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Individuals with Parkinson's disease and their experiences with changes in communication and behavioral speech therapies
Get PDFBackground: Parkinson's disease (PD) is a major public health concern that affects the lives of nearly one million older adults in the United States. According to the World Health Organization, disability and deaths related to PD are rising more than any other neurological disease (2022). PD is ranked the 14th leading cause of death in the United States and is expected to reach 1.2 million by 2030 (Moya-Gale\u301 & Levy, 2019). Hypophonia is the slowed contractions of the muscles used in speech paired with the reduced movement in the muscles that support breathing, vocal loudness, and articulation (Parkinson Foundation, 2023). Current treatment options for the management of these symptoms include medication therapy or behavioral speech therapy. Individuals living with Parkinson's disease (ILwPD) have difficulty maintaining the skills learned in speech therapy and are at an increased risk for decreased quality of life (QoL) and isolation (Bryans et al., 2021). There is a gap in the current literature of the lived experience of ILwPD and the barriers and facilitators to maintaining skills learned in behavioral speech therapy. Aim: The purpose of this Quality Improvement (QI) project was to capture the personal experiences of ILwPD and hypophonia. Additionally, to increase Advanced Practice Registered Nurses (APRNs) knowledge of the strategies used to assist ILwPD with resources for management of PD, and educate APRNs on the barriers and facilitators of the transition from using the techniques learned in behavioral speech therapy to daily activities. Method: A speech language pathologist (SLP) served as community liaison and provided contacts for opportunities for recruitment for the QI project, which included the Michigan Parkinson's Foundation and a local PD support group. The QI team attended a meeting of the local support group to assist with recruitment. Recruitment for the project stalled using the provided opportunities and required the QI team to expand recruitment to other local support/exercise groups and to correspond with a local neurologist, whose specialty includes working with ILwPD. The QI team attended a virtual conference of the American Parkinson Disease Association (APDA) which provided an opportunity to listen to a panel, consisting of ILwPD and a caregiver of an ILwPD, about their lived experiences. Inclusion criteria was used to screen participants. If participants met the inclusion criteria a Zoom\ua9 interview was conducted using a series of questions covering topics regarding experiences since being diagnosed with PD, experience with behavioral speech, and overall guidance for individuals diagnosed with PD. The responses were transcribed and analyzed for the identification of 4 themes. Secondary data was collected on participants who did not meet inclusion criteria for the enrichment of the QI project. Results: Seven individuals participated in the QI project. Three individuals had secondary data collected. Four individuals met inclusion criteria and were interviewed. Demographic data was collected on all seven participants for the QI project. In an analysis of the transcriptions by the QI team four themes emerged: 1. loss and judgment, 2. self-awareness, 3. resiliency, and 4. encouragement. The QI team also identified barriers and opportunities for improvement related to aspects of the PDSA process of this project. Conclusion: The literature supports the benefits of speech therapy as a critical intervention for individuals with PD who have experienced changes with communication, such as hypophonia, as medication typically does not improve these symptoms. There is a lack of utilization to refer ILwPD to behavioral therapies and a lack of awareness of the resources that are available within the community. This project allowed the QI team the opportunity to explore the perspective of ILwPD who have experienced communication changes and have participated in speech therapy to better understand the potential barriers and facilitators. To improve APRN practice in the future, it is important to identify the cardinal symptoms of PD, initiate a collaborative care team for the ILwPD centered around rehabilitative therapies, and to understand and utilize the resources locally and nationally for ILwPD. This could include a local referral to SLP for behavioral speech therapy or providing information on online resources (i.e. Parkinson's Voice Project).Thesis (D.N.P.)--Michigan State University. Adult gerontology primary nurse practitioner, 2024Includes bibliographical references (pages 50-57
THE POTENTIAL FOR SUSTAINABLE WOOD HARVESTING IN MALAWI\u2019S MIOMBO WOODLANDS : ESTIMATING TREE GROWTH, BIOMASS PRODUCTION, AND DEGRADATION
