xvi, 68 p. : ill. / Approximately 1.5 million concussions occur annually in the United States, many affecting individuals between the ages of 15 and 18. Little is known about this age group's response to a concussion as they have been thought to respond differently than adults due to immature brain development. Additionally, relying on symptoms alone to determine level of brain function may lead to early return back to sport participation. Through the use of 3 computerized tests, neuropsychological and attentional deficit recovery post concussion was assessed between 12 subjects with concussions and 12 controls up to 2 months after injury. Memory tasks and symptoms resolved within a week after injury. Executive function tests showed small group differences up to two months post injury, suggesting these types of tests may be a useful tool in the evaluation of concussion recovery and provide an objective measure in evaluation. / Committee in charge: Dr. Li-Shan Chou, Chair; Dr. Lou Osternig, Member; Dr. Sierra Dawson, Member; Dr. Grace Golden, Member

abstract: Due to the history of colonization, disruption of Indigenous life ways, and encroachment of external Western ideals and practices upon tribal peoples in New Mexico, the protection and preservation of tribal customs, values, traditions, and ways of thinking are critical to the continued existence of the tribes. It has taken many years for tribal communities, such as the 19 Pueblos of New Mexico, to get to where they find themselves today: In a paradoxical situation stemming from the fact that Pueblo people are told to pursue the iconic American Dream, which was not actually designed or intended for tribal peoples and that always seems to be just out of reach for many community members. Yet many of them do their best to emulate the capitalistic consumption and the Western way of life. What is troubling about this is that perhaps many of these people are starting to forget that it was the strength of their ancestors and their dreams that allowed Pueblo people to be here today. So, how do Pueblo people address this paradox? How do they begin to give newer generations, such as the youth, the tools to question and to assess future programs and the future of the tribal communities? Furthermore, what does such a process of preserving and reclaiming mean for future governance? Are these communities prepared to accept the outcomes? This compilation seeks to address these issues by examining a) the creation and delivery of Western medicine for American Indians in New Mexico and b) a discussion of Pueblo culture and belief systems. The exploration will include not only discussing health and health care concerns, but it will also engage the future considerations that tribal governments in New Mexico, specifically Pueblo Indian communities, must reflect on to ensure the preservation of the culture and values of Pueblo people. Finally, specific recommendations for action and discussion will be delivered in the form of a policy paper that is designed for tribal leadership and tribal administrative audiences and suggested for implementation. / Dissertation/Thesis / Doctoral Dissertation Social Justice and Human Rights 2015

abstract: ABSTRACT The population of older adults in the United States is growing disproportionately, with corresponding medical, social and economic implications. The number of Americans 65 years and older constitutes 13.7% of the U.S. population, and is expected to grow to 21% by 2040. As the adults age, they are at risk for developing chronic illness and disability. According to the Centers for Disease Control and Prevention, 5.7 million Americans have heart failure, and almost 80% of these are 65 years and older. The prevalence of heart failure will increase with the increase in aging population, thus increasing the costs associated with heart failure from 34.7 billion dollars in 2010 to 77.7 billion dollars by 2020. Of all cardiovascular hospitalizations, 28.9% are due to heart failure, and almost 60,000 deaths are accounted for heart failure. Marked disparities in heart failure persist within and between population subgroups. Living with heart failure is challenging for older adults, because being a chronic condition, the responsibility of day to day management of heart failure principally rests with patient. Approaches to improve self-management are targeted at adherence, compliance, and physiologic variables, little attention has been paid to personal and social contextual resources of older adults, crucial for decision making, and purposeful participation in goal attainment, representing a critical area for intervention. Several strategies based on empowerment perspective are focused on outcomes; paying less attention to the process. To address these gaps between research and practice, this feasibility study was guided by a tested theory, the Theory of Health Empowerment, to optimize self-management, functional health and well-being in older adults with heart failure. The study sample included older adults with heart failure attending senior centers. Specific aims of this feasibility study were to: (a) examine the feasibility of the Health Empowerment Intervention in older adults with heart failure, (b) evaluate the effect of the health empowerment intervention on self-management, functional health, and well-being among older adults with heart failure. The Health Empowerment Intervention was delivered focusing on strategies to identify and building upon self-capacity, and supportive social network, informed decision making and goal setting, and purposefully participating in the attainment of personal health goals for well-being. Study was feasible and significantly increased personal growth, and purposeful participation in the attainment of personal health goals. / Dissertation/Thesis / Doctoral Dissertation Nursing and Healthcare Innovation 2017

