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Development of a Dynamic Next Generation Semicircular Canal Assessment Device
No full textAccurate evaluation of vertical semicircular canal (SCC) function remains a critical gap in vestibular diagnostics. This dissertation presents an integrated and automated rotational testing platform that delivers precise, repeatable stimuli for assessment of all six SCC planes. Here, we designed, validated, and acquired preliminary normative data for a rotational testing paradigm consisting of the vertical computerized rotational head impulse test (crHIT-Vertical), the sinusoidal harmonic acceleration test (vSHA), and the velocity-step (vVST) test. crHIT-Vertical yielded higher VOR gains with <5% of values falling outside normative limits compared to 35% in for standard vHIT, with significantly reduced variability and asymmetry across all canals. vSHA testing at 0.08, 0.16, and 0.64 Hz produced VOR gains that increased proportionately with chair velocity and showed consistent gain-phase relationships across canal planes (p < 0.05). vVST revealed shorter time constants and smaller gains in vertical versus horizontal planes, with no correlation to vHIT metrics regardless of acceleration or deceleration. Together, these protocols establish a unified, frequency-dependent framework for precise evaluation of both vertical and horizontal SCC function, directly addressing longstanding diagnostic limitations in vestibular care.</p
Exploring the Influence of Peripheral Macronutrient Utilization in Regulating Metabolism-Fueled Tumorigenic Glioblastoma Stem Cells
No full textMetabolic rewiring of cancer stem cells plays a pivotal role in promoting tumorigenicity and recurrence in glioblastoma (GBM), making tumor recurrence inevitable. The presence of glioblastoma stem cells (GSCs) is a major factor behind the poor prognosis of GBM. Despite trimodal therapy, surgical resection, temozolomide chemotherapy, and radiotherapy, GSCs often invade into eloquent brain areas, become unresectable and resistant to treatment, promoting recurrence. GSCs leverage the postoperative wound healing period to invade into critical brain regions, making therapeutics less effective due to the inability to seek and destroy these GSCs. The recurrent nature of GBM negatively impacts conventional treatment strategies leading to a growing need for alternate therapeutic strategies. In this dissertation, we demonstrate a linear relationship between metabolic substrate utilization, stemness, and tumorigenicity in GBM. Transcriptomic analyses of patient derived GSCs and using known inhibitors of metabolic substrate utilization indicated that fat utilization fuels stemness and tumorigenicity of GSCs. We identified a distinct stemness-driven genomic difference between recurrent and newly diagnosed tumors, emphasizing the role of metabolism in fueling recurrence. Through metabolic studies in the patient derived GSCs, we were able to establish that the GSCs majorly rely on utilizing fatty acids by performing fatty acid oxidation (FAO), while depending less on glucose or glutamine oxidation for their energy requirements. We were able to determine that inhibiting the preferred metabolic substrate utilization, i.e., FAO, in GSCs by knocking out CPT1A contributes to a remarkable change in stemness potential and a significant reduction in the tumorigenic potential of the GSCs. we study the effect of a non-invasive and non-pharmacological intervention by utilizing a low carbohydrate high fat diet (LCHFD) in delaying and/or stopping proliferation of GSCs, with an aim to leverage this understanding to answer the clinically unmet needs. </p
Austere Lives: Afro-Caribbean Geographies of Political Austerity
No full textAustere Lives traces the racialized, classed, and gendered fallouts of the entrenchment of neoliberal austerity in the long 1980s across the North Atlantic. Through reading the epistolary memoirs of Black, Caribbean-descended subjects who were socialized into the logics of neoliberal austerity as children, the dissertation explores how this transformative era’s commencement of a new iteration of racial capitalism ushered forth our political present. Contributing to existing academic and popular culture reckonings with both the legacies of the long 1980s and also austerity as an everyday lived experience, Austere Lives utilizes epistolary memoir as historiographical method as well as textual object to situate the literary autobiographical among these debates.Despite the authors’ geographic separation and individual differences, they all exhibit similar sober, stoic, skeptical, and anti-romantic sensibilities vis-à-vis the inevitability of racial capitalism’s futures, in which Black bodies will always be in peril. Metaphorically and affectively animated by the contours of austerity as a state policy that strips resources from vulnerable populations - justified by rationales of moderation and economic scarcity - I term the emergent mentality of these memoirists political austerity. The dissertation maps how political austerity differently manifests through these authors’ narratives of their childhoods in the 1980s, foreclosing citizenship and the potential to belong in their countries of birth. Resisting this tragedy, however, are simultaneously produced alternative versions of Black sustainment and relief grounded in community kinship structures, which I term their alternative attachments. Taken together, the chapters of Austere Lives traverse multigenerational Afro-Caribbean Canadian, US, British, and Australian geographies of Black immigrant placemaking from the postwar, end of empire mass migrations to the children these authors took heed to write to several generations later. </p
Examining Obesity in African American Families Through a Social Environmental Lens: A Comprehensive Analysis
