Medicine and Health Sciences Commons^™

Testing Peplau's Theory Of Interpersonal Relations In Nursing Using Data From Patient Experience Surveys, Thomas Arthur Hagerty

Dissertations, Theses, and Capstone Projects

Patients' experiences in hospitals are important indicators of quality. Patients' opinions about their experiences in hospitals are significantly associated with their opinions of those hospitals' nursing services. Nurses in the US have traditionally focused on patients' experiences, and Peplau's (1952/1991) theory of interpersonal relations is early evidence of that focus. This study tested Peplau's (1952/1991) theory of interpersonal relations in nursing using confirmatory factor analysis (CFA) on data from 12,436 patient experience surveys. Two hypotheses were supported: (a) patient experience data (i.e. responses on the Consumer Assessment of Healthcare Providers and Systems - Hospital [HCAHPS] survey) collected from patients in …

Developmental Coordination Disorder: The Relationship Between Gait And Attention With Possible Implications For Early Identification And Intervention, Yocheved Bensinger-Brody

Dissertations, Theses, and Capstone Projects

The aim of this research was to evaluate how increased levels of challenge to attentional capacity would affect the motor planning and coordination in the gait of children at risk of Developmental Coordination Disorder (DCD) across developmental ages. The study incorporated a dual task paradigm requiring both motor and attention performance, with the primary hypothesis that children who are at risk of DCD across different ages (3- to 8 yrs.-of-age) would demonstrate an alteration in their motor strategies if they were simultaneously engaging in an attention task. A secondary hypothesis of this study was that there is an underlying deficit …

Effect Of The New York City Overdose Prevention Program On Unintentional Heroin-Related Overdose Death, 2000-2012, Anne Elizabeth Siegler

Dissertations, Theses, and Capstone Projects

Background: Drug overdose mortality is the leading cause of injury death in both the United States (US) and New York City (NYC). Heroin-related overdoses make up the majority of overdoses in NYC. Since 2006, when a law was passed that allowed for layperson administration of naloxone, an opioid antagonist, heroin-related overdose deaths have decreased in NYC. No studies to date have investigated a possible association between the implementation of this intervention and heroin-related overdose mortality.

Objectives: To investigate the possible association between overdose prevention programs (OPPs) and heroin-related overdose mortality in NYC, using interrupted time series and geospatial analytic …

The Audiometric Profile Of Young Adults Who Report Difficulty With Speech Perception In Noise, Michael R. Higgins

Dissertations, Theses, and Capstone Projects

This study examined speech perception abilities in young adults (18-24 years) who reported having difficulty perceiving speech in the presence of background noise despite clinically-normal hearing. The purpose of this study was to compare the audiometric profile of young adults with and without perceived difficulty with speech perception in noise. The Speech, Spatial and Qualities of Hearing Scale (SSQ) was administered to obtain a measure of how participants rate their speech perception in noise under different listening conditions. Audiometric tests included standard audiometric thresholds (250-8000 Hz), high frequency pure tone thresholds (9000-12,500 Hz), QuickSIN, distortion product otoacoustic emissions (DPOAEs), and …

Trauma, Mental Health, And Substance Use Among Homeless Families: The Importance Of Shelter Environment, Nisha Nicole Beharie

Dissertations, Theses, and Capstone Projects

Homelessness is at historical levels in the United States and New York City has not been immune to this nationwide trend. Homeless populations are not only increasing in number but are remaining in the shelter for longer periods of time. Homelessness, itself has been shown to have negative consequences on mental health and physical health, but its effects are particularly significant for families with children who have greater needs and who are more susceptible to negative experiences at early ages that can have lifelong impact. Despite this recent data there has been very little to no research on the potential …

Housing And The Environment: Smoking Triggers And Tobacco Smoke Exposure, Shannon Farley

Dissertations, Theses, and Capstone Projects

Background: Despite decades of smoking prevalence declines and more recent smoke-free indoor and outdoor air laws, smoking causes 400,000 preventable deaths and secondhand smoke (SHS) exposure leads to 40,000 deaths from respiratory and cardiovascular disease among non-smokers annually. Built and social environment factors linked to smoking include tobacco retailer density and neighborhood poverty. Housing environments including multiunit housing are linked to SHS exposure and adverse health outcomes.

Objectives: To investigate possible associations of different environmental factors with smoking, SHS exposure, and SHS-related health outcomes.

