Medicine and Health Sciences Commons^™

Healthcare Outcomes And Resource Utilization Associated With Neonatal Hypoglycemia: Analysis Of Data From The Hcup Kid’S Inpatient Database, Brook T. Alemu

Health Services Research Dissertations

Neonatal hypoglycemia is the most common metabolic abnormality in infants and is associated with neurological damage and death. The risk of developing hypoglycemia among infants born from diabetic mothers is even higher. Although much work has been performed addressing issues for treatment and care, research related to neonatal hypoglycemia has been focused on the clinical or individual level risk factors. Contextual risk factors such as hospital characteristics, neighborhood economic status, and regional variations were not considered in earlier studies. Additionally, although healthcare resources utilization of hypoglycemia has been adequately addressed in the adult population, this topic has not been studied …

Development And Validation Of A Hybrid Virtual/Physical Nuss Procedure Surgical Trainer, Mohammad F. Obeid

Computational Modeling & Simulation Engineering Theses & Dissertations

With continuous advancements and adoption of minimally invasive surgery, proficiency with nontrivial surgical skills involved is becoming a greater concern. Consequently, the use of surgical simulation has been increasingly embraced by many for training and skill transfer purposes. Some systems utilize haptic feedback within a high-fidelity anatomically-correct virtual environment whereas others use manikins, synthetic components, or box trainers to mimic primary components of a corresponding procedure.

Surgical simulation development for some minimally invasive procedures is still, however, suboptimal or otherwise embryonic. This is true for the Nuss procedure, which is a minimally invasive surgery for correcting pectus excavatum (PE) – …

Effects Of A Unilateral Strength And Plyometric Training Program For Division I Soccer Players, Eric Potter

Human Movement Studies & Special Education Theses & Dissertations

The current thesis examined the effects of a unilateral strength and plyometric program on power (bilateral and unilateral vertical jumps), speed (20 meter sprint), and agility (Agility T- Test) in collegiate soccer players compared to a traditional bilateral-based training program. Due to the fact that a majority of the research on performance variables in athletes is done using bilateral lifting and plyometric programs, yet most movements in field sports such as sprinting and changing direction are unilateral-based, this specific topic could have value for enhanced performance for athletic populations. The participants included 34 male and female Division-I soccer players who …

A Web-Based Interprofessional Education Program For School Nurses And Athletic Trainers: A Pilot Study, Lauren Ashley Welsch

Health Services Research Dissertations

Background: Interprofessional education (IPE) programs have been shown effective in improving interprofessional collaborative practice (ICP) through increased communication and teamwork amongst healthcare professionals with the ultimate goal of improving patient safety and outcomes. However, their use and subsequent outcomes have not been reported amongst athletic trainers (ATs) and school nurses (SNs) in secondary school healthcare. The purpose of this study is to develop, implement and evaluate an IPE program designed to meet the needs of this unique healthcare setting. In addition, qualitative analysis will further describe the communication between ATs and SNs. Methods: A mixed method exploratory design was employed. …

Effects Of A Collaborative Care For Depression Intervention On Health Service Utilization And Depression Severity, Girlyn Arganza Cachaper

Health Services Research Dissertations

Depression is the leading cause of disability worldwide, disproportionately affecting the Medicaid population. Collaborative care programs for depression are transforming primary care to increase access and coordinate physical and behavioral health services. Understanding the relationships between components of collaborative care programs, characteristics of participants, and their effect on outcomes can maximize program effectiveness. A pilot collaborative care for depression program within a Medicaid managed care organization was evaluated using administrative claims and case management data. Participants (n=444) included adults with prior Medicaid coverage and a comparison group identified using one-to-one propensity score-matching. Multivariate logistic regression models estimated the odds of …

Effects Of Carboxylated Nanodiamonds On Macrophages During And After Differentiation, Maisoun E. Bani Hani