No full textIntroduction:African American (AA) women and families experience disproportionately high obesity rates, with 55.9% of AA women aged 20+ classified as obese. Despite evidence supporting family-centered approaches, the influence of the family social environment on obesity in AA families remains unclear. This dissertation aimed to: (1) review the role of the social environment on obesity in AA families; (2) validate the Family Health Scale (FHS) in a subsample of AA families; and (3) examine the predictive power of family health on BMI and obesity.Methods:Aim 1 used a scoping review of 14 studies (2014–2024) examining obesity and social environmental factors among AA families. Aim 2 used 2020 FHS Study data to conduct exploratory and confirmatory factor analyses assessing reliability and measurement invariance across racial groups. Aim 3 employed multivariate and logistic regression to test associations between FHS subscales and BMI in the full sample and AA subsample, adjusting for sociodemographic variables.Results:The review showed that AA family health and obesity are shaped by sociohistorical context. Aim 2 supported a four-factor FHS structure. Aim 3 found an inverse relationship between family health and BMI, highlighting the role of family dynamics in weight outcomes.Discussion/Conclusions:Results confirm the FHS as a reliable, multidimensional tool capturing social, emotional, lifestyle, resource, and support factors within families. Subscales were positively correlated, and the model demonstrated strong fit and cross-group equivalence.Implications:Validated tools like the FHS can strengthen research on social determinants, guide targeted family-centered interventions, and inform future longitudinal and cross-group studies to improve family health and obesity outcomes
A Socioecological Model for Understanding Racial Inequities in Child Maltreatment Case Outcomes
No full textChild maltreatment is substantiated at higher rates in low-income communities of color, with disproportionality most pronounced for Black children, who are twice as likely as non-Latino White children to enter foster care due to substantiated maltreatment. Most research has focused on individual-level risks without accounting for systemic factors, including structural racism. Using a broader contextual lens, maltreatment outcomes can be viewed as shaped by individual, family, and community factors. Structural racism is linked to poverty, higher crime, and limited health care access, creating conditions in which maltreatment occurs. This study examined contextual and systemic contributors to racial inequity using a multilevel model that included family-level variables (poverty, caregiver mental health, caregiver substance use) and county-level variables (poverty, mental health resources, incarceration rates). Two publicly available datasets from the Florida Department of Children and Families and the Florida Department of Health were used, with a sample of 618,720 Black maltreatment cases across 67 Florida counties (2017–2021). Hierarchical logistic regression assessed the odds of substantiation as a function of family and community variables. Family-level factors, especially caregiver mental health and substance use, were the strongest predictors, while community-level factors were not significant. Overlap between levels may explain these patterns, suggesting structural inequities shape caregiver risks. Findings underscore the need for culturally informed, intersectional, strengths-based approaches that recognize both risks and resilience in Black families to promote equitable child welfare outcomes.</p
Understanding Barriers and Decision-Making Pathways in Drug Addiction Treatment: A Community-Based Study on Black/African Americans in Miami-Dade County
No full textDrug addiction remains a significant public health concern, especially within Black communities in Miami-Dade County. Yet limited understanding of how individuals recognize addiction and decide to seek treatment restricts the development of culturally relevant interventions. This dissertation examines how Black adults in Miami-Dade County understand addiction, interpret their treatment experiences, and navigate pathways to recovery. Using a community-based and interpretive phenomenological approach, twenty-five participants were recruited through community and faith-based organizations in Liberty City and completed in-depth narrative interviews.Findings show that decisions to seek help were shaped by identity, family influence, spirituality, and experiences of stigma. Participants described addiction recognition as a personal and relational process that involved shifts in self-perception rather than clinical diagnoses. Treatment experiences varied widely. Some found support through compassionate, nonjudgmental relationships, while others encountered systems that felt impersonal, inflexible, or focused on insurance rather than care. Seven themes highlight the importance of belonging, trust, dignity, and active listening in supporting recovery.This study contributes to medical sociology by situating addiction within cultural and community contexts rather than viewing it solely as an individual or biomedical issue. It underscores the need for culturally responsive and community-driven approaches that center Black voices and experiences. By framing recovery as a lifelong and relational process, the study offers insight into how empathy, cultural understanding, and meaningful connections can strengthen pathways to treatment for marginalized populations.</p
Barriers to Measurement-Based Care Implementation: Clinician Behavioral Determinants
No full textMeasurement-Based Care (MBC) integrates routine assessments into treatment to improve client outcomes, yet it's effectiveness depends on clinician fidelity. Theoretical frameworks, including the Consolidated Framework for Implementation Research (CFIR) and Contextualized Feedback Intervention Theory (CFIT), highlight mechanisms influencing MBC use (Damschroder et al., 2022; Riemer & Bickman, 2011), while the Theoretical Domains Framework (TDF) identifies clinician behaviors critical to implementation (Atkins et al., 2017). Key TDF domains including beliefs about capabilities, consequences, behavioral regulation, and social influences shape MBC fidelity. This study examines these domains to identify barriers and facilitators of MBC use. Data was collected from a randomized controlled trial study assessing unidimensional (client outcomes) and multidimensional (client outcomes & therapeutic process indicators) MBC. Clinicians (N = 59) from four community mental health clinics serving youth (ages 11-16) in inpatient, intensive outpatient, and