Methods: Many data sources were used: New York City Community Health Survey, Department of Consumer Affairs, …

Development Of Instructional Competencies For Assessing And Managing Suicide Risk For Baccalaureate Nursing Education, Abigail Kotowski

Dissertations, Theses, and Capstone Projects

Suicide is a major health problem and a leading cause of death throughout the world. Reforming health professional education has been identified as a primary goal for suicide prevention, and although nursing leadership is involved in this reform, nurses frequently lack the competence to care for patients in suicidal crisis. An identified gap in baccalaureate nursing education is instructional competencies for assessing and managing suicide risk. Instructional competencies are targeted components of knowledge, attitudes, and skills that nursing students need to know in order to assess and manage patients expressing suicidal ideation. This study aimed to develop a set of …

Attitudes Of Normal Hearing Listeners Towards Personal Sound Amplification Products: Sound World Solutions Cs50, Marisa Viets

Dissertations, Theses, and Capstone Projects

Over 23 million individuals in the United States have some degree of hearing loss but do not own hearing aids. Individuals may choose not to adopt hearing aid technology for an assortment of reasons, including the stigma associated with hearing aids, cost of the devices, or denying the effects of hearing loss. Prevalence of hearing aid usage remains low despite research indicating that untreated hearing loss is correlated with decreased quality of life and accelerated cognitive decline. In recent years, personal sound amplification products (PSAPs) have entered the market as simple, low cost, discreet devices in attempt to reach non-users …

Attitudes Of Normal Hearing Listeners Towards Personal Sound Amplification Products: Etymotic Bean, Jennifer Rhoades

Dissertations, Theses, and Capstone Projects

Despite the remarkable prevalence of hearing loss in the United States, only a small percentage of these individuals utilize hearing aids. Many factors have been associated with the non-adoption of hearing aids, including financial reasons and the stigma associated with hearing aid use. Personal sound amplification products (PSAP) have been recently introduced as a more discrete and less costly type of assistive listening technology. While the Food and Drug Administration does not approve these devices for individuals with hearing loss, they are advertised as being useful for boosting soft sounds and amplifying speech in the presence of background noise.

The …

An Electromyographic Comparison Of The Functional Performance Of The Gluteus Maximus Muscle In Prolonged Sitting Versus Standing Populations, Kerry Campagnola, Giusi Gerbino, Erica Johnson, Adrienne O’Keefe

Dissertations, Theses, and Capstone Projects

PURPOSE: A common clinical concern of Physical Therapists is the inexplicably weak gluteus maximus (GM) muscle; we hypothesized that this may be linked to the popular habit of prolonged sitting. The purpose of this study was to determine if surface electromyography (sEMG) output and timing of the GM and hamstrings muscles differed between people who sit for prolonged periods of time and people who stand for prolonged periods of time. METHODS: The design of our study was a single session case-control study. Subjects were 22 healthy adults (23-36 years old) who either sat or stood for 8-10 hours a day …

Development And Validation Of A Bangladeshi Pediatric Silhouette Scale (Bpss), Ana Mola

Dissertations, Theses, and Capstone Projects

There is no culturally congruent children's silhouette scale to understand how Bangladeshi mothers perceive their children's body sizes and weight categories. The purpose of this study was to develop and validate an ethnic congruent Bangladeshi Pediatric Silhouette Scale (BPSS) and a facial feature scale to assess the mothers' perceptions of their children's body sizes, weight categories and facial features. The study methodology was a quantitative, descriptive design with scale content validation. The sample was comprised of 29 Bangladeshis mothers ages 25-40 and their four-five year old children living in London, England and New York City. The Mola Facetool analyses revealed …

Age, Cognition, And Listening Effort, Sapna Mehta

Dissertations, Theses, and Capstone Projects

Older adults are reported to have more difficulty understanding degraded speech than younger adults. This may be due to greater recruitment of cognitive resources in adverse listening conditions. The purpose of this study was to examine the relationship between listening effort as measured by a dual task paradigm and cognitive abilities, specifically, working memory and selective attention, in normal-hearing older and younger adults in various background noise conditions. Results revealed that speech recognition scores were poorer for older adults, and speech recognition scores declined with decreasing signal-to-noise ratio. Stroop test scores suggested better selective attention ability in the younger participants, …

Assessment Of Physical Performance In Adolescents Of Varying Body Weight, Nicholas Dalonzo, Nicole Liquori, Nicole Savarese

