Digital Commons Network^™

The Effect Of Functional Movement Control On Patient-Reported Outcomes In Individuals With Non-Arthritic Hip Pain, Ryan Mcgovern

Electronic Theses and Dissertations

Purpose: Both the single leg squat test and step-down test assess for deficiencies relating to the hip and surrounding musculoskeletal structures and could be useful in the evaluation of functional movement control for individuals with non-arthritic hip pain. The purpose of this study is to determine if individuals with non-arthritic hip pain that improve functional movement control during the single leg squat test and step-down test have better patient-reported outcomes than those that do not improve, following the implementation of a rehabilitation intervention and a standardized home-exercise program.

Subjects: Forty-six individuals (31 females; 15 males) with a mean age of …

Exploring Maternal Factors Linked To Weight Status In Salvadorian Infants, Carmen M. Kiraly, Melanie Turk, Melissa Kalarchian, Cheryl Shaffer

Electronic Theses and Dissertations

Background: Obesity rates in the US have risen dramatically, especially among Hispanic adults and children. Because of the high prevalence of overweight and obesity in Latino children by preschool age, it is prudent to examine maternal factors potentially linked to weight status during an infant’s first year of life. The literature on risk factors of child obesity has focused primarily on children of Mexican descent, and little research exists for other Latino populations, such as Salvadorans. Objective: To investigate maternal physiologic and infant feeding factors associated with infant overweight and/or obesity in a sample of Salvadoran mother-infant dyads. Methods: A …

The Lived Experience Of Recovery Following Transoral Robotic Surgery (Tors) For Head And Neck Cancer, Katharine Mahalik

Electronic Theses and Dissertations

Abstract

Ongoing advances in minimally invasive surgical techniques, such as transoral robotic surgery (TORS), has enabled select patients with head and neck cancer to receive treatment that results in less disfigurement and dysfunction compared with traditional approaches. While TORS research has focused mainly on functional surgical outcomes, a need exists to understand recovery following TORS from the patient perspective. A hermeneutic phenomenological approach was used to recruit patients who had recently undergone TORS at a major academic health system in northeastern US. Data were collected using audio-recorded telephone interviews and field notes and analyzed concurrently. Participants included 17 HNCS (12 …

The Effects Of Learning Mindfulness Based Stress Reduction On Psychosocial Variables And Hba1c In Adolescents With Type 1 Diabetes, Denise Van Sant - Smith

Electronic Theses and Dissertations

ABSTRACT

THE PHYSIOLOGICAL AND PSYCHOSOCIAL EFFECTS OF AN ONLINE MINDFULNESS BASED STRESS REDUCTION INTERVENTION ON ADOLESCENTS WITH TYPE 1 DIABETES

By

Denise E. Van Sant – Smith

Date: 4-5-2019

Dissertation Supervised by Linda Goodfellow, PhD, RN, FAAN

Background: Stress has been shown to increase glucose levels through a sympathetic physiological response resulting in a release of chemicals such as adrenalin and cortisol, a response which results in an even greater need for insulin. Adolescents with Type 1 Diabetes may not be able to change or decrease the amount of stress in their lives but they may be able to …

Modeling And Prediction Of Amorphous Solid Dispersion Formation Using A Molecular Descriptor, Kevin Deboyace

Electronic Theses and Dissertations

Poor aqueous solubility of an active pharmaceutical ingredient (API) is a significant hurdle during drug development. Delivering a drug in its amorphous solid-state is a potential method to overcome this issue, since the amorphous form has increased apparent aqueous solubility. However, the amorphous state is only metastable, and is thermodynamically driven to recrystallize. As a result, pure amorphous drugs are seldom used in marketed products. Intimately mixing a drug in its amorphous form with a polymer, known as an amorphous solid dispersion (ASD), has the potential to significantly extend the physical stability of the amorphous form, while maintaining the benefit …

Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani

Electronic Theses and Dissertations

As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding …

An Ethical Analysis Of Reproductive Justice In The Context Of The Egenics Movement In The United States, Bernetta Welch

Electronic Theses and Dissertations

The history of forced sterilization and the American cultural agreement with this practice robbed women of color of control of their own bodies, destinies, and communities. Negative eugenics as genetic proof of low intelligence, low possibility, and low productivity fed the system of compulsory sterilization even though the science proved faulty and incorrect. As advances in medical technology and genetic science increases, eugenics is making a return into the American psyche. Vulnerable populations which include women of color make reproduction and the subsequent control of their bodies vulnerable once again.

