ASU Electronic Theses and Dissertations
This collection includes most of the ASU Theses and Dissertations from 2011 to present. ASU Theses and Dissertations are available in downloadable PDF format; however, a small percentage of items are under embargo. Information about the dissertations/theses includes degree information, committee members, an abstract, supporting data or media.
In addition to the electronic theses found in the ASU Digital Repository, ASU Theses and Dissertations can be found in the ASU Library Catalog.
Dissertations and Theses granted by Arizona State University are archived and made available through a joint effort of the ASU Graduate College and the ASU Libraries. For more information or questions about this collection contact or visit the Digital Repository ETD Library Guide or contact the ASU Graduate College at gradformat@asu.edu.
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- All Subjects: Health Sciences
- Genre: Doctoral Dissertation
Effect of a Wii Fit® intervention on balance, muscular fitness, and bone health in middle-aged women
on-governmental agencies and activists and others. The various terminologies used to refer to it attest to differences in knowledge systems, perceptions, and lived experiences emerging from divergent cultures and ideologies. In the last two decades, these debates have evolved from a local matter to a global health concern and human rights issue, coinciding with the largest influx of African refugees to the Western nations. Various forms of female circumcision are reported in 28 countries in the African Continent; Somalia has one of the highest prevalence of female circumcision and the most severe type. The practice is antithetical to Western values and poses an ideological challenge to the construction of the normal body, its bodily processes and its existential being-in-the-world. From the global health perspectives, female circumcision is deemed to be a health hazard--especially during childbirth--though the scientific evidence is inconclusive from studies conducted in post-migration. Yet, Somali refugee women have higher childbearing disparities in host nations, including the U.S. They are also perceived as difficult patients and resistant to obstetrics interventions. Although their FGC status and "cultural" differences are often cited, there is a lack of adequate explanations as to why and how these factors shape patient-provider interactions and affect outcomes. The objectives of this dissertation study are to quantitatively and qualitatively explore these questions within and between Somali refugee women and their healthcare providers in Arizona. Two theoretical frameworks and methods--culture consensus and embodiment-- are applied to identify variations in childbearing knowledge and to explore how the cultural phenomenon of circumcision is subjectively and intersubjectively embodied in the context of childbearing. Culture consensus questionnaire (N=174) and ethnographic interviews (N=40) using phenomenology approach were conducted. Analyses suggest cross-cultural disagreement hinged on: faith in science versus God, pregnancy/childbirth interventions, language challenges, and control-resistance issues; intra-cultural disagreement underscores that Somalis are not culturally homogenous group. Preconceptions of female circumcision body as a cultural phenomenon has different and conflicting meanings that may adversely impact patient-provider interactions and outcomes.
The aims of Experiment I were to (i) compare the lip reading difficulty of the AzAV sentences to that of other sentence materials, (ii) compare the speech-reading ability of CI listeners to that of normal-hearing listeners and (iii) assess the gain in speech understanding when listeners have both auditory and visual information from easy-to-lip-read and difficult-to-lip read sentences. In addition, the sentence lists were subjected to a multi-level text analysis to determine the factors that make sentences easy or difficult to speech read.
The results of Experiment I showed that (i) the AzAV sentences were relatively difficult to lip read, (ii) that CI listeners and normal-hearing listeners did not differ in lip reading ability and (iii) that sentences with low lip-reading intelligibility (10-15 % correct) provide about a 30 percentage point improvement in speech understanding when added to the acoustic stimulus, while sentences with high lip-reading intelligibility (30-60 % correct) provide about a 50 percentage point improvement in the same comparison. The multi-level text analyses showed that the familiarity of phrases in the sentences was the primary driving factor that affects the lip reading difficulty.
The aim of Experiment II was to investigate the value, when visual information is present, of bimodal hearing and bilateral cochlear implants. The results of Experiment II showed that when visual information is present, low-frequency acoustic hearing can be of value to speech understanding for patients fit with a single CI. However, when visual information was available no gain was seen from the provision of a second CI, i.e., bilateral CIs. As was the case in Experiment I, visual information provided about a 30 percentage point improvement in speech understanding.
Sixty-two family caregivers of children with ASD (M =7.61, range: 6-11 years old) participated in this survey study. Participants provided demographic information and completed measures of HRQoL, FQoL, caregiver sleep, SOC, parental stress, child sleep, and child behavior.
Caregivers with longer sleep duration reported better mental health and better FQol. Caregivers who reported insomnia symptoms, non-restorative sleep, and insufficient sleep were more likely to report poorer mental health than caregivers who did not report these sleep disorder symptoms. A stronger caregiver SOC was associated with lower caregiver stress, better mental health, and better FQoL. Significant relationships were found between shorter caregiver sleep duration or sleep disorder symptoms (i.e., difficulty staying asleep, early morning awakening, insufficient sleep) and greater child sleep problems. Moreover, short sleep duration or insufficient sleep among caregivers was significantly associated with greater parenting stress. Notably, biological parents with Restless Legs Syndrome (RLS) had children with more restless sleep and higher rates of some behavior problems.
There are a number of potential connections between sleep problems of children with ASD and sleep problems of their caregivers that are likely rooted in genetic, environmental, socio-economic, and behavioral factors. Interventions for sleep problems must address the context of the family and consider that sleep problems may be common to the caregiver and the child. The results of this study support findings from many prior studies and point to salient variables for future research and interventions to promote healthy caregiver sleep.
Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.