Medicine and Health Sciences Commons^™

Cultural Conflict In Medicine: A Moral Debate Between Paternalism And Patient Autonomy, Hannah Webb

Honors Theses

In today’s society filled with globalization and mass movement of people and ideas, there is an ever present question of how each individual society fits into the overall culture of a diversified country such as the United States. The idea of the US as a melting pot has triggered the inability to create a “one size fits all” style of living. In terms of medicine, westernized practices are typically accepted in a majority of the world. However, conflicting traditional practices as well as religious beliefs are still present in some areas of the world as well as in the US …

Differences Between Healthcare Systems In Costa Rica & The United States And How Those Differences Affect The Overall Quality Of Healthcare, Carlie Decker

Honors Theses

This thesis seeks to examine the similarities and differences between the healthcare system employed in Costa Rica and the healthcare system employed in the United States through a series of interviews and web-based research. Four healthcare system components will be examined in order to determine the success of each system. These components include health insurance coverage, access to pharmaceuticals, medical licensing requirements, and medical research.

Following the completion of the interviews and research, I found that United States citizens pay nearly four times the amount Costa Rican citizens do for health insurance coverage. This dramatic increase in price can be …

Physician Assistants: The Rise Of A Career From A Missed Opportunity In Nursing, Madeline Jary

Honors Theses

The implementation of the concept of mid-level providers in healthcare has undoubtedly contributed greatly to the solution of the physician shortage. This shortage of physicians had posed a problem in the delivery of health care for decades, particularly in rural areas. Nurse Practitioners and Physician Assistants as we know them today may not have existed without previous groundwork and inspiration. The introduction of the nurse clinician concept by Frances Reiter in 1943 led to the later development of a masters nurse clinician program at Duke University by Dr. Eugene Stead and Thelma Ingles. Despite the denial of accreditation of the …

A Holistic Approach To Therapy And Management Of Lower Back Pain, Lauren Ross

Honors Theses

My thesis project is focused on the concept of pain. It is a compilation of input from my intern advisor, a licensed physical therapist, and from my thesis advisor, a professor within the Integrative Holistic Health and Wellness department. It is an exploration of the origin, effects, development, types, perception, costliness and treatments of low back pain, through a holistic, anatomical, neurological and integrative approach. My research is expressed through a thorough power-point project with several diagrams, pictures and information, as well as a research paper containing significant detail.

This thesis project effectively defines what pain is in the body …

Secondary Analysis Of Adolescent And Young Adult Sexual Health In Kalamazoo And Jackson Counties, Kayla Bolter

Honors Theses

Based off of the Healthy People 2020 goals regarding sexual health behaviors and reduction in the proportion of gonorrhea infections among males and females ages 15-44, the purpose of this thesis to provide the necessary evidence that a sexual health education intervention needs to be implemented into the campus of Western Michigan University in order to reduce the rates of gonorrhea among college students aged 20-24 in Kalamazoo County. This is a secondary analysis that compared the reported gonorrhea rates in Kalamazoo County, Michigan to the reported rates of gonorrhea in Jackson County, Michigan. Several components were compared within each …

Secondary Analysis Of Adolescent And Young Adult Sexual Health In Kalamazoo And Jackson Counties, Jenna Moreau

Honors Theses

This secondary analysis is a comparison of two Counties, Kalamazoo and Jackson, to see if the presence of a university has impact on reported Chlamydia cases. Nationally, 20-24 year olds account for the highest number of reported Chlamydia infections. This age group also accounts for the large majority of college students that attend Western Michigan University found in Kalamazoo County. It is believed that by collecting this data, there will be an obvious need for implementation of an education intervention for students at Western Michigan University regarding sexual health.

