Medicine and Health Sciences Commons^™

Travel Tales: The Role Of Storytelling In Abroad Experience And Healing, Colleen N. Mcmurray

Capstone Collection

This capstone paper examines the perceived effectiveness of storytelling in the healing process. It aims to answer the question: What role does storytelling play in the healing of returning travelers? The study was conducted by analyzing forty digital videos, categorizing themes, and analyzing the themes in relation to themes found within several articles about the power and effects of storytelling. Five principal themes were used from the data collected. The themes were then used to gain a deeper understanding of how storytelling makes the storyteller feel and how storytelling can be used for healing. The author of this paper has …

Scoliosis Analog Model For The Evaluation Of Bracing Technology, Chloe Ly Chung

Theses and Dissertations (ETD)

Thoracolumbar braces are commonly used to treat Adolescent Idiopathic Scoliosis (AIS). Braces serve to reduce and prevent progression of the spinal curve by applying corrective forces. The magnitude and direction of these corrective forces applied by the brace to the spine remain unknown. Additionally the brace fitting process involves making alterations to the brace that affect its corrective force capacity. The objective was to design and validate an analog model of a mid-thoracic single curve scoliotic deformity for quantifying structural properties of the brace and the force response of the brace on the spine. This model was used to investigate …

The Effect Of Neurostimulation On Ischemic Pain And Methods Of Assessing Pain, Kaylee Keck

Biomedical Engineering

Peripheral arterial disease (PAD) impacts approximately eight million people in the United States [1]. Disease progression leads to chronic ischemic pain, hindering quality of life. Pharmaceuticals are a typical treatment for pain associated with PAD; but as few as 30% of patients have a significant reduction of pain (≥50%) [2].

Neurostimulation is commonly used as a treatment for various diseases and injuries, including Parkinson’s disease and sports-related back and knee injuries [2]. The objective of the study was to explore neurostimulation and its effect on pain and paresthesia for a model of acute peripheral ischemia in young college students.

Pain …

Hyperpolarized 129xe Magnetic Resonance Imaging Of Radiation-Induced Lung Injury, Ozkan Doganay

Electronic Thesis and Dissertation Repository

Lung cancer is the largest contributor to cancer-related mortality worldwide. Only 20% of stage III non-small cell lung cancer patients survive after 5-years post radiation therapy (RT). Although RT is an important treatment modality for lung cancer, it is limited by Radiation-Induced Lung Injury (RILI). RILI develops in two phases: (i) the early phase (days-weeks) referred to radiation pneumonitis (RP), and (ii) the late phase (months). There is a strong interest in early detection of RP using imaging to improve outcomes of RT for lung cancer. This thesis describes a promising approach based on ¹²⁹Xe gas as a contrast …

Interpretation Of Mutations, Expression, Copy Number In Somatic Breast Cancer: Implications For Metastasis And Chemotherapy, Stephanie Dorman

Electronic Thesis and Dissertation Repository

Breast cancer (BC) patient management has been transformed over the last two decades due to the development and application of genome-wide technologies. The vast amounts of data generated by these assays, however, create new challenges for accurate and comprehensive analysis and interpretation. This thesis describes novel methods for fluorescence in-situ hybridization (FISH), array comparative genomic hybridization (aCGH), and next generation DNA- and RNA-sequencing, to improve upon current approaches used for these technologies. An ab initio algorithm was implemented to identify genomic intervals of single copy and highly divergent repetitive sequences that were applied to FISH and aCGH probe design. FISH …

Physical Therapy After Triangular Fibrocartilage Injuries And Ulnar Wrist Pain, Mohamed A. Abdelmegeed

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The ulnar side of the wrist has been referred to as the “black box” of the wrist because of its complex structures and sophisticated anatomy, disorders at this anatomical site have been compared to those of low back pain

Purposes: The purpose of this study was to apply the Brief International Classification of Functioning (ICF) Core Set for Hand Conditions to the physical therapy outcome measures, and to evaluate the contribution of these measures to overall health in subjects with ulnar wrist pain. A secondary purpose was to investigate the effect of wrist orthotics and strengthening exercise on …

Engineering Novel Detection And Treatment Strategies For Bacterial Therapy Of Cancer, Jan T. Panteli

