Medicine and Health Sciences Commons^™

A Survey Of Radiology Practices' Use Of After-Hours Services, Adam Harris Kaye

Yale Medicine Thesis Digital Library

Purpose: To identify the characteristics of and the motives behind radiologists use, or lack thereof, of after-hours services. Methods: From August 2005 to June 2006, 300 non-specialty hospitals randomly selected from the 2005 American Hospital Association Directory of Hospitals were contacted by phone, email, and mail, with an attempt made to speak to the chief of radiology. We obtained 115 responses, a 38.3% response rate, including 64 from practices that used an external after-hours service. Responses were analyzed using descriptive statistical analyses. Results Practices gave convenience as the most important reason they use an after-hours services, with value for recruiting …

The Role Of Frizzled-1 And Frizzled-3 In Olfactory Sensory Neuronal Targeting, Mina Safain

Yale Medicine Thesis Digital Library

THE ROLE OF FRIZZLED-1 AND FRIZZLED-3 IN OLFACTORY SENSORY NEURONAL TARGETING. Mina G. Safain. Department of Neurosurgery, Yale University School of Medicine, New Haven, CT. While most areas of the brain do not exhibit profound neurogenesis or continuing synaptogenesis in the adult, there are notable exceptions which include the olfactory and hippocampal regions of the nervous system. In the olfactory system the olfactory sensory neurons continually turn over and extend their axons into the olfactory bulb in a highly precise manner. Some preliminary data exists that suggests the presence of Wnt and Frizzled (Fz) family members in the primary olfactory …

Does The Duration Of Type 2 Diabetes Correlate With Changes In Taste Deficits?, Ann T. Mclaughlan

PCOM Biomedical Studies Student Scholarship

The loss of insulin sensitivity in Type 2 diabetes interferes with cellular utilization of glucose. The underlying down-regulation of insulin receptors and the resulting insulin resistance is wide-spread throughout the body. The cardiovascular consequences may be indirectly responsible for decreased taste sensitivity because of diminished perfusion of the taste buds in this patient population. This study utilized an inexpensive, non-invasive technique, electrogustometry, to directly stimulate the taste buds by applying a variable, direct-current stimulus to measure taste receptor thresholds in newly-diagnosed ( < 2 years) and long-standing diagnosed (> 6 years) male and female Type 2 diabetes mellitus subjects. Taste thresholds were elicited by application of an …

Protection Of Macrophages J774a.1 By Purine Nucleoside Analogues From Bacillus Anthracis Mediated Necrosis, Zadkiel R. Alvarez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Eight years after the lamentable anthrax attacks, major scientific effort continues to be done, in order to stop imminent acts of bioterrorism. Innovative ways of therapy against the anthrax disease are being investigated. B. anthracis, the etiological agent of the infection, has a dormant stage in its life cycle known as the endospore. When conditions become favorable spores germinate, transforming into vegetative bacteria. In inhalational anthrax, the most fatal manifestation of the disease, spores enter the organism through the respiratory track, and are phagocytosized by alveolar macrophages of the lungs. Spores are able to sense nutrient availability, activating their germination …

The Implementation Of The Kentucky Transitions: A Money Follows The Person Demonstration Grant Program, Amie Goodin

MPA/MPP/MPFM Capstone Projects

Kentucky Transitions is a Kentucky Medicaid program that is funded primarily by a grant from the Centers for Medicare and Medicaid Services. The purpose of this program is to transition individuals residing in long-term care facilities back into the community, where they will continue to receive health, social, and other benefits but do so in an approved residential setting. Individuals living in the community may experience higher quality of life and the increased ability to choose how and when they receive services, while Medicaid reaps the projected financial benefit of providing less-expensive community alternatives for care.

Though Kentucky Transitions operates …

Medication Therapy Management: Is It Worth Medicare’S Time?, Jennifer White

MPA/MPP/MPFM Capstone Projects

Problem:

Medication Therapy Management (MTM) is a service that a pharmacist can provide to any of their patients, but mostly to those who are either high risk patients for adverse events or those who are new to chronic medication therapy. As Medicare Part D has begun to cover MTM services, more and more pharmacists and other clinicians are becoming providers of MTM.

