Medicine and Health Sciences Commons^™

Incidence, Clinical Manifestations And Risk Factors Of Acute Rheumatic Fever: A Systematic Review And Meta-Analysis Of The Global Perspective, Jessica Fritzler

Masters Theses

Acute Rheumatic Fever (ARF) is a system-wide disease in which chronic, wide spread inflammatory changes occur in response to a group A streptococcal (GAS) infection that most often affects children and adolescents and those from developing countries. The aim of this study is to calculate the global incidence of ARF and identify the frequencies of major and clinical manifestations and risk factors globally to provide a better indication of the burden of disease and additional information on the dispersion of manifestations and risk factors. A meta-analysis was conducted by pooling cross-sectional and cohort studies, and Morbidity and Mortality Weekly Reports …

The Effect Of Dietary Specialism And Generalism On Evolutionary Longevity In An Early Paleogene Mammalian Community, Samantha Glonek

Masters Theses

This study examines the relationship between relief index (RFI) on first and second mandibular molars and longevity of the genus. The molars were extracted from small-bodied, arboreal mammals during the late-Paleocene, early-Eocene in the Bighorn Basin in Wyoming. This study site is a well-known location to research and study fossil mammals of this time period. The study was conducted and analyzed at the genus level due to the relatively small number of specimens available and identifiable at the species level. Dietary breadth, or how broad or narrow a dietary preference is for a mammal, is an area of concentration within …

Role Of Race/Ethniciy, Pre-Pregnancy Bmi, And Socioeconomic Status On Risk For Large-For-Gestational (Lga) Infants Born To Women With Gestational Diabetes Mellitus (Gdm), Anna M. Kiefer

Masters Theses

Background Fetal macrosomia occurs in approximately 10% of all pregnancies taking place in the United States. Babies born LGA are placed at a greater risk for shoulder dystocia, perinatal trauma, cesarean section, jaundice, hypoglycemia, and neonatal intensive care admission. Even more, the long-term impacts are severe and include increased risk of becoming overweight or obese and developing type 2 diabetes later in life. Women with gestational diabetes mellitus (GDM) have higher rates of delivering macrosomic offspring due to insulin resistance taking place beyond what is normal during a pregnancy. Additionally, maternal obesity, socioeconomic status, and race/ethnicity have been associated with …

Influence Of Socioeconomic Status On Event-Free Survival In Children Diagnosed With Acute Lymphoblastic Leukemia, Jordan L. Chester

Masters Theses

Acute lymphoblastic leukemia (ALL) is the most common type of cancer diagnosed in children. However, little is known about how socioeconomic status (SES) influences the outcomes of children diagnosed with ALL. The goal of the research study was to understand how SES impacted the outcomes of children diagnosed with ALL, with a particular interest in children living in West Michigan. Children ages 0-14 years who received treatment for ALL at Spectrum Health’s Helen DeVos Children’s Hospital’s Pediatric Hematology and Oncology program between the years 2002-2011 were considered for this study. Eligible participant’s zip codes and dates of relapse/death were obtained …

The Role Of Affective Forecasting And The Impact Bias In Nutritional Health Behaviors, Matthew D. Fallon

Masters Theses

Previous literature on affective forecasting has studied its role in health decisions, but there is little research investigating affective forecasting in diet choices and eating behaviors. The present study collected affective forecasts from 43 college participants before eating an indulgent snack and then observed emotions immediately after eating the snack. We predicted that emotion predictions would be significantly stronger than observed emotions, in support of previous literature on the impact bias. We also predicted that optimism would predict a stronger impact bias and that extraversion and neuroticism would have a role in forecasts and observed emotions. Contrary to our hypothesis, …

Assessing The Potential Benefits Of Recreational Therapy On Functioning Outcomes, Samantha R. Lamkin

