Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

The Importance Of Managing Psychosocial Health: A Case Study, Mary Insana Fisher, Harold L. Merriman

Mary Insana Fisher

Managing the physical aspects of lymphedema requires an individual to be committed to daily treatment of this chronic condition. Performing manual lymph drainage, using compression bandaging or compression garments, exercising, and caring for the skin all take time and a high level of dedication. This commitment to self-care can be emotionally and psychologically exhausting. When coupled with other emotional stressors in a patient’s life, successful treatment of lymphedema is challenging. We present a case demonstrating how the physical and psychological aspects of care interplay, and, when well-managed, can positively affect the outcome.

A Comparison Of The Upper Limb Lift Test Between Women With Breast Cancer And Healthy Control Subjects, Mary Insana Fisher, Lucinda Pfalzer, Ellen W. Levy, Shana Harrington, Lynn H. Gerber, Nicole L. Stout

Mary Insana Fisher

Presentation at the World Confederation for Physical Therapy Congress, held May 1-4, 2015, in Singapore. Background: Objective measures of upper limb (UL) function specific to breast cancer survivors (BC) are limited. Motion, strength, and muscular endurance are measurable components of UL function. A clinical test that quantifies these components is needed. Purpose: This study compares the Upper Limb Lift Test (ULLT) between women with BC and healthy control subjects (HC) at baseline, 1-3 months, and 12+ months post-operatively enrolled in a prospective surveillance trial with early intervention. A secondary purpose was to validate the ULLT by comparing findings to self-reported …

Oncology Section Task Force On Breast Cancer Outcomes: An Introduction To The Edge Task Force And Clinical Measures Of Upper Extremity Function, Pamela K. Levangie, Mary Insana Fisher

Mary Insana Fisher

With the proliferation of outcome measures in the literature, many of which lack documentation of sufficient psychometric properties to justify use, it is difficult to document patient change or demonstrate effectiveness of interventions. The goal of the Section on Research’s EDGE (Evaluation Database to Guide Effectiveness) Task Force is to facilitate identification of valid and reliable tests and measures that reflect clinically important outcomes and are responsive to change for standard use across selected patient groups. This paper lays the groundwork for understanding the work of the Oncology Section’s Breast Cancer EDGE Task Force on clinical measures of shoulder function …

The Power Of Empowerment: An Icf-Based Model To Improve Self-Efficacy And Upper Extremity Function Of Survivors Of Breast Cancer, Mary Insana Fisher, Dana Howell

Mary Insana Fisher

Breast cancer is one of the most frequently diagnosed cancers among women. Breast cancer treatments often negatively impact the function of the arm, and quality of life and upper extremity function does not always return to a prediagnosis level. Survivors of breast cancer may also experience feelings of diminished self-efficacy related to functional deficits resulting from their physical limitations. The International Classification of Functioning (ICF) provides a framework for rehabilitation practitioners to address physical and psychological impairments, activity limitations, and participation restrictions. Patient outcomes may be improved by fostering self-efficacy through empowerment. This paper explores how the ICF model and …

The Association Between Critical Thinking And Scholastic Aptitude On First-Time Pass Rate Of The National Physical Therapy Examination, Daniel W. Suckow, C. Jayne Brahler, Betsy Donahoe-Fillmore, Mary Insana Fisher, Philip A. Anloague

Betsy Donahoe-Fillmore

Objectives: 1) To investigate the relationships among critical thinking (CT) abilities, overall academic performance in the Doctorate of Physical Therapy (DPT) program as measured by cumulative grade point average (GPA), and National Physical Therapy Examination (NPTE) licensure scores, and 2) To determine if NPTE scores were significantly different between groups of students who were classified as having low, moderate or high CT abilities. Background: It is well-established that physical therapy practice requires good clinical reasoning skills. Passage of the NPTE is required for licensure. Research to date has been mixed as to whether CT abilities or GPA can predict success …

The Effects Of Home-Based Pilates In Healthy College-Age Females, Betsy Donahoe-Fillmore, Mary Insana Fisher, C. Jayne Brahler

Betsy Donahoe-Fillmore

Objectives: To quantify and determine the effects of Pilates on core endurance, hamstring flexibility, balance, body composition/mass and perceived stress level in healthy college age females. Study Design: Randomized controlled trial design. Background: Emerging research on the Pilates technique is inconclusive regarding benefits to core endurance, flexibility, balance, body mass, and perceived stress. Methods and Measures: Female college students (n=57; 18-35 years old) were randomly assigned to a Pilates group, who exercised at home with a DVD, or a control group who did not engage in Pilates practice. Core endurance, hamstring flexibility, balance, body composition and stress measurements were taken …