The intent of MTM is to decrease adverse events and healthcare costs to both the patient and the third party payer. In realizing the benefits of MTM, it is important to assess these outcomes to see if clinical, …

Physician Recruitment At Highlands Regional Medical Center: What Works?, Sarabeth Blankenship

MPA/MPP/MPFM Capstone Projects

There is a physician shortage in eastern Kentucky because older physicians are retiring, and younger physicians are choosing to practice in more urban, affluent areas. Eastern Kentucky is plagued with persistent poverty and lacks cultural amenities. These facts put together myths regarding rural practice create a shortage.

My research consisted of interviewing twenty physicians currently practicing at Highlands Regional Medical Center in Prestonsburg, Kentucky. I created a survey instrument that asked questions of physicians regarding demographics characteristics, medical school attended, and what motivated them to practice at Highlands. I chose Highlands because I was able to get interviews scheduled with …

Employability After Substance Abuse Treatment In Kentucky: An Analysis Of The Kentucky Treatment Outcome Study, Steven Scrivner

MPA/MPP/MPFM Capstone Projects

Public funding of substance abuse treatment (SAT) in Kentucky dates back to the 1950s when legislators sought to curb the problem of alcoholism through legislative acts. The definition of substance abuse expanded through the years to include other substances such as cocaine, marijuana and opiates.

Employment after SAT is a critically important outcome for policymakers to consider when allocating funds because it assists in social re-integration, helps to prevent relapse and promotes economic self-sufficiency. Because of this, employment is an important factor to consider when assessing the impact SAT has on its clients (participants).

The Kentucky Alcohol and Other Drug …

Best Practices For Increasing Pro-Social Behavior In Adolescents With Mental Health And Behavioral Disorders, Danielle Armbrust-Malone

All Graduate Theses, Dissertations, and Other Capstone Projects

Approximately 2 to 16 percent of the general population has a disruptive behavior disorder such as oppositional defiant disorder (ODD) or conduct disorder (CD) (Corcoran & Walsh, 2006). In a school setting, youth with these disorders may engage in acts such as disrespecting teachers, swearing at others, threatening others, assaulting staff or students, stealing, or vandalizing property and may benefit from a day treatment program which provides mental health services in a school setting. (Whitfield, 1999). Micro intervention strategies such as cognitive behavioral therapy and contingency management and mezzo interventions such as family therapy have been used to treat disruptive …

Minnesota Health Care Programs: Renville County Human Servics Outreach Project, Bethany Leindecker

All Graduate Theses, Dissertations, and Other Capstone Projects

Purpose:

To develop an outreach program for use by Renville County Human Services staff to educate potential service recipients and other community residents about Minnesota health care programs.

To assist outreach staff in gaining skills and knowledge necessary to effectively conduct the outreach.

Llmhs Elderly Services Outreach Program: Lincoln, Lyon & Murray Human Services, Jamie Olson

All Graduate Theses, Dissertations, and Other Capstone Projects

Right now there is a lack of professional and community knowledge regarding the services LLMHS provides to those over age 65. Thus, there are elderly who are in need of help who are not getting connected to a county long term care social worker. The elderly may need help to simply get connected to resources, have questions answered, correct misconceptions about long term care, get recommendations, or assistance paying for home and community based services. There are also many providers and professionals with questions about what LLMHS does and does not do as well as what the assistance programs can …

Best Practices For Vulnerable Adult Investigation Policies And Procedures At Blue Earth County, Anna Stindt

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this project is to update the policies and procedures for conducting vulnerable adult investigations in Blue Earth County to reflect changes in the statute and to incorporate current best practices for conducting investigations.

