Medicine and Health Sciences Commons^™

Are New Sodium Targets In The National School Lunch Program Feasible And Are They Necessary?, Yaneve Shemesh

PCOM Biomedical Studies Student Scholarship

In many societies, high salt intake is a continuing issue in adults, and is of growing concern in children due to the prevalence of processed foods. In response, the USDA has set three targets for sodium in meals offered in the National School Lunch Program (NSLP), and the National School Breakfast Program (NSBP). This 8-year goal is meant to decrease overall sodium levels in both meal programs. However, many associated with school nutrition ask if there is significant evidence to show what effect sodium plays on children’s health, and thus determine if these targets are necessary or achievable. In addressing …

The Influence Of Matrix Stiffness On Extracellular Matrix Protein Expression In 3d Encapsulated Mammary Fibroblasts, Kathryn Woods

PCOM Biomedical Studies Student Scholarship

A disease that transcends all races is breast cancer, the second leading cause of death among women with cancer. One factor, which participates in breast tumor progression, is the extracellular matrix (ECM), an acellular, protein-rich entity, which drives several cell, processes shown to promote tumorigenesis. Specifically, abnormal expression patterns and cross-linking of matrix fibers induces a more dense tissue structure, which has been reported to drive breast cancer progression. Alterations in ECM expression and cross-linking are in part due to carcinoma-associated fibroblasts (CAFs), activated fibroblasts which deposit copious ECM in the breast tumor environment. The goal of this study is …

Enhanced Cgmp-Dependent Signaling In Astrocytes: Novel Therapeutic Target In Alzheimer's Disease, Nyema M. Woart

PCOM Biomedical Studies Student Scholarship

Over five million Americans suffer from Alzheimer’s Disease (AD), with an expected 34% increase in the incidence in this disease over the next decade. Unfortunately, there is no cure for AD. Recent studies have indicated that drugs which increase the levels of cyclic guanosine-3’5’-monophosphate (cGMP) may help preserve learning and memory in AD and enhance cognition in the aging brain; however, the mechanism(s) of how cGMP exerts this beneficial effect is unknown. The present findings now suggest that elevation of cGMP in astrocytes depresses inhibitory potassium currents in these cells to stimulate their protective influence on neuronal activity. Cellular currents …

Use Of Swine Small Intestine Submucosa As A Dermal Suture, Paige E. Black

PCOM Biomedical Studies Student Scholarship

The purpose of this preliminary study is to determine if swine small intestine submucosa (SIS) can be used to create a suture that will perform comparably to commercially available chromic gut sutures when placed into a wound in rat dermis. This study is part of an ongoing collaboration that has explored SIS as a biologic scaffold in various tissues and surgical procedures. In this study, eight Sprague-dawley rats were divided into two groups, each receiving a full thickness skin wound between the scapula, made by a 5mm biopsy punch. The wound was then closed with commercially available chromic gut suture, …

Mdivi-1, A Mitochondrial Division Inhibitor, Exerts Cardioprotective Effects In Myocardial Ischemia/Reperfusion (Mi/R) When Given At Reperfusion, Devon P. Stutzman

PCOM Biomedical Studies Student Scholarship

Acute myocardial infarction (MI) remains a leading cause of morbidity and mortality worldwide. Accompanying MI is myocardial ischemia/reperfusion (MI/R) injury, which results in cardiac contractile dysfunction and additional myocardial cell death. MI/R injury is initiated in part by mitochondrial-derived reactive oxygen species due to mitochondrial membrane potential collapse and uncoupling of the electron transport chain, which may be due to mitochondrial fission in MI/R. Mitochondrial fission is in turn associated with shortening/fragmentation of mitochondria, decreased ATP production, and is thought to promote cardiac contractile dysfunction and post-reperfused cardiomyocyte loss, leading to increased infarct size. Therefore, inhibiting mitochondrial fission may be …

An Analysis Of Cognitive Factors In School-Aged Children With Emotional Disturbance And Adhd Using The Wisc-Iv, Maria Fragnito Maddalo

PCOM Psychology Dissertations

Children with Emotional Disturbance and ADHD demonstrate social, emotional, and behavioral symptoms that present many challenges for School Psychologists because of differences between each student’s individual needs. A high level of comorbidity exists for these children with internalizing and externalizing symptoms. Little is known about neurocognitive factors as they relate to ED versus ADHD. The current study examined the cognitive profiles of a total of 58 children with ED versus ADHD, using the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). Index scores that were examined included Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed. The groups were compared …