Doctoral Dissertations

Finding and treating cancer is difficult due to limited sensitivity and specificity of current detection and treatment strategies. Many chemotherapeutic drugs are small molecules that are limited by diffusion, making it difficult to reach cancer sites requiring high doses that lead to systemic toxicity and off-target effects. Tomographic detection techniques, like PET, MRI and CT, are good at identifying macroscopic lesions in the body but are limited in their ability to detect microscopic lesions. Biomarker detection strategies are extremely sensitive and able to identify ng/ml concentrations of protein, but are poor at discriminating between healthy and disease state levels due …

The Effectiveness Of Implementing Standard Of Care Best Practices Including Use Of Daily Incentive Spirometry To Improve Dyspnea And Quality Of Life In Adults With Chronic Obstructive Pulmonary Disease (Copd), Christine Gallagher

Doctor of Nursing Practice (DNP) Program

Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease characterized by symptoms of dyspnea, cough, and wheezing. Many patients with COPD are on daily medications for their symptoms yet these symptoms continue to persist, impairing their quality of life. Patients with COPD experience respiratory muscle weakness that contributes to dyspnea and an inability to participate in daily activities. GOLD (2014) guidelines state that the goal of therapy in these patients is to reduce symptoms, increase participation in activities, and restore the highest level of independent functioning. The guidelines recommend the use of inspiratory muscle training (IMT) in …

Kinematic And Kinetic Effects Of Alterations In Lumbar Lordosis In People With Tight Hamstrings, Dema Assaf

Theses and Dissertations (ETD)

The etiology of nonspecific low back pain is sparsely understood. To better understand the contributing factors to nonspecific low back pain, there are often common concurrent pathologies that are investigated to determine their functional relationship to low back pain. One such pathology, investigated further in this thesis, is tight hamstrings. Specifically, the effect of hamstring length on pelvic position during gait and activities of daily living under normal and altered spinal position were investigated as part of this study in a motion analysis lab.

First, a marker validation study was conducted to ensure the accuracy of sagittal spinal measures of …

Adverse Effects Of Asparaginase In Pediatric Patients With Acute Lymphoblastic Leukemia, Chengcheng Liu

Theses and Dissertations (ETD)

Acute lymphoblastic leukemia (ALL) is the most common type of childhood cancer. Asparaginase is a critical treatment component for ALL. However, its use is complicated by adverse effects, such as hypersensitivity, osteonecrosis and pancreatitis.

Hypersensitivity to asparaginase typically requires discontinuation of current formulation and substitution with other formulations, but the differential diagnosis can be challenging, and the diagnostic utility of antibody tests is unclear. We comprehensively analyzed anti-Elspar (native E.coli asparaginase) IgG antibodies in 410 pediatric patients treated on an asparaginaseintensive front-line clinical trial. Of 169 patients (41.2%) who exhibited clinical allergy, 147 (87.0%) were positive for anti-Elspar antibody. Of …

Diabetes Type 2 Self-Management Education Program: Short Messaging From Patient Portal To Web-Enabled Device, Lynn S. Holcomb

Evidence-Based Practice Project Reports

Only one in eight adults with diabetes reaches target goals for disease management, which can lead to clinical complications, costly both economically and in quality and duration of human life. The standard of care is a quarterly 15-minute face-to-face visit-- arguably inadequate to impart self-care knowledge. The purpose of this EBP project was to deliver a 30-day diabetes self-management education program (DSMEP) utilizing widely accessible web-based technology to facilitate adults with diabetes to reach targeted goals. Using the Chronic Care Model as a framework, the DSMEP design was based on an extensive literature review of the delivery of DSMEP in …

The Effect Of An Educational Intervention On Oral Anticoagulation Therapy Knowledge In Primary Care, Elizabeth D. Deck

Evidence-Based Practice Project Reports

It is estimated that three million people in the United States are on oral anticoagulation therapy (warfarin). Populations studied have been found in therapeutic range 64% of the time (Pernod, Labarere, & Bosson, 2008). The low percentage of therapeutic range is attributable to (a) adherence, (b) monitoring infrequency, (c) Vitamin K antagonists, and (d) the effects of aging and comorbidities. The purpose of this evidence-based practice (EBP) project was to examine whether an educational intervention would improve the knowledge of patients receiving warfarin therapy. Roy’s model for patient adaptation and the Stetler Model for EBP were used as frameworks for …