Masters Theses

Background: The aim of recreational therapy, like all rehabilitation therapies, is to promote the functionality and well-being of a person with disability. However, unlike other forms of therapy, recreational therapy utilizes a unique approach to rehabilitation by incorporating meaningful daily life activities into the patient’s individualized rehabilitation plan. Gains in functionality can be quantified using a Likert scale measurement Functional Independence Measures (FIM®). Previously conducted research shows a positive association between recreational therapy services and functionality gains in specific populations of persons with disability with stroke, traumatic brain injury, and spinal cord injury being most heavily represented. Problem: Research gaps …

Effects Of Aging And Dietary Phytoestrogens On Sperm Production In Sprague Dawley Rats, Brian Cutler

Masters Theses

Estrogens, in addition to testosterone, are physiologically relevant to normal sperm production in the testis and sperm maturation in the epididymis. Previous studies from our lab demonstrated that daily sperm production declines from 15 to 18 months of age in Sprague Dawley rats, and treatment with estrogen during this period attenuated the age-associated decline. Phytoestrogens are present in standard rodent diets at high levels (350-650 mg/kg) and may be potential endocrine disruptors. The purpose of this study was to investigate the effect of removing dietary phytoestrogens during aging on sperm production. Retired breeder Sprague Dawley rats were obtained at 9 …

Midwives For Haiti: Process Evaluation, Denielle M. Riley

Masters Theses

The reduction of maternal mortality is a long-time international objective. One often underemphasized component of addressing complex and context-driven health problems, such as maternal mortality, is the importance of program evaluation. Program evaluation has been identified as particularly scarce among safe motherhood initiatives, which seek to reduce maternal deaths and improve the health outcomes of mothers (Freedman et al., 2007). Useful program evaluation starts with process evaluation. This study is a case study process evaluation of postpartum data collection, which utilizes interviews, observations, and document review. The purpose of this study was to evaluate, describe, and compare the intended and …

The Role Of Metastasis Suppressor Cd82 In The Deactivation Of The C-Met Signaling Pathway In Prostate Cancer, Katie L. Uhl

Masters Theses

BACKGROUND AND PURPOSE: Prostate cancer is the second leading cause of cancer deaths among men in the United States. Metastasis plays a major role in patient prognosis and treatment options. One of the factors that influences metastasis is the activation of the c-Met signaling pathway. Activation of the growth factor c-Met results in cytoskeletal rearrangement, migration, and invasion. Previous studies have shown CD82 to act as an active metastatic suppressor in normal, healthy cells and is downregulated in various forms of cancer. When CD82 is re-expressed in cancer cells, the cells no longer express metastatic characteristics. The purpose of this …

Vascular Effects Of Dietary Supplement Bmpea On Mesenteric Porcine Vasculature, Clifford Cooper

Masters Theses

β-methylphenylethylamine (BMPEA) was first synthesized in the 1930’s as a potential stimulant and amphetamine replacement. It was expected to act as an indirect sympathomimetic agent that binds to peripheral α- and β- adrenergic receptors to control vascular responses in peripheral sites. The effects of BMPEA were never studied in humans, but due to its structural similarity to amphetamines as well as the effects noticed in animal studies in the 1920’s and 1930’s, BMPEA was assumed to work as a vasoconstrictor. In the current study, porcine mesenteric arteries were used as a model following confirmation of arterial viability with the known …

Effect Of Michigan State-Funded Child And Adolescent Health Center (Cahc) In Directing The Health And Wellness Of West Michigan's Oakridge School District, Amber M. Bytwerk

Masters Theses

School-based health centers are an integrated and proactive resource to promote health and wellness of students, as well as the surrounding community. Literature shows that the number of school-based health centers are steadily increasing across America, with few looking at their integration into the population. Within West Michigan, only two such clinics are operational. Applying data from the Michigan Profile for Healthy Youth (MiPHY) and primary data collected from school staff and administrators, an evaluation was conducted on the interconnectedness and behavioral effects of a community branching from the school-based health center. This project is based on review of: the …

A Comparative Content Analysis Of Sports Concussions In News And Entertainment Print Media Publications In 2005 Versus 2015, Shayla N. Henrikson

Masters Theses

This study examined four distinct areas of sports concussion as they are presented in the media; definitions/descriptions of concussion, informants for direct quotes about concussions, signs and symptoms, and duration of time missed from sport including removal from play. The study examined print media articles published in 2005 (n=64) and 2015 (n=136). Additionally, journal articles aligning with the research components were analyzed to provide a review of the scope of knowledge during each of the collection periods. Overall, the discussion of sports concussion in the media broadened between 2005 and 2015. There was more variety in the descriptions used, types …

Re-Optimization Of Radiation Therapy Dose To The Prostate Using Cbct: Reducing Dose To Organs At Risk, R. Charles Keider Jr.

