UMD Theses and Dissertations
Permanent URI for this collectionhttp://hdl.handle.net/1903/3
New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a given thesis/dissertation in DRUM.
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Item The Association of Certified Rehabilitation Counselors' Attitudes Toward Counseling Individuals with Substance Use Disorders with Their Frequency and Perceived Confidence of Providing Substance Abuse Screenings and Referrals(2010) Rodgers, Roe Ann; Fabian, Ellen S.; MacDonald-Wilson, Kim; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The purpose of this study was to assess the nature and extent of a nationally representative random sample of Certified Rehabilitation Counselors' (CRCs') attitudes toward counseling individuals with SUDs and their frequency and perceived confidence of providing substance abuse screenings and referrals. The study (a) explores attitudes of CRCs regarding counseling individuals with substance abuse disorders (SUDs); (b) examines whether CRCs' attitudes toward counseling individuals with SUDs are associated with their frequency in providing substance abuse screenings and referrals for individuals with SUDs; (c) determines if CRCs' attitudes toward counseling individuals with SUDs are associated with their perceived confidence in providing substance abuse screenings and referrals for individuals with SUDs. The independent variables were subscales of the Drug and Drug Problems Perceptions Questionnaire (DDPPQ) used to investigate CRCs' attitudes toward counseling individuals who have problems with drug use and the Alcohol and Alcohol Problems Perceptions Questionnaire-Revised (AAPPQ-R) used to explore attitudes toward counseling individuals who have problems with alcohol use. The dependent variables were frequency questions and perceived confidence statements from the Alcohol and Other Drugs Vocational Rehabilitation Counselor Survey (AOD-VRC) used to measure the frequency and perceived confidence of providing substance abuse screenings and referrals. The study participants were 764 CRCs who were direct service providers from multiple employment settings. Participants were recruited from an online survey sent to a national random selection of CRCs obtained from Commission on Rehabilitation Counselor Certification (CRCC) database. Results indicated that this sample of CRCs have somewhat positive attitudes toward counseling individuals with SUDs. Results from this sample of CRCs show that there are associations between CRCs' attitudes toward counseling individuals with drug use problems and alcohol use problems with perceived confidence in providing substance abuse screenings and referrals, but not with frequency of providing substance abuse interventions. Applied implications, limitations of the study, and future research suggestions were discussed.Item Closed Loop System Identification of Postural Control with Bilateral Vestibular Loss(2009) Amenabar, Katharine Elizabeth; Jeka, John J; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Human upright stance can be characterized as a combination of feedback and plant. Feedback consists of integrated sensory signals, producing estimates of position and velocity of the body segments while plant includes both musculotendon dynamics and body dynamics. Separating plant and feedback is possible mathematically through closed loop system identification. By studying bilateral vestibular loss (BVL) patients it is hoped knowledge regarding human posture and the role of the vestibular system will be gained. Two BVL patients and two age, height and gender matched controls had visual and mechanical perturbations applied simultaneously to determine these properties. Both leg and trunk kinematics and EMG data were collected. Using frequency response functions plant and feedback properties were calculated. Plant and feedback dynamics differ. BVL patients show more variable weighted hip EMG data, supporting the idea that this population can not properly use hip movement with their lack of vestibular system.Item Retention of a novel visuomotor gain in patients with Parkinson's disease is context-specific(2009) Venkatakrishnan, Anusha; Contreras-Vidal, José L; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Hypometria or reduced movement amplitude is a major concern in Parkinson's disease (PD) since it impairs multiple functional activities of daily living, including fine motor control tasks, such as handwriting. Recent research using virtual or computer-based environments, wherein visual information about hand movement is altered and dissociated from perception (e.g., position sense or kinesthesia) of hand movement itself, has shown increases in handwriting size in patients with PD. In fact, preliminary findings in our laboratory have shown that gradual alterations in visual feedback of movement facilitate adaptation of handwriting size in patients with PD, plausibly by recruiting neural networks other than the basal ganglia, such as those in cerebellum. The purpose of this study was to determine whether these adaptive effects persist after a week following visuomotor training in patients with PD and can favorably transfer to other functional writing and drawing tasks. Thirteen patients with Parkinson's disease and twelve healthy, age-matched subjects practiced handwriting either under gradually manipulated (intervention) or intact (placebo) visual display of handwriting size. The results from this study show for the first time, that these adaptive effects may persist for at least up to a week in PD; however, a single training session seemed inadequate to transfer these acquired changes to paper-pen writing and drawing. Additionally, experimental manipulation of task demands during training also helped maintain movement quality in patients with PD as against the placebo group. These findings have important implications in designing rehabilitative