It was proposed that there would be a higher prevalence of …

Evaluation Of Modafinil In Preclinical Behavioral Assays Of Abuse Liability, Amanda J. Quisenberry

Dissertations

Modafinil is an FDA-approved drug for the treatment of narcolepsy with efficacy in the treatment of chronic fatigue syndrome, obstructive sleep apnea, and shift-work sleep disorder. Modafinil’s wake-promoting and cognitiveenhancing effects are reportedly similar to those of traditional psychostimulants, but without the side effects typically associated with these substances. Modafinil has also been investigated as an agonist replacement therapy for psychostimulant dependence, although results of clinical trials are equivocal. Few studies have examined its behavioral effects in combination with psychostimulants and the neuropharmacological actions of modafinil are not well understood. The primary aim of this study was to assess modafinil’s …

The Partial Characterization Of The 142r Protein Of Tanapox Virus, Krystal N. Seibert

Dissertations

Due to the complex nature of cancer, a variety of strategies are being employed to treat patients. Among these are oncolytic viruses that conditionally replicate in tumor cells with specific cellular landscapes. Several viruses including Herpesviruses, Adenoviruses, and Poxviruses, predominantly vaccinia virus (VV), have been explored for their oncolytic potential. Most of these viruses can productively infect a variety of cell types and it is one goal to create conditionally lethal viruses that can only replicate in tumor cells. Due to the prevalence of p53 inactivating mutations in cancers viruses that are restricted to p53 null cells are desirable and …

Grip Strength, Multimorbidity, And Disability, Amy M. Yorke

Dissertations

The presence of two or more chronic health conditions, also known as multimorbidity, is one of the most prevalent health disorders experienced by adults. Adults with multimorbidity and functional limitations represent clinical and financial challenges to the current health care system. The purpose of this three-paper dissertation is to examine the relationship between grip strength, multimorbidity, and the prediction of disability in adults. Data from the 2008 Health and Retirement Study (HRS), a nationally representative, longitudinal study completed on Americans age 50 years and over, are used for the dissertation.

The objective of the first paper is to investigate the …

Quantifying Value In Public Health: Using Economic Methods To Analyze System Change, Theresa M. Green

Dissertations

In this time of economic downturn, it is becoming increasingly important for organizations, including those in public health, to “prove their worth,” to show the value in improvement strategies. Health agencies have learned to discuss impact in terms of health outcome and mortality/morbidity measures. However, it is critical that these impacts are also expressed in a way that shows cost-efficiency and economic benefit especially for promising, evidence-based public health interventions. Although several methods of economic evaluation including cost-effective analysis, cost-utility analysis, or cost-benefit analysis and return on investment (ROI) have been used in social sciences and health research, fewer examples …

The Effects Of A Moisture-Wicking Fabric Shirt On The Physiological Responses During Acute Exercise In The Heat, Kimberly Wigboldy

Masters Theses

The purpose of this study is to investigate the effects that a form fitted, moisture-wicking fabric shirt, promoted to have improved evaporative and ventilation properties, has on the thermoregulatory, physiological and perceptual response during moderate intensity exercise in the heat for an extended duration of exercise of 90 minutes. Ten healthy subjects (7 males, 3 females), completed two heat stress tests consisting of 20 minute seated rest in a neutral environment (24°C, 60% RH), 30 minute seated rest in a hot environment (33°C, 60% RH), and 90 minutes of exercise(50% V0_{2 peak}) on a magnetically-braked cycle ergometerin a …

A Preliminary Study Of The Articulatory And Acoustic Features Of Forward And Backward Tone Placement In Singing, Krista Wyllys

Masters Theses

A variety of terms exist for describing tone quality in singing, and voice scientists, voice therapists, teachers of singing, and students of singing use different terms to describe the same sound. One aspect of tone quality is tone placement. Teachers of singing often rely on imagery and imitation to elicit correct tone placement from students of singing. More concrete data about what produces forward and backward tone placement could supplement singing teachers’ current practice of using imagery and imitation to elicit a desirable tone quality. This study examined forward and backward tone placement to determine the articulatory gestures and acoustic …

Use Of A Specific Alpha7 Nicotinic Acetylcholine Receptor Agonist Can Prevent Loss Of Retinal Ganglion Cells In An In Vivo Rat Glaucoma Model, David Mata

