Medicine and Health Sciences Commons^™

A Critical Analysis Of Infant Mortality In Kalamazoo County, Audrey Jensen

Honors Theses

The following is a review of the state of infant and fetal health in Kalamazoo County in the 21st century. Since infant health is a marker for the effectiveness of health care, this review will analyze the leading causes of infant mortality in Kalamazoo County. Statistical indicators show that Kalamazoo County falls below both state and national IMR averages. The leading causes of infant mortality in Kalamazoo are considered preventable infant deaths. Therefore, this review will make recommendations for the reduction of IMR through the improvement of preventative prenatal healthcare practices.

Developmental And Cultural Perspectives On Children’S Postoperative Pain Management At Home, Brooke N. Jenkins, Michelle A. Fortier

Psychology Faculty Articles and Research

Outpatient surgery is extremely common in children, and approximately 4 million children experience significant pain after surgery in the USA each year. Management of children's postoperative pain in the home setting is suboptimal and is impacted by characteristics of children and parents, as well as the larger family and cultural context. In particular, developmental status of the child, parental beliefs regarding pain expression and analgesic use in children, cultural values and language barriers can affect management of children's postoperative pain. Targeting the myriad barriers to children's pain management by capitalizing upon the use of tailored interventions may help bridge the …

Palliative Care In Africa: A Global Challenge., Christian R Ntizimira, Jean Luc Nkurikiyimfura, Olive Mukeshimana, Scholastique Ngizwenayo, Diane Mukasahaha, Clare Clancy

Ambulatory and Primary Care Articles

We are often asked what challenges Rwanda has faced in the development of palliative care and its integration into the healthcare system. In the past, patients have been barred from accessing strong analgesics to treat moderate to severe pain, but thanks to health initiatives, this is slowly changing. Rwanda is an example of a country where only a few years ago, access to morphine was almost impossible. Albert Einsten said 'in the middle of difficulty lies opportunity' and this sentiment could not be more relevant to the development of palliative care programmes. Through advocacy, policy, and staunch commitment to compassion, …

Lack Of Medicaid Funding For Occupational Therapy Serving The Autism Spectrum Disorder Population Ages 0-5 Years, Nadia Yala

Honors Theses

The prevalence of autism in the United States is currently 1 in 68 children (Autism Alliance of Michigan, 2014). This is considered an epidemic. There are a variety of treatments available in the state of Michigan for children with autism, such as occupational therapy, speech therapy, physical therapy, and applied behavior analysis (ABA). Effective April 1^st, 2013, Michigan increased their funding cap for ABA therapy for treating children with autism. However, there is a lack of knowledge within the community and amongst professionals in regards to the critical treatment occupational therapy practitioners provide and as a result, there …

Improving Functional Mobility Following A Basal Ganglia Stroke, John Covilli

Case Report Posters

Background: The basal ganglia are located in the and are involved in voluntary motor control, emotional reactions, and cognition. The putamen is housed in the basal ganglia, and is involved in learning and motor skills. Stroke is the 4th leading cause of death in the U.S. and leads to 1 out of every 19 deaths. Stroke is the largest cause of disability in older adults, and the largest consumer of rehabilitation services in the U.S. Hypertension is a major risk factor for causing a stroke, and over 90% of patients that have had a basal ganglia stroke have also had …

The Role Of An International Cross Cultural Interprofessional Healthcare Immersion Program In Doctor Of Physical Therapy Education: An Educational Case Report, Jayme Keith

Case Report Posters

Purpose: The purpose of this educational case report is to describe an interprofessional international cross-cultural immersion healthcare program and to discuss the role of this program in the development of Doctor of Physical Therapy (DPT) students’ cultural competence, interprofessionalism, and social responsibility. Description: The Ghana Cross Cultural Health Immersion (GCCHI) program provides annual primary health care services and education in Sekondi, Takeradi and outlying communities in Ghana. Student and faculty participants from the University of New England (UNE) work in conjunction with the Ghana Health Services, Cape Coast University medical students and community health workers in order to meet the …

The Role Of An International Cross Cultural Interprofessional Healthcare Immersion Program In Doctor Of Physical Therapy Education: An Educational Case Report, Jayme Keith