Masters Theses

Cancer of the prostate is the second most common cancer among American males. The prostate is small gland, located in the pelvis, posterior to the bladder and anterior/inferior to the rectum. Due to this location when irradiating the prostate the normal tissue organs at risk are the bladder and rectum. Negative effects seen when these structures are irradiated can include; bladder stricture, dysuria, hematuria, diarrhea, rectal bleeding, and proctitis.

In order to eliminate or reduce these negative effects more precise and accurate treatment techniques have been employed. Intensity Modulated Radiation Therapy (IMRT) has been successful in achieving greater precision when …

Evaluation Of The Nutritional Options For Wellness (Now) Program: Mitigating Cardiovascular Disease And Type 2 Diabetes Through Food Pantries, Sarah L. Henning

Masters Theses

Individuals with a lower socioeconomic status are at higher risk for chronic disease diagnosis and complications (Gerteis et al., 2014). The NOW Program is a social service program that was created in order to relieve some of the burden placed on these individuals utilizing the charitable food system. The purpose of the study was to perform a quantitative program evaluation on the NOW Program which is administered by pantry coordinating organization. The NOW Program connects chronically ill, low income members of Kent County with local food pantries that offer diet specific food and health education about their specific chronic disease …

Sexual Health Education Among The Intellectually And Developmentally Delayed Populations: An Examination Of Medical Providers Perspective, Sarah E. Nota

Masters Theses

Sexuality is a recognized human right as it influences mental, social and emotional wellbeing. Despite this, individuals with intellectual or developmentally delays (ID/DD) rarely receive the necessary sexual education. ID/DD persons are also at an increased risk for sexual abuse, further demonstrating the strong need for education. A natural setting in which to receive unbiased and informative sexual health information is through their medical provider. The purpose of this research was to examine current clinic standards, education, and perceptions of medical providers in regards to sexual education for ID/DD adolescents. Medical providers and students within West Michigan were surveyed with …

Functional Movement Screen Score By Somatotype Category, Amanda Kelch

Masters Theses

Background: The Functional Movement Screen (FMS) is a tool used by fitness and health professionals to assess the quality of movement patterns in active populations. The literature has established descriptive values for FMS scores in various populations. However there has not yet been a study establishing the descriptive values of FMS score based on the somatotype categories. Establishing these descriptive values may provide a better understanding of how an individual's somatotype affects their ability to move. Purpose: The purpose of this study was to establish FMS scores for the four simplified somatotype categories (normal, endomorph, mesomorph, and ectomorph). Methods: Participants …

Optical Tracking System To Monitor Laparoscopic Training, William D. Rytlewski

Masters Theses

Laparoscopic Surgery, also known as Minimally Invasive Surgery, is a surgical technique where surgeons perform surgery through small incisions in the patient’s abdomen using a camera to monitor the movements of the instruments inside the patient. In order for the surgery to be performed, the surgeon must possess a unique set of skills obtained through training using a variety of techniques. Simulators are the preferred method of training for laparoscopic surgery since they provide medical residents with real world scenarios as well as a tremendous amount of feedback on what he/she did wrong or right. However, due to the high …

Sociodemographic Characteristics Of Heart Failure Associated Hospital Readmissions In Michigan Medicare Patients, Kelsey A. Peterson

Masters Theses

Repeated hospital admissions constitute a large proportion of healthcare expenses, but are incurred by a small minority of chronically ill patients. Rising healthcare expenditures and the link between readmissions and quality of care make readmission rates a high priority for clinicians as well as insurance payers. Though hospital readmissions have many components, one of the relationships which is still inconclusive is that between socioeconomic status and hospital readmission rates.