Mathematical Aids Epidemic Model: Preferential Anti-Retroviral Therapy Distribution In Resource Constrained Countries, Nadia Abuelezam

HMC Senior Theses

HIV/AIDS is one of the largest health problems the world is currently facing. Even with anti-retroviral therapies (ART), many resource-constrained countries are unable to meet the treatment needs of their infected populations. ART-distribution methods need to be created that prevent the largest number of future HIV infections. We have developed a compartment model that tracks the spread of HIV in multiple two-sex populations over time in the presence of limited treatment. The model has been fit to represent the HIV epidemic in rural and urban areas in Uganda. With the model we examine the spread of HIV among urban and …

Localization Of Deformed Wing Virus (Dwv) In The Brains Of Apis Mellifera (European Honey Bees), Karan Samir Shah

Honors Theses

The purpose of the current research project is to design a successful in-situ hybridization to identify regions within the brains of honeybees where DWV replicates. The localization of the virus in the brains of the bees can draw a connection between CCDand DWV.In conclusion, these results demonstrate that in bees infected with DWV the virus replicates actively in very important regions of the brain, including neuropils that are responsible for vision and olfaction. This means that the virus could adversely affect the vision and olfaction of the honeybees making it difficult for bees to behave normally.

Examination Of The Capacity Of The Cathelicidins To Control Bacillus Anthracis Pathogenesis, Mark W. Lisanby

All ETDs from UAB

cillus anthracis is a gram-positive, spore forming bacterium that causes infection through three routes: cutaneous, gastrointestinal and pulmonary. Historically, anthrax pathogenesis was thought to be initiated via the uptake of spores by resident macrophages, which then transited to the regional lymph nodes. While en-route, the spores germinated and developed into bacilli within the phagolysosome, escaped into the cytoplasm, killed the cell and eventually the host. Following the recent use of B. anthracis as a biological weapon, researchers began to reevaluate anthrax pathogenesis in order to develop novel treatments. One aspect of anthrax pathogenesis that saw renewed interest was the intracellular …

Biomechanical Evaluation Of A 6.5-Mm Headless, Tapered Variable Pitch Screw (Acutrak Plus) In Equine And Synthetic Bone, Andrew James Czak Lewis

LSU Master's Theses

Objectives – To compare compression pressure (CP) of 6.5mm Acutrak Plus (AP) and 4.5mm AO cortical screws (AO) when placed in simulated lateral condylar fractures of variable thickness in cadaveric equine third metacarpal (MC3) bones, and to compare pullout force and strength of AP and AO screws when placed in a synthetic bone substitute. Results – The AO screw configurations generated significantly greater compressive pressure compared to the AP configurations. The ratio of mean CP for AP screws to AO screws at 20, 12, and 8-mm, were 21.6%, 26.2%, and 34.2% respectively. For the pullout study, the AP constructs generated …

The Effectiveness Of Placing A Mid-Level Provider In Triage As An Intervention To Improve Patient Flow In The Emergency Department, Penney A. Burlingame

MUSC Theses and Dissertations

With increasing scrutiny on the condition of the nation's emergency services and emphasis on patient satisfaction and pay for performance, Emergency Departments (EDs) are examining ways to improve public perceptions of satisfaction and quality. A reduction in ED wait times and left without being seen (LWBS) volumes can have a significant impact on patient satisfaction scores. The purpose of this study is to determine if placement of a mid-level provider in triage to perform medical screening exams (MSEs) will reduce ED wait times, increase efficient patient flow, and increase patient and staff satisfaction. For one hundred sixty nine days, a …

Metabolomic Investigation Of A New Rat Model Of Autosomal Recessive Polycystic Kidney Disease, Hayley White

Theses : Honours

Metabolomics is complementary to genomics, transcriptomics and proteomics; however, it has the capacity to reflect the activities of the organism at a functional level. Metabolomics can therefore be used as a diagnostic tool by identifying the up- or down-regulation of metabolites in the cell, tissue, plasma, serum or urine. Specifically, these are, but are not limited to, identifying biomarkers of disease, monitoring drug treatments, and monitoring surgical procedures such as organ transplant. Autosomal recessive polycystic kidney disease (ARPKD) makes up 5-8% of patients requiring kidney dialysis and/or transplantation and of these, an estimated 50% of patients progress to end-stage renal …