Synthesis And Evaluation Of Polysialic Acid-Polycaprolactone Based Micelles For Drug Delivery, Weston Ryan

Honors Capstone Projects - All

The growing use and investigation of pharmaceuticals to treat disease has offered the field of drug delivery an opportunity to further improve upon the effects provided, as well as address therapeutic complications. An effective long-term treatment for rheumatoid arthritis (RA) has yet be developed, while many current treatments pose disadvantageous side effects due to undesirable reactions outside of the diseased tissue. Therefore, there is a need for an improved strategy for RA treatment. A previously developed drug carrier system based on polysialic acid (PSA) and polycaprolactone (PCL) micelles was shown to be effective for in vitro therapeutic use. The evaluated …

Development Of Polyhydroxyalkanoate Nanoparticles For Cancer Therapy, Philip Choiniere

Honors Capstone Projects - All

Polyhydroxyalkanoates (PHAs), a class of biopolyesters produced and stored by bacteria, have garnered attention for a number of industrial and biomedical applications. The goal of the current study was to extend the use of PHAs to drug delivery for the treatment of cancer. As a first step, the cytotoxicity of poly(3- hydroxy-octanoate-co-10-undecanoate) (PHOU) towards the A549 lung carcinoma cell line was determined and nanoparticles were prepared via a single emulsion technique. Elution tests, whereby cells were grown in fluid extracts obtained from media incubated for 24 hours at 37°C with PHOU films, did not result in any significant changes in …

Correlation Matrix Analysis Identifies Gene Signatures Of Immune Cell Subsets And Their Interactions In Follicular Lymphoma, Jason R. Westin

Dissertations & Theses (Open Access)

There are important but ill-defined interactions between benign immune cell subsets and neoplastic B cells within follicular lymphoma (FL). Using the novel technique of correlation matrix analysis (CMA) of publicly available FL whole-tumor gene expression profiling (GEP) data, we have identified signatures of immune cell subsets. Overall survival correlated most highly with a model using signatures of macrophages, T cells, and stroma, which was able to add significantly to existing clinical prognostic tools. From our own data of a cohort of 43 FL tumors sorted into B-cell and non-B cell (NB) fractions for GEP, CMA of the tumor infiltrating NB …

The Characterization Of Amyloid Fibrils And Novel Synthetic Heparin-Binding Peptides Binding To Cell Surfaces, Nicole Marie Hackenbrack

Chancellor’s Honors Program Projects

No abstract provided.

A Qualitative Examination Of Optimal Professional Traits Of Physical Therapists. – An Exploratory Investigation, Nicholas G. Wood

Honors College Theses

Physical therapists are constantly searching for aspects of their professional practice to improve, in order to enhance interactions with patients, eventually leading to a more successful practice (Resnek & Jensen, 2003). Although this is the case, limited research has been found which has examined optimal qualities of physical therapists from neither a qualitative perspective, nor based upon their location. Thus, the purpose of this study is to use a qualitative approach to describe optimal qualities necessary for a successful physical therapy practice. In addition, this study aims to determine if therapists practicing in a rural community describe different qualities than …

The Effects Of Horseback Riding On The Gait Of Adolescents, Sarah L. Hayes

Undergraduate Distinction Papers

ABSTRACT

The objective of this study was to investigate the changes that occur in the gait of a set of subjects after they ride a horse. Eleven riders with a developmental disability were selected and included in an experimental group and nineteen “typical” subjects or those without a developmental disability were included as a second comparison group. The length of time the subjects were able to remain standing in a tandem stance and in a one-legged stance without becoming unbalanced was measured and recorded. The stride length of the subject’s second and third step from heel to heel was also …

