Medicine and Health Sciences Commons^™

Will Clinical Decision Support Mechanisms Reduce The Amount Of Unnecessary Computed Tomography?, Andrea Ciarmello

Dissertations and Theses

Clinical Decision Support Mechanisms (CDSMs) are to patient safety. When used in Radiology, CDSMs can improve radiation dose, quality assurance, and patient care. When paired with the electronic health record, CDSMs provide clinicians with patient-specific data that will help lower healthcare costs and improve patient outcomes. This study demonstrates how introducing clinical decision support mechanisms in electronic health record software will help improve unnecessary CT scans and hinder patient radiation exposure. The ordering physician can now consistently and reliably choose the proper scan each time.

Patient Frailty: A Review, Lakshmi Sailaja Kodavati

Dissertations and Theses

According to Geriator (2011), frailty is a common clinical syndrome in older adults that carries an increased risk for poor health outcomes such as falls, incident disability, hospitalization, and mortality. An operational definition of frailty is the existence of at least three out of five observable criteria indicating compromised energetics: low grip strength; low energy; slowed walking speed; low physical activity; and unintentional weight loss (Fried, et al. 2001).

According to Dubois and Charpillet (2017), most transitions into frailty are due to unintentional weight loss which, in turn, impacts gait performance and subsequent general mobility. In this literature review, the …

Identification Of Adhd And Comorbid Disorders In Children: The Potential Role Of Minority Group Membership, Rachel H. Tayler

Dissertations and Theses

Identification of ADHD and Comorbid Disorders in Children: The potential role of minority group membership

by

Rachel Tayler, MSc, MA

Advisor: Sarah O’Neill, PhD

Attention-Deficit/Hyperactivity Disorder (ADHD) affects six million US children. Females, Latinx, and possibly Black children have lower rates of diagnosis than their Male and White non-Latinx peers. ADHD is behaviorally defined, and as such, clinicians' perceptions of symptoms and determination of diagnoses may be influenced by demographic factors such as race, ethnicity and sex.

This vignette study examined whether clinicians' implicit ethnic, racial, and sex biases affect diagnosis of ADHD and comorbid conditions. Psychiatry trainees and pediatricians …

Finding Trends In Big City Health Issues With Data Visualization, Shridhar Kulkarni

Dissertations and Theses

In recent years, data visualization has become one of the most effective tools to understand and identify unseen features of the large datasets available. An open source data set available for health issues for big cities across the United States was obtained. There are numerous indicators presented in the dataset including Demographics, Chronic Health Diseases, Social and Economic Factors, Food Safety, Mortality Rates, Cancer and Life Expectancy Rates. The dataset encompassed myriad of demographics as well as specific data for a number of US cities. The data was explored in different methods in Data points in terms of the demographic …

Digital Dentistry- The Future Of Oral Health, Vidhi Shah

Dissertations and Theses

Background and objective: In the digital world, dentistry appears to be at least a decade behind in adopting the latest technologies in comparison to consumer electronics, biomedical engineering and aeronautics. However, recently, dental professionals have experienced the evolution of the dental profession as technological growth. Digital dentistry is the future of dentistry, and it will be essential to adopt and integrate technology into practice to improve the quality of care. The new generation of digital dentistry opens the exploration of innovations and advancement in technologies which will dramatically impact and improve all of dentistry. The objective of this paper is …

Towards Wide Implementation Of Dance Therapy In Mental Health, Pin-Wen Chou

Dissertations and Theses

In recent years, Dance Movement Therapy (DMT) has been increasingly mentioned in the field of mental health counseling. Despite the progress of DMT in terms of studies showing its efficiency for various forms of mental health conditions such as depression and trauma, the implementation of DMT amongst mental health therapists is still not as widespread as other forms of therapies such as verbal and art therapies. In this project, we aim to determine the underlying causes of its low implementation by surveying a set of populations, specifically mental health patients, mental health therapists that do not specialize in dance/movement therapy, …

Physical Therapy With Adjunct Therapies In Patients With Chronic Pain And Disability Post-Motor Vehicle Accidents, Lakshmi Subramanian