interventions to enhance functional sensorimotor performance in patients with PD.Item Architecture in Defense of Dignity(2008) Derenick, David; Noonan, Peter V; Architecture; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Architecture can help people defend dignity when they most need it. This thesis investigates three areas in which a place may offer support: identity, or personhood; liberty, or control over environment; and vitality, or sense of purpose. The thesis proposes a design for an inpatient rehabilitation center, for people who have suffered from traumatic brain injury (TBI). Challenges to dignity are not limited to health care settings, but TBI highlights these challenges by impairing a patient's own defenses and straining a family's ability to cope. Among proposed architectural elements are rooms allowing self-expression yet offering respite; luminous shafts providing for control of daylight, fresh air, and information; and empowering dining and garden spaces. Rehabilitation is transitional, occurring after acute hospital treatment and ideally leading to a return home. A site in Philadelphia near hospital campuses, but rooted in a residential neighborhood, is an ideal for a place of dignified transition.Item "Go aphasia!": Examining the efficacy of Constraint-Induced Language Therapy for individuals with agrammatic aphasia(2008-08-25) Virion, Christine; Faroqi-Shah, Yasmeen; Hearing and Speech Sciences; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Recently, high intensity short-term therapy with a heavy emphasis on verbal language (called constraint induced language therapy, CILT) has gained momentum in aphasiology. However, the entire extent of its applicability and limitations has not been fully studied, especially with regard to specific aphasic deficits. This thesis sought to: 1) determine the efficacy of the originally published CILT protocol (o-CILT) with a deficit specific population (four individuals with agrammatic aphasia) and 2) examine the potential effect of a modified CILT protocol, which additionally focused on grammatical accuracy (g-CILT). Results revealed differences between the performance of individuals with agrammatism in this study and previously published CILT data. Findings also demonstrated that participants receiving g-CILT produced more significant gains on tests of aphasia severity and grammaticality, while individuals receiving o-CILT showed more highly significant changes on discourse measures of grammaticality. This paper suggests that, for individuals with agrammatism, CILT in its original form may not evince significant changes on tests of aphasia severity and grammatical production and a grammatical modification appears to increase the efficacy of CILT.Item A Voxel Based Approach to Identifying Lesion Sites in Aphasia: Comprehension and Production Deficits in Syntax, Semantics and Phonology(2007-08-20) Kling, Therese Danielle; Shah, Yasmeen; Braun, Allen; Hearing and Speech Sciences; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The cortical regions of the brain traditionally associated with deficits of production and comprehension in language are Broca's and Wernicke's areas. Recent evidence suggests that other brain regions are involved and may be specific to linguistic areas of syntax, semantics and phonology. This paper describes the MRI results and language scores of 31 left hemisphere stroke patients with aphasia. Patients' lesions obtained from these MRI scans were reconstructed onto templates and entered into a voxel-based analysis program called Analysis of Brain lesion (ABLe) (Solomon, Raymont, Braun, Butman & Grafman, 2007) along with language scores. The results provided evidence for five key neuroanatomical regions of interest. These include the insula, the planum temporale, the operculum, the temporoparietal occipital (TPO) junction and the putamen. The results revealed common as well as unique areas of brain lesion for each of the behaviors.Item The Effect of Working Alliance on Client Drop-out for Persons with Disabilities in a State-Federal Vocational Rehabilitation Agency(2007-08-13) Stapleton, Mary; Fabian ,Ph.D., Ellen; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The existence of a working alliance between a counselor and a client has been viewed as a critical component of the therapeutic process in the psychological literature (Bachelor, 1995). The construct of working alliance has been the focus of interest in research literature as a measure of positive therapy outcomes. According to Horvath (2001 ) two decades of empirical research have consistently linked the quality of the alliance between therapist and client with therapy outcome. The 1998 Amendments to the Rehabilitation Act mandate that persons with disabilities must be "active and full partners" in the rehabilitation process. In the federal-state rehabilitation setting there is limited time to form an alliance( Safran&Muran, 1998), so that the initial interview becomes critical in engaging the client in this process. Therefore, this study measured the working alliance after the initial in-take session. Working alliance was measured by the Working Alliance Inventory (WAI) developed by Horvath & Greenberg (1989). The dependent variable was the Individualized Plan for Employment (IPE) which represents the agreed upon goals and tasks between the DORS counselor and client. The major hypothesis was that a strong working alliance between counselor and client would predict an IPE, and a poor alliance would not. The study participants were 111 persons with disabilities who applied and were found eligible for services in FY 2006 through the Maryland Division of Rehabilitation Services (DORS). The investigation was conducted at 16 DORS offices throughout the state . The major finding was the lack of any significant relationship between working alliance and IPE . The second major finding was the clients gave generally