Medicine and Health Sciences Commons^™

Inclusive Sports Environments: Youth Gymnastics Coaches’ Perceptions On Promoting Inclusivity For Autistic Athletes, Alec D. Sheaffer

Occupational Therapy Doctorate Capstone Projects

Background: Despite the positive physical, psychological, and social benefits of sports, children with disabilities participate in sports at a lower rate than their typically developing peers. Partnerships between occupational therapists and youth sports providers can facilitate inclusive sports environments that enable equitable access to sports for all children.

Purpose: The purpose of the Capstone Project was to explore youth gymnastics coaches’ perceptions on inclusive sports participation following an educational module.

Theoretical Framework. The occupational justice framework (Townsend & Wilcock, 2004) guided the development of the project through the view that equitable participation in preferred occupations is an individual right.

Methods. …

Ot Cht Treatment And Intervention For Adult Clients After A Nerve Transfer Surgery: A Pilot Survey, Katheryn Fister

Occupational Therapy Doctorate Capstone Projects

Background: This study used a pilot survey to collect data regarding how current occupational therapists who are also certified hand therapists are working with adult clients after a nerve trans- fer surgery. The pilot survey was conducted virtually via email and created using Qualtrics software.

Purpose: The purpose of this research was to create a survey tool and obtain data to describe current occupational therapy practice trends, outcomes, and education for clients after a nerve transfer surgery. The research sought to determine what interventions are commonly incorporated, what are common outcomes, what education is being provided, what is included …

A Review Of Factors That Impact Breastfeeding And Postpartum Depression, Brooke Crowley, Kara Roman, Andrea Olmstead, Jaydeen Morris, Jason Brumitt

Doctor of Medical Science (DMSc)

Postpartum depression is experienced by up to 15% of mothers and can greatly impact the experience that they have with their newborns.¹ Postpartum depression can be associated with young maternal age, smoking, antenatal depression, stress during pregnancy, and newborns requiring intensive care.² It most often develops about 6 or more weeks after birth and can range from postpartum “blues” to postpartum psychosis.³ If left untreated, postpartum depression can lead to poor maternal-fetal bonding, breastfeeding failures, and worse outcomes for the psychological and physical development of the child.³ Untreated postpartum depression is also associated with extended periods …

Conjugated Pneumococcal Vaccination To Decrease The Incidence Of Acute Otitis Media In Pediatric Populations Under Five Years Old, A Scoping Review, Thomas Dillon Murray, Michelle Rhea, Erika Mccarthy, Kristy Asbell

Doctor of Medical Science (DMSc)

Background

Acute otitis media (AOM) is one of the most common pediatric diseases and can lead to long term complications. Due to the inflammation caused by AOM, damage can be done to the middle ear, impacting a child's auditory sense. As they grow older, this can result in developmental delay and impact many other aspects of their life. AOM associated with long term hearing loss is most prevalent in rural communities. Early detection and treatment of AOM can prevent inflammation from progressing to chronic scarring but many rural communities do not have access to expedient medical care.

One of the …

Physical Activity And Reduced Risk Of Cognitive Decline, Ashley Tolentino, Erika Mccarthy, Travis Adelman, Taryn Pearl

Doctor of Medical Science (DMSc)

Similar to dementia management, treatment of mild cognitive impairment includes both non-pharmacologic and pharmacologic options to help prevent progression of further cognitive decline and dementia. Pharmacologic treatment of reversible causes include discontinuation of medications causing cognitive side effects, treating sleep disturbances, treating depression , and correcting deficiencies in vitamin B12 or thyroid hormone.² Another important step includes vascular risk factor modification with pharmacologic treatment of hypertension, which has been identified as an important risk factor of dementia. ³Non-pharmacologic interventions include various methods of cognitive rehabilitation (e.g., memory training and exercise). Exercise programs lasting 6 to 12 months have …

An Ex-Vivo Investigation Of The Effect Of Skin Conditioning With Formulation Vehicles On The Dermal Disposition Of Diphenhydramine Perfused Directly Into The Dermis, Nasim Rezvani Haghighi Shirazi

Selected Full-Text Dissertations 2020-

It is well known that the composition/excipients of a topical dermatological drug product (TDDP) affect the permeation of an active pharmaceutical ingredient (API) through the skin. While it is generally accepted that the vehicle mostly modulates the release of the API from the product, little is known whether the vehicle might also influence the kinetics of the API within the skin itself. In one attempt to answer this question, we developed an ex-vivo model using pig ear and a retrodialysis/microdialysis technique to deliver the API directly into dermis and measure the API dermal pharmacokinetics (dPK). We compared the dPK of …