Masters Theses

Acetylcholine (ACh) has been shown to have a neuroprotective effect against glutamate-induced excitotoxicity in cultured retinal ganglion cells (RGCs) through activation of α7 nicotinic ACh receptors (nAChRs). In this study, the neuroprotective effects of the α7 nAChR agonist, PNU-282987, were investigated using an in vivo model of glaucoma in adult Long Evans rats. Hypertonic saline injections were used to induce a glaucoma model. After one month, retinas were removed, flat mounted, fixed and labeled with an antibody against Thy 1.1 to label RGCs and fluorescently tagged for visualization. Eye drop application of PNU-282987 resulted in neuroprotection against RGC loss in …

Expression Of The Chemokine Receptor, Cxcr4, And Its Ligand, Sdf-1, Are Increased In Purkinje Cells Of The Multiple System Atrophy Cerebellum, Megan Welter

Masters Theses

Multiple System Atrophy (MSA) is a sporadic, neurodegenerative disease that consists of three conditions: autonomic dysfunction, Parkinsonism and cerebellar ataxia. Our lab conducted an Affymetrix global gene expression analysis using pons tissue of MSA patients to determine genes that are differentially expressed when compared to non- MSA controls. This study identified upregulated genes, including the C-X-C chemokine receptor type 4, CXCR4, to which stromal cell-derived factor-I (SDF-1) is the natural ligand. The CXCR4/SDF-1 signaling pair has been sho.wn to play multiple roles in the brain, such as inducing neuronal apoptosis and promoting leukocyte recruitment during inflammation. The MSA cerebellum presents …

Executive Functions And Social Interactions: Developing Social Scenarios, Mackenzie Waite

Masters Theses

The aim of this study was to develop a series of vignettes to form the basis for an assessment of executive functions (EFs) for 9 – 12 year old children. Although EFs are necessary for effective social communication and positive social interactions, currently, most EF assessments focus on impersonal activities. Little research exists that incorporates real-time processing using ecologically valid social scenarios. The current study aims to develop realistic scenarios that children could encounter in daily life. Ethnographic interviews were conducted with six participants, who worked in a school with 9-12 year old children, to gain their perspective on social …

Motivational Interviewing Assessment And Behavior Therapy As A Stepped-Care Approach To The Treatment Of Adolescent Depression, Tanya N. Douleh

Dissertations

Depression is a significant public health concern with a lifetime prevalence of 24.01 for adolescents in grades 9-12 (Lewinsohn, Hops, Roberts, Seeley, & Andrews, 1993) and a point prevalence of 4-6% (Kessler, Avenevoli, & Ries, 2001). The risks associated with adolescent onset depression include comorbidity, depressive episodes continuing into adulthood, and suicidality. These risks make it imperative to develop effective treatments to address adolescent depression. Stepped care is an approach to treatment which involves treatment of illness using the least invasive measures first and moving toward more invasive treatment as indicated by ongoing assessment. Through a single-participant design, the current …

Impact Of Participating In A Short-Term Intervention Model Of Sports Education Camps For Children With Visual Impairments, John Michael Mcmahon

Dissertations

This three-paper format dissertation explores three topics relevant to participating in a short-term model Sports Education Camp for youth with vision impairments. The three papers are independent studies, yet build upon each other by first measuring physical performance in certain skills, then exploring their levels of self-perception, body mass index, and level of physical activity in their local communities, and finally describing the population of participants at various points over a 25-year period. Papers one and two examined differences in pre- and post-camp measures for first-time and repeat participants, with the first paper focusing on physical performance, and the second …

Discovery And Characterization Of A Tanapoxvirus Encoded Human Neuregulin Mimetic, David Jeng

Dissertations

Studies on large dsDNA viruses such as poxviruses have been helpful in identifying a number of viral and cellular growth factors that contribute to our broad understanding of virus-host interaction. Orthopoxviruses and leporipoxviruses are among the most studied viruses in this aspect. However, tanapoxvirus (TPV) a member of the genus Yatapoxvirus, still remains largely unexplored, as the only known hosts for this virus are humans and monkeys. Here, we describe the initial characterization of an EGF-like growth factor mimicking human neuregulin from TPV, expressed by the TPV-15L gene. Assays using a baculovirus expressed and tagged TPV-15L protein demonstrated the ability …