Case Report Papers

Background and Purpose: Today’s healthcare team requires providers to be culturally sensitive and competent interprofessional collaborators. Interprofessional Education (IPE) helps to provide a collaborative foundation for healthcare providers. Cross-cultural immersion (CCI) educational programs foster cultural awareness. Service-learning (SL) programs create opportunities for students to have interprofessional and cross cultural experiences. The purpose of this educational case report is to describe an interprofessional international cross-cultural immersion healthcare program and to discuss the role of this program in the development of (DPT) students’ cultural competence, interprofessionalism, and social responsibility. Case Description: The Ghana Cross Cultural Healthcare Immersion (GCCHI) is a University based …

Improving Independent Functional Mobility Following A Left Basal Ganglia Hemorrhagic Stroke: A Case Report, John Covilli

Case Report Papers

Background and Purpose: The purpose of this case report is to compile and summarize the physical therapy management for improving independent functional mobility following a left basal ganglia hemorrhagic stroke in the outpatient setting. Additionally, this report will provide a brief overview of the presentation and medical management of a left basal ganglia hemorrhagic stroke. Case Description: The patient, JD, had a stroke on 2012 and was left with multiple impairments ranging from his cognition to his strength and active range of motion. This case covers his physical therapy management over a 12 week period with hour long appointments twice …

Postoperative Management And Core Stabilization Interventions For A Semi-Pro Football Athlete Following Lumbar Discectomy: A Case Report, Isaiah Iaea

Case Report Papers

Although there is evidence to support a high success rate to return to work in the general population and to sports play in athletes following discectomy, less is known regarding the interventions that played a role in their return. The following case describes the interventions and management of a recreational football player following discectomy. Case description: The patient was a self-described highly active 24-year-old male post discectomy. The patient had pain, poor body mechanics, gait abnormalities, range of motion deficits, and strength deficits of his low back and lower extremities. Physical therapy interventions included soft tissue mobilization, stretching, exercise, and …

A Community That Dances Never Dies: An Ethnographic Study On People Of The African Diaspora Within The African Dance And Drum Community In Chicago, Ifetayo Kitwana

Creative Arts Therapies Theses

This ethnographic study explored the possible innate healing properties and therapeutic aspects of West African dance within a public community setting for people of the African diaspora, specifically the African dance and drum community of Chicago. The study was conducted to identify a possible means for preventative work, explore the unique mental health needs of African Americans and expand the understanding of dance/movement therapy concepts outside of the clinical setting. The study revealed the usefulness of West African dance as a means to connect African Americans to their heritage of physical, mental, and spiritual healing. A narrative analysis of informal …

Test-Retest Reliability And Minimal Detectable Change Of The Modified Fresno Test Of Evidence Based Practice In Dpt Students, Erin Pike, Lisa Gerhardt

Research Report Posters

Poster presenting a research study whose purpose was to determine the test-retest reliability and MDC of the MFT in first, second, and third year DPT students, and to compare the mean total score of the MFT among the three student groups. Using a simple random sample, 21 students were recruited from each of the three UNE DPT classes. The participants completed the MFT twice, separated by 14 days, in a UNE classroom. Students in the third year class completed the validated 13-item MFT and, due to a photocopying error, students in the first and second year class completed an 11-item …

Postoperative Management And Core Stabilization Interventions For A Semi-Pro Football Athlete Following Lumbar Discectomy: A Case Report, Isaiah Iaea

Case Report Posters

Background: Many cases of low back pain (LBP) are idiopathic in nature, however, LBP in result of a herniated intervertebral disc exerting pressure on the nerve root may require lumbar discectomy to relieve sciatica and radiating pain. Although there is evidence to support successful return to work in the general population and return to sports in professional athletes, less is known regarding the interventions that played a role in their return. Purpose: The purpose of this case report is to describe the physical therapy management and core stabilization interventions for a semi-pro football athlete following lumbar discectomy who sustained a …

Re-Demonstration Without Remediation--A Missed Opportunity? A National Survey Of Internal Medicine Clerkship Directors, Mary R. Hawthorne, Katherine C. Chretien, Dario Torre, Shobhina G. Chheda

Medicine Faculty Publications

Background: Many different components factor into the final grade assigned for the internal medicine clerkship. Failure of one or more of these requires consideration of remedial measures.