Perception Of Students As Partners In Learning Among Students And Faculty Members Of Sonam Karachi, Pakistan, Anum Shiraz Gujrati

PhD-HS 2024

Background: Students as Partners (SaP) has emerged as a student-centred approach where students are taken as active partners in determining learning outcomes and pedagogies rather than being merely passive learners and consumers in Higher Education (HE). It shifts the focus from the teacher-centred to the student learning environment and from a product to process-orientated outcomes. There is still a need to explore the perception of students as partners in HE among undergraduate and graduate nursing students and faculty members.
Purpose: The purpose of the study is to explore the perception of students and faculty members regarding students as partners in …

Concept Of Health-Related Quality Of Life Among People With Heart Failure In Karachi, Pakistan, Anny Ashiq Ali

PhD-HS 2024

Background: Non-communicable diseases (NCDs), including cardiovascular diseases, are a leading cause of global mortality. The mortality rate for cardiovascular diseases is on the rise, with 80 % to 86 % of fatalities, particularly in low- and middle-income countries, including Pakistan. Among NCDs, heart failure (HF) is a condition for which there is no cure, and patients rely on supportive treatments to maintain their quality of life. HF not only affects physical well-being but also has far-reaching consequences on the emotional, social, and cognitive aspects of life. In the context of Pakistan, where unique healthcare, sociocultural, and economic factors prevail, the …

The E-Liquid Flavorings Cinnamaldehyde, Vanillin, And Ethyl Vanillin Induce Cellular Stress Responses In Human Proximal Tubule (Hk-2) Epithelial Cells, Ashley J. Cox

Theses, Dissertations and Capstones

The use of electronic nicotine delivery systems (ENDS) has become popular in recent years as an alternative to traditional cigarettes. These devices heat and subsequently vaporize e-liquids for inhalation by the user, which allows for the delivery of ingredients such as flavorings, nicotine, and solvents through the vapor. Flavorings used in e-liquids are “generally recognized as safe” (GRAS) for consumption by the Food and Drug Administration (FDA), however there are currently no recommendations on safety regarding the inhalation of flavoring agents. While research characterizing effects of e-liquids and their flavorings is abundant in lung and respiratory tract models, few studies …

Examining The Impact Of Firearm Recoil During A Round Of Trap Shooting On Neurometabolic Changes Associated With Traumatic Brain Injury, Lakota Jones

Theses, Dissertations and Capstones

The CDC identifies concussion as a blunt, blow, or jolt to the head resulting in brain injury. Shooting sports do not impose a direct blow to the head but instead inflict rapid acceleration to the brain via recoil transfer. Exposure to rapid, repetitive recoil may cause physiological disturbances in the brain, therefore resulting in mild traumatic brain injury (TBI). Chronic recoil transfer and overpressure exposure influencing neurometabolic changes of TBI have yet to be measured. The objective of this study was to examine kinetic energy experienced in trap and skeet shooters following one round of shooting in comparison to neurometabolic …

Perception Of Students As Partners In Learning Among Students And Faculty Members Of Sonam Karachi, Pakistan, Anum Shiraz Gujrati

MBE 2024

Background: Students as Partners (SaP) has emerged as a student-centred approach where students are taken as active partners in determining learning outcomes and pedagogies rather than being merely passive learners and consumers in Higher Education (HE). It shifts the focus from the teacher-centred to the student learning environment and from a product to process-orientated outcomes. There is still a need to explore the perception of students as partners in HE among undergraduate and graduate nursing students and faculty members.
Purpose: The purpose of the study is to explore the perception of students and faculty members regarding students as partners in …

The Impact Of Local Physiology On The Corrosion Of Orthopedic Alloys, Madison Nicole Brown

Theses and Dissertations (ETD)

Introduction. Total knee arthroplasty (TKA) is used in the treatment of end-stage osteoarthritis of the knee. It is one of the most common elective surgeries performed with predictions expecting significant increases in the number of procedures performed over the next decade. However, the patient satisfaction rate after TKA is as low as 80%. Cobalt-chromium-molybdenum (CoCrMo) is regularly used for TKA protheses due to the alloy’s mechanical strength, biocompatibility, and corrosion resistance. The corrosion resistance of this alloy relies on a passive oxide layer. This oxide layer can be impacted by phagocytic cells which can leave pits and craters on implant …