Naturalistic Clinical Decision Making By Emergency Department Staff And The Assignment Of Categorical Suicide Risk Ratings Within An Urban Veteran Population, Gerd R. Naydock

PCOM Psychology Dissertations

The ability to comprehensively and effectively identify those individuals who are at greatest risk to engage in self-directed violence (SDV) forms the cornerstone for all professional suicide prevention activities. To that end, mental health professionals have come to rely on the use of risk stratification to identify at-risk individuals as a way to inform and guide risk management and treatment, without having the benefit of empirical evidence to support such practices. The current program evaluation examined archival data comprised of suicide risk assessments conducted by mental health professionals on suicidal veterans (N = 1,560) in the emergency department of a …

Institutional Aggression: Psychometric Development Of A Predictive Risk Assessment Screening Tool, Lauren Spotts M.S.

PCOM Psychology Dissertations

Aggression among those with mental illnesses has been extensively reviewed. Research has shown that aggression within an institutional or hospital setting, that is presently termed “Institutional Aggression,” threatens the ability to provide a safe and therapeutic environment for both patients and staff. Although earlier measures have been designed to address this construct, the present study examines Institutional Aggression based on the parameters of the Overt Aggression Scale (OAS; Yudofsky, Silver, Jackson, Endicott, & Williams, 1986). The purpose of the current study was to determine the predictive relationship between clinical and sociodemographic factors and the rate of Institutional Aggression with the …

Developing Executive Functions Through Mindfulness Training In School-Aged Children, Ashley Black Adams

PCOM Psychology Dissertations

Well-developed executive functions are necessary for successful classroom functioning. Students with executive function deficits can fall behind academically as well as socially and emotionally, relative to their same-aged peers. Effective interventions for developing executive functions within the school environment are essential for addressing this issue. This study examines changes in students’ executive functions as a result of their participation in a mindfulness training intervention. Participants included four ten-year old elementary school boys who took part in a ten-week mindfulness training intervention. The data were generated through pre and post assessments with an executive function teacher rating scale and a Goal-Attainment …

The Effects Of Speech Impairment On Quality Of Life Over Time In Patients With Amyotrophic Lateral Sclerosis, Jacqueline Kelley Blessinger

PCOM Psychology Dissertations

Limited research exists on how speech impairments affect quality of life (QOL) factors over time in patients with amyotrophic lateral sclerosis (ALS). A review of the literature, including the history, disease course, and prevalence of ALS, is presented. Physical and psychosocial functioning, especially the decline of bulbar functioning’s potential impact on QOL factors and communication style, are outlined. This study is a follow-up study on a study by Duff, who found a significant difference in QOL relative to level of bulbar functioning in a cross-sectional design. The current study used a longitudinal design to look at bulbar functioning, specifically levels …

The Psychometric Properties Of The Professionalism Assessment Rating Scale, Jennifer K. Olivetti

PCOM Psychology Dissertations

The issue of professionalism in the training of medical students has become a major focus within the field of medical education. For years, the Philadelphia College of Osteopathic Medicine (PCOM) has measured the quality of osteopathic medical students (DO students) interpersonal and communication skills through SP (SP) encounters in which SPs rate the DO students relative to eight criteria (items) which, in aggregate, are known as the Professionalism Assessment Rating Scale (PARS). These criteria are linked in the literature to patient outcomes, patient adherence, patient satisfaction, and malpractice. This study investigated the psychometric properties of the PARS, based on data …

A Qualitative Study Of How Children Experience And Live With Long Qt Syndrome, Patrick Mcelwaine

PCOM Psychology Dissertations

Long QT syndrome (LQTS) is an inherited and potentially fatal disorder affecting approximately 1 in 2,000 people. Children often experience anxiety and a sense of loss of control as they try to manage the medical, social, and psychological stress that accompanies being diagnosed with LQTS. The present study utilized a qualitative research design to examine how children experience and live with long QT syndrome. Semistructured interviews were conducted with eight children between the ages of 7 to 12 who were diagnosed with LQTS. This period in a child’s life is very important for developing social skills and self-esteem as peers …