Biological Sciences Theses & Dissertations

Nanodiamonds (ND) are a carbon-based nanomaterial that are increasingly being proposed for developing novel imaging techniques, as carriers of biomolecules and therapeutic drugs, as coatings for implants, and for other biomedical applications. The exceptional chemical, mechanical, and optical properties of ND make this material suitable in a wide range of fields. The application of ND in the biomedical field is attractive but requires more in-depth investigation into the safety of ND and its interactions with different cells and systems. The effects of ND on the immune system are not fully understood or investigated and there are several controverting reports regarding …

Motor Learning Guided Treatment For Acquired Apraxia Of Speech, Rachel K. Johnson

Communication Disorders & Special Education Faculty Publications

Purpose: The purpose of this study was to expand the evidence on the effectiveness of motor learning guided approach for the treatment of acquired apraxia of speech. This study investigated the influence of practice frequency and number of targets per practice set on transfer of speech motor learning.

Method: This is a multiple baseline single-case study across two treatment cycles involving two individuals with chronic acquired apraxia of speech. Treatment Cycle 1 investigated the influence of self-controlled practice on speech motor learning through two conditions of practice. Treatment Cycle 2 investigated the influence of number of targets on transfer of …

Delayed Hypersensitivity To Nanosecond Pulsed Electric Field In Electroporated Cells, Sarah D. Jensen, Vera A. Khorokhorina, Claudia Muratori, Andrei G. Pakhomov, Olga N. Pakhomova

Bioelectrics Publications

We demonstrate that conditioning of mammalian cells by electroporation with nanosecond pulsed electric field (nsPEF) facilitates their response to the next nsPEF treatment. The experiments were designed to unambiguously separate the electroporation-induced sensitization and desensitization effects. Electroporation was achieved by bursts of 300-ns, 9 kV/cm pulses (50 Hz, n = 3–100) and quantified by propidium dye uptake within 11 min after the nsPEF exposure. We observed either sensitization to nsPEF or no change (when the conditioning was either too weak or too intense, or when the wait time after conditioning was too short). Within studied limits, conditioning never caused desensitization. …

Controllable Moderate Heating Enhances The Therapeutic Efficacy Of Irreversible Electroporation For Pancreatic Cancer, Chelsea M. Edelblute, James Hornef, Niculina I. Burcus, Thomas Norman, Stephen J. Beebe, Karl Schoenbach, Richard Heller, Chunqi Jiang, Sigi Guo

Bioelectrics Publications

Irreversible electroporation (IRE) as a non-thermal tumor ablation technology has been studied for the treatment of pancreatic carcinoma and has shown a significant survival benefit. We discovered that moderate heating (MH) at 43°C for 1-2 minutes significantly enhanced ex vivo IRE tumor ablation of Pan02 cells by 5.67-fold at 750 V/cm and by 1.67-fold at 1500 V/cm. This amount of heating alone did not cause cell death. An integrated IRE system with controllable laser heating and tumor impedance monitoring was developed to treat mouse ectopic pancreatic cancer. With this novel IRE system, we were able to heat and maintain the …

Impact Of Inpatient Care In Emergency Department On Outcomes: A Quasi-Experimental Cohort Study, Aisha Lateef, Soo-Hoon Lee, Dale Andrew Fisher, Wei-Ping Goh, Hui Fen Han, Uma Chandra Segara, Tiong Beng Sim, Malcolm Mahadehvan, Khean Teik Goh, Noel Cheah, Aymeric Yt Lim, Phillip H. Phan, Reshma A. Merchant

Management Faculty Publications

BACKGROUND: Hospitals around the world are faced with the issue of boarders in emergency department (ED), patients marked for admission but with no available inpatient bed. Boarder status is known to be associated with delayed inpatient care and suboptimal outcomes. A new care delivery system was developed in our institution where boarders received full inpatient care from a designated medical team, acute medical team (AMT), while still residing at ED. The current study examines the impact of this AMT intervention on patient outcomes.