Incidence Of Pathologic Nodal Disease In Clinically Node Negative, Microinvasive/T1a Breast Cancers, Pranammya Dey

Yale Medicine Thesis Digital Library

Axillary staging in early-staged breast cancer can impact adjuvant treatment options but is also associated with increased morbidity. The incidence of pathologic nodal positivity in patients with microinvasive or T1a disease by histologic subtype is not well characterized and thus, the value of sentinel node biopsy remains controversial in these patients. We sought to analyze patient demographics and tumor characteristics associated with pathologic nodal disease in patients with clinically node negative (cN0), microinvasive and T1a breast cancers.Women >18 years old with clinically node negative (cN0) and pathologic microinvasive or T1a breast cancer who underwent upfront surgery were identified from the …

Barriers To Methadone For Hiv Prevention Among People Who Inject Drugs In Kazakhstan, Amanda Rachel Liberman

Yale Medicine Thesis Digital Library

Background: In Eastern Europe and Central Asia, HIV incidence and mortality continue to increase, and this epidemic is concentrated among people who inject drugs (PWID). In Kazakhstan, the prevalence of HIV among PWID is higher than for any other key population. Opioid agonist therapies like methadone are the only evidence-based treatment for opioid use disorder and thus are crucial tools for HIV prevention. Though methadone has been provided for free in Kazakhstan since 2008, less than 1% of PWID currently access this service. An intervention to increase methadone scale-up is necessary, and the Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework …

Ballistic And Explosive Orthopaedic Trauma Epidemiology And Outcomes In A Global Population, Jamieson M. O'Marr

Yale Medicine Thesis Digital Library

Introduction:This thesis critically examines the epidemiological trends and clinical outcomes associated with ballistic and explosive orthopedic trauma, focusing exclusively on data coming from low- and middle-income countries (LMICs). Given the rising prevalence of civilian casualties in contemporary conflict zones and incidents of urban gun violence, there is an amplified need to bolster our understanding of these injuries. This is particularly important in LMIC civilian settings where a majority of this trauma is occurring but where the current literature is extremely lacking. This research aims to contribute significantly to the global medical community's capacity to provide informed, LMIC relevant evidence-based care …

Exploration Of Associations Between Asthma And Depression In Older American Adults: A Pooled Cross-Sectional Analysis Of Medicare Recipients, Brian Ring

Graduate Research Theses & Dissertations

Background

While unclear in older populations within the US, individuals with asthma are disproportionally affected by depression relative to those without asthma. This work explores the associations between asthma, depression, sociodemographic, and disease-related factors in a US population ≥ 65 years of age.

Methods

A pooled cross-sectional analysis of Medicare Current Beneficiary Survey (MCBS) data was utilized to determine the association between asthma and depression from 2018 to 2020. Depression was defined as a score of ≥ 10 from the Patient Health Questionnaire-9 (PHQ-9). Disease-related variables were recorded if the subject met Medicare claims criteria for the calendar year. Multivariable …

Polycystic Ovary Syndrome And The Effects Of A Ketogenic Diet: A Scoping Review, Dayelise Fleigle

Doctor of Medical Science (DMSc)

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in females of reproductive age.¹ It is estimated that 7% of women worldwide are impacted.¹ Diagnosis of PCOS is based on the widely adopted Rotterdam Criteria, though there are other proposed criteria.² Using the Rotterdam Criteria, two out of three of the following must be present to establish a diagnosis of PCOS: clinical or biochemical signs of hyperandrogenism, oligo-anovulation, and/or polycystic ovaries seen on ultrasound.² Patients with PCOS may also present with one or more of the following: overweight/obese body mass index (BMI), infertility, insulin resistance, dyslipidemia, …

Fecal Microbiota Transplantation In Prevention Of Recurrent C. Difficile Infection, Emmiline Chou

Doctor of Medical Science (DMSc)

Clostridium difficile is a gram-positive, spore-forming anaerobic bacterium that causes a spectrum of clinical presentations from mild diarrhea to severe colitis. Clostridium difficile infection (CDI) remains a persistent challenge with a notable burden of recurrence in a subset of 1 patients. Recurrent CDI is associated with increased healthcare costs, heightened risk of complications and elevated mortality rates. While standard antibiotic therapies can be effective initially, they often fail to provide sustained clinical remission, making alternative treatment

1 options such as fecal microbiota transplantation (FMT) necessary. Biotherapeutics is another alternative with less risks of resistance than with antibiotic therapy. Efforts to …