A Narrative Analysis Of The Experiences Of Living With Hiv For Heterosexual Men, Tanya Millard

Theses : Honours

The number of heterosexual men presenting with Human Immunodeficiency Virus (HIV) is steadily increasing in Australia. A paucity of literature currently exists surrounding the experience of living with HIV for heterosexual men, with most information targeted towards gay men, injecting drug users (IDUs) and women. This narrative literature review examines the body of knowledge concerning the experiences of heterosexual men living with HIV. The findings of this review indicate that for heterosexual men, HIV significantly impacts on their physical, psychological and social well being. In particular, they struggle with social and intimate relationships, negotiating disclosure, managing their stigmatised identity, and …

Balancing Multiple Roles: A Pilot Study Exploring The Complexity Of Role Balance In Working Mothers With Primary School Aged Children, Katherine Prince

Theses : Honours

For working mothers, maintaining a balance between work and parenting roles is a challenge. Each role presents its own set of physical, mental and temporal demands which frequently compete for the limited personal and environmental resources available to the mother. These competing demands can create conflict and stress, which prompts a coping response. The coping response initiated is a physiological reaction to the mother's appraisal of her situational conflict, and follows a process of appraisal. Firstly the working mother appraises the conflict itself. This is followed by the appraisal of the personal and environmental resources, constraints and demands. Finally, a …

At Options With Children With Autism, Melissa Stevens, Megan Neppl

Occupational Therapy Capstones

According to information from the Center for Disease Control Prevention (2007) it is estimated that autism affects 1 in 150 births. The Autism Society of America (2007) reports that the prevalence of autism is expected to increase by 10-17 % per year. It has been shown through research that assistive technology can benefit or increase performance in children with autism spectrum disorder. It also can address performance areas limited in children with autism, such as communication, cognition, self-care, leisure, social/play, productivity, and sensorimotor (Reed, 2002). Assistive technology can aid these children in various contexts such as school, home, and play. …

Occupational Therapy: A Vital Link To Transition Success Of High School Students, Ann B. Disilvestro

Occupational Therapy Capstones

Occupational therapists have engaged in school-based therapy practice since the 1970's when the Education for the Handicapped Act (EHA) was enacted to provide a free public education for students with disabilities in the least restrictive environment. Since law mandated related services, occupational therapists have the opportunity to service students in all grade levels. However, over the course of time, most therapists gravitated toward servicing the student under the age of twelve. As a result, few therapists have devoted their full attention to meeting all the challenges of secondary level students with disabilities, especially for transitioning of students into the community. …

A Participant Model: Predictive Medical And Behavioral Factors Of Prostate Cancer Screening Attendees At Markey, Shana L. Steinbach

MPA/MPP/MPFM Capstone Projects

Problem Statement

The Prostate Cancer Screening Program at the Markey Cancer Center co-sponsors prostate cancer screenings with the Prostate Cancer Education Council. All participation, including African-American attendance, has decreased 38% from years 2006 to 2008 and program managers are seeking insight to improve program participation by acquiring knowledge of behavioral and medical characteristics that may influence screening attendance. Because of the higher incidence of prostate cancer in African-American men (ACS, 2008), a specific program goal is also to increase screening attendance for this minority population.

Research Strategy

Questions that assess participant behavior, personal, and family medical history are analyzed to …

A Cognitive Behavioral Approach To Occupational Therapy Hippothearpy [I.E.., Hippotherapy] For Children And Adolescents With Mood Disorders, Abby Heaton, Krista Tangen

Occupational Therapy Capstones

Children and adolescents are increasingly being identified with mood disorders. A growing concern is that children and adolescents are not afforded a wide range of interventions to address the symptoms of mental illness. Cognitive behavioral therapy (CBT) has been identified as a useful treatment method for mood disorders. Hippotherapy has also been utilized in the treatment of mental illness. A literature review was conducted to explore the therapeutic benefits of cognitive behavioral therapy and hippotherapy for children and adolescents diagnosed with mood disorders. Although CBT has been recognized as useful, CBT methods applied to hippotherapy in occupational therapy does not …