The Reproductive Justice Movement is a collaboration of organized women …

Precision Medicine And It's Ethical And Social Implications: Public Health And Gobal Persepctives, Evangel Sarwar

Electronic Theses and Dissertations

Ever since President Obama's launch of the Precision Medicine Initiative (PMI) in 2015, precision medicine (PM) has been anticipated as the new paradigm for healthcare with the capacity to “empower patients, researchers, and providers to work together toward the development of individualized care,” through research, technologies, and policies (President Obama, 2015). Precision Medicine (PM), in the form of genomics, offers unprecedented promise of providing new tools for improving health and reducing the burden of diseases, not just for the U.S. - but also globally. According to World Health Organization, genomics research and precision medicine will play a major part in …

The Ethical Challenge Of Conflicts Of Interest In Healthcare, Fahad Alhazmi

Electronic Theses and Dissertations

Conflicts of interest are prevalent across all walks of society, and unfortunately, the healthcare industry is not immune to these impediments. Conflicts of interest arise when the objective of upholding a patients’ interest collide with the physicians’ secondary goals and is mostly but not always related to monetary gain.

To avoid conflict of interest, it is advisable for medical practitioners to weigh the pros and cons that their actions would inflict. Medical practices whose benefits outweigh the associated risks are ethically upright hence avoid conflict of interest.

Each section proposes solutions for the conflicts of interest encountered at the disparate …

“I Do Have A Softer Side”: A Phenomenological Investigation Of The Prisoner-Dog Relationship In The Canine Partners For Life Training Program, Kathleen Kocherzat

Electronic Theses and Dissertations

This qualitative study investigated the relationship between incarcerated dog handlers and the service dogs they trained. Six men at a large northeastern prison were interviewed during the summer of 2017; all were current or former dog trainers in the Canine Partners for Life (CPL) training program. The men were serving prison sentences ranging anywhere from several years to life without parole. The interviews focused on their lived experience, rasing and training puppies for a period up to eighteen months. The qualitative data consisted of approximately thirteen hours of transcribed interviews, which were then interpreted using the phenomenological psychological method developed …

The Association Between Depression, Anxiety And Clinical Outcomes For Type 2 Diabetes Mellitus, Elham Heidari

Electronic Theses and Dissertations

Objective: To evaluate the impact of depression and/or anxiety on clinical outcomes of diabetes, including glycosylated hemoglobin (HgA1c), blood glucose, blood pressure, total cholesterol, weight and LDL among patients with incident type 2 diabetes mellitus (T2DM).

Method: A retrospective cohort study utilizing electronic medical record (EMR) data from a primary care physician (PCP) group practice was conducted to identify patients newly diagnosed with T2DM with at least 6 months pre-diagnosis and 12 months post-diagnosis of EMR data using International Classification of Disease 9th edition Clinical Modification (ICD-9-CM) coding. The presence of comorbid depression and anxiety was identified to identify four …

Community Pharmacists And Substance Use Disorders: Attitudes, Knowledge And Practices, Deepika Rao

Electronic Theses and Dissertations

Background: Substance use disorder (SUD) is a serious health concern affecting a large proportion of the US population. Community pharmacists are well-positioned to prevent, screen, and provide appropriate treatment for SUD. Stigma towards these patients and SUD results in reduced quality of care as well as poor treatment outcomes. It is imperative that pharmacists have the appropriate knowledge of and attitude towards prevention, harm reduction and treatment to develop therapeutic relationships and improve their delivery of pharmacy services

Objective: To assess knowledge, practices (with an emphasis upon screening), stigma and general attitudes of community pharmacists towards SUD and evaluate the …

Access To Care And The Use Of Healthcare Services By Women In Rural Cameroon: A Participatory Action Research Study, Grace Tadzong-Awasum