Get PDFThesis (Ph.D.)--Michigan State University. Forestry - Doctor of Philosophy, 2024Tropical forests, including the Miombo woodlands in Malawi, are important in addressing climate change and mitigation through biomass and carbon storage. The primary objectives were to study tree growth and biomass accumulation through dendrochronology and to understand how degradation affects biomass availability for wood energy in Malawi. Dendrochronology was used to observe growth increments and estimate biomass accumulation in the Liwonde Forest Reserve in Malawi. The growth rates of the destructively sampled and analyzed species were particularly low in the range of 1.85mm to 2.97mm per year. The disc increment percentage diameter growth values for size classes ranged from as high as 17% annual growth experienced in the 5cm-9.99cm diameter size class to 3% growth experienced in the above 25cm diameter size class.Most countries in Africa lack quantitative data on forest degradation rates, and this study demonstrates how a remote sensing fractional cover tool that maps across a broad landscape of forests and trees outside of forests can be used to do this quantitative analysis. The study presents a new detailed forest map for Malawi, with spatial and quantitative measurements of both forest degradation and deforestation. The study estimated the maximum biomass stock in the Liwonde forest reserve through forest inventory data and growth increments obtained from the dendrochronology analysis. The average above-ground carbon accumulation estimated in this Miombo forest inventory was 33.77 t C ha per year and increased to 37.3 t C ha over a one-year period. After forecasting wood provision from the forest reserve and comparing it to the current supply from the forestry inventory, the findings indicate that the reserve cannot meet the district's demand. Currently, 38% of its 26,472.8 hectares are deforested and degraded. The findings call for stringent management proscriptions for the reserve to be sustainably utilized to meet the community\u2019s wood energy needs.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
EPIDEMIOLOGY, BIOLOGY, MOLECULAR DETECTION, AND POPULATION STRUCTURE OF THE OAK WILT FUNGUS, BRETZIELLA FAGACEARUM
Get PDFThesis (Ph.D.)--Michigan State University. Plant Pathology - Doctor of Philosophy, 2024Oak wilt, caused by the ascomycete fungus Bretziella fagacearum, is a lethal vascular disease affecting Fagaceae hosts, primarily oaks (Quercus spp.), in both forest and urban settings in the United States. B. fagacearum is vectored by sap beetles (Coleoptera: Nitidulidae) when spore-laden insects visit fresh wounds on healthy trees. The pathogen also spreads through functional root grafts. Oak wilt has been confirmed in 24 states in the U.S., with widespread occurrence in the Midwest and Texas. This dissertation investigates various aspects of oak wilt, including epidemiology, biology, diagnosis, complete genome analysis, and population genetics of B. fagacearum. The epidemiology of oak wilt was studied by inoculating mature northern red oaks (Q. rubra) at three field sites in northwest Michigan with a conidial suspension (2 x 106 conidia/ml) at 4-week intervals from March to November. Inoculated trees were evaluated to assess disease progression at 15-day intervals. Trees inoculated from March to September were succumbed to infection, with rapid disease progression in June and July. Inoculations in October and November did not result in infection. The progression of oak wilt was correlated with predicted sap flow rates, indicating that seasonal sap flow variations, influenced by sapwood development, affect disease incidence and progression. These findings provide valuable information on key risk periods for infection, which can be used to refine management guidelines to prevent tree injury. The biology of B. fagacearum was studied by monitoring sporulation on infected northern red oaks at 12 field sites in northwest Michigan, from March to November 2018-2020. Mycelial mats (sporulating structures) were categorized into eight developmental and morphological stages, with significant variation in colony-forming units among the stages. This visual rating system helps distinguish between infectious and non-infectious mats and assess the risk of above-ground infection, providing critical information for arborists and forestry professionals. The study identified two peaks of mycelial mat production, one in early summer (May and June) and another in early fall (August and September). B. fagacearum detection from diseased samples was enhanced through the optimization and validation of a TaqMan real-time PCR assay, offering greater specificity and sensitivity than traditional methods. A non-destructive sampling method for detecting B. fagacearum in red oaks and chestnuts was also developed and validated. Best practices for traditional, and non-destructive sampling were streamlined for culture-based detection method. The complete genome of B. fagacearum was sequenced and annotated, revealing a total length of 27,072,536 bp and 7,554 predicted proteins. This genome resource providing a crucial reference for population studies and insights into the molecular epidemiology and biology of the pathogen. Population genetic analyses using whole genome resequencing of 93 isolates from 15 states identified significant stratification, revealing four distinct genetic clusters corresponding to specific geographical regions: Upper Midwest, Mid-Atlantic and Southeast, Michigan, and Texas. The Upper Midwest served as a center of genetic diversity with potential gene flow among populations, while Texas isolates formed a highly distinct cluster, suggesting potentially limited gene flow and local adaptation. The first report of B. fagacearum infecting orchard-grown chestnut trees in Michigan underscores the need for constant vigilance and monitoring in chestnut orchards to promptly detect and manage potential infections. This dissertation also includes detailed methods for diagnosing oak wilt, B. fagacearum identification, storage and assays for pathogenicity trials in non-lignified seedlings and mature trees.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