A Discursive Analysis Of A Pregnancy Center: How Pregnant Women Are Encouraged To Develop A Sense Of Self-Worth And Emotional Wellbeing Through The Use Of Rhetoric And Imagery, Jessica Postma

Masters Theses

This study presents and alternative approach to how pregnancy is interpreted in western society and how settings such as a pregnancy center both challenges and reinforces these social standards. The promotion of abstinence, the aversion to abortion, notions of truth and morality, religious narratives, and the standard of care are all integral components to this analysis of pregnancy, language, and culture.

Explicit Teacher-Implemented Phoneme Awareness Instruction: Preschool Effects, Heather M. Osterhouse

Masters Theses

The purpose of the current study was to investigate the impact of explicit, concentrated, teacher-implemented phonological awareness instruction for ―at risk‖ 4- year-olds. Early childhood educators were trained to implement a 10-week program delivered for 20-minute sessions, four times a week, in their classrooms. The program focused on phonological awareness beginning at the level of letter-sound knowledge and advancing to blending and segmenting constituent phonemes in words. Pre- to post-treatment comparisons of phonological awareness and letter knowledge skills indicated that children in the experimental group made significant gains in comparison to the control group in phoneme blending and letter knowledge. …

An Examination Of Executive Function, Mild Cognitive Impairment And Fall Risk In Community Dwelling Older Adults, Jennifer A. Blackwood

Dissertations

The aim of this three-paper dissertation was to examine the relationship between fall risk, executive function (EF) and mild cognitive impairment (MCI) in community dwelling older adults. Papers one and two describe how mild changes in cognition influence performance on four measures of fall risk, the Five Times Sit to Stand Test (FTSTS), usual gait speed, the Timed Up and Go (TUG) test, and the Activities Specific Balance Confidence Scale (ABC) in a group of community dwelling older adults. The third paper describes if participation in a progressively challenging domain specific computerized cognitive training intervention influenced performance on measures of …

A Prospective Examination Of Mindfulness Training On The Mitigation Of Postraumatic Stress Symptoms, Abby E. Blankenship

Dissertations

The current study investigated the ability of a one-session computerized mindfulness intervention to mitigate posttraumatic stress disorder (PTSD)-like symptoms in response to a trauma analogue. Ninety-two participants were randomly assigned to either mindfulness training or no treatment. Participants assigned to the mindfulness training completed a 1-hour computerized mindfulness training and practiced their skills for 1 week. All participants were exposed to an analogue for real-life trauma and were assessed at 1- and 2-week follow-up. Participants assigned to the mindfulness condition exhibited significantly lower levels of PTSD-like symptoms at 2-week follow-up in comparison to the no treatment condition. In addition, participants …

Relations Between Oral Pharyngeal Size And Kinematic Measures Of Tongue Related Swallowing Movements, Danielle Monast

Honors Theses

Background: Though the tongue plays a critical role during the oral phase of swallowing, studies have found that the size and shape of tongue movements during swallowing can vary greatly among individuals. One factor that may contribute to this movement variability is oral-pharyngeal cavity geometry. A cavity with a different size and shape may require different movements for efficient swallowing. While there are a number of studies that have attempted to relate the oral-pharyngeal anatomy with features of orofacial movement, these studies focused on speech movements and no studies have directly evaluated the relation between swallowing related tongue movements and …

Crizotinib: A Tyrosine Kinase Inhibitor, Graham Mclaren

Honors Theses

Crizotinib is a small molecule tyrosine kinase inhibitor that is currently being marketed by Pfizer under the trade name Xalkori^®. After its development in 2005, an appropriate target was discovered in 2007. By 2011 the FDA had approved crizotinib for use in patients with ALK+ non small cell lung cancer (NSCLC). ALK+ NSCLC is caused by a genetic mutation that truncates and flips a section of the EML4 gene and attaches it to a section of the ALK gene. The result is the EML4-ALK oncogene. The resulting protein from this mutation is capable of undergoing ligand independent dimerization, …