METHODS: We conducted a retrospective quasi-experimental cohort study to analyze outcomes between the AMT intervention and conventional …

Advances In Developing Therapies To Combat Zika Virus: Current Knowledge And Future Perspectives, Ashok Munjal, Rekha Khandia, Kuldeep Dharma, Swati Sachan, Kumaragurubaran Karthik, Ruchi Tiwari, Yashpal S. Malik, Deepak Kumar, Raj K. Singh, Hafiz M. N. Iqbal, Sunil K. Joshi

Bioelectrics Publications

Zika virus (ZIKV) remained largely quiescent for nearly six decades after its first appearance in 1947. ZIKV reappeared after 2007, resulting in a declaration of an international “public health emergency” in 2016 by the World Health Organization (WHO). Until this time, ZIKV was considered to induce only mild illness, but it has now been established as the cause of severe clinical manifestations, including fetal anomalies, neurological problems, and autoimmune disorders. Infection during pregnancy can cause congenital brain abnormalities, including microcephaly and neurological degeneration, and in other cases, Guillain-Barré syndrome, making infections with ZIKV a substantial public health concern. Genomic and …

Defects In Skeletal Muscle Subsarcolmmal Mitochondria In A Non-Obese Model Of Type 2 Diabetes Mellitus, Nicola Lai, China Kummitha, Charles Hoppel

Electrical & Computer Engineering Faculty Publications

Skeletal muscle resistance to insulin is related to accumulation of lipid-derived products, but it is not clear whether this accumulation is caused by skeletal muscle mitochondrial dysfunction. Diabetes and obesity are reported to have a selective effect on the function of subsarcolemmal and interfibrillar mitochondria in insulin-resistant skeletal muscle. The current study investigated the role of the subpopulations of mitochondria in the pathogenesis of insulin resistance in the absence of obesity. A non-obese spontaneous rat model of type 2 diabetes mellitus, (Goto-Kakizaki), was used to evaluate function and biochemical properties in both populations of skeletal muscle mitochondria. In subsarcolemmal mitochondria, …

The Effect Of Magnification Loupes On Dental Hygienists' Posture While Exploring, Emily Ludwig, Gayle B. Mccombs, Susan L. Tolle, Daniel M. Russell

Dental Hygiene Faculty Publications

Purpose: The purpose of this study was to determine the effects of dental magnification loupes on posture during instrumentation.

Methods: A convenience sample of 27 right-handed dental hygienists, with no prior history of injuries or disabilities of the head, neck, or trunk region, enrolled in the study. Baseline posture calibration was taken and tri-axial accelerometers were placed on four locations of the head and trunk (occipital region of head; cervical vertebrae C5; thoracic vertebrae T5; lumbar vertebrae L1) to measure acceleration and the orientation of the body to gravity. Participants were randomly assigned to wear self-supplied magnification loupes during either …

The Relationship Of Early Class Start Times On Sleepiness And Driving Behaviors In An Emerging Adult Population, Jessica L. Fry

Psychology Theses & Dissertations

Teenage driver sleepiness is a recent concern for preventing motor vehicle fatalities. Early school start times limit the amount of sleep teenage high school students acquire during the week and have been related to increased crash risk. The current study extends this finding to teenage and emerging adult college students. The author examined the link between sleepiness and teenage driving behaviors, including the relationship between school start times and sleepiness. In all, 536 participants were recruited to participate in an online survey assessing driving and sleep behaviors. Correlations and path analysis found that sleepiness fully mediated the relationship between early …

Breaking The Silence: A Phenomenological Exploration Of Secondary Traumatic Stress In U.S. College Student Affairs Professionals, Robert Jason Lynch

Educational Leadership & Workforce Development Theses & Dissertations

Breaking the Silence: A Phenomenological Exploration of Secondary Traumatic Stress in U.S. College Student Affairs Professionals is a qualitative-intensive mixed methods study using phenomenology and art-based research techniques to uncover the essence of secondary traumatic stress in U.S. college student affairs professionals. Researchers in the fields of psychology, counseling, social work and other helping professions suggest that repeated exposure to individuals experiencing trauma, or hearing repeated details of an individual’s trauma, have negative outcomes on professional helpers. Coined secondary traumatic stress, this phenomenon may be defined as “the stress resulting from helping or wanting to help a traumatized or suffering …

Measuring Outcomes In Competence And Confidence In Clinical Skills Through The Use Of Standardized Patients, Jennifer W. Cuchna

Health Services Research Dissertations

Limited literature is available concerning the use of standardized patients (SPs) in physical therapy education related to outcomes which are assessed. The purpose of our study was to investigate the effects SP implementation had on first year, doctor of physical therapy (DPT) student’s communication and patient interviewing skills and their confidence in those skills.