Defining Success : Student-Athlete Perspectives
Get PDFThesis (Ph.D.)--Michigan State University. Higher, Adult, and Lifelong Education - Doctor of Philosophy, 2024With numbers over half a million, student-athletes are a significant, yet unique, population on college campuses. They encounter unique experiences and face unique challenges, not the least of which is navigating the competing roles of student and athlete. Navigating these roles within the high-stakes and competitive world of collegiate athletics is the context in which student-athletes must develop a definition of success.Based on the theoretical framework of Chickering and Reisser\u2019s (1993) vectors of establishing identity and developing purpose, the purpose of this qualitative, descriptive study was to determine how student-athletes define success from their personal perspective and move toward a more nuanced understanding of how the development of their student-athlete identity and perspective on career transition informed their definition of success. Seventeen former student-athletes were interviewed utilizing a semi-structured format with open-ended questions. Themes related to the student-athletes\u2019 definitions of success, how the definitions changed over time, and how their definitions of success impacted their career transition were identified from the responses. The results of the study suggest student-athletes participate in an iterative process of developing and refining their definition of success as they progress through various experiences and developmental stages. The process is largely reactive and highlighted by an overwhelming lack of intentional decision-making. Recommendations are made for how institutions can more fully support student-athletes through a proactive process of defining success.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
CONFRONTING MEMORY : MULTI-DIRECTIONALITY OF 20TH CENTURY GENOCIDES IN NAMIBIA AND GERMANY
No full textThesis (M.A.)--Michigan State University. German Studies - Master of Arts, 2024This thesis examines the intersection of memory, violent histories, and politics related to the 1904-1908 Herero and Nama genocide \u2013 what scholars have referred to as the first genocide of the 20th century. The thesis focuses on memory politics and contemporary discourse regarding genocide and violent histories in Namibia and Germany. Focusing on information presented in colonial historical documents such as the August 1918 British Blue Book and the 1919 German White Book as case studies, the thesis aims to situate the 1904-1908 genocide within the framework of European imperialism and global history, thereby facilitating an understanding of how memory functions across various sociopolitical, transnational, and transtemporal contexts.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
OPTIMAL SAMPLING STRATEGIES USING CASE-CONTROL STUDIES FOR BINARY SECONDARY OUTCOMES UNDER BUDGET CONSTRAINTS
Get PDFThesis (Ph.D.)--Michigan State University. Biostatistics - Doctor of Philosophy, 2024A case-control study is efficient for investigating the association between outcomes and exposures. After conducting the primary outcome analysis, researchers can utilize the existing case-control study data to perform a secondary outcome analysis. Several methods have been proposed for analyzing secondary outcomes in case-control studies over the past few decades, but few of them have focused on the study design aspect. We propose optimal sampling strategies under a budget constraint for case-control studies with binary and Poisson secondary outcomes. We then extend our optimal sampling strategy by considering a confounder and derive the parameter of interest using doubly-weighted estimating equations. The term "optimal" refers to minimizing the variance of the estimator of the parameter of interest. We elucidate our proposed methods by developing the asymptotic variance of the estimator of the coefficient using weighted estimating equations and doubly-weighted estimating equations. Furthermore, we derive the optimal sampling ratio formulas through the Lagrange multiplier method based on certain monetary constraints. We verify our proposed methods through Monte Carlo simulation studies. Additionally, we apply our methods to empirical epidemiological studies that motivated the method development.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
ADVANCES IN MACHINE LEARNING AND INTEGRATED CIRCUITS FOR SMART ASSISTIVE TECHNOLOGIES