Electronic Theses and Dissertations

Women in rural Cameroon do not access health care as timeously and as often as they should. They fail to get screened for common diseases, with the consequence that such diseases are often diagnosed at a very advanced stage. This accounts for the high morbidity and mortality rates as well as low life expectancy recorded among women. The purpose of this study was to explore and understand the health access experiences of women in rural Cameroon. Methodology: Participatory action research was used guided by a Focused ethnography in phase one. Twenty-five women aged 21-77 years were recruited through local the …

Take Charge For Therapy Discharge: Outcomes Of A Patient Education Program Applying The Co-Op Approach, Kathryn Westley

Electronic Theses and Dissertations

A thorough needs assessment at HealthSouth Rehabilitation Hospital of Largo revealed slight dissatisfaction scores on the Press Ganey survey for both the occupational therapy department and discharge planning processes. This quality improvement project, Take Charge for Therapy Discharge, implemented a two-session patient education protocol using the Cognitive Orientation to Occupational Performance (CO-OP) approach. Using the Patient-Specific Functional Scale (PSFS), participants identified and prioritized three therapy goals and rated their perceived current performance. Results demonstrated a significant difference between the participants’ PSFS pre and post-intervention scores. Patients’ improved self-perceived goal attainment scores served as evidence that, in addition to using …

Probiotic Use In Trauma Patients: A Pathway To Determining The Standard Of Care To Improve Outcomes, Heather Vitko

Electronic Theses and Dissertations

The gut microbiome consists of normally non-pathogenic bacteria, viruses, and fungi. These friendly microbes serve to maintain GI barrier function and integrity, play a role in host nutrient and drug metabolism, immunomodulation, and prevent pathogenic bacteria from colonizing or causing disease. The importance of a healthy microbiome for the overall health of the host is just recently being appreciated within the medical and science communities. Disruption of the microbiome places one at greater risk for illness and infection. Patients who suffer a traumatic injury are among those at highest risk for complications associated with microbial imbalance, or dysbiosis. In addition …

Using An In Vitro-In Vivo Correlation For The ‘Bioequivalence By Design’ Development Of An Immediate Release Carbamazepine Product, Douglas Steinbach

Electronic Theses and Dissertations

The quality of a drug product may be characterized by the consistency with which its indicated clinical effect, and safety profile, is experienced by the patient. The concept that such quality should be built into a product is at the core of the United States Food and Drug Administration’s (FDA) quality by design (QbD) initiative. This vision for pharmaceutical product development emphasizes the risk-based identification of critical quality attributes (CQA) which summarize a product’s performance, the efficient refinement of critical product/process parameters (CPP) that can affect such attributes, and the systematic development of CPP limits, which assure appropriate performance of …

Synthesis Of Novel 6-Substituted And 5-Substituted Pyrrolo[2,3-D] Pyrimidine Antifolates As Targeted Anticancer Therapies, Xinxin Li

Electronic Theses and Dissertations

The dissertation will give an introduction, background and current research progress in the areas of antifolates and chemotherapy of anticancer. The design and synthesis of classical 6- substituted pyrrolo[2,3-d]pyrimidines and 5-substituted pyrrolo[2,3-d]pyrimidines as potential antifolates have been described. The design variations include: methylated thiophene regioisomers, fluorinated phenyl regioisomers, thionyl regioisomers on the side chain of pyrrolo[2,3-d]pyrimidines. As a part of this study, a series of new compounds have been synthesized and characterized. Of these, ten final compounds were submitted for biological evaluation.

Independence Through Patient Education In A Spinal Cord Injury Population, Justin Mctish

Electronic Theses and Dissertations

The Know More, Live Better program was developed because the population of people with Spinal Cord Injuries (SCI) includes a substantial number of young people, who often readmit into hospitals for preventable causes such as pressure ulcers, respiratory infections, and bowel/bladder infections. These complications can be avoided through patient education. A needs assessment was conducted at the SCI unit at Good Shepherd Rehabilitation Hospital in Allentown, PA. This assessment included structured observation of patient education in the therapy process, semi-structured interviews about site needs and patient education topics completed with patients and occupational therapists on staff, and surveys of multi-disciplinary …

Characterization Of G-Protein Coupled Receptors In Pain, Depression And Anxiety, Neil Lax