Investigating the conditions which have a substantial impact on the rate of hospital readmissions, heart failure stands out as it is the leading cause of death in the United States. This …

Subcutaneous Tissue Depth Over Intraosseous Infusion Sites In A Cadaveric Model, Megan Marie Glazier

Masters Theses

BACKGROUND: When emergent intravenous access is not available an intraosseous (IO) infusion is performed. To accurately perform an IO infusion, the healthcare provider must precisely palpate and identify the associated anatomical landmark for placement. A thicker layer of subcutaneous tissue over the insertion site can make this process difficult, leading to an increased risk of misplacement. PURPOSE: To relate the subcutaneous tissue depth with body mass index (BMI) and percent body fat in order to better understand IO placement sites in relation to these body composition factors. SUBJECTS: Male and female unembalmed cadavers (n=22) between the ages of 54-95 years …

Effects Of Fatty Acid Structure On Endothelial Cell Expression Of Connexin43, Albert E. Sowers Iii

Masters Theses

The epidemic of obesity-related metabolic and cardiovascular diseases is linked to elevated fatty acids (FA). Epidemiological data argue that trans FA contribute to the development and progression of these disease processes. Previous work suggests the similarity in structure between saturated and trans FA may stimulate inflammation through trans FA interactions with toll-like receptor 4 (TLR4). To evaluate the impact of trans FA on cardiovascular health, the response of endothelial cells to trans FA was evaluated. Specifically, responses to the 18-carbon trans FA elaidic acid (EA) were compared to the same length cis FA oleic acid (OA). Endothelial cells were exposed …

The Nutrient Intake Of Homeless Women Of Grand Rapids, Michigan, Emily D. Popma-Metsaars

Masters Theses

Background Homeless individuals comprise about 1% of the American population with 1/3 of this particular population being women. And despite the potential for hunger, the homeless population has a similar prevalence of overweight/obese as other Americans. The Heartside neighborhood of Grand Rapids is a very low-income area of the city, inhabited by the poor and homeless. The Food Access in Michigan Project is studying the relationship between food insecurity and food environments in Michigan.

Objectives The purpose of this study was to determine the characteristics of the diet of homeless women in Heartside. This study examined the level of food …

The Lived Experience: Pulmonary Arterial Hypertension And Intravenous Prostaglandin Therapy, Phyllis D. Boone

Masters Theses

A descriptive phenomenological study was proposed to obtain a subjective description of the experience of living with intravenous prostaglandin treatment for pulmonary arterial hypertension. It was intended to determine what kinds of elements are common to the experience with study participants, to develop an aggregate structure of the experience from the individual descriptions of it, and add to what is now known about this phenomenon. It was anticipated that the stories told by the participants could help to determine how nurses can assist future patients to live optimally within the confines of a palliative treatment for this incurable illness.

Unfortunately, …

A Study Of The Effect Of Splinting On Pain During Tip Pinch For Osteoarthritis Of The First Carpometacarpal Joint, Leana Tank

Masters Theses

The following research project focused on the effect of a prefabricated neoprene first carpometacarpal splint on osteoarthritis pain with tip-pinch, strength measurements of tip-pinch and functional performance. The following questions were explored throughout this study:

1. There will be a significant decrease in mean pain levels when the subject’s hand is splinted as compared to mean pain levels when the hand is not splinted.