Our study utilized a comparison group, repeated measures design with the collection of four survey instruments at pre-test and two posttest time points. The instruments for our study measured general self-efficacy (GSE), task-specific self-efficacy (Self-Perceived Communication Competence (SPCC) and Froehlich Communication Competence (FroCom) and confidence (Standardized …

Unmet Needs And Service Utilization By Informal Caregivers, Ryan Marie Diduk-Smith

Health Services Research Dissertations

The number of Americans expected to live into their 80’s and 90’s is growing at an increased rate in the United States, and the numbers of those aging adults with multiple chronic conditions also continues to grow. It is estimated that by 2050, there will be 89 million adults over the age of 65 years living in the United States. For a variety of reasons, including policy, personal, and financial reasons, many aging adults are choosing to “age in place” or to remain in the community. With the increase in the numbers of aging adults in the community, the ability …

Initial Construct Validity Evidence Of A Virtual Human Application For Competency Assessment In Breaking Bad News To A Cancer Patient, Timothy C. Guettermann, Frederick W. Kron, Toby C. Campbell, Mark W. Scerbo, Amy B. Zelenski, James F. Cleary, Michael D. Fetters

Psychology Faculty Publications

Background: Despite interest in using virtual humans (VHs) for assessing health care communication, evidence of validity is limited. We evaluated the validity of a VH application, MPathic-VR, for assessing performance-based competence in breaking bad news (BBN) to a VH patient.

Methods: We used a two-group quasi-experimental design, with residents participating in a 3-hour seminar on BBN. Group A (n=15) completed the VH simulation before and after the seminar, and Group B (n=12) completed the VH simulation only after the BBN seminar to avoid the possibility that testing alone affected performance. Pre-and postseminar differences for Group A were analyzed with a …

Alcohol And Substance Use Knowledge, Attitudes, Subjective Norms, Self-Efficacy, Perceived Behavioral Control, And Behavioral Intentions Among Omani College Students, Muna S. Bait Ajzoon

Health Services Research Dissertations

Alcohol and/or substance use among college students is a serious public health issue. In Oman, studies addressing college student’s alcohol and/or substance use are limited. The purpose of this study was to identify knowledge, attitudes, subjective norms, self-efficacy, and perceived behavioral control associated with alcohol and/or substance usage patterns among Omani college students (OCSs); identify behavioral intentions for alcohol and/or substance use among OCSs; and facilitate the development of culturally relevant evidenced-based interventions for Omani young people by communicating study findings to policymakers and healthcare program leaders.

A cross-sectional design used an online survey completed by college students from Oman …

Predictive Value Of Adhd Symptomatology On Motives And Outcomes Of Stimulant Misuse, Alexander Laszlo Peterkin

Psychology Theses & Dissertations

ADHD stimulant misuse is defined as taking a stimulant used to treat ADHD either without having a prescription for that stimulant or in a manner that deviates from the prescription’s instructions. This has been a growing trend among undergraduate students over recent years. Prior research has found that misusers are likely to have severe symptoms of ADHD, misuse for primarily academic reasons, and display problems associated with substance abuse. The current study aimed to determine the predictive value of ADHD symptomatology on frequency of ADHD stimulant misuse, mediated by academic motives for misuse and substance abuse problems. The survey for …

Using Constant Time Delay And Ecoaching To Teach Employment Skills To Young Adults With Autism Spectrum Disorder And Intellectual Disability In A Community Work Environment, Annemarie L. Horn

Communication Disorders & Special Education Theses & Dissertations

The goal of secondary education is to prepare students for greater levels of independence, especially in the areas of continued education and community employment. However, despite underlying potential, young adults with autism spectrum disorder (ASD) and comorbid intellectual disability (ID) are vastly underrepresented in the area of post secondary employment. This could be attributed to the unique characteristics and learning needs of these students, or it may be a function of the lack of effective, evidence-based teaching practices, implemented with fidelity.