Impacts Of Objective And Subjective Social Inclusion On The Quality Of Life Of Individuals With Schizophrenia Spectrum Disorders And Major Depressive Disorder, Katie A. Johanning-Gray

PCOM Psychology Dissertations

Increased social inclusion and enhanced quality of life for individuals with severe mental illnesses (SMIs) are goals of the recovery movement. The present study examined the differences in reported subjective social inclusion (SubSI) and objective social inclusion (ObjSI) between individuals diagnosed with schizophrenia spectrum disorders (SSDs) and those diagnosed with Major Depressive Disorder (MDD). Furthermore, the amount of variance in quality of life (QOL) which can be predicted by type of diagnosis, SSDs or MDD, symptom severity, and SubSI and ObjSi was determined. An archival data set was used. Participants were 337 individuals whose primary diagnosis was an SSD or …

Siblings Of Children With Long Qt Syndrome: Relationships And Coping, Courtney Mccuen-Wurst Ms, Lcsw

PCOM Psychology Dissertations

Long QT syndrome (LQTS) is a congenital heart disorder, usually diagnosed in childhood, that may lead to cardiac arrest, seizures, syncope, and sudden death. The birth of a child with LQTS, as well as the social, physical, and psychological functioning of the affected child, can have a significant impact on the family. The family stress associated with having a child with any disability or chronic illness is likely to affect the lives of siblings. The lack of research on the effects of having a sibling with long QT syndrome on individuals who do not have LQTS provided the rationale for …

Is Regenerative Injection Therapy (Prolotherapy) Effective At Reducing Pain Associated With Knee Osteoarthritis?, Ashley Aloi

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is regenerative injection therapy (prolotherapy) effective at reducing pain associated with knee osteoarthritis?”

Study Design: Review of all English language primary studies published in 2012 and 2013.

Data Sources: One randomized control trial, one randomized crossover study and one single-arm uncontrolled study were found using PubMed and Ebscohost.

Outcomes Measured: Clinical outcome for all three articles was measured using the Western Ontario McMaster University Osteoarthritis Index (WOMAC); which specifically focuses on quality of life, function, and pain reduction after the use of prolotherapy versus the saline …

Is Rabeprazole A Safe Treatment For Gastroesophageal Reflux Disease In Children Ages 1-16 Years?, Sarah Applegarth

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of the selective EBM review is to determine whether or not Rabeprazole is a safe treatment for GERD in children less than sixteen years old.

Study Design: Review of three randomized controlled studies. All three studies were published in English between 2007-2013.

Data Sources: Three randomized, un-blinded, controlled studies found using Medline and PubMed

Outcomes Measured: Each trial measured the adverse events that occurred with the use of Rabeprazole for the treatment of GERD in children less than sixteen years of age. This was done by using subjective reporting of treatment-emergent adverse events (TEAE’s). Differences in the …

Is Prophylactic Oxybutynin Safe And Effective In Reducing The Severity Of Palmar Hyperhidrosis In Adults?, Kristin K. Amicone

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine “Is prophylactic oxybutynin safe and effective in reducing the severity of palmar hyperhidrosis in adults?”

STUDY DESIGN: This review is based on two randomized controlled trials (RCTs) and one non-randomized crossover study published in 2008, 2011, and 2012. The studies compared the safety and efficacy of oxybutynin in reducing the severity of palmar hyperhidrosis.

DATA SOURCES: All articles used were published in English, in peer-reviewed journals, and found using PubMed, Ebscohost, and Cochrane Review databases.

OUTCOMES MEASURED: For all studies, the safety and effectiveness of oxybutynin on palmer hyperhidrosis …

Does Far Infrared Therapy Reduce The Incidence Of Arteriovenous Fistula Malfunction In Patients With Renal Disease Undergoing Hemodialysis?, Parker Barrett

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not far infrared therapy reduces the incidence of arteriovenous fistula (AVF) malfunction in patients with renal disease undergoing hemodialysis.

STUDY DESIGN: Review of three primary randomized controlled trial studies published from 2007-2013.

DATA SOURCES: Three peer-reviewed randomized controlled trials studying the effectiveness of far infrared therapy in the preservation of native arteriovenous fistula function in patients with chronic kidney disease requiring hemodialysis. Data searches done in PubMed, CINAHL Plus and EBSCOhost.

