in education. Immigrants from Jamaica to the United States are an ideal population to examine how cross-linguistic influence (CLI) impacts morphosyntax as JC and sE differ in morphosyntactic constructions, including verb tense- marking, subject-verb agreement, and copula use. While much of the work in the field of CLI has examined spoken language pairs with varying degrees of similarity (or difference) between the languages, examining CLI in a …

A Randomized Controlled Trial Of Psychological Outcomes Of Mobile Guided Resonant Frequency Breathing In Young Adults With Elevated Stress During The Covid-19 Pandemic, Al Amira Safa Shehab

Dissertations, Theses, and Capstone Projects

Deep breathing practices have shown promise in reducing stress, anxiety, and depression in different populations, including young adults. Specifically, resonant frequency breathing can exert an impact on stress response systems through the vagus nerve and the hypothalamo-pituitary-adrenal (HPA) axis. This may induce reductions in stress and improvement in emotion regulation. Young adults, including college students, tend to be at a higher risk for psychological distress, as they face several psychosocial challenges. The COVID-19 pandemic has imposed new and unique stressors that resulted in higher levels of stress and emotional symptoms and it has been shown that this may have placed …

The Effect Of Anticipatory Anxiety On Fear Extinction Learning, Daniela C. Echeverria

Dissertations, Theses, and Capstone Projects

Adaptive regulation of fear is dependent on successful fear extinction learning; therefore, investigating factors that both enhance and diminish fear extinction learning is a critical line of research. In the present study, we induce mild anticipatory anxiety during fear extinction learning in an attempt to modulate how participants extinguish fear memory. In the experiment, we apply a classic three-day fear learning protocol to both control participants (N = 20) and an experimental group (N = 20) with fear acquisition, fear extinction, and fear recovery phases; each phase is separated by a period of 24 hours and we use a skin …

Delayed Modulation Of Glutamate Receptors By Anti-Epileptic Drugs After Traumatic Brain Injury In Rats, Edgar Rodriguez

Dissertations, Theses, and Capstone Projects

Traumatic brain injury (TBI) is a significant health concern. Around 74 million people sustain a traumatic brain injury worldwide. The damage caused by TBI produces two types of injury; primary and secondary injuries. Primary injury is caused within milliseconds and is irreversible. Secondary brain injury is delayed and produced by molecular, cellular, and structural disruption after the initial injury. One of the most devastating dysfunction after TBI is glutamate neurotransmitter overactivation that could lead to neurotoxic levels of glutamate in the brain (i.e., excitotoxicity). Excitotoxicity has been linked with the development of epilepsy after TBI, also known as post-traumatic epilepsy …

Antecedents Of Borderline Personality Disorder And Antisocial Personality Disorder: An Examination Of Gene X Environment Interactions, Amy L. Medina

Dissertations, Theses, and Capstone Projects

Current thinking suggests that genotypes associated with impulse-control disorders and negative emotionality, such as monoamine oxidase-a (MAOA), interact with negative early environmental factors like childhood maltreatment and develop into the disorders know as Borderline Personality Disorder (BPD) and Antisocial Personality Disorder (ASPD). Using existing data from a prospective cohort design study of the consequences of child abuse and neglect, participants (N = 896 represent individuals with documented histories of child abuse and neglect and a matched comparison group that were followed up into adulthood and interviewed. A subsample of 631 participants gave permission for DNA extraction and analyses during …

Constructing Curriculum: Centering Identities In Sex Education, Jozette Belmont

Dissertations, Theses, and Capstone Projects

Sex education (sex ed) is a state-by-state and school-by-school issue, and there are no federal laws which mandate medically accurate education. In New York, schools only offer one semester of health education which often happens in the last semester of twelfth grade. Further, LGBTQIA+ people’s sexual health and identities are rarely mentioned. Therefore, this project asks: What are the ways sex ed curricula and policies in New York address the needs of LGBTQIA+ youth? To answer this question, I use a critical policy analysis to compare curriculum from the New York City Department of Education (NYCDOE) and Peer Health Exchange …

When Is A Sandwich Too Much? A Critical Look At Teenage Parenthood And Its Impact On The Lives Of Their Parents, Shirley P. Grant

Dissertations, Theses, and Capstone Projects

The transition into early parenthood also implies a shift to early grandparenthood for the parents of teenage parents. The stigmas and stereotypes associated with teenage pregnancy and parenthood are also experienced by their parents for the decisions their children have made. Furthermore, some of these grandparents are caregivers to aging parents while also parenting their younger children. These people, recently called, “the club sandwiched” generation, appear to be experiencing physical, social, economic, and psychological impacts because of their responsibilities of caring for three generations but have not yet received much attention in academic literature. Teenage pregnancy can affect any family. …