abstract: Ensemble learning methods like bagging, boosting, adaptive boosting, stacking have traditionally shown promising results in improving the predictive accuracy in classification. These techniques have recently been widely used in various domains and applications owing to the improvements in computational efficiency and distributed computing advances. However, with the advent of wide variety of applications of machine learning techniques to class imbalance problems, further focus is needed to evaluate, improve and optimize other performance measures such as sensitivity (true positive rate) and specificity (true negative rate) in classification. This thesis demonstrates a novel approach to evaluate and optimize the performance measures (specifically sensitivity and specificity) using ensemble learning methods for classification that can be especially useful in class imbalanced datasets. In this thesis, ensemble learning methods (specifically bagging and boosting) are used to optimize the performance measures (sensitivity and specificity) on a UC Irvine (UCI) 130 hospital diabetes dataset to predict if a patient will be readmitted to the hospital based on various feature vectors. From the experiments conducted, it can be empirically concluded that, by using ensemble learning methods, although accuracy does improve to some margin, both sensitivity and specificity are optimized significantly and consistently over different cross validation approaches. The implementation and evaluation has been done on a subset of the large UCI 130 hospital diabetes dataset. The performance measures of ensemble learners are compared to the base machine learning classification algorithms such as Naive Bayes, Logistic Regression, k Nearest Neighbor, Decision Trees and Support Vector Machines. / Dissertation/Thesis / Masters Thesis Computer Science 2017

abstract: The American Diabetes Association reports that diabetes costs $322 billion annually and affects 29.1 million Americans. The high out-of-pocket cost of managing diabetes can lead to noncompliance causing serious and expensive complications. There is a large market potential for a more cost-effective alternative to the current market standard of screen-printed self-monitoring blood glucose (SMBG) strips. Additive manufacturing, specifically 3D printing, is a developing field that is growing in popularity and functionality. 3D printers are now being used in a variety of applications from consumer goods to medical devices. Healthcare delivery will change as the availability of 3D printers expands into patient homes, which will create alternative and more cost-effective methods of monitoring and managing diseases, such as diabetes. 3D printing technology could transform this expensive industry. A 3D printed sensor was designed to have similar dimensions and features to the SMBG strips to comply with current manufacturing standards. To make the sensor electrically active, various conductive filaments were tested and the conductive graphene filament was determined to be the best material for the sensor. Experiments were conducted to determine the optimal print settings for printing this filament onto a mylar substrate, the industry standard. The reagents used include a mixture of a ferricyanide redox mediator and flavin adenine dinucleotide dependent glucose dehydrogenase. With these materials, each sensor only costs $0.40 to print and use. Before testing the 3D printed sensor, a suitable design, voltage range, and redox probe concentration were determined. Experiments demonstrated that this novel 3D printed sensor can accurately correlate current output to glucose concentration. It was verified that the sensor can accurately detect glucose levels from 25 mg/dL to 400 mg/dL, with an R2 correlation value as high as 0.97, which was critical as it covered hypoglycemic to hyperglycemic levels. This demonstrated that a 3D-printed sensor was created that had characteristics that are suitable for clinical use. This will allow diabetics to print their own test strips at home at a much lower cost compared to SMBG strips, which will reduce noncompliance due to the high cost of testing. In the future, this technology could be applied to additional biomarkers to measure and monitor other diseases. / Dissertation/Thesis / Masters Thesis Bioengineering 2017

abstract: According to the ADA (American Diabetes Association), diabetes mellitus is one of the chronic diseases with the highest mortality rate. In the US, 25 million are known diabetics, which may double in the next decade, and another seven million are undiagnosed. Among these patients, older adults are a very special group with varying physical capabilities, cognitive functions and life expectancies. Because they run an increased risk for geriatric conditions, Type 2 diabetes treatments for them must be both realistic and systematic. In fact, some researchers have explored older adults’ experiences of diabetes, and how they manage their diabetes with new technological devices. However, little research has focused on their emotional experiences of medical treatment technology, such as mobile applications, tablets, and websites for geriatric diabetes. This study will address both elderly people's experiences and reactions to devices and their children's awareness of diabetes. It aims to find out how to improve the diabetes treatment and create a systematic diabetes mobile application that combines self-initiated and assisted care together. / Dissertation/Thesis / Masters Thesis Design 2017

abstract: The inspiration to undertake this pilot study came after observation and reflection by the clinician-researcher, a board-certified music therapist who has used the harp as the primary instrument when facilitating sessions, on hundreds of music therapy sessions that took place at a facility for behavioral health and chemical dependency. It was observed that the use of improvised harp music as a therapeutic intervention within the context of a music therapy session seemed to relax patients who reported that they were nervous or anxious, and it was also noted that following a listening exercise that consisted of improvised harp music, patients appeared calmer and reported that they felt more comfortable. This research aims to determine if improvised harp music at the opening of a music therapy session creates a calmer environment in which to share information, compared with a guided verbal relaxation and ambient ocean drum sounds for the opening of the music therapy session. Social-behavioral research was conducted in the form of a fifty minute individual music therapy session with six subjects. Each therapy session used improvised music and verbal processing with the therapist, with three subjects in the experimental group and three in the control group. Each individual rated two different types of affective responses on scales of one to ten and completed a five-question survey at the end of the session. All the research subjects showed an increase in positive affect at the end of the music therapy session. / Dissertation/Thesis / Masters Thesis Music Therapy 2018