Dissertations and Theses

This project is a thorough literature review of studies concerning physical therapy interventions in conjunction with adjunct treatments for patients post-motor vehicle accidents focused on the therapy’s efficacy as related to functional outcome measures. Physical therapy is frequently treatment of choice for patients after minor motor vehicle accidents. However, most patients seek concomitant therapies like acupuncture, chiropractic, epidural steroid injection, and psychological counselling. This paper seeks to gather data on the efficacy of different treatment modalities when used in conjunction with each other. Often patients are traumatised or develop anxiety about driving requiring counselling and therapy. The vast majority of …

Can The Kanban Technique Reduce Medical Errors?, Juhi Hegde

Dissertations and Theses

This study discusses common medical errors and the extent of harm caused in the United States and explores the application of the Kanban technique of Lean Management in the healthcare industry to reduce medical errors. It also describes various scenarios of how the visual scheduling/ signaling system has been incorporated for continuous process improvement in the clinical and non-clinical sectors of the industry based on several review articles. Furthermore, a survey study was performed in order to assess whether ‘Kanban Visual Management System’ utilization in healthcare has the ability to reduce medical errors. A convenience sample of healthcare providers was …

Chronic Migraine: Role Of Cgrp Antagonists And Botox, Gabriella Hassan

Dissertations and Theses

Chronic migraine (CM) is characterized by the International Headache Society classification (ICHD-3) as headache that occurs for greater than or equal to 15 days a month, lasting 4 or more hours. For chronic migraine patients, the goal with prophylactic treatment is to prevent future attacks and reduce the migraine frequency and severity. OnabotulinumtoxinA is the most universally accepted medication for the treatment of chronic migraine; and if successful, reduces migraine frequency up to 50%. The goal of CGRP (Calcitonin-gene-related peptide) antagonists is to reduce the frequency of chronic migraines by targeting the CGRP protein that is elevated during a migraine …

Perception Of Healthcare Providers On Mirror Therapy For Stroke, Dhwani Kamlesh Doshi

Dissertations and Theses

Stroke is a very important health problem faced worldwide with high mortality and incidence. The majority of stroke survivors suffer temporary or permanent disabilities of which hemiparesis is one of the most common. Hemiparesis makes it difficult for patients to perform their activities of daily living and often they have declining quality of life. Mirror therapy (MT) is a an inexpensive, easy and safe intervention which has been proven to be very effective to improve the motor function in hemiparetic stroke. Despite this, it is not often employed. Hence, the purpose of this study was to explore the awareness and …

Analysis Of Delays In Processing Times In An Ophthalmology Clinic, Kai Yung Natalie Lui

Dissertations and Theses

Efficiency is an important component of any medical practice. It facilitates quality care, reduction in wait time, patient and staff satisfaction, and decreased cost. The purpose of this study was to identify bottlenecks in the current processing system in the Eye Center at Hershey Penn State Medical Center. Data was obtained about patients arriving at the clinic for ancillary tests such as visual field testing and retinal imaging. Analysis of this data revealed a statistically significant longer average length of visit for patients who received testing in comparison to those who did not. However, due to the small sample size …

Study Of Satisfaction Of Inpatient Discharge Based On Nurses’ Perceptions, Hong Lin

Dissertations and Theses

Patient satisfaction plays an important role in providing quality health care, and discharge satisfaction is part of overall patient satisfaction since it reveals how patients feel about their stay. In this paper, we evaluated inpatient discharge satisfaction based on nurses’ perceptions. An anonymous survey was used to evaluate how satisfied the patients were when being discharged from the acute care hospital with survey questions answered by nurses who work on medical-surgical floors. Data was collected from the questionnaires and analyzed using Excel.

Mechanisms Of Value-Biased Prioritization In Fast Sensorimotor Decision Making, Kivilcim Afacan-Seref

Dissertations and Theses

In dynamic environments, split-second sensorimotor decisions must be prioritized according to potential payoffs to maximize overall rewards. The impact of relative value on deliberative perceptual judgments has been examined extensively, but relatively little is known about value-biasing mechanisms in the common situation where physical evidence is strong but the time to act is severely limited. This research examines the behavioral and electrophysiological indices of how value biases split-second perceptual decisions and the possible mechanisms underlying the process. In prominent decision models, a noisy but statistically stationary representation of sensory evidence is integrated over time to an action-triggering bound, and value-biases …