Dissertations, Theses, and Capstone Projects

Fifty-one healthy adolescents of both gender without any neuromuscular, musculoskeletal or cardiopulmonary disorders and between the ages of 12 and 17 with a mean age of 14.09 years (SD: 1.45 years) were recruited to participate in the 6-minute walk test. Several measurements such as height, weight and leg length were taken before testing, along with heart rate, blood pressure and oxygen saturation (SPO2) before, after and 10 minutes post 6-minute walk test. Walk distance was also quantified and used as an outcome measure. The adolescents were divided into two groups prior to statistical testing. The first group was classified as …

Dancer Performance On The Lower Quarter Y Balance Test: A Longitudinal Study, Megan Dehey, Kelly Kaems, Molly Saunders, Gabrielle Schneider

Dissertations, Theses, and Capstone Projects

Purpose: There is a need in the current literature for further information regarding dancer performance on the Y Balance Test (YBT). This study tracked the test scores of a group of dancers to assess change over time and relationship of balance scores to injury risk. It is hoped that clinicians may be able to use the information found in this study to more accurately screen dancers for asymmetries, deficits, and changes over time using the YBT. Such screenings would allow for more effective care and better assessment of readiness to return to dance. Method: A group of 12 dancers between …

Attitudes Towards Music Levels At Orthodox Jewish Weddings, Evan Hirschhorn

Dissertations, Theses, and Capstone Projects

Noise induced hearing loss is a deficit in the sensorineural part of the hearing mechanism, produced by the damaging effects of overstimulation by high intensity sound levels, usually over a period of time. Much of the noise literature has focused on occupational noise; however, the noise levels measured at non occupational and recreational settings have been found to be notably high as well. Attitudes and behaviors may vary based on demographics as such hearing conservational practices may benefit by honing in on demographic information. In the Orthodox Jewish community, weddings have a central role in community life, attended by many …

The Effects Of Maximal Strength Training On Gait And Balance In Persons With Multiple Sclerosis: A Pretest Posttest Pilot Study, Janet Klein, David Park, Charles Wright, Michael Zervas

Dissertations, Theses, and Capstone Projects

Background: Physical Therapy strength training programs utilizing mild to moderate intensity are commonly prescribed to address many of the deficits found in multiple sclerosis, but studies examining the effectiveness of higher intensity strength training in gait and balance have not been performed. Maximal strength training (MST), which involves lifting nearly maximal weights (85-95% of an individual’s one repetition maximum [1RM]) with low repetitions, has been shown to improve functional abilities in both healthy and non-MS impaired populations. The higher intensity training used in MST may result in greater activation of the CNS, providing a greater stimulus to improvement than …

Interactions Between Descending And Somatosensory Inputs In Humans, Lisa Krivis, Ann Mackey, Maureen Mcdonough, Denise Uttaro

Dissertations, Theses, and Capstone Projects

In this study, we assessed the corticospinal integration in healthy people while seated. Corticospinal integration was assessed by establishing the latency and amplitude of motor evoked potentials (MEPs) evoked following transcranial magnetic stimulation (TMS) of the primary motor cortex area representing the leg muscles, and the latency and amplitude of spinally-mediated reflex responses. Further, the modulation pattern of the spinally-mediated reflex responses were determined following subthreshold and suprathreshold TMS. All compound muscle action potentials, descending motor or spinally-mediated reflexes were recorded from the leg muscles through surface electromyography. Both subthreshold and suprathreshold TMS induced a similar modulation pattern on the …

The Lived Experience Of Family Nurse Practitioners Performing Sexual Health Assessments, Madeleine Mary Lloyd

Dissertations, Theses, and Capstone Projects

Sexuality incorporates a multitude of feelings including beliefs, fantasies, and aspects of pleasure, intimacy, and reproduction. In addition, sexuality involves rights to gender identity and role, sexual acts and orientation. Sexual and reproductive health and rights is a global health, development, and human rights priority. Universal access to sexual and reproductive health is essential. Negative sexual health outcomes are increasing in the United States and sexuality is often a neglected area for health providers including nurses. With an increasing share of the primary care services nationally, family nurse practitioners (FNPs) have the means to provide quality sexual health care across …

Women Of Faith: Adaptation Of African American Women Breast Cancer Survivors, Pearline Lincoln Okumakpeyi

Dissertations, Theses, and Capstone Projects

The purpose of this study was to gain an understanding of the adaptation experience of African American women breast cancer survivors. The African American women's perception of the influence of faith on the breast cancer survivorship experience was explored.