abstract: Critical infrastructures in healthcare, power systems, and web services, incorporate cyber-physical systems (CPSes), where the software controlled computing systems interact with the physical environment through actuation and monitoring. Ensuring software safety in CPSes, to avoid hazards to property and human life as a result of un-controlled interactions, is essential and challenging. The principal hurdle in this regard is the characterization of the context driven interactions between software and the physical environment (cyber-physical interactions), which introduce multi-dimensional dynamics in space and time, complex non-linearities, and non-trivial aggregation of interaction in case of networked operations. Traditionally, CPS software is tested for safety either through experimental trials, which can be expensive, incomprehensive, and hazardous, or through static analysis of code, which ignore the cyber-physical interactions. This thesis considers model based engineering, a paradigm widely used in different disciplines of engineering, for safety verification of CPS software and contributes to three fundamental phases: a) modeling, building abstractions or models that characterize cyberphysical interactions in a mathematical framework, b) analysis, reasoning about safety based on properties of the model, and c) synthesis, implementing models on standard testbeds for performing preliminary experimental trials. In this regard, CPS modeling techniques are proposed that can accurately capture the context driven spatio-temporal aggregate cyber-physical interactions. Different levels of abstractions are considered, which result in high level architectural models, or more detailed formal behavioral models of CPSes. The outcomes include, a well defined architectural specification framework called CPS-DAS and a novel spatio-temporal formal model called Spatio-Temporal Hybrid Automata (STHA) for CPSes. Model analysis techniques are proposed for the CPS models, which can simulate the effects of dynamic context changes on non-linear spatio-temporal cyberphysical interactions, and characterize aggregate effects. The outcomes include tractable algorithms for simulation analysis and for theoretically proving safety properties of CPS software. Lastly a software synthesis technique is proposed that can automatically convert high level architectural models of CPSes in the healthcare domain into implementations in high level programming languages. The outcome is a tool called Health-Dev that can synthesize software implementations of CPS models in healthcare for experimental verification of safety properties. / Dissertation/Thesis / Ph.D. Computer Science 2012

abstract: In the United States, under the provisions set forth by a policy known as community benefit, nonprofit hospitals receive special tax exemptions from government in exchange for providing a wide range of health care services to the communities in which they are located. In recent years, nonprofit hospitals have claimed billions of dollars as community benefit justifying their tax-exempt status. However, growing criticism by numerous stakeholders has questioned the extent to which the level of community benefit claimed by nonprofit hospitals reflects the exemptions they receive. In addition, a dearth of research exists to understand the relationship between community benefit claims and the impact they have on improving the health of communities. In an effort to better understand the relationship between community benefit claims, tax status, and community health outcomes this study examines the community benefit policies of a nonprofit healthcare system representing hospitals in California, Nevada, and Arizona. It does so by reviewing materials produced by the system, her hospitals, vested stakeholders, and government that have shaped the development, implementation, and assessment of community benefit policy processes. Findings of the study suggest that the majority of nonprofit hospital community benefit claims are consumed by shortfalls reported between costs associated with providing care to Medicare and Medicaid patients and the compensation nonprofit hospitals receive from government. Results of the study also demonstrate that community benefit policies do positively impact the health of communities. However, future community benefit policies need to be refined to include measures that capture the magnitude of community health improvement if the relationship between policy and health outcomes is to be fully realized. / Dissertation/Thesis / Ph.D. Public Policy 2013

abstract: Nurses are using health information technology during patient care activities in acute care at an unprecedented rate. Previous literature has presented nurses' response to technology obstacles as a work-around, a negative behavior. Using a narrative inquiry in one hospital unit, this dissertation examines nurses' interactions when they encounter technology obstacles from a complexity science perspective. In this alternative view, outcomes are understood to emerge from tensions in the environment through nonlinear and self-organizing interactions. Innovation is a process of changing interaction patterns to bring about transformation in practices or products that have the potential to contribute to social wellbeing, such as better care. Innovation was found when nurses responded to health information technology obstacles with self-organizing interactions, sensitivity to initial conditions, multidirectionality, and their actions were influenced by a plethora of sets of rules. Nurses self-organized with co-workers to find a better way to deliver care to patients when using technology. Nurses rarely told others outside their work-group of the obstacles that occurred in their everyday interactions, including hospital-wide process improvement committees. Managers were infrequently consulted when nurses encountered technology obstacles, and often nurses did not find solutions to their obstacles when they contacted the Help Desk. Opportunities exist to facilitate interactions among nurses and other members of the organization to realize better use of health information technology that improves quality and safety while decreasing cost in the patient experience. / Dissertation/Thesis / Ph.D. Nursing and Healthcare Innovation 2013