The purpose of this study was to examine the effectiveness and participant perceptions of implementing the constant time delay …

Protective Factors Against Peer And Social Media Sex Messages: The Moderating Role Of Parental Influences On African American Emerging Adult Students' Sexual Behaviors, Jacqueline Eunice Haywood

Psychology Theses & Dissertations

The most recent research on risky sexual behaviors is primarily based on adolescent, predominately White, or multiple race (e.g., African American and White) samples. There is a paucity of literature focused exclusively on African Americans, particularly African American emerging adults between the ages of 18 and 25. Given the increased risk for sexually transmitted infections (STIs) for college aged African Americans, it is important to understand factors that may decrease engaging in risky sexual behaviors that are specific to this group. The current study examined the roles of parental warmth and communication about sex as protective factors. Participants (n = …

Sexual Orientation Differences In Treatment Expectation, Alliance, And Outcome Among Patients At Risk For Suicide In A Public Psychiatric Hospital, Martin Plöderl, Sabine Kunrath, Robert J. Cramer, Jen Wang, Larissa Hauer, Clemens Fartacek

Community & Environmental Health Faculty Publications

BACKGROUND: Sexual minority (SM) individuals (gay, lesbian, bisexual, or otherwise nonheterosexual) are at increased risk for mental disorders and suicide and adequate mental healthcare may be life-saving. However, SM patients experience barriers in mental healthcare that have been attributed to the lack of SM-specific competencies and heterosexist attitudes and behaviors on the part of mental health professionals. Such barriers could have a negative impact on common treatment factors such as treatment expectancy or therapeutic alliance, culminating in poorer treatment outcomes for SM versus heterosexual patients. Actual empirical data from general psychiatric settings is lacking, however. Thus, comparing the treatment outcome …

A Variant Pfcrt Isoform Can Contribute To Plasmodium Falciparum Resistance To The First-Line Partner Drug Piperaquine, Satish K. Dhingra, Devasha Redhi, Jill M. Combrinck, Tomas Yeo, John Okombo, Philipp P. Henrich, Annie N. Cowell, Purva Gupta, Matthew L. Stegman, Jonathan M. Hoke, Roland A. Cooper, Elizabeth Winzeler, Sachel Mok, Timothy J. Egan, David A. Fidock

Biological Sciences Faculty Publications

Current efforts to reduce the global burden of malaria are threatened by the rapid spread throughout Asia of Plasmodium falciparum resistance to artemisinin-based combination therapies, which includes increasing rates of clinical failure with dihydroartemisinin plus piperaquine (PPQ) in Cambodia. Using zinc finger nuclease-based gene editing, we report that addition of the C101F mutation to the chloroquine (CQ) resistance-conferring PfCRT Dd2 isoform common to Asia can confer PPQ resistance to cultured parasites. Resistance was demonstrated as significantly higher PPQ concentrations causing 90% inhibition of parasite growth (IC₉₀) or 50% parasite killing (50% lethal dose [LD₅₀]). This mutation …

Factors Influencing Distribution Of Prosthetic Devices In Iran: An Economic Analysis, Sarah Tensen

Virginias Collegiate Honors Council Conference

An estimated 177,622 Iranians have suffered an injury resulting in amputation. Prosthetic devices in Iran are scarce due to wealth disparity, wars, and lack of vital resources. Without prosthetic devices, amputees face unemployment, homelessness, a lowered self-esteem and cannot fully participate in society. I examined economic factors influencing the distribution of prosthetic devices and reviewed articles that focus on healthcare costs, distributions and services, relationships between Iran and other countries, etiology of amputation to find a solution for the prosthetic distribution issues. I concluded issues resulted from high costs, unequal distributions of wealth and resources, unsafe conditions, and a deficit …