OUTCOMES MEASURED: Primary outcome measured was episodes of AVF malfunction due to stenotic complication. …

How Safe And Effective Is Tryptophan In Improving Sleep In Healthy Individuals With Mild Sleep Disorders?, Genevieve Asante-Odame

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not tryptophan is effective in improving sleep in healthy individuals with mild sleep disorders.

STUDY DESIGN: Systematic review of three published, randomized controlled trials (double-blind, placebo-controlled) between 2005-2010, all English language.

DATA SOURCES: Three randomized controlled trials published between 2005 and 2010 were found using PubMed/MEDLINE and Cochrane databases.

OUTCOMES MEASURED: Improved sleep quality and duration of sleep, which were measured using sleep diaries and sleep study questionnaires.

RESULTS: The first study, Cubero et al showed that administration of diet containing high levels of tryptophan reflected more …

Is Collagenase Clostridium Histolyticum A Safe And Effective Treatment For Adult Patients With Dupuytren’S Contracture?, Heather N. Bailey

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not collagenase clostridium histolyticum is a safe and effective treatment for adult patients with Dupuytren’s contracture.

STUDY DESIGN: Review of two double-blind, placebo-controlled randomized controlled trials and one cross-sectional study. All of these studies are published in English between 2009-2013.

DATA SOURCES: Two double-blind, placebo-controlled randomized controlled trials and one cross-sectional study found using PubMed.

OUTCOMES MEASURED: Each randomized controlled trial measured the ability to meet the primary end point and all secondary endpoints, percent decrease in degree of contracture, increase in range of motion, patient satisfaction, …

Is Treatment With Topical Glyceryl Trinitrate Effective In Reducing Elbow Pain In Patients With Lateral Epicondylitis?, Benjamin Chartier

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not treatment with topical glyceryl trinitrate is effective in reducing elbow pain in patients with lateral epicondylitis.

Study Design: Review of two English language randomized controlled trials and one primary study published 2003, 2009, 2011.

Data Sources: Two double blind randomized controlled and one prospective comparison study comparing the effectiveness of gylceryl trinitrate to placebo in the treatment of pain related to lateral epicondylitis, found using PubMed, EBSCOhost, and CINAHL Plus.

Outcome(s) Measured: The outcome studied was patient self-rated elbow pain at rest, pain with activity, pain …

Is Yoga Effective In Reducing Fibromyalgia-­Related Symptoms In Women With Fibromyalgia?, Molly R. Beckmann

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not yoga is effective in reducing fibromyalgia-related symptoms in women with fibromyalgia.

Study Design: Review of two published double blind, randomized controlled trials published in 2010 and one before-after study published in 2012 were used for this review and selected based on their relevance to the clinical question

Data Source: Studies were found using PubMed, AMED, and CINAHL Plus.

Outcomes Measured: All three studies measured improvement of fibromyalgia symptoms based on a variety of well-validated measures, most notably the Fibromyalgia Impact Questionnaire, the Quality of Life Profile …

How Effective Is Acupuncture In Treating Persistent Allergic Rhinitis In Children And Adults?, Diana M. Casallas

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this evidence based medicine review is to determine whether or not acupuncture is effective in treating persistent allergic rhinitis in children and adults. Study design: Review of three published, randomized controlled trials (RCTs) published in 2004, 2007, and 2013. All English language. Data Source: The three randomized controlled trials that used in this review were found using PubMed. Outcome measured: Symptoms of nasal obstruction, rhinorrhea, sneezing and itching were measured with the Total Nasal Symptom Score (TNSS). Other outcomes measured were: Daily rhinitis scores, relief medication scores symptom free days and relief quality of life questionnaire …

Is Bitemporal Ect More Effective Than Bifrontal Ect In Reducingthe Symptoms Of Depression In Adults?, Talia M. Brinton

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not bitemporal ECT is more effective than bifrontal ECT in the treatment of adults with major depressive disorder. STUDY DESIGN: Review of three published randomized controlled trials, all English language. All RCTs were published after 1999 and studied patients older than 17 years old. DATA SOURCES: Three randomized control trials were found using PubMED, OVID, and Medline. Articles were selected based on relevance and that the outcomes of the studies mattered to patients. OUTCOME(S) MEASURED: Hamilton Rating Scale for Depression- 24 item completed by practitioner. RESULTS: The …

Will The Addition Of Oxaliplatin To 5-Fluorouracil (5fu), And Leucovorin Improve Disease Free Survival Of Patients With Stage Iii Colon Cancer Who Had Surgical Resection Of The Tumor?, Sarah Cotter

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not the addition of oxaliplatin to 5FU and leucovorin will improve disease free survival of patients with stage III colon cancer who had surgical resection of the tumor.