Electrode And Headgear Design For Accurate Tdcs, Henry Bernstein

Dissertations and Theses

Stimulating the brain with a low current that is focused on specific regions of the brain has been shown to modify brain function and treat various neurological diseases. Transcranial direct current stimulation (TDCS) has been an effective and life changing alternative treatment for a vast range of neurological conditions including depression, epilepsy, stroke rehabilitation, addiction and chronic pain but only if it is administered correctly. During TDCS, a weak constant current is applied to precise locations on the scalp to modulate brain activity. Those locations can be determined by the cumbersome 10-20 EEG measurement system, transcranial magnetic stimulation or neuronavigation. …

Taurine's Effect On Cocaine Reward And Neurogenesis In The Adolescent Male Rat Brain., Avery E. Villa-Gonzalez

Dissertations and Theses

Adolescence is a developmentally critical transition from childhood to adulthood including both maturation of the body and the brain. Neuroplastic changes result in dynamic organization of the brain during adolescence, leaving them vulnerable to development of mental illness and drug-seeking behavior. According to the United Nations Office on Drugs and Crime, the psychostimulant cocaine is the second most popular illicit drug in the world. Cocaine, amongst having many detrimental effects, has shown to also decrease hippocampal neurogenesis, resulting in decreased neuroplasticity and cognitive dysfunction. Previous students in our laboratory have shown that treatment of adult male rats with the essential …

Investigations Into The Effects Of Water Exchange And The Structure Of Lanthanide Chelates, Katherine Marie Payne

Dissertations and Theses

Lanthanide chelates are effective agents for improving contrast in MR images. Optimizing the relaxation of inner sphere water molecules is a common focus of research in this field. However, the efforts to design an optimal contrast agent have commonly over-looked the relationship of water position and water exchange kinetics. This work explores structural conformation, the impact of very fast water exchange kinetics on hydration, and differing tumbling rates for regioisomers of a number of lanthanide chelates. We have grown crystals of LnDOTMA and obtained structural data by X-ray diffraction that provide a picture of the chelate during water exchange and …

Investigation In To The Effect Of Spin Locking On Contrast Agent Relaxivity, Julian Saunders Haigh

Dissertations and Theses

The current trend in magnetic resonance imaging (MRI) is towards higher external magnetic field strengths (B₀) to take advantage of increased sensitivity and signal to noise ratio (SNR). Unfortunately, as (B₀) increases the effectiveness (relaxivity) of clinical gadolinium (Gd³⁺⁾-based contrast agents (CAs) administered to enhance image contrast is significantly reduced. Excellent soft tissue contrast can be generated with current agents despite their non-optimum relaxivities but necessitates large doses. The limits of detection of a CA at high B₀ fields can be lowered by recovering the lost relaxivity and is a pre-requisite to the …

Facile Methods For The Analysis Of Lysophosphatidic Acids In Human Plasma, Jialu Wang

Dissertations and Theses

Lysophosphatidic acid (LPA) influences many physiological processes, such as brain and vascular development. It is associated with several diseases including ovarian cancer, breast cancer, prostate cancer, colorectal cancer, hepatocellular carcinoma, multiple myeloma atherosclerotic diseases, cardiovascular diseases, pulmonary inflammatory diseases and renal diseases. LPA plasma and serum levels have been reported to be important values in diagnosing ovarian cancer and other diseases. However, the extraction and quantification of LPA in plasma are very challenging because of the low physiological concentration and similar structures of LPA to other phospholipids. Many previous studies have not described the separation of LPA from other phospholipids, …

Selective Indicators For Optical Determination Of Disease Biomarkers, Lovemore Hakuna

Dissertations and Theses

The most abundant biological thiols, homocysteine (Hcy), cysteine (Cys) and glutathione (GSH) have been the subject of intense research due to their association with a wide range of diseases. They play a key role in maintaining the redox status of biological systems. Selective detection methods for these thiols are challenging due to their similar structures and properties. Current commercially available detection methods use separations, fragile and expensive enzymatic or immunogenic materials and complex instrumentation. This has led to a global effort towards developing simple and inexpensive optical probes and indicators selective for specific biological thiols.