Granting Personhood For Sentient Non-Human Animals And Sentient Artificial Intelligences: A Demonstrative Argument, Jeremiah Meadows

Virginias Collegiate Honors Council Conference

While the subject of personhood has been exhaustively debated regarding the unborn, personhood for sentient animals and artificial intelligences is a concept that is rarely deliberated. Humanity has learned that there are multiple animal species which are very similar to humans in their self-awareness, emotional capacity, and free will. These traits have been partially developed for artificial intelligences as well, and those characteristics will evolve alongside human and technological development. As stratified societies emerged, there have been multiple occurrences where individuals were deemed lesser but then later acquired equal standing. Dr. Daniel Wilson, roboticist, wrote in his novel Robopocalypse, “It …

The Use Of Rhyme, Rhythm, And Melody As A Form Of Repetition Priming To Aid In Encoding, Storage, And Retrieval Of Semantic Memories In Alzheimer’S Patients, Faiz Plastikwala

Virginias Collegiate Honors Council Conference

Treating Alzheimer’s disease, especially through non-pharmaceutical means, has become increasingly important over the past few decades. I examined the use of melody, rhyme, and rhythm as encoding mechanisms to aid in the retrieval of long term semantic information by juxtaposing previous experiments in the field. Melody, rhyme, and rhythm provide an organizational structure to facilitate the encoding of information. Specifically, chunking, the grouping of smaller units into larger ‘chunks’, helps facilitate long term encoding in patients, and is the byproduct of the organizational structure of a text. A major drawback of using these devices is the loss in the depth …

Depression In Low-Income Adolescents: Guidelines For School-Based Depression Intervention Programs, Gopika Hari

Virginias Collegiate Honors Council Conference

Studies reveal that low income is a significant risk factor for depression and only roughly 25% of children with mental illnesses receive adequate help, the majority of which comes from schools. This study establishes guidelines for depression intervention programs in low-income high schools through a literature review of current practices. This study found that a multi-layered approach with screening, universal education, and high-risk intervention is most effective. Screening should be conducted with a modified PHQ-a test and timely clinical interviews by school psychologists. All students and teachers should receive universal depression education curriculum consisting of principles like depression literacy and …

Latanoprost And Timolol In Hydrogel Soft Drug-Dispensing Contact Lenses: A Comparative Analysis, Neha Potdar

Virginias Collegiate Honors Council Conference

Glaucoma patients only can instill glaucoma eye drops. This results in 1-7% absorption of the medication. Surveys show that patients forget to take their medication and have difficulty inserting their eye drops. Researchers at the Massachusetts Eye and Ear Infirmary have developed latanoprost drug-dispensing hydrogel soft contact lenses that dispense the drug to help facilitate the process. However, some glaucoma patients do not respond to latanoprost because they have uveitic glaucoma or do not want to experience latanoprost’s ocular side effects. Patients need an alternative which can be inserted into these contact lenses. Another commonly used glaucoma drug is timolol …

Ebola Virus - Epidemiology, Diagnosis, And Control: Threat To Humans, Lessons Learnt, And Preparedness Plans - An Update On Its 40 Year's Journey, Raj Kumar Singh, Kuldeep Dhama, Yashpal Singh Malik, Muthannan Andavar Ramakrishnan, Kumaragurubaran Karthik, Rekha Khandia, Ruchi Tiwari, Ashok Munjal, Mani Saminathan, Perumal Arumugam, Sunil Kumar Joshi

Bioelectrics Publications

Ebola virus (EBOV) is an extremely contagious pathogen and causes lethal hemorrhagic fever disease in man and animals. The recently occurred Ebola virus disease (EVD) outbreaks in the West African countries have categorized it as an international health concern. For the virus maintenance and transmission, the non-human primates and reservoir hosts like fruit bats have played a vital role. For curbing the disease timely, we need effective therapeutics/prophylactics, however, in the absence of any approved vaccine, timely diagnosis and monitoring of EBOV remains of utmost importance. The technologically advanced vaccines like a viral-vectored vaccine, DNA vaccine and virus-like particles are …