intensive in-home services settings used an online Measurement Feedback System (MFS) to implement MBC with their clients (N = 955). Baseline clinician measures included: self-efficacy, Personal Innovativeness in the Domain of Information Technology, Numeracy and Graph Skills, Monitoring and Feedback Attitudes Scale, Regulatory Focus, Internal Feedback Propensity, and Team Psychological Safety. Hierarchical Linear Modeling (HLM) revealed significant clinician-level variability in MBC fidelity. Overall fidelity was low (42% completion rate, 44% viewing rate, and 25% implementation index). Contrary to hypotheses, self-efficacy negatively predicted fidelity, while session count positively predicted higher fidelity. Significant office-level differences emerged, suggesting that factors beyond clinician characteristics (e.g., organizational and structural elements) impact MBC use. Further research should explore multi-level barriers to support MBC adoption across diverse community settings.</p
AI for Content Management
No full textRecent advances in generative AI have enabled marketers to produce content at unprecedented speed. However, conventional content testing methods such as A/B testing and multi-armed bandit testing have not evolved to match this accelerated pace. This dissertation addresses this challenge by proposing two novel AI-driven systems designed to enhance the speed and efficiency of content testing in marketing. In the first essay, I propose the Email Open Rate Predictor (EMOP), an AI system that leverages recipients' characteristics, headlines’ topics, emotions, and campaign sending times to predict email campaign open rates. EMOP enables marketers to instantly evaluate countless variations of email campaigns without needing large samples or waiting hours for results. The second essay presents DeepAudio, an AI system specifically developed to assess the likeability of audio ads, filling a critical gap since prominent online audio platforms currently lack built-in ad testing capabilities. DeepAudio integrates established psychological insights on ad effectiveness with advanced AI algorithms to automatically evaluate multiple audio ads. Extensive validation confirms DeepAudio's robustness and generalizability, providing marketers with immediate and actionable insights. Together, EMOP and DeepAudio provide marketers with efficient and effective tools, significantly enhancing their ability to optimize content performance at the speed of modern AI content creation.</p
Racial, Ethnic, and Cultural Considerations in Hoarding Presentation, Assessment, and Vulnerability
No full textHoarding disorder is a severe and persistent mental illness that has detrimental effects at the individual, family, and community level. Despite these effects, there is a dearth of research examining how race, ethnicity, or culture may influence hoarding. We conducted two studies to examine hoarding phenomenology, assessment, and vulnerability across race and ethnicity. Study 1 combined data from crowdsourcing platforms (n = 1,185) and archival data from clinical research studies (n = 984) to test for measurement invariance of the Saving Inventory-Revised 9 across the primary ethnic (Hispanic/Latino and non-Hispanic/Latino) and racial (Asian, Black, and White) groups in the United States. Study 2 investigated potential nuances in hoarding symptoms and associated features across four groups from an online community sample: Asian (n = 73), Black (n = 68), Hispanic/Latino (n = 84), and White (n = 82). In the first study, we found evidence to support the cross-cultural validity of the three-factor model of hoarding, with some nuances related to item functioning across the racial groups. In our second study, we found that our participant groups differed in mean levels of clutter, acquiring, and saving beliefs, and the relationships between these variables also differed across groups. Materialism contributed to acquiring symptoms to a similar degree across groups. The findings from both studies indicate that sociocultural factors do impact hoarding in nuanced, yet important ways. Our research suggests a need to further investigate the role of sociocultural influences in hoarding to improve construct validity, assessment, and identification of vulnerability factors.</p
The Reciprocal Processes between Personal and Professional Development among Psychoanalytically Oriented Psychotherapists
No full textPsychoanalytically oriented psychotherapies (POP) emphasize understanding unconscious thoughts and feelings, their origins, and using relationships as a catalyst for change. While research supports POP’s efficacy and long-term benefits (Abbass et al., 2014; Shedler, 2010), little is known about how practitioners develop expertise through personal and professional experiences beyond a theoretical and anecdotal nature. This study investigates the professional and personal developmental processes of POP practitioners and how these processes reciprocally influence one another. This researcher recruited 13 middle, senior, and late senior career POP practitioners who graduated with their terminal degrees between 1990 and 2014 and are practicing in the U.S. Efforts were made to recruit practitioners across developmental stages. This researcher conducted semi-structured interviews and used interpretive phenomenological analysis (IPA) to analyze interview data, allowing for rich, deep examinations of the meaning that participants created out of their lived experience (Smith & Shinebourne, 2012). Five themes and 22 subthemes depicted practitioners’ change processes emerged from the interviews: (a) Deepening Clinical Presence Through Personal Experience, (b) Developing Awareness and Insight, (c) Transformation Through Relational Encounters, (d) Internalizing Theory Enriches Clinical Practice and Personal Experiences, and (e) Reflecting on Cultural Identity and Social Consciousness Promotes Humility, Empathy, and Responsibility These themes and subthemes were explained in detail with examples to illustrate participants’ developmental processes. Findings of this study may better inform future avenues for research, education and training, the field of psychoanalytic psychology, and policy regarding promoting growth among POP practitioners.</p