A Novel Caspase 8 Selective Small Molecule Potentiates Trail-Induced Cell Death, Octavian Bucur, Gabriel Gaidos, Achani Yatawara, Bodvael Pennarun, Chamila Rupasinghe, Jérémie Roux, Stefan Andrei, Bingqian Guo, Alexandra Panaitiu, Maria Pellegrini, Dale Mierke, Roya Khosravi-Far

Dartmouth Scholarship

Recombinant soluble TRAIL and agonistic antibodies against TRAIL receptors (DR4 and DR5) are currently being created for clinical cancer therapy, due to their selective killing of cancer cells and high safety characteristics. However, resistance to TRAIL and other targeted therapies is an important issue facing current cancer research field. An attractive strategy to sensitize resistant malignancies to TRAIL-induced cell death is the design of small molecules that target and promote caspase 8 activation. For the first time, we describe the discovery and characterization of a small molecule that directly binds caspase 8 and enhances its activation when combined with TRAIL, …

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 …

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 …

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 …

A Comparison Of The Upper Limb Lift Test Between Women With Breast Cancer And Healthy Control Subjects, Mary Insana Fisher, Lucinda Pfalzer, Ellen W. Levy, Shana Harrington, Lynn H. Gerber, Nicole L. Stout

Physical Therapy Faculty Publications

Presentation at the World Confederation for Physical Therapy Congress, held May 1-4, 2015, in Singapore.

Background: Objective measures of upper limb (UL) function specific to breast cancer survivors (BC) are limited. Motion, strength, and muscular endurance are measurable components of UL function. A clinical test that quantifies these components is needed.

Purpose: This study compares the Upper Limb Lift Test (ULLT) between women with BC and healthy control subjects (HC) at baseline, 1-3 months, and 12+ months post-operatively enrolled in a prospective surveillance trial with early intervention. A secondary purpose was to validate the ULLT by comparing findings to self-reported …

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.

Design And Development Of Two Component Hydrogel Ejector For Three-Dimensional Cell Growth, Thomas Dunkle, Jessica Deschamps, Connie Dam

Honors Scholar Theses

Hydrogels are useful in wound healing, drug delivery, and tissue engineering applications, but the available methods of injecting them quickly and noninvasively are limited. The medical industry does not yet have access to an all-purpose device that can quickly synthesize hydrogels of different shapes and sizes. Many synthesis procedures that have been developed result in the formation of amorphous hydrogels. While generally useful, amorphous hydrogels exhibit limited capability in tissue engineering applications, especially due to their viscous properties. This endeavor aims to modulate the appropriate gelation parameters, optimize the injection process, and create a prototype that allows for the extrusion …

Site-Specific Immunomodulator: A Novel Treatment For Crohn's Disease, Brian Bressler, Kevin P. Bethel, Ralf Kleef, Sophie L. Reynolds, Simon Sutcliffe, David W. Mullins, Hal Gunn

Dartmouth Scholarship

We investigated the mechanism of action, safety, and efficacy of the Site-Specific Immunomodulator (SSI) QBECO, a novel immunotherapy for Crohn’s disease (CD). Using human monocytic THP-1 cells, we demonstrate that SSI QBECO (derived from the common colon bacteria E. coli) activates macrophages to an M1 phenotype (associated with enhanced capacity to eliminate bacteria and activate innate immune responses). We assessed SSI QBECO in a compassionate use protocol of ten adult patients with active CD. Patients with moderate to severe clinical symptoms receiving conventional CD treatments and/or complementary therapies were included, except patients receiving anti-TNF medications. SSI QBECO was self-administered subcutaneously …

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 …

Mechanisms Of Bone Loss In Inflammatory Arthritis: Diagnosis And Therapeutic Implications, Steven R. Goldring, Ellen M. Gravallese

Ellen M. Gravallese

Rheumatoid arthritis represents an excellent model in which to gain insights into the local and systemic effects of joint inflammation on skeletal tissues. Three forms of bone disease have been described in rheumatoid arthritis. These include: focal bone loss affecting the immediate subchondral bone and bone at the joint margins; periarticular osteopenia adjacent to inflamed joints; and generalized osteoporosis involving the axial and appendicular skeleton. Although these three forms of bone loss have several features in common, careful histomorphometric and histopathological analysis of bone tissues from different skeletal sites, as well as the use of urinary and serum biochemical markers …

The Role Of Occupational Therapy In The Prevention Of Infant Torticollis & Plagiocephaly, Anne H. Zachry

Faculty Presentations

AOTA includes health promotion as an Intervention approach in the Occupational Therapy Practice Framework: Domain and Process. As health care professionals, occupational therapy practitioners are responsible for promoting public health and wellness. Occupational therapists need to educate parents and caregivers about the importance of varying infant positions, providing tummy time, and limiting infant time spent in baby gear.