Get PDFThesis (Ph.D.)--Michigan State University. Electrical and Computer Engineering - Doctor of Philosophy, 2024Assistive technologies have emerged as powerful tools for assessing physical health and wellness through monitoring physiological parameters such as movement and heart rate. However, our overall health is influenced not only by physiological parameters but also by mental health factors and environmental influences. Therefore, in the pursuit of holistic wellness, assistive technologies need to support multimodal sensing to monitor various aspects of individuals' health, including physiological health, mental wellness, and environmental parameters that influence personal health and wellness. The challenges arise when these technologies must be implemented in real-time and in miniaturized point-of-care platforms where multi-modal sensing algorithms must run efficiently, and resources, including power, are limited. Solving these challenges requires converging engineering practices with psychological and physiological principles. This work aims to implement resource-efficient algorithms to assess social interaction parameters as an important mental health factor and to enable high-performance point-of-care devices to monitor physiological and environmental parameters in a miniaturized and effective manner. In this work, an extensive dataset for human interaction in virtual settings was prepared. Efficient algorithms were developed to identify levels of two highly important social interaction parameters, \u2018affect\u2019 and \u2018rapport.\u2019 We analyzed affect in time intervals based on the conversation turns and analyzed rapport in 30-second time intervals, which is the highest temporal resolution reported in the literature. We achieved an affect prediction accuracy of 76.8% and a rapport prediction accuracy of 73.6%, which are the highest reported results for analyzing multi-person groups. Furthermore, to support monitoring physiological and environmental parameters, electrochemical solutions were identified as a highly effective method. We introduced new architecture to overcome limited supply potentials in modern point-of-care devices. In our novel design, the potential window for electrochemical reactions doubles compared to the traditional designs. This, in return, facilitates a significantly wider range of target elements that can be monitored with this novel architecture. Overall, the enhanced algorithms and architecture introduced in this work enable multimodal sensing of important personal health and wellness parameters.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
DESIGN AND ANALYSIS OF DYNAMIC ANTENNA ARRAYS FOR RADAR AND REMOTE SENSING APPLICATIONS
No full textThesis (Ph.D.)--Michigan State University. Electrical and Computer Engineering - Doctor of Philosophy, 2024The need for fast and reliable sensing at millimeter-wave frequencies has been increasing dramatically in recent years for a wide range of applications including non-destructive evaluation, medical imaging, and security screening such as concealed contraband detection. Imaging based approaches have been of particular interest since the wavelengths at millimeter-wave frequencies provide good resolution and are capable of propagating through clothing with negligible attenuation allowing the identification of concealed contraband. While various implementations for millimeter-wave imaging have been developed, the new technique of active incoherent millimeter-wave (AIM) imaging, developed in our research group, is of particular interest because it solves fundamental limitations inherent in other approaches. Furthermore, AIM enables imaging with significantly fewer elements than phased arrays and costs less than passive imagers. This is enabled by actively transmitting noise signals, allowing the system to capture scene information in the spatial Fourier domain. When the received signal at each of the array elements are spatio-temporally incoherent, the spatial coherence function of the captured signals represent samples of the measured visibility which can be further processed via an inverse Fourier transformation to recover the measured scene. With a good quality recovered image, additional processing can be applied for detection and/or classification on specific spatial features. However, images often contain more than the required information necessary for effective classification results which means that unnecessary resources are used for the collection and processing of redundant information.In this dissertation, I present on the design and analysis of array dynamics for radar and remote sensing applications. Specifically, I investigate approaches to measure specific spatial Fourier information which can be useful for direct classification therefore eliminating the need of full image recovery. I present an adapted formulation of the spatial coherence function by considering individual antenna trajectories within a dynamic antenna array. The measured visibility, hence, becomes a function of array trajectory over a slow time dimension. The use of array dynamics further reduces the hardware requirements in the AIM technique by introducing a new degree of freedom in the array design. By allowing the receiving elements