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 …

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 …

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 …

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 …

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 …

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., …

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 …

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. …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

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, …

Incarceration-Related Stigma And Caring Self-Efficacy Among Long-Term Care Nurses, Sandra D. Langston

Dissertations, Theses, and Capstone Projects

Background: A silver tsunami is occurring in U.S. prisons because of an unprecedented increase in the older population. Prisons are structurally ill-suited to care for this population and financially burdened with providing the necessary medical and nursing care. States have enacted legislation to afford justice-involved persons parole to manage chronic conditions in community-based long-term care (LTC) facilities. Changes in Medicaid regulations provide a seamless transition from prison to community long-term care for this population. However, it is not known if the stigma of justice involvement impacts the perception of long-term nurses concerning this population.

Aims/Purpose: This study examined the effects …

Synthesis Of Fluoroorganics And Applications Of Novel Fluorinated Building Blocks, Wei Wei

Dissertations, Theses, and Capstone Projects

Diastereoselectivity of fluorination of a carbanion alpha to a sulfone in enantiomerically pure N-Boc protected (R)- and (S)-2,2-dimethyl-4-((arylsulfonyl)methyl)oxazolidines has been studied. Fluorination proceeded with good to excellent diastereoselectivity, which was base-dependent and was highest with lithium diisopropylamide (LDA). Diastereoselectivity also depended on the aryl moiety of the aryl sulfone and was highest with benzothiazole-derived sulfones. Under basic conditions, epimerization at the C–F stereogenic center alpha to the sulfone has been achieved for the first time and proceeded with good to excellent diastereoselectivity, which was highest in the case of a benzothiazole sulfone and with a lithium base. …

Second Generation Phenyloxadiazolyl Methyl Sulfones For Thiol-Specific Bioconjugations, Guillaume Dewaele-Le Roi

Dissertations, Theses, and Capstone Projects

The role of antibody-based molecular agents for diagnosis and therapy of cancer has expanded significantly over the past decades. However, most of these constructs are synthesized using traditional bioconjugation methods based on the random ligations between the molecular cargo and lysine residues within the protein. These non-specific approaches can create poorly defined conjugates with suboptimal immunoreactivity and in vivo performance while Site-specific approaches to antibody bioconjugation based on ligations between maleimides and free cysteine residues have long stood as attractive alternatives. Yet the inherent instability of the thiol-maleimide linkage has fueled the search for new, more stable thiol-reactive prosthetic groups. …

Late Talkers: Maternal Input And Attention Allocation In Mother–Child Dyad Play, Toby B. Mehl

Dissertations, Theses, and Capstone Projects

Late talkers (LT) are two-year-old children with expressive language delays, who do not yet have a lexicon of fifty words, and do not combine words. Maternal child-directed language to these children, termed ‘maternal input’ may influence their language learning. The first aim of this study was to examine the relationship between a child’s language, as measured by expressive vocabulary, and the child-directed speech by the mother of the child. Maternal input to late-talking children was compared to the maternal input presented to two typical language matched groups: an age-matched group of children (AM) and a vocabulary-matched group of children (VM) …

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 …

Leveraging Bio-Inspired Molecules For Cancer Theranostics, Douglas S. Macpherson

Dissertations, Theses, and Capstone Projects

A variety of molecules can be radiolabeled and delivered to a cancer site for the purposes of diagnostics and therapy. Among the most promising of tumor targeting molecules are peptides and antibodies. These bio-inspired molecules can be designed and synthesized to target and respond to cancer cells based on the properties of those cells. Matrix metalloproteinase (MMP) enzymes are over-expressed by some metastatic cancers, in which they are responsible for the degradation and remodeling of the extracellular matrix. In recent years, MMPs have emerged as promising targets for enzyme-responsive diagnostic probes because oligopeptides can be designed to be selectively hydrolyzed …

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 …

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.) …