Prostaglandins To Ease The Pain Of Intrauterine Device Insertion, Brittney Ayles

Doctor of Medical Science (DMSc)

Intrauterine devices (IUDs) are effective contraceptives, but they continue to be underutilized by adolescent and young adult females in part due to the anticipated pain of device insertion and lack of standardized analgesia during device insertion. This systematic review evaluates the use of prostaglandins (dinoprostone and misoprostol) and topical lidocaine formulations for analgesic efficacy during IUD insertion. Randomized controlled trials and systematic reviews published in the last 10 years with the primary outcome of pain reduction during IUD insertion using either prostaglandins or topical lidocaine were included given the study included nulliparous women. Electronic search via PubMed was conducted, and …

Psilocybin’S Role In Major Depressive Disorder: A Scoping Review, Carlos Barajas

Doctor of Medical Science (DMSc)

Psilocybe cubensis are a group of mushrooms containing psilocybin with a history of consumption dating back to ancient civilization. Researchers believe the ritual use of psilocybin dates back 3,000 years amongst the indigenous people of Mexico and Central America.¹ Psilocybin is responsible for the effects associated with the consumption of “Magic Mushrooms”. These effects include hallucinations, delusions, and feelings of derealization. ² In 1973, the United States federal government classified psilocybin as a Schedule I substance under the Controlled Substance Act, and today the DEA continues to identify the chemical as “high potential for abuse” with “no currently accepted …

A 3d Dlt View Correction Tool For Manual Digitizing: A Cross-Platform Application For Correcting Shifted Image Coordinates Prior To Object Coordinate Reconstruction, William Moynihan

Theses, Dissertations and Capstones

While 3D direct linear transformation is a versatile motion capture method, care must be taken so that the cameras are not bumped or adjusted between the object space calibration phase and the end of video recording. Disturbing the cameras during this time will misalign the view, making the movement data invalid for the associated calibration. The purpose of this study was to design and validate a cross-platform software application for transforming image coordinates from a bumped camera to be compatible with the object space calibration and to determine the relationship between reconstruction error and changes to bumped camera views.

For …

Impact Of The Methamphetamine Epidemic On Healthcare, Amanda Brumfield

Theses, Dissertations and Capstones

Introduction: The surge in methamphetamine use in the U.S. has presented various challenges for individuals and healthcare systems. Research has shown high relapse rates, oral health issues, and increased susceptibility to blood-borne viruses among users, underscoring the gravity of the situation. Furthermore, the absence of approved pharmacological treatments and systemic barriers to effective treatment highlighted the pressing need for holistic approaches to address this epidemic successfully.

Purpose of the Study: The purpose of this research was to identify the challenges faced by treatment providers specializing in substance use disorder treatment amid rising instances of methamphetamine abuse, including managing heightened relapse …

Ssri/Snri Medications Vs. Cognitive Behavioral Therapy In The Treatment And Management Of Postpartum Anxiety, Kelsey Sederquest

Physician Assistant Scholarly Project Papers

The purpose of this literature review is to determine the effects of cognitive behavioral therapy (CBT) and Selective Serotonin Reuptake Inhibitors/Selective Norepinephrine Reuptake Inhibitors (SSRI/SNRI) in women suffering from postpartum anxiety. Efficacy of nonpharmacological, pharmacological, and combination therapy compared within this review. Lastly, prophylactic treatment of anxiety was examined in women who were pregnant or who were newly postpartum without diagnosis of anxiety. In this review the database PubMed was utilized to conduct research that included many different keywords. The articles included were limited to within the last 30 years, and research was narrowed by limiting patient population to postpartum …

A Mindfulness Approach To Regulate Depressive-Associated Emotional Eating, Jillian G. Montefusco

Doctor of Nursing Practice Scholarly Projects

Background: Depression affects 350 to 500 million people globally, with depressive-associated emotional eating (DAEE) impacting approximately 43.5% of these individuals. Depressive-associated emotional eating contributes to obesity through poor dietary choices and weight gain, leading to the projection that by 2048 all United States citizens will be overweight or obese.

Local Problem: At a Chicago weight loss center, the Emotional Appetite Questionnaire screened 75 patients, revealing that 56% (N = 42) ate more during sadness, boredom, and loneliness, and 50.7% (N = 38) ate more during depression, indicating significant DAEE.