Highly selective chemical probes and …

Detection Of Homocysteine With Bridged Viologen Chemical Probes, Davin Rautiola

Dissertations and Theses

Increased blood plasma concentrations of the aminothiol homocysteine (Hcy) are associated with a variety of disease states including those which cause impaired renal function, many forms of cardiovascular disease, and neurodegenerative diseases such as Alzheimer's. Therefore, Hcy has the potential to be a significant diagnostic biomarker. Routine monitoring of Hcy plasma concentration is encumbered by the time and resources required to quantify Hcy using currently accepted instrumental analysis methods. As part of the continuing effort to develop a quick, reliable, inexpensive, and user-friendly test to quantify Hcy at the point of care, we have designed a series of novel colorimetric …

Bismuth Nanoparticles As Medical X-Ray Contrast Agents: Synthesis, Characterization And Applications, Anna Laura Brown

Dissertations and Theses

Bismuth based nanomaterials have recently attracted attention as heavy element X-ray contrast agents because of the high atomic number and predicted biological compatibility of bismuth. Nanoparticle X-ray contrast agents may enable a number of novel medical imaging applications, including blood pool and site-directed imaging. However these hypothetical applications are hindered by lack of suitable synthetic methods for production of imaging agents. This dissertation describes synthesis of a novel class of bismuth nanoparticles that are aqueously stabilized using poly and monosaccharides. These particles are synthesized using highly biologically compatible reagents and are oxidatively stable in water and in moderately basic buffered …

Investigation Of The Structure And Dynamics Of Regioisomeric Eu³⁺ And Gd³⁺ Chelates Of Nb-Dotma: Implications For Mri Contrast Agent Design, Benjamin Charles Webber

Dissertations and Theses

The detection of disease and abnormal pathology by magnetic resonance imaging (MRI) has been aided significantly by the use of gadolinium (Gd³⁺)-based contrast agents (CAs) over the past three decades. MRI and MRI CAs play a critical role in diagnosing tumors and diseases of the central nervous system. The agents used clinically have been shown to safely increase MRI contrast despite the toxicity of Gd³⁺, owing to the high kinetic and thermodynamic stability of these chelates. However, current CAs enhance contrast at a small fraction of what is theoretically possible. This leads to the necessity of …

Automated Channel Assessment For Single Chip Medradio Transceivers, Mark Alexander Hillig

Dissertations and Theses

Modern implantable and body worn medical devices leverage wireless telemetry to improve patient experience and expand therapeutic options. Wireless medical devices are subject to a unique set of regulations in which monitoring of the available frequency spectrum is a requirement. To this end, implants use software protocols to assess the in-band activity to determine which channel should be used. These software protocols take valuable processing time and possibly degrade the operational lifetime of the battery. Implantable medical devices often take advantage of a single chip transceiver as the physical layer for wireless communications. Embedding the channel assessment task in the …

Development And Implementation Of Acoustic Feedback Control For Scanning Probe Microscopy, Rodolfo Fernandez Rodriguez

Dissertations and Theses

A remote-sensing acoustic method for implementing position control feedback in Scanning Probe Microscopy (SPM) is presented. The capabilities of this feedback control using the new Whispering Gallery Acoustic Sensing (WGAS) method is demonstrated in a Shear-force Scanning Probe Microscope that uses a sharp probe attached to a piezoelectric Quartz Tuning Fork (QTF) firmly mounted on the microscope's frame. As the QTF is electrically driven its mechanical response reaches the SPM frame which then acts as a resonant cavity producing acoustic modes measured with an acoustic sensor strategically placed on the SPM head. The novelty of the WGAS resides in using …

Investigation Of Blood Pressure Measurement Using A Hydraulic Occlusive Cuff, Kusha R. Bhattarai

Dissertations and Theses

This thesis presents an improved oscillotonometric system for the measurement of human blood pressure. The study included:

1. The design of a hydraulic occlusive cuff,

2. The investigation of the wave forms taken from the blood pressure measurements, and

3. The design of a mechanism for the simulation of human blood pressure pulse.

In this study, an experimental system consisting of a rigid shell occlusive cuff, a constant volume displacement pump, a transducer, and a chart recorder was designed and used for data collection.

Psychodrama And The Terminal Patient : Concepts And Application, Marilyn Jacobs Bohan

Dissertations and Theses

This study examines the concepts of psychodrama and dying, death and bereavement that effectively meet individual needs for working through grief. It is the premise of this thesis that the working through grief to foster acceptance, self-worth and dignity, in the final st.age of life, is facilitated by psychodramatic methods of "acting through" the problems of the situation.