Methotrexate And Cardiovascular Events, Alpesh Shah

Electronic Thesis and Dissertation Repository

We conducted a systematic review and meta-analysis to assess the association of MTX with cardiovascular morbidity, cardiovascular mortality and all-cause mortality in patients with autoimmune disease. Our primary outcome was incident cardiovascular events. After screening 13,479 citations, we identified a total of 30 eligible studies. We synthesized adjusted risk estimates using a random effects model. MTX was significantly associated with a 25% reduction in cardiovascular events (pooled RR: 0.75, 95% CI: 0.65, 0.86, I²: 11%), a 55% reduction in cardiovascular mortality (0.45, 95% CI: 0.26, 0.80, I²: 33%) and a 40% reduction in all-cause mortality (0.60, …

Piecing The Puzzle Together With The Use Of Physical Therapy, Mikayla Pruitt

Honors Projects

For my Honors Project I decided to create a set of exercise cards for children with autism. The front of each card had a picture symbolizing the exercise/activity, and on the back included directions, supplies and tips to complete the activity. The following is a selection of a few exercise cards from each of the four exercise sections, as well as the title card, table of contents cards, information cards, and source cards.

Experimental Investigation On The Relationship Between Lead Exposure And Thyroids In Diabetes, Salah Sumar Ali Al-Zadjali

Dissertations

Lead exposure can cause multiple systemic toxicities, particularly affecting the hematopoietic, nervous and renal systems. However, its effects on the thyroid functions are not well elucidated and the published studies are controversial. In addition, although there are several experimental thyroid models, each one of them has its own limitations. Accordingly, in this dissertation, we investigated the possible relationship between lead exposure, thyroid functions and short-term systemic toxicity in two animal models, namely normal (non-diabetic) and diabetic animals. We also investigated the possibility of developing a hormonal thyroid model. In the non-diabetic model, Wistar rats were divided into five groups and …

Is Yoga Effective In Reducing Fibromyalgia-­Related Symptoms In Women With Fibromyalgia?, Molly R. Beckmann

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not yoga is effective in reducing fibromyalgia-related symptoms in women with fibromyalgia.

Study Design: Review of two published double blind, randomized controlled trials published in 2010 and one before-after study published in 2012 were used for this review and selected based on their relevance to the clinical question

Data Source: Studies were found using PubMed, AMED, and CINAHL Plus.

Outcomes Measured: All three studies measured improvement of fibromyalgia symptoms based on a variety of well-validated measures, most notably the Fibromyalgia Impact Questionnaire, the Quality of Life Profile …

Is Pilates-Based Exercise Effective In Improving Balance In Healthy Adults Over The Age Of 18?, Abby Ott

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Pilates-based exercise is effective in improving balance in healthy adults over the age of 18.

Study Design: Review of three English language randomized controlled trials (RCTs) published in 2006, 2009 and 2012.

Data Sources: Three non-blind randomized controlled trials published in peer reviewed journals found via PubMed.

Outcome(s) Measured: Efficacy was measured with the experimental group participating in a predetermined number of Pilates classes and the control group refraining from any exercise or continuing their pre-study, non-Pilates exercise routines. Change in balance was measured using a …

Does Balneotherapy Effectively Reduce Non-Specific Chronic Low Back Pain In Adults?, Jenna Srebnik

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not balneotherapy effectively reduces non-specific chronic low back pain in adults.

STUDY DESIGN: Review of three single blind, follow up randomized controlled trials (RCT), published in 2012 and 2005.

DATA SOURCES: Three peer reviewed RCTs were found using PubMed and all compared balneotherapy against various control groups.

OUTCOMES MEASURED: Low back pain of patients was assessed using dose of analgesic consumed, visual analog pain scale (VAS) and Oswestry Low Back Pain Disability Questionnaire (OSWDQ). The tools used to assess significance of outcomes measured were Pvalues, change in …

Does Neuromuscular Electrical Stimulation As An Adjunct To Traditional Physical Therapy Improve Post-Operative Mobility After Total Knee Arthroplasty In Comparison To Traditional Pt Alone In Patients 50-85 Years Old?, Kelsey L. Welsh

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective Evidence Based Medicine (EBM) review is to determine whether or not neuromuscular electrical stimulation (NMES) as an adjunct to traditional physical therapy (PT) improves post-operative mobility including walking and stairclimbing ability following total knee arthroplasty (TKA) in comparison to traditional PT alone in patients 50-85 years old.

STUDY DESIGN: Review of three English language primary studies published after 1999.