Methods: This quasi-experimental quality improvement project uses a pre- and post-evaluation …

Effect Of Acute Care Discharge Delays On Inpatient Rehabilitation Facility (Irf) Utilization, Eric Garrard

Student Dissertations

Discharge delays present hospitals with challenges in managing costs for Medicare admissions. Meanwhile, Inpatient Rehabilitation Facilities (IRF) are subject to strict pre-admission requirements that can complicate efficient transitions of care for patients with intensive rehabilitation needs. The purpose of this retrospective quantitative correlational study was to examine any relationship between acute care discharge delays and IRF utilization. This study investigated whether length of stay (LOS) and Medicare Advantage prior authorization requirements impact IRF referrals by reviewing 3,747 medical records of acute stroke patients aged 65 years and older at a regionally integrated healthcare system over a 3-year period (2020- 2022). …

Role Of Myocardin Effector Genes On The Progression Of Cytoskeletal Remodeling And Phenotype Switching Of Hpmcs, Kasumi Sato

Biotechnology Theses

Pleural fibrosis (PF) is characterized by thickening of the pleura around the lungs due to mesothelial cells transitioning into myofibroblasts. Our research delved into the role of Myocardin (MYOCD) in this transition, revealing Twinfilin 1 (TWF1) and Leiomodin 1 (LMOD1) as significant genes influenced by MYOCD. In our investigation, we explored how TWF1 and LMOD1 impact cytoskeletal changes in human pleural mesothelial cells (HPMCs) induced by Transforming growth factor beta (TGF-β). Knocking down TWF1 resulted in reduced expression of Calponin 1 and alpha-Smooth Muscle Actin (α-SMA), while LMOD1 knock-down suppressed α-SMA expression. Inhibition of TWF1 hindered stress fiber formation but …

Promoting Parental Comfort To Facilitate Conversations On Adolescent Sexual Health And Behaviors, Angelina Jolie Banes, Lauren Liddell

Nursing | Senior Theses

This thesis proposal will investigate the impact of a comprehensive digital sexual health education program on the comfort levels of parents and teens when discussing sensitive topics such as pregnancy and sexually transmitted infections (STIs). The research is guided by Orem’s Self-Care Deficit Nursing Theory, which emphasizes the need to assess and address individuals’ self-care deficits, including the ability to engage in safe and informed sexual behaviors. The research design is a quantitative, quasi-experimental study with a one-group pre and post-test design. The sample consists of 50 parents and 50 teens from Marin County, who will participate in an online …

Furry Friends & Brighter Futures: Enhancing The Life Skills Of Toddlers With Autism Through Animal Assisted Therapy, Abigail Rosales Tolentino

Nursing | Senior Theses

Autism Spectrum Disorder (ASD) encompasses a broad spectrum of challenges that impact social interaction, communication, and behavior. While Applied Behavior Analysis (ABA) stands as a common therapeutic approach, there is a growing recognition of the need for personalized interventions. Animal Assisted Therapy (AAT) emerges as a promising avenue for enhancing social interactions. This study focuses on the utilization of dogs in AAT for toddlers aged 12 to 36 months with confirmed ASD diagnoses. The experimental group will undergo a combined intervention involving standard ABA therapy alongside weekly AAT sessions, whereas the control group will receive standard ABA therapy alone. Pre- …

Icu Nurse Mental Health: Telehealth Versus In-Person Therapy Effectiveness, Ariel Mach

Nursing | Senior Theses

Background Nurses working within high-stress specialties, such as Intensive Care Units (ICUs), often face a lack of resources aimed at supporting their mental health. The expectation for the nurses is to independently manage their psychological well-being based on their knowledge and educational background. However, many times it is difficult to manage persistent stress, anxiety, or depression and this could adversely affect the quality of patient care and eventually lead to burnout. Telehealth therapy has become more readily available and used since the COVID-19 pandemic, leading to two forms of treatment delivery. Currently, there is limited research on the effectiveness of …

Pediatric Vaccination Adherence: Enhancing Compliance Among First-Generation Asian American Parents, Katelyn Leong

Nursing | Senior Theses

Background: Vaccine adherence in the pediatric population refers to receiving vaccines as per the recommended schedule, which significantly reduces vaccine-preventable diseases and enhances community immunity. Vaccine hesitancy, driven by concerns such as safety, misinformation, or cultural beliefs can affect adherence. National coverage of state-mandated vaccines among kindergarteners declined from 95% to around 93% between 2019 and 2022, varying across different vaccines. Objective: This research proposal’s focus is to determine if an educational intervention targeting first-generation Asian Americans, who have adopted their immigrant parents' misinformation about vaccines, will effectively increase vaccination rates among their children. The study aims to assess the …