Electronic Theses and Dissertations

Chronic pain and major depressive disorder are widespread conditions in the world. Interestingly, these conditions often occur comorbidly, with each individual disease amplifying the symptoms of the other. A significant amount of preclinical research in pain and depression focuses on G-protein coupled receptors (GPCRs), implying that GPCRs may be useful in treating this comorbidity. Our efforts have sought to characterize several poorly understood GPCRs, including the serotonin receptor subtypes 2C and 7 (5-HT2CR and 5-HT7R) and metabotropic glutamate receptor 5 (mGluR5), along with more well-known GPCRs such as the mu opioid receptor (MOR), and the role that they play in …

Tumble Tots: Outcomes Of A Gymnastics Program For Children With Disabilities, Cayla Leichtenberger

Electronic Theses and Dissertations

Despite the benefits, children with disabilities do not participate in recreational activities as often as typically developing peers. The purpose of the program was to: 1) describe the benefit of a gymnastics program on a child’s development, and 2) identify the impact of a staff training program. Engagement in the proposed program aimed to ultimately contribute to a child’s involvement in recreational activities, health and quality of life (QOL). All participants in the gymnastics program demonstrated a positive change in motor and communication skills. Pre-test data from the staff training program indicated that none of the gymnastics staff members were …

Sensory-Based Programming In Mental Health: Sense Of Self, Nikki Yeckel

Electronic Theses and Dissertations

The doctoral experiential component (DEC) for this Capstone was completed at the Veterans Affairs Healthcare System (VA) in Pittsburgh, Pennsylvania. The program, called Sense of Self, was implemented with the Veteran mental health (MH) population in an inpatient psychiatric rehabilitation unit at the VA. Sense of Self was a three-day educational program that educated Veterans on the sensory systems and sensory processing, provided calming or alerting strategies with use of sensory materials, and assisted the Veterans in creating sensory home programs based on personal goals. The goals of this Capstone were to inform the staff of the Veteran demographic population …

The Influence Of Age, Gender, And Thiol Repletion In An In Vivo Model Of Lewy Body Disorders, Daniel Mason

Electronic Theses and Dissertations

Lewy body disorders are a family of neurological brain disorders associated with olfactory, motor, and cognitive deficits and are collectively defined as α-synucleinopathies, as they are characterized by hallmark “Lewy bodies” composed of aggregated, fibrillar α-synuclein. It is not certain but often posited that fibrillar α-synuclein seeds the progressive, self-propagating spread of Lewy pathology through neuroanatomical circuitry. Furthermore, the site of disease induction is still debated. In Aim I, we developed a novel protocol for generating reproducible and robust α-synucleinopathy in the limbic temporal lobe following infusions of preformed α-synuclein iv fibrils into the mouse olfactory bulb, which is frequently …

Ultrasound Visual Biofeedback And Accent Modification: Effects On Consonant And Vowel Accuracy For Mandarin English Language Learners, Courtney Armstrong

Electronic Theses and Dissertations

The number of individuals in the United States who speak languages other than English continues to increase. With the increase of language diversity comes a potential rise in communication challenges for those who speak with non-mainstream American English accents as English language learners. A portion of these individuals may elect to seek accent modification services, perhaps due to decreased intelligibility or communication breakdowns. Thus, speech-language pathologists must research and provide effective techniques to enhance intelligibility of all American English speakers for optimal communication. Few approaches employ a variety of treatment methods to improve speech sound accuracy, naturalness and intelligibility to …

Effects Of Natural Antioxidants On Motor And Cognitive Deficits In An Animal Model Of Aging And Obesity And Dopaminergic-Like Sh-Sy5y Cell Line, Sneha Potdar

Electronic Theses and Dissertations

Aging is a universal phenomenon. One of the greatest challenges faced by the elderly population is to sustain a healthy standard of living. Advancing age is associated with increased motor and cognitive deficits. Loss of balance, falls, hip fractures, and poor memory all contribute to a decline in the quality of life of the aging population. While ongoing research is making advances to find therapeutic interventions for neurodegenerative disorders like Parkinson’s and Alzheimer’s diseases, there is a pressing need to address deficits associated with normal aging.