of the antenna array to dynamically move across the measurement plane, the spatial Fourier domain can be efficiently sampled using as few as two receiving antennas. Discussion of the effects of trajectory approaches on the measured spatial Fourier information are presented. Furthermore, I expand on a specific array trajectory where as few as two antennas can generate a ring filter (i.e., spatial Fourier sampling function exhibiting a form of a ring) that can efficiently identify spatial Fourier artifacts pertaining to sharp edges in the scene. This approach enables an imageless approach to differentiate scenes containing objects with sharp-edge that are generally made artificially. I then present a real-time rotational dynamic antenna array operating at 75 GHz with two noise-transmitting sources as required by the AIM technique and two receivers to generate the ring filter. Compared to traditional millimeter-wave imaging, this non-imaging approach further reduces the required number of antennas. Experimental measurements using the AIM based rotational dynamic antenna array demonstrate the possibility of detecting concealed contraband via the direct measured spatial Fourier domain information.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
FACTORS THAT INFLUENCE STUDENT LEARNING DURING A WEEK-LONG ZOO EDUCATION PROGRAM
Get PDFThesis (Ph.D.)--Michigan State University. Zoology - Doctor of Philosophy, 2024Zoos have been under attack by animal rights groups for decades. Despite significant reforms to improve animal welfare in accredited zoos and aquariums across North America, and significant participation in animal conservation efforts globally, these attacks persist. If zoos are to continue long-term, they need to establish themselves as community resources. One way that zoos can act as community resources are as resources for science education. For zoos to establish themselves as educational resources, there first must be evidence that zoos are positively impacting the education of their visitors. To date, however, the published research is limited and the most prominent research claiming to verify the educational impact of zoos has been highly criticized. Most research on zoo education to date has focused on the education of visitors during informal zoo visits. There is even less research regarding formal zoo education programming that typically occurs during school field trips. Research investigating how current programming designed to help elementary school students learn science through a five-day school field trip would help both zoos and elementary educators understand how students learned, and what impacted learning during participation in this program. The research outlined in this dissertation helps to answer these questions through an investigation of the BIG Zoo Lesson (BZL). A case study design was used for this research because it provided an appropriate approach to understand a complex situation with several different sets of data. A total of 9 teachers and their 48 students were interviewed both before and after their participation in the BZL and observed during the five school days they spent using a zoo as their classroom. These observations included scripted observations of lessons and activities, and direct observations of selected students during their daily one-hour animal observations. Additionally, students\u2019 BZL journals were digitally scanned, producing 2628 images of student artifacts. From the cross-referenced analysis of this data, several conclusions were made. First, the BZL facilitated active STEM learning by upper elementary students. Students appeared highly engaged during these learning experiences and appeared to both gain and retain some understanding of the science concepts in these lessons. Second, learning recorded by students through student artifacts during the BZL was retained at greater rates than learning not recorded for upper elementary students. Lastly, proximity to and observation of live animals during the BZL facilitated engagement in learning for upper elementary students. It appeared that this engagement led to greater understanding and retention of conceptual knowledge. Parent chaperone behavior during daily one-hour observation periods appeared to impact student learning by impacting engagement and on-task behavior during daily one-hour animal observations. The use of activities during daily one-hour animal observations not designed to task students with conducting independent investigations utilizing science practices may have impacted student identification of their own observations as learning. Overall, the design of the BZL provided learning experiences for upper elementary students utilizing live animals and animal artifacts not available to typical elementary teachers. The use of these resources facilitated engaging active learning experiences that positively impacted student learning. The insights from this research can help to improve learning experiences for all BZL participants and inform program design for zoo educational field trips, thereby helping zoos establish themselves as community educational resources.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references