Purpose: To determine which assessment components are used to assign students a passing grade for the clerkship and what remediation measures are required when students do not pass a component.

Methods: A national cross-sectional survey of Clerkship Directors in Internal Medicine (CDIM) institutional members was conducted in April 2011. The survey included sections on remediation, grading practices, and demographics. The authors analyzed responses using descriptive and comparative statistics.

Results: …

Engineered Plga Nanoparticles For Delivery Of Sirna In Mcf-7 Breast Cancer Cells, Sydney Pong, Samit Shah, Vivek Gupta

Student Scholar Symposium Abstracts and Posters

Small interfering RNAs have been an emerging medical treatment for molecular based diseases as they are capable of gene-specific knockdown. Appropriate and efficient delivery remains one of the biggest challenges in the development of siRNA as an anti-cancer treatment. Nanoparticles containing siRNA were characterized and the efficacy of various peptides in the transfection of the nanoparticles were tested. A gene silencing assay was developed in order to determine the effect of siRNA therapeutics on gene functionality in breast cancer cells.

Increasing Response Time And Response Evaluation Time Compensates For Information Processing Difficulties In Persons At Risk For Alcoholism, Yasmin Akbari

Student Scholar Symposium Abstracts and Posters

Parental history of alcoholism is associated with increased alcoholism risk in their children. One factor increasing alcoholism risk is the presence of attention and information encoding disruptions in adult children of alcoholics (ACOA) compared to persons who are not ACOAs (NACOA). Alcohol ingestion reduces these disruptions in ACOAs. This study examined whether alterations of information processing parameters can function like alcohol and reduce processing disruptions experienced by the ACOA.

Participants were 80 ACOAs and 80 NACOAs, partitioned into four groups of 20 participants. During learning, subjects studied presentations of stimulus items followed by the presentation of associated response items. The …

The Effect Of Chronic Sleep Deprivation On Tumor Necrosis Factor Alpha And Bone Health In Peri-Menopausal Rats, Megan Robertson, Derek Booth, Erin Wainwright, Cody Arbuckle, Frank Frisch

Student Scholar Symposium Abstracts and Posters

Post-menopausal osteoporosis is a common syndrome in the United States. The cessation of estrogen signaling coupled with the production of pro-inflammatory cytokines from sleep deprivation leads to an even greater risk of post-menopausal osteoporosis by creating an imbalance between osteoblasts and osteoclasts. With estrogen no longer present to regulate the concentration of osteoclasts and pro-inflammatory cytokines increasing production of osteoclasts, bone is degraded at a faster rate than it is formed. One of the most common treatments for osteoporosis is Zolendronate (a nitrogenous bisphosphonate), which decreases the number of osteoclasts in bone. This preliminary study looked at the effects on …

Assessment Of The Effects Of Caffeine, Gallic Acid, And Epigallocatechin-3-Gallate On Cell Inhibition, Pim-3 And E. Cadherin Protein Levels In Two Lines Of Pancreatic Cancer Cells, Lena Haddad, Melissa Rowland-Goldsmith

Student Scholar Symposium Abstracts and Posters

According to the American Cancer Society, pancreatic cancer is currently the fourth leading cause of cancer related deaths in the United States. In addition to being an exceptionally aggressive form of cancer, it is particularly difficult to treat because it is usually diagnosed in late stages after the onset of metastasis (1). Consequently, the current treatments used, including chemotherapy and radiation, have been rendered ineffective (2). As a result, focus has been placed on using dietary alternatives which are known to possess chemopreventive properties (3). Previous studies have indicated that Gallic acid (an important phytochemical in pomegranates) and Epigallocatechin-3-Gallate (the …

Toxicity And Cosmesis Outcomes For Single Fraction Intra-Operative Electron Radiotherapy (Ioert) For Breast Cancer, Monica Hanna, Robert Ash, Wesley Babaran, Michele M. Carpenter, Afshin Forouzannia, Jay K. Harness, Brian Kaltenecker, Snehith Maddula, Venita Williams, Lawrence Wagman