Interdisciplinary Health Fair And The Tendencies Of Young Adults To Receive Follow-Up Health Care, Kaelyn Monroe

Honors Theses

The following proposal outlines the planning, implementation, and follow-up regarding an organized health fair that aims to promote healthy lifestyle in a minority population. The health fair will be conducted on October 9' 2012 at Climax Scott's Alternative High School. The populations addressed through this project include: 60 students ranging from 16-19 years of age, 30 individuals 19 years or older and 10 teachers. The health fair will be organized by three senior-level Bronson School of Nursing students: Alexandra Scheidt, Abby Smith, and Kaelyn Momoe. The thesis project committee consists of: Dr. Sally Vliem, Professor Wendy Kershner, and Professor Alice …

A Comparison Of Caregiver And Speech-Language Pathologist's Ratings Of Speech Outcome In Oral Cleft Clinic, Emily Swain

Honors Theses

Background: Cleft lip and/or palate is one of the most common congenital anomalies. The goal of treatment of cleft palate is normal speech, but a proportion of children with clefts exhibit speech disorders. Various outcome measures are used, but relatively few have focused on self-assessment or caregiver perception of outcome. The studies that have been done focus on comparing parents' and speech-language pathologists' ratings of speech outcome. These studies can be used to determine the degree to which caregivers are satisfied with speech outcome over time.

Purpose: The purpose of this study was to describe the relationship between speech ratings …

Interdisciplinary Health Fair And The Tendencies Of Young Adults To Receive Follow-Up Health Care, Alexandra Scheidt

Honors Theses

The following proposal outlines the planning, implementation, and follow-up regarding an organized health fair that aims to promote healthy lifestyle in a minority population. The health fair will be conducted on October 9' 2012 at Climax Scott's Alternative High School. The populations addressed through this project include: 60 students ranging from 16-19 years of age, 30 individuals 19 years or older and 10 teachers. The health fair will be organized by three senior-level Bronson School of Nursing students: Alexandra Scheidt, Abby Smith, and Kaelyn Momoe. The thesis project committee consists of: Dr. Sally Vliem, Professor Wendy Kershner, and Professor Alice …

Residential Treatment Of Adult Women With Eating Disorders, Chelsea Cook

Honors Theses

A qualitative-type study was done in which residents of a residential eating disorder facility were interviewed about their eating disorder and daily life in the treatment center. The Academy of Nutrition and Dietetics uses the Nutrition Care Process which includes Intervention amongst its four steps. This study will look at the intervention of nutrition education and counseling on these residents and relate it back to Social Learning theory.

Eight residents agreed to the study. All participants were female, and ages ranged from 18-38 with an average age of 24.75. The registered dietitian serving the residents was also interviewed. Interviews were …

When Evil Met Science: Nazi Medicine And Eugenics, Ashley Corey

Honors Theses

During World War II, millions of innocent people were murdered in Nazi Germany. For Hitler and his followers, having a pure race meant having a strong, unified country, and Germany took this idea to extreme and disturbing lengths. Corruption filled the government at all levels. As physicians were the only people authorized to run the gas chambers, traditional healers became death symbols. The Nazis and their physicians used their power to manipulate and murder for the collective goals of the country, as well as the personal gains that came with the high-end job titles. As I reveal the history and …

Prevalence Of Pregnancy Folkloric Beliefs Among Nurse-Midwifery Client Populations, Iris Aleece Campbell

Honors Theses

OBJECTIVE: To explore prevalence of pregnancy related folklore beliefs by conducting a survey of CM/CNMs in the United States. Research questions included: What folklore beliefs are most commonly encountered by nurse-midwives? Does the prevalence of folklore beliefs differ by geography? Does the type of folklore beliefs differ by the ethnicity and culture of the nurse-midwifery clientele?

METHODS: After IRB and ACNM approval, a geographically diverse sample of 1,000 active CM/CNM members was sent an invitation email. The survey was developed following a literature review to include 12 pregnancy beliefs. Responders were asked to rate how frequently they heard each (never-I, …