high WAI scores to DORS counselors and 59 % (66) had an IPE. Despite this positive finding , those with high WAI scores were no more likely to have an IPE .Additionally, there was an effect of disability category upon the WA. In summary, the findings suggest that factors external to the WA may be more significant barriers to employment outcomes for DORS clients. The implications for people with disabilities, counselors, and counselor educators are discussed within the context of these findings.Item Comparison of Assistive Mobility Devices with Axillary Supports(2006-12-15) Borrelli, James; Haslach, Henry; Mechanical Engineering; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Assistive ambulatory devices with axillary supports are compared using a multidisciplinary approach. Axillary supports are commonly referred to as "shoulder supports" on standard crutches. A framework is presented that compares axillary supports based on loading characteristics during initial contact and during a stride. The underlying goal of this research is to lay the foundation for an axillary support design that is safe. The force normal to the axillary support of two types of assistive devices, axillary crutches and the Strutter, is found experimentally for 2-point gait and 2-point gait with no hands. A dynamic model is developed to estimate the force tangential to the axillary support required for axillary crutches and the Strutter to have the same stride time. Models for the Strutter are also developed to study the response of the axillary support to impact loads due to initial contact.Item The Dynamics of Multi-sensory Re-weighting in Healthy and Fall-prone Older Adults(2006-08-04) Allison, Leslie K.; Jeka, John J.; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Multi-sensory re-weighting (MSR) is an adaptive process that prioritizes the visual, vestibular and somatosensory inputs that provide the most reliable information when environmental conditions change. This process is thought to degrade with increasing age, and to be particularly deficient in fall-prone versus healthy older adults. This dissertation presents three studies designed to investigate age- and fall-related changes in MSR. The first study examined the assumption of impaired MSR in healthy and fall-prone older adults using a two-frequency touch/vision experimental design with stimuli at varying amplitudes. Both healthy and fall-prone older adults demonstrated the same pattern of adaptive gain changes as healthy young adults. No group differences in the overall levels of vision and touch gain were found. These results suggest that, for small amplitude vision and touch stimuli, the central sensory re-weighting adaptation process remains intact in healthy and fall-prone older adults. In the second study the effects of a sensory-challenge balance exercise program on laboratory measures of MSR and clinical measures of balance were investigated. Following the intervention the normal adaptive pattern of gain change was unaltered, while declines in overall vision and touch gains that reflect down-weighting of the sensory stimuli were seen. Improvements in four clinical balance measures were observed. These findings indicate that MSR processes in fall-prone older adults are modifiable, that sensory challenge balance exercises may facilitate the ability to down-weight unstable sensory inputs, and that these effects may generalize to other components of balance. A third study explored the dynamics of sensory re-weighting in healthy and fall-prone older adults. Absolute levels of gain, and the rate of adaptive gain change, were examined before and after large changes in visual motion stimulus amplitude. Compared to young adults, gains in both older adult groups were higher when the stimulus amplitude was high, and gains in the fall-prone elderly were higher than both other groups when the stimulus amplitude was low. Both older groups demonstrated slowed sensory re-weighting over prolonged time periods when the stimulus amplitude was high. These results reflect age- and fall-related changes in the extent and rate of down-weighting unstable visual inputs.Item Discriminatory Practices Charged Under EEOC: An Empirical Analysis of Investigated Complaints Filed by those who have Cancer(2005-06-10) McKenna, Maureen Ann; Fabian , Ellen; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Previously unexplored data from the Equal Employment Opportunity Commission (EEOC) Integrated Mission System database is analyzed with specific reference to allegations filed by individuals with cancer of workplace discrimination under ADA Title I between July 27, 1992 and September 30, 2003. These allegations are compared to those from a general disability population on key dimensions of workplace discrimination--specifically, demographic characteristics of the charging parties, the industry designation, location, and region site of employers against whom complaints are filed, types of alleged adverse actions and resolution of these complaints. Study results showed allegations derived from charging parties with cancer are more likely than those from the general disability population studied to involve issues of discharge, terms and conditions of employment, lay-offs, wages and terms conditions of employment and demotion. Compared to the general disability group, charging parties with cancer were more likely to be female, approximately 47 years of age and Caucasian. Allegations derived from charging parties with cancer were also more likely to be filed against smaller employers (15-100 workers) or those in the service industries compared to those from the general disability population. Claims filed by those with cancer were likely to be found to have merit more than those filed from the general disability population. Implications for rehabilitation counselor education are addressed and recommendations for further research are provided.