This study utilized the directed qualitative content analysis method, which extracted themes and patterns that emerged in a narrative content. The 15 study participants were self-identified African American breast cancer survivors. The study was conducted using semi-structured interview questions that were derived from the modes of the Roy Adaptation Model (RAM). The discussion was framed within the context of the themes …

Content Analysis Of Applied Learning From High Fidelity Patient Simulation Orientation To Critical Care, Patricia M. Span

Dissertations, Theses, and Capstone Projects

The Institute of Medicine (IOM) reported that over 98,000 deaths occur in hospitals from medical errors in the United States. In a follow-up IOM report, it was noted that nurses have a direct impact on patient morbidity and mortality and are often the last line of defense for patient safety. The challenge for nurse educators in hospitals is to ensure that as newly licensed nurses enter the workforce, orientation outcomes reflect acquisition of knowledge and skills, which are applied in practice. When newly licensed registered nurses are hired into critical care units, this puts them in a position where they …

Diagnostic Procedures Using Radiation And Risk Of Thyroid Cancer: Causal Association Or Detection Bias? An Examination Of Population Cancer Trends And Data From The Nyc Fire Department, Rachel Zeig-Owens

Dissertations, Theses, and Capstone Projects

Background: Thyroid cancer (TC) is a common cancer diagnosis in the United States, whose incidence is increasing. Disaster and radiation treatment studies show high doses of radiation can cause TC. Some diagnostic procedures, whose use is increasing, expose individuals to low-dose radiation but can also incidentally detect subclinical TC. Evidence regarding low-dose radiation risk is limited.

Objectives: To investigate the possible association of greater use of diagnostic procedures with TC, either causally through radiation exposure or via incidental detection.

Methods: Two data sources were used: National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) data and Fire Department of the …

Hearing Conservation Attitudes And Behaviors At Orthodox Jewish Weddings, Audrey Margulies

Dissertations, Theses, and Capstone Projects

Previous research has shown that prolonged exposure to noise can cause permanent hearing loss. Noise levels at Orthodox Jewish weddings can reach extremely high and damaging levels, yet the hearing conservation attitudes and behaviors of the attendees are unknown. The objective of this study is to identify the attitudes and behaviors of Orthodox Jewish wedding attendees toward hearing conservation. The major questions are: 1. What are the sound exposure levels at Orthodox Jewish weddings? 2. Do attendees hold positive attitudes toward the need for hearing conservation at Orthodox Jewish weddings? 3. What hearing conservation is being practiced at weddings among …

Cochlear Implantation As A Treatment Option For Adults With Post-Lingual Single Sided Deafness: A Systematic Review Of The Literature, Elvera Bader

Dissertations, Theses, and Capstone Projects

Adults with post lingual single sided deafness experience a myriad of issues as a result of their condition. Speech perception in noise and localization are well documented as being compromised in this population due to the loss of binaural auditory input. Cochlear implantation was introduced in the 2000s as an experimental treatment option for suppression/abatement of tinnitus in individuals with SSD, with consistent demonstration in reduction of tinnitus severity. Most recently, the focus has shifted to the potential reintroduction of binaural effects, and subsequently, improvements in speech in noise and localization performance through this treatment modality. The present systematic review …

Discerning Between Types Of Otitis Media And Their Evidence Based Treatments: A Review For The Audiologist, Hadassah Norowitz

Dissertations, Theses, and Capstone Projects

Otitis media is an inflammatory pathology of the middle ear and middle ear mucosa which accounts for the majority of cases of childhood hearing loss diagnosed by audiologists. However, considerable confusion exists regarding the distinction between otitis media with effusion, also known as middle ear effusion or “glue ear”, and acute otitis media, the quintessential ear infection. Since many children are referred for audiological evaluation in the process of determining the course of treatment and outcomes of treatment, audiologists must be knowledgeable of the evidence of efficacy for various treatment options as they field questions from parents with incomplete information …

Effect Of Absent Tactile Sensation On Multi-Digit Coordination Underlying Hand Control, Michael P. Alcorn, Bruce Faulkner, Matthew Macina, Brian Sherman

Dissertations, Theses, and Capstone Projects

We investigated the effect of anesthesia, causing absent tactile sensation feedback, on multi-digit coordination underlying hand control. The purpose of the study is to expand our understanding on the essential role of tactile sensation feedback in the sensorimotor integration process by examining the motor coordination patterns during multi-digit forces production tasks. We hypothesized that absent tactile sensation feedback would interrupt the force sharing pattern at local and non-local digits. Twelve participants were utilized for data collection and statistical analysis (25.6 ± 4.1 years old, 6 males and 6 females), right-handed (according to their preferred hand use for writing and eating) …