Heightened Levels Of Stress And Contributing Factors In Caregivers Of Special Needs Children, Heather Velon

Georgia State Undergraduate Research Conference

No abstract provided.

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, …

Human Issues In Horticulture: A Bibliography, Diana M. Farmer

NPP eBooks

This is a comprehensive bibliography of a rather broad subject area—horticultural therapy. The subject reflects a change in the definition of horticulture as the art and science of growing fruits, vegetables and flowers to include horticulture’s effects on human well-being. The number of citations also reflects the growth and continuing evolvement of this discipline. This bibliography does not include journal articles. It does include monographs, treatises, books, pamphlets, theses, dissertations and media published prior to 2000. The gardening references include a human focus and there are references as well to associated topics such as universal design, accessibility, human perception, environment …

The Preparatory Set: A Novel Approach To Understanding Stress, Trauma, And The Bodymind Therapies, Peter Payne, Mardi A. Crane-Godreau

Dartmouth Scholarship

Basic to all motile life is a differential approach/avoid response to perceived features of environment. The stages of response are initial reflexive noticing and orienting to the stimulus, preparation, and execution of response. Preparation involves a coordination of many aspects of the organism: muscle tone, posture, breathing, autonomic functions, motivational/emotional state, attentional orientation, and expectations. The organism organizes itself in relation to the challenge. We propose to call this the "preparatory set" (PS). We suggest that the concept of the PS can offer a more nuanced and flexible perspective on the stress response than do current theories. We also hypothesize …

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 …

Validation Of A 5k Age And Weight Run Handicap Model, Paul M. Vanderburgh, Lloyd L. Laubach

Paul M. Vanderburgh

Though increasing age and body weight (BW) have been widely known to be associated with slower distance run times, the common convention in 5K road races is to categorize competitors by age and, sometimes, BW. This has the disadvantage of assigning only small numbers of competitors to age categories and giving advantage to runners close to the minimum age or BW values allowable. Using recent advances in the modeling of distance run performance by BW combined with empirical evidence quantifying the independent effect of age on cardiovascular endurance, we previously published the derivation of the 5K Handicap (5KH), an age …

Body Weight Penalties In The Physical Fitness Tests Of The Army, Air Force, And Navy, Paul M. Vanderburgh, Todd A. Crowder

Paul M. Vanderburgh

Recent research has empirically documented a consistent penalty against heavier service members for events identical or similar to those in the physical fitness tests of the Army, Air Force, and Navy. These penalties, not related to body fatness, are based on biological scaling models and have a physiologic basis. Using hypothetical cases, we quantified the penalties for males, 60 vs. 90 kg body weight, and females, 45 vs. 75 kg, to be 15-20% for the fitness tests of these three services. Such penalties alone can adversely impact awards and promotions for heavier service members. To deal equitably with these penalties …

Body Mass Bias In A Competition Of Muscle Strength And Aerobic Power, Paul M. Vanderburgh, Lloyd L. Laubach

Paul M. Vanderburgh

Recently, a fitness competition called the Pump and Run (PR) has been popularized. Composed of 2 events, a 5-km road race time (RT) in seconds and a maximal-repetition bench press (BPR) with resistance based on a percentage of body mass (M), the final score (RTadj) equals RT - 30(BPR). From published findings, the authors hypothesized that the PR would impose a bias against heavier competitors. Furthermore, the potential for age bias in this event has not been evaluated. Therefore, the purpose of this study was to investigate M and age bias in the PR for men and women. For 74 …

Correction Factors For Body Mass In Military Physical Fitness Tests, Paul M. Vanderburgh

Paul M. Vanderburgh

Recent research findings combined with the theoretical laws of biological similarity make the compelling case that all physical fitness test items for the Army, Air Force, and Navy impose a 15-20% physiologic bias against heavier, not fatter, men and women. Using the published findings that actual scores of muscle and aerobic endurance scale by body mass raised to the 1/3 power, correction factor tables were developed. This correction factor can be multiplied by one’s actual score (e.g., push-ups, sit-ups, abdominal crunches, or curl-ups repetitions or distance run time) to yield adjusted scores that are free of body mass bias. These …