2. There will be a significant decrease in mean pain levels for the second session as compared to the first.

3. There will be a significant increase in mean tip pinch strength measurements when the subject’s …

Factors Affecting Occupational Therapists’ Decisions To Join Their State Association, Shawn Thomas Ross

Masters Theses

The following research focused on the factors affecting occupational therapists’ decisions to join, withdraw from, or never join their state association. Data was collected using a mixed methods design consisting of a survey that included quantitative questions and a qualitative question. The survey was sent to 1,908 occupational therapists in Michigan and 497 (26%) were returned and usable. Occupational therapists consistently reported dissatisfaction with their state association. Three themes developed regarding reasons occupational therapists’ decisions about membership: prioritization, interpersonal and group communication, and benefits. State and national association memberships were found to be associated. The greatest predictor of membership was …

A Narrative Study: Exploration Of Arts And Crafts As Meaningful Productivity In A Middle-Old Adult Who Resides In An Independent Living Facility, Sara E. Thornburg

Masters Theses

This qualitative study explored the meaningfulness of engagement in arts and crafts in one older adult who resides in an independent living facility. A narrative approach was used and one participant was purposefully selected for the study. Data was collected through the use of semi-structured interviews. Additional data sources included the participant’s book of memories, artifacts, and photos. Analysis consisted of thorough readings of the data and the development of a chronology from the participant’s stories and hook of memories. Participant feedback and peer debriefing was elicited in order to insure validity of the researcher’s findings. Consistent with narrative research, …

Examining The Effects Of Nurse Work Hours, Inter-Shift Recovery, Fatigue, And Sleep Debt On Intent To Leave, Amy M. Manderscheid

Masters Theses

The nursing profession contains dedicated professionals who work varying shifts with assorted time frames to recover before returning to work. The purpose of this study was to examine shift work, inter-shift recovery, fatigue, sleep debt and intent to leave among full-time nurses. Data were collected through the use of electronic questionnaires from a sample of 36 registered nurses from the Sigma Theta Tau Kappa Epsilon Chapterat- Large.

Findings revealed significant differences among nurses working 10 hour shifts and their accumulation of sleep debt in comparison to nurses working 8 or 12 hour shifts. Significant differences were not found between acute …

Using Art In Occupational Therapy With People Who Have Cancer: A Qualitative Case Study, Jennifer R. Dochod

Masters Theses

OBJECTIVE. To explore the role of art, with a small group of people who have cancer, as a means provide distraction from pain, to help express feelings, and to assist in making connections with others.

METHOD. Using a randomized sample from Gilda’s Club, a support center for those with cancer, in-house social workers recruited two participants to take part in a small group case study conducted by a master’s level occupational therapy student.

RESULTS. Two participants enrolled in the art class conducted by the researcher. Predetermined questions gathered through participant interviews and class discussions provided the data. Although the participant …

Occupations, Habits And Routines: A Case Study Of An African-American Woman, Michelle Leigh Velting

Masters Theses

Obesity is a growing problem in the United States. African-American women make up a large portion of the obese population in the United States, however, the treatment techniques available have had limited success with this group. Although many health professionals are involved with the treatment of obesity, literature involving the value of occupational therapy with this population is limited. This mixed-methods case study identified the daily occupations, habits, and routines of a middle-class obese African-American woman. The participant was selected via a health care professional in the area of Grand Rapids, MI. The Occupational Questionnaire (OQ), Model of Human Occupation …

Development Of A Needs Assessment For Youth Violence Prevention Programs In A Large Midwestern City, Laura Lynn Savel

Masters Theses

This research project was designed to examine the relationship between the needs for violence prevention programs and the qualities of occupational therapists. A needs assessment relevant to violence prevention program could not be located. One was therefore created based on the literature available as well as professional input. A pilot study was conducted, revisions were made and the needs assessment was distributed when approval was granted. The assessment was distributed to elementary, middle and high school principals, assistant principals, occupational therapists, guidance counselors/psychologists, and support staff from two western Michigan school systems. A model program was created based on the …

Long-Arm Splinting For Lateral Epicondylitis: A Case Study, Crystal Wolters

Masters Theses

Lateral epicondylitis is a debilitating condition that has a significantly negative effect on the occupational lives of many people. There appears to be no recognized ideal treatment method for the condition. Long-arm splinting for lateral epicondylitis has not been addressed in the literature. A case study was used to thoroughly describe one participant’s experience with long-arm splinting to treat her lateral epicondylitis. She was interviewed, observed, and measurements were taken of her affected arm’s range of motion and strength. The seven themes which were identified through these methods include a description of how her lateral epicondylitis developed, her description of …