Increase in oxidative stress and a decline of antioxidant mechanisms with aging have been …

The Association Of Prescription Opioid Exposure And Patient Factors With Prolonged Postoperative Opioid Use In Opioid Naive Patients, Jennifer Lanzillotta

Electronic Theses and Dissertations

Background

Research suggests prolonged postoperative opioid use occurs in 4-13% of opioid naïve patients and is related to factors other than surgical pain. However, it is unclear which patient factors and prescribing practices are associated with prolonged use after surgery among opioid naïve patients.

Objectives

To identify factors associated with prolonged postoperative opioid use (refills 90-180 days after surgery) in opioid naïve patients in two domains: specific patient characteristics (demographics, smoking status, comorbidities, etc.) and exposure through postoperative opioid prescriptions (in oral morphine milligram equivalents [OME]).

Methods

An electronic medical record dataset analysis of inpatient and outpatient opioid naïve adult …

Workplace Bullying, Nurse Practice Environment, Patient Outcomes: A Descriptive Study, Noreen Houck

Electronic Theses and Dissertations

Better nursing practice environments are associated with improved patient safety, yet little is known about the nurse’s experiences of bullying or flourishing within the practice environment. This study described nurses’ experiences of workplace bullying and flourishing and identified associations with patient outcomes.

The study used an exploratory cross-sectional survey design following Donabedian’s Quality Framework of structure-process-outcome and informed through critical feminist theory. The study took place at a large medical facility in the northeastern United States. A multi-instrument survey included four sections. The demographic section and the Practice Environment Scale of the Nurse Work Index (PES-NWI) were used to measure …

The Effect Of The Movie Time Social Learning Method On The Emotional Inferencing Skills In An Adult With Autism Spectrum Disorder, Jenna Reade

Electronic Theses and Dissertations

Individuals with autism spectrum disorder (ASD) have difficulty finding employment and maintaining social relationships. Professional and personal interactions require individuals to make inferences, or read between the lines. Inferencing is a challenge for individuals with ASD because it requires complex information processing. More specifically, it involves the integration of cognitive and linguistic information. There is a lack of research using complex stimuli to treat inferencing. An A-B-A-B design with one adult with ASD was used to examine the effectiveness of a movie-based method, Movie Time Social Learning(Vagin, 2012), on improving the emotional inferencing skills of one young adult with …

Self-Assembling Bioaffinity Hydrogels For Localized Antibody Delivery, Wen Liu

Electronic Theses and Dissertations

The scope of illnesses that are being treated using monoclonal antibodies (mAbs) has been expanding from cancers to autoimmune diseases due to their high specificity to their molecular target. Because many of the new mAbs are aimed to modulate the immune system, an emerging concern is that patients with chronic illnesses are subjected to immune-related Adverse Events (irAEs). Loss of immunological tolerance to self-antigens or increased susceptibility to infections have been documented in some mAb treatments. Localized sustained release of mAb at disease sites might mitigate the risk of such toxicities. Antibody drugs are formulated typically for parenteral delivery because …

The Myth Of Promiscuity: Examining Black Male Sexual Narratives And Sexual Identity, Seth Young

Electronic Theses and Dissertations

Black masculinity and sexuality are common topics across areas of philosophy, psychology, cultural studies and others. Yet, these topics are dedicated to the racial narrative of hypersexual Black male, the sexual objectification of Black men, and their presumed promiscuity. While such topics are important, there is little qualitative research that looks at the complexity and emotionality of African American men’s sexual experiences. Using the theoretical research on black masculinity and sexuality as its backdrop, this dissertation explores how heterosexual, African American men experience their sexuality. The study incorporates narrative inquiry and in-depth, semi-structured interviews to gather stories of five African …

Macromolecule Loading On Plga Particles Through Surface Adsorption, Yiwei Wang

Electronic Theses and Dissertations

The advent of biotherapeutics have impacted the ways in which diseases are treated. In many instances development of recombinant proteins and oligonucleotides into therapeutics are slowed by poor stability of the candidate drugs. Progress has been made in using polymeric particles as carriers of macromolecule drugs. Historically the method is to encapsulate biological drugs into spherical polymeric matrices. Owing to its biocompatible and biodegradable nature, poly (d,l-lactic-co-glycolic acid) (PLGA) has been used extensively in formulating biological drugs into nano- and micro-sized particles. The development of PLGA biologic formulations, however, has been hampered by matrix acidification; the hydrolysis of the polymer …