Retrospective Chart Review Of Patients Following Unilateral Total Knee Replacement To Assess Achievement Of Functional Milestones Based On Type Of Anesthetic Used Intra-Operatively, William S. Benish, Lolline Chong, Elana Kram, Danielle Krieger

Dissertations, Theses, and Capstone Projects

PURPOSE: Given the large number of Total Knee Replacements (TKR) performed annually in the US and the prediction that those numbers will increase, providing optimal analgesia during TKR is an important strategy for reducing cost and improving patient outcomes. Currently, no standard analgesia protocol for TKR exists and facilities in the US and world-wide use varied methods of analgesia. The purpose of the present study is to determine which analgesic technique; femoral nerve block (FNB), saphenous nerve block (SNB) or periarticular injection (PAI), within the context of a multi-modal pain management regimen, results in optimal TKR patient outcomes and achievement …

Investigating The Effects Of Combining Treadmill Training With Trans-Spinal Direct Current Stimulation On Motor Skill Recovery After Spinal Cord Injury, Jennifer Blake, Rebecca Bullen, Jeremy Pahl, Samantha Scicchigno

Dissertations, Theses, and Capstone Projects

This study assessed the effect of treadmill training with or without trans-spinal direct current stimulation on motor recovery following a T13/L1 spinal cord hemi section in CD-1 mice. Mice all received the same spinal cord injury, which resulted in left hind limb paralysis, and were assigned to one of three groups. Control animals received no treatment. Treadmill only mice were treated with 5 sessions of treadmill training. Treadmill + stimulation animals were treated with concurrent treadmill training and trans-spinal direct current stimulation. Progress was assessed by analyzing each subject’s steps on a horizontal ladder test, which the animals performed both …

Implications Of Muscle Activation Patterns On Balance In The Elderly, Arielle Bailey, Goldie Baum, Hadassa Radzik, Aruna Woods

Dissertations, Theses, and Capstone Projects

More than one third of adults ages 65 years old and older fall each year in the United States. This can result in trauma, hospital admissions, and potential death. The purpose of this study was to investigate the effects of waist-pull perturbation training on balance in the elderly. There were two experimental groups, elderly non-fallers (n=9) and elderly fallers (n=5) between ages 65-86, and a control group comprised of young, healthy subjects (n=10) ages 21-31. All subjects underwent baseline and post-training measurements using EMG recordings of the tibialis anterior, gastrocnemius, vastus lateralis and semimembranosus. Training was performing using repeated waist-pull …

The Influence Of Forward Head Posture On Suprahyoid Activity During Oropharyngeal Swallowing: A Surface Electromyographic Analysis, Brianne Carroll, Sierra Hunt, Katherine Sheeleigh, Mark Wnukowski

Dissertations, Theses, and Capstone Projects

STUDY DESIGN: Within subjects repeated measures design.

OBJECTIVE: The aim of this research is to explore the effect that Forward Head Posture has on the mylohyoid muscle during swallowing in a healthy population.

BACKGROUND: Forward Head Posture (FHP) is the most common deviation from ideal head posture, and has become more prominent due to the rise of smart phones and the prevalence of computers in the household and workplace. FHP is associated with a variety of detrimental effects on the musculoskeletal system that arise from the abnormal positioning of the cranial and cervical bones and joints. In particular, the muscles …

Use Of The Bioness L300® Functional Electrical Stimulator In Acute Stroke Rehabilitation, Christine Flanigan, Colleen M. Martinez, Beth N. Terranova, Nicholas Wildi

Dissertations, Theses, and Capstone Projects

Purpose. Over 150,000 people in the U.S. every year experience foot drop following a stroke, slowing their ambulation and increasing their falls risk. We explore whether the use of functional electrical stimulation (FES) to the common fibular nerve during acute rehabilitation can maximize ambulation gains. Methods. Five in-patients admitted at Burke Rehabilitation Hospital experiencing foot drop participated. While receiving conventional physical therapy, four subjects wore the Bioness L300® device, and one subject used an elastic figure-8 wrapped elastic bandage. Gait parameters were evaluated at initial evaluation, an intermittent evaluation, and discharge. Results. During their stay, subjects significantly improved in gait …