Student Scholar Symposium Abstracts and Posters

Background: Adjuvant radiation therapy is proven to reduce local recurrence in patients with early stage breast cancer. To reduce toxicity, improve geographic accuracy, and reduce treatment time, IOERT can be utilized as an alternative to external beam radiation therapy. The study’s objective was to determine the short term toxicity and cosmesis profile of single fraction IOERT given as definitive treatment in a community setting. Materials and Methods: From Mar 2012 to Jul 2014, 84 patients (3 bilateral), ages 45-91 y.o. with stage 0-II were treated with IOERT (Mobetron, IntraOp Medical, Sunnyvale, CA). A single 21 Gy fraction was administered to …

Molecular Insights Into Prostate Field Cancerization: Telomere Length, Egr-­‐1 Expression, And Regulation Of Mic-­‐1, Pdgf-­‐A, And Fas, Emily Frisch, Kristin Gabriel, Marco Bisoffi

Student Scholar Symposium Abstracts and Posters

The diagnosis of prostate cancer (adenocarcinoma) relies on screening for elevated prostate-specific antigen (PSA) in blood samples and on digital rectal examination (DRE). With high PSA levels and/or abnormal DRE, physicians recommend a biopsy, which often misses the location of the adenocarcinoma and results in false negatives. Previous studies have shown expression of the key transcription factor early growth response 1 (EGR-1), the pro-survival factor macrophage inhibitor cytokine 1 (MIC-1), and the growth stimulatory platelet derived growth factor A (PDGF-A) to be up-regulated in histologically normal tissues 1 centimeter adjacent to prostate adenocarcinomas. We hypothesize that tumors emerge from “field …

Adjusting Learning Parameters To Increase Cognitive Resource Allocation In Persons With Alcoholism Risk, Brooke Snelgrove, Taylor Stephens, Yasmin Akbari, Reyn Yoshiura, Lilian Andrade

Student Scholar Symposium Abstracts and Posters

Parental history of alcoholism is associated with increased alcoholism risk in their children. One factor increasing alcoholism risk is the presence of attention and information encoding disruptions in adult children of alcoholics (ACOA) compared to persons who are not ACOAs (NACOA). Alcohol ingestion reduces these disruptions in ACOAs. This study examined whether alterations of information processing parameters can function like alcohol and reduce processing disruptions experienced by the ACOA. Participants were 80 ACOAs and 80 NACOAs, partitioned into four groups of 20 participants. During learning, subjects studied presentations of stimulus items followed by the presentation of associated response items. The …

Prostate Field Cancerization -- Thinking Outside The Tumor, Dor Shoshan, Marco Bisoffi

Student Scholar Symposium Abstracts and Posters

Prostate field cancerization (or field effect) is characterized by the presence of molecular alterations in histologically normal tissues adjacent to adenocarcinomas. Accordingly, our research indicates deregulated expression of several proteins that define this type of molecular pathology. The scope of the present study was to determine the expression of the key transcription factor and potential marker of field cancerization early growth response 1 (EGR-1) in human prostate tissues derived from prostatectomies and biopsy cores.

EGR-1 was detected by immunofluorescence using a polyclonal anti-human EGR-1 and Alexa Fluor 488-conjugated secondary antibodies. EGR-1 expression was quantitated by determining the pixel count per …

Accommodating Hyperaroused Information Processing In Persons At Risk For Alcoholism, Kellianne Clark, Jaclyn Cutler

Student Scholar Symposium Abstracts and Posters

In the search for the factors related to the heightened alcoholism risk in adult children of alcoholics (ACOA), it has been reported that these persons possess a high incidence of attention deficit disorders (ADD) as determined by clinical assessment instruments. However, investigations of alcoholism risk and ADD indicate that, in contrast to the hypoarousal model of ADD, the ACOA’s attention problems represent hyperarousal of attention mechanisms resulting in reduced ability to select and encode relevant information. If true, then unlike persons with ADD, clinical and cognitive assessments of ACOAs would benefit if the ACOA was provided with more time to …

The Economics Of Implementing Population Health Strategies: Progress In Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

Successful strategies to scale up and spread complex community-level interventions require an understanding of the resources required for implementation, how best to distribute them among supporting institutions, and how resource consumption and distribution varies across settings. This session reviews methods and early findings from the RWJF’s Public Health Delivery and Cost Studies (DACS) Initiative, which includes 12 inter-related studies examining the causes and consequences of variation in the costs of delivering complex community-level prevention strategies across more than 300 community settings in 12 states. Findings from these studies highlight the value of studying the economics of implementation, the measurement and …