A Team Approach To Cortical Visual Impairment (Cvi) In Schools, Donna Shaman

Occupational Therapy Capstones

Cortical visual impairment (CVI) is presently the fastest growing cause of visual impairment in children. The influx of children with CVI entering school districts requires Individualized Education Program (IEP) teams to gain expertise about CVI and learn best practices to work with these children. CVI experts agree that a collaborative transdisciplinary team can best serve the complex needs of the children. Written by an occupational therapist, this project designs a CVI manual, A Team Approach to CVI in Schools, which reviews current literature and provides support for client centered, occupational based education for children with CVI. The literature review points …

Sensory Processing Disorder: Raising Awareness, Stephanie Thomas, Karla Emmerich

Occupational Therapy Capstones

It is estimated by Miller (2006) that 1 in 20 children are impacted by Sensory Processing Disorders (SPDs). The Individuals with Disabilities Education Act of 1990 is legislation that places families at the core of the intervention process and acknowledges the importance and the influence families have on a child's development (Cohn, Miller, & Tickle-Degnen, 2000). Cohn et al. stress family-centered practices require therapists to understand and listen to the hopes and outcomes that are most important for the children's families. At STRIDE Learning Center, a developmental preschool in Cheyenne, Wyoming, parents and teachers have requested more information on Sensory …

Ot Cultural Competence Website, Kelly Bjoralt, Kristy Henson

Occupational Therapy Capstones

Cultural competence, in health care, is becoming increasingly important as minority populations continue to grow in the United States. Although it is clear that cultural sensitive, client-centered care directly effects treatment outcomes, students and clinicians may not know where or how to access cultural resources. Culturally competent care is vital to the field of occupational therapy as client-centered care is viewed as a means of providing the best outcomes and quality of care.

A literature review was conducted to identify current cultural resources available. Based on the findings, an adult learning theory was used in conjunction with effective website design …

An Occupational Therapist's Manual For Animal Assisted Therapy With Emotionally Distrubed Adolescents, Ann Marie. Bilek, Hannah Osborne

Occupational Therapy Capstones

According to the comprehensive literature review, animals are currently being used as an effective tool during therapy and have been reported to promote improvement with communication, behaviors, quality of life, and self esteem of different treatment populations. Since emotionally disturbed adolescents often lack appropriate skills in the areas of communication, social interactions, self-esteem, independence, and boundaries, it can be challenging for occupational therapists to provide opportunities for development of these skills. Animal assisted therapy may be a tool that can assist in bridging the gap between the adult therapist and emotionally disturbed adolescents and provide a medium to promote skill …

An Occupational Therapists' Guide To Guillain-Barré Syndrome, Kelsey Hewitt, Stephanie White

Occupational Therapy Capstones

Guillain-Barre syndrome (GBS) is a rare polyneuropathy that affects 2,720 people per year in the United States (NIH, The National Women’s Health Centre, 2004). Guillain-Barre syndrome has a rapid onset that causes the patient to lose sensation and muscle strength within 48-72 hours. This project provides a resource for occupational therapists treating Guillain-Barre Syndrome (GBS) to access information regarding the etiology, incidence/prognosis, assessments, and course of medical treatment. The Occupational Adaptation model serves as a foundation for treatment of the product-a guide for occupational therapy intervention. Interventions are organized to be compatible with the Occupational Therapy Practice Framework (American Occupational …

Preterm Infants With Gastroesophageal Reflux Disorder: An Intervention Handbook For Paretns [I.E. Parents], Melissa Cramer

Occupational Therapy Capstones

One of the problems that health care workers practicing in the neonatal intensive care unit (NICU) face is providing care that is individualized to each infant and his/her family, being supportive to the infant during their development and to parental roles, and being sensitive to the needs of each infant and his/her parents and family (Lawhon, 2002). There is an additional challenge when the infant is also diagnosed with gastroesophageal reflux (GERD). Parents are often the primary caregivers and advocates for their infant in the NICU; for this reason, it is important that they understand and take part in their …