Study Design: Review of three published, double blind randomized control trials in the English language in 2004, 2007, and 2009.

Outcomes Measured: The outcome is disease free survival of colon cancer. It is measured using periodic patient follow-up. History and PE, neuro assessment, liver and kidney function tests, CEA test, CBC, and imaging studies such as colonoscopy or barium …

Is Benzoyl Peroxide And Clindamycin Effective Combination Treatment For Progressive Macular Hypomelanosis In Adults?, Samantha Colosi

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not there is efficacy with combination treatment benzoyl peroxide and clindamycin for progressive macular hypomelanosis in adults.

Study Design: A review of three English language studies. One published in 2006 and two in 2011. Includes two RCT’s and one randomized left-right comparison study.

Data Sources: Researched articles via PubMed and Cochrane database. All articles were published in peer-reviewed journals. Two randomized, controlled trials and one randomized left-right comparison study were used.

Outcomes Measured: The outcomes measured by: subjective patient ratings based on photographs before and after treatment …

Is Bevacizumab Effective In Inhibiting The Growth Of Recurrent Pterygium?, Sharon L. De La Cruz

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Bevacizumab is an effective treatment in inhibiting the growth of recurrent pterygium.

Study Design: Review of three published, English language randomized controlled trials published in 2010, 2012, and 2013.

Data Sources: Three randomized controlled trials measuring the efficacy of Bevacizumab to inhibit the growth of recurrent pterygium were found using PubMed and OVID databases.

Outcome(s) Measured: The severity and progression of pterygium recurrence as well as corneal neovascularization were the main outcomes measured. Conjunctival injection, thickness, and size of the fibrovascular tissue were examined in subjects …

Is Ginger An Effective Treatment For Moderate Or Severe Dysmenorrhea In Females Over The Age Of 18?, Katy N. Degraw

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not ginger is a safe and effective treatment for moderate or severe dysmenorrhea in females over the age of 18.

STUDY DESIGN: Review of three randomized controlled studies. All three studies are published in English between 2009-2013.

DATA SOURCES: Three randomized placebo controlled studies found using PubMed and Medline.

OUTCOMES MEASURED: The outcomes that were measured were severity of pain, duration of pain, change in symptoms, and change in severity. This was done by using a visual analogue scale, 5-point Likert scale, Wilcoxon’s rank-sum test, and verbal …

In Adult Patients With Pc-Bppv, Is The Semont Maneuver Effective In Reducing Symptoms Of Vertigo?, Gabriel D. Frampton

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not in adult patients with PC-BPPV, is the Semont Maneuver effective in reducing symptoms of vertigo?

STUDY DESIGN: Review of three published, randomized controlled trials (two double-blind and one single blinded), all English language.

DATA SOURCES: The three randomized controlled trials that were used for this review were found using PubMed and Medline. Articles were selected based on relevance and that the outcomes were patient oriented.

OUTCOME(S) MEASURED: Dix-Hallpike Test performed before and after the Semont Maneuver to asses nystagmus and questionnaires/self reported symptom status after the …

Is Tamoxifen Prophylaxis Effective In Reducing The Incidence Of Breast Cancer In Women Who Are At High Risk?, Maria Deveau

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this EBM review is to determine whether or not Tamoxifen prophylaxis is effective in reducing the incidence of breast cancer in woman who are at high risk.

STUDY DESIGN: Review of three English language primary studies published from 2005 to 2007.

DATA SOURCE: Three double-blind randomized control trials found using the PubMed and Cochrane database.

OUTCOME MEASURED: The primary outcome by all three studies included incidence of breast cancer.

RESULTS: Three double- blind randomized controlled trials were included in this review. Study by Powles et al showed statistically significant reduction in the incidents of breast cancer …