Even Perfusion Pump-Integrated Blood Oxygenator, Dongfang Wang, Joseph B. Zwischenberger

Surgery Faculty Patents

A blood oxygenator includes an integral pneumatic pump disposed substantially within a housing thereof, an inlet blood flow redirector, and an outflow blood collector. An atrium provided at an inlet of the oxygenator promotes even delivery of blood to the oxygenator. In use, the oxygenator provides an even dispersion of blood therethrough, establishing even perfusion and reducing areas of stagnant blood flow.

Sharon’S Inspirational Journey With Crossfit In The Fight Against Huntington's Disease, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Effect Of Dual Tasking On Walking Over Even And Uneven Surfaces In Functionally Independent Community Older Adults, Olajide L. Kolawole

Seton Hall University Dissertations and Theses (ETDs)

While several studies have reported a decrement in performance by older adults while walking and concurrently performing a dual task on even surfaces, to date the effects of dual tasking while walking on uneven surfaces commonly found in the community has received less attention. Thus, we sought to test the hypothesis that an incremental decrement in gait parameters will be observed, when walking on an uneven versus an even surface and furthermore, that this decrement would be dependent upon the concurrent performance of a secondary cognitive and/or motor task in functionally independent-living-community older adults.

Dynamic Gait Index assessed the subject’s …

Assessing Cultural Competence In Health Professional Student's, Sophia Jones

Seton Hall University Dissertations and Theses (ETDs)

Background-The United States has become a more diverse society and healthcare professionals must be ready to meet the needs of this more culturally diverse society. Students studying in the many areas of healthcare must learn to be culturally competent. To ensure that students are culturally competent and can provide culturally competent care routed in a global perspective their abilities must be developed and assessed. With the absence of any such assessment tool in the literature reviewed the objective set forth in a preliminary study was to develop a tool to assess cultural competence from a global perspective. With this …

Assessing Risk Factors And Levels Of Functioning Across The Continuum Of Psychosis, James Castorina

Theses and Dissertations

Schizophrenia and other related psychotic disorders are often associated with impairments in social and general functioning. It has been proposed that there may be underlying factors such as personality traits or cognitive abilities that contribute to one's psychosis proneness, or levels of schizotypy. In the current study, we expect to see a decline in overall functioning and verbal memory according to symptom severity. Particularly, we hypothesize a similar pattern with overall functioning and verbal memory in regards to negative symptomology with comparable results between an outpatient sample and those with high levels of schizotypy. Furthermore, based on prior research, we …

Sailing As A Therapy Modality For Occupational Therapy; Requirements Prior To Participation, Carrie Bell

Honors Theses

Many outdoor activities are currently being utilized by recreational therapists to aid in the development of play and leisure skills, education, social skills training, and even therapeutic community. The process of using these outdoor activities can aid clients in emotional, physical, cognitive and social functions. Although these types of activities have been primarily utilized in recreational therapy intervention sessions, these activities carry the potential to also fit within the domain of occupational therapy. In order to engage in the recreational activity of sailing, persons must have specific cognitive, physical, emotional and social abilities. The purpose of this study is to …

A Randomized Noninferiority Trial Of Condensed Protocols For Genetic Risk Disclosure Of Alzheimer's Disease, Peter J. Whitehouse, Melissa Barber Butson

Faculty Scholarship

Introduction Conventional multisession genetic counseling is currently recommended when disclosing apolipoprotein E (APOE) genotype for the risk of Alzheimer's disease (AD) in cognitively normal individuals. The objective of this study was to evaluate the safety of brief disclosure protocols for disclosing APOE genotype for the risk of AD. Methods A randomized, multicenter noninferiority trial was conducted at four sites. Participants were asymptomatic adults having a first-degree relative with AD. A standard disclosure protocol by genetic counselors (SP-GC) was compared with condensed protocols, with disclosures by genetic counselors (CP-GC) and by physicians (CP-MD). Preplanned co-primary outcomes were anxiety and depression scales …