DATA SOURCES: Three randomized controlled trials comparing traditional PT with PT and adjuvant NMES following TKA in patients 50-85 years old found using PubMed and EBSCOhost Web.

OUTCOMES MEASURED: Clinical outcome was measured in each …

Dysregulation Of Micrornas In Blood As Biomarkers For Diagnosing Prostate Cancer, Rhonda W. Daniel

Theses and Dissertations

Prostate cancer is the most common noncutaneous cancer among men, yet current diagnostic methods are insufficient and more reliable diagnostic markers need to be developed. The answer that can bridge this gap and enable more efficient diagnoses may lie in microRNAs. These small, single stranded RNA molecules impact protein expression at the translational level and regulate important cellular pathways. Dysregulation of these small RNA molecules can have tumorigenic effects on cells and lead to many types of cancers.

Currently the Prostate-Stimulating Antigen (PSA) is used as a diagnostic marker for prostate cancer. However, many factors can elevate PSA levels such …

Femtosecond Laser Beam Propagation Through Corneal Tissue: Evaluation Of Therapeutic Laser-Stimulated Second And Third-Harmonic Generation, William R. Calhoun Iii

Theses and Dissertations

One of the most recent advancements in laser technology is the development of ultrashort pulsed femtosecond lasers (FSLs). FSLs are improving many fields due to their unique extreme precision, low energy and ablation characteristics. In the area of laser medicine, ophthalmic surgeries have seen very promising developments. Some of the most commonly performed surgical operations in the world, including laser-assisted in-situ keratomileusis (LASIK), lens replacement (cataract surgery), and keratoplasty (cornea transplant), now employ FSLs for their unique abilities that lead to improved clinical outcome and patient satisfaction.

The application of FSLs in medical therapeutics is a recent development, and although …

Joint Attention Intervention With Assisting Parent­ Mediated Techniques To Increase A Toddler With Autism Spectrum Disorders' Use Of Joint Attention: A Single Case Study, Rebecca Schulz

All Graduate Theses, Dissertations, and Other Capstone Projects

Attention Intervention (JAI) conducted by graduate researcher, parent, and caregiver, would change the use of joint attention (JA) by a three-year-old suspected of having Autism Spectrum Disorder (ASD). The participant was a three-­year-­old child suspected of having ASD. Intervention was conducted twice per week for 30-45 minute duration by the student graduate researcher at a university clinic under the supervisor of Dr. Bonnie Berg, CCC­SLP. The parent and child's caregiver were trained in JAI and implemented the intervention daily in the home environment. The author's research question was, "Will the use of a JAI parent­mediated intervention model increase the JA …

The Effect Of Music Therapy Interaction On Child And Parental Preoperative Anxiety In Parents Of Children Undergoing Day Surgery, Christopher R. Millett

Theses and Dissertations--Music

Young children who experience high levels preoperative anxiety often exhibit distress behaviors, experience more surgical complications, and are at a higher risk for developing a variety of negative postoperative consequences. A significant factor in pediatric preoperative anxiety is the level of anxiety present in their caregivers. Music therapy interventions addressing a variety of procedural outcomes have been met with success. The purpose of this study was to investigate the comparative effectiveness of two music therapy interventions on reducing preoperative anxiety in young pediatric surgical patients and their caregivers.

A total of 40 pediatric patient and caregiver dyads were included in …

Drug Interactions With Glutaredoxin Orthologues, Kahlilah R. Napper, Thomas C. Leeper, Ram Khattri, Daniel Morris, Caroline Davis

Williams Honors College, Honors Research Projects

Glutaredoxin, an enzymatic protein, is an important component of cell viability and function. It catalyzes reactions involved in DNA synthesis and innate immunity [1,4]. Glutaredoxin is also essential in antibiotic resistance in pathogenic bacterial species. Pseudomonas aeruginosa in particular is responsible for infecting the lung tissue of its human hosts, resulting in the development of pneumonia and cystic fibrosis [3]. Because glutaredoxin is pertinent in cell proliferation of eukaryotic and bacterial cells alike, medicinal fragments that take advantage of the subtle differences in protein structure of the orthologous proteins can be synthesized and enhanced to bind bacterial glutaredoxins, without inhibiting …