Medicine and Health Sciences Commons^™

The Fight For Zadroga, Naeisha Rose

Capstones

The attack on the World Trade Center cost many first responders and volunteers, like Ken George, a retired highway crewmember who was part of the search and rescue, to lose their health. Ken had needs a respirator for his restricted airway disease, he is o n 33 medications and five years ago he had a heart attack. Bi- =weekly or monthly, he visits a doctor for his PTSD, his heart, his lungs and general healthcare. After seeing the devastating conditions that the responders like Ken worked in, Congresswoman C arolyn Maloney (D-12) worked tirelessly with many politicians, both Democrats and …

Improving Patient Care Outcomes To Reduce Recurrent Admissions Of Patients With Chronic Obstructive Pulmonary Disease, Lisa Maria Friedrich

Seton Hall University DNP Final Projects

Purpose:Transitional care is time-limited, with the goal of ensuring safety and health continuity for at-risk patients with chronic obstructive pulmonary disease (COPD) as they move from one setting to the next. An acute care episode of COPD ranges from relatively healthy adults to adults with multiple chronic conditions or those in the end-of-life phase. The primary quality concern of an urgent need to improve health care is in response to the gaps of sufficient experience to manage patients with COPD, leading to hospital readmissions. Implementation of standards of care for the improvement of health-related quality of life (HRQL) of COPD …

Adhd And Social Impairment Among Children: Problem Solving Skills As A Potential Mediator, Rebecca Mccord

Senior Theses

This study tested the hypothesis that problem solving skills mediate the relation between ADHD symptoms and social impairment in children. Problem solving skills were evaluated by the Test of Problem Solving 3 – Elementary Version (TOPS), which separated problem solving skills into six different subtypes: making inferences, sequencing, negative questions, problem solving, predicting, and determining causes. ADHD symptoms were assessed through the parent report of the Disruptive Behavior Disorder Scale (DBD). Social impairment was assessed through the parent report of social skills using the Social Skills Improvement System (SSIS). Three hundred seventy-two (372) children between the ages of eight and …

Travel Tales: The Role Of Storytelling In Abroad Experience And Healing, Colleen N. Mcmurray

Capstone Collection

This capstone paper examines the perceived effectiveness of storytelling in the healing process. It aims to answer the question: What role does storytelling play in the healing of returning travelers? The study was conducted by analyzing forty digital videos, categorizing themes, and analyzing the themes in relation to themes found within several articles about the power and effects of storytelling. Five principal themes were used from the data collected. The themes were then used to gain a deeper understanding of how storytelling makes the storyteller feel and how storytelling can be used for healing. The author of this paper has …

Cerebral Oximetry Readings In The Sitting Position Versus Supine Position For Patients Undergoing General Anesthesia, Christopher Turner

Doctoral Projects

Problem: Inadequate cerebral blood flow is a significant risk for patients undergoing surgery in the sitting position. Placing the patient in a sitting position may cause a drop in pressure at the level of the brain when compounded with induction and maintenance of general anesthesia. These changes may cause a decrease in cerebral blood flow and oxygenation. Inadequate perfusion for a prolonged period of time could produce negative neurological consequences in the short and long term postoperative period.

Purpose: The purpose of this project is to determine if there is a significant drop in cerebral oximetry, from baseline, when patients …

The Effects Of Training Programs Using Free Weights And Free Motion Machines On Strength In Untrained College-Age Females, Katherine Milton

Graduate Theses

No abstract provided.

Scoliosis Analog Model For The Evaluation Of Bracing Technology, Chloe Ly Chung

Theses and Dissertations (ETD)

Thoracolumbar braces are commonly used to treat Adolescent Idiopathic Scoliosis (AIS). Braces serve to reduce and prevent progression of the spinal curve by applying corrective forces. The magnitude and direction of these corrective forces applied by the brace to the spine remain unknown. Additionally the brace fitting process involves making alterations to the brace that affect its corrective force capacity. The objective was to design and validate an analog model of a mid-thoracic single curve scoliotic deformity for quantifying structural properties of the brace and the force response of the brace on the spine. This model was used to investigate …

An Exploration Of Nurse Adherence To Ventilator-Associated Pneumonia Bundle Interventions: A Quantitative Study, Alexis Luna

Senior Theses

Ventilator-associated pneumonia (VAP) poses a significant health risk to patients on mechanical ventilation in hospital intensive care units (ICU). It is the responsibility of the nurse to implement VAP bundle interventions to decrease the prevalence of VAP in mechanically ventilated patients. The objective of the study was to measure nurse perception of adherence to VAP bundle interventions of oral hygiene, head-of-bed elevation, spontaneous breathing trials, daily sedation vacations, and peptic ulcer and deep vein thrombosis prophylaxis. A descriptive study involving a sample population of 28 ICU nurses at 3 hospitals in northern California was conducted. A 57-item questionnaire was developed …

The Effect Of Neurostimulation On Ischemic Pain And Methods Of Assessing Pain, Kaylee Keck

Biomedical Engineering

Peripheral arterial disease (PAD) impacts approximately eight million people in the United States [1]. Disease progression leads to chronic ischemic pain, hindering quality of life. Pharmaceuticals are a typical treatment for pain associated with PAD; but as few as 30% of patients have a significant reduction of pain (≥50%) [2].

Neurostimulation is commonly used as a treatment for various diseases and injuries, including Parkinson’s disease and sports-related back and knee injuries [2]. The objective of the study was to explore neurostimulation and its effect on pain and paresthesia for a model of acute peripheral ischemia in young college students.

Pain …

Icloudecg: A Mobile Cardiac Telemedicine System, David S. Clifford

Masters Theses

With rising healthcare costs and a substantially growing number of patients 65 or over, the benefits of telemedicine and patient self-monitoring systems are becoming increasingly evident. Patients, physicians, hospitals, and even insurance providers benefit from vigilant, cost-effective patient monitoring systems. This thesis describes the development of a portable, smart-phone connected system for continuous cardiac monitoring. The system is capable of continuously monitoring the conditions of the heart, automated detection of cardiac arrhythmias, and real-time notifying patients and physicians of the detected abnormalities. The system consists of four main subsystems: 1) a Bluetooth capable chest-strap ECG, 2) an Android-enabled mobile device, …

Feasibility Of Using Arterial Spin Labeling For Detecting Longitudinal Changes In Cerebral Blood Flow, Tracy Ssali

Electronic Thesis and Dissertation Repository

The ability of the perfusion MRI technique, arterial spin labeling (ASL), to quantify cerebral blood flow (CBF) makes it attractive for longitudinal studies of changes in brain function, such as those related to chronic pain. However, ASL's poor spatial resolution makes image alignment between sessions difficult, leading to increased variance and greater Type-I errors. In addition, variability due to differences in basal blood flow between sessions and confounding effects such as the arterial transit time (ATT) have the potential to reduce reproducibility over time. The focus of this thesis is to investigate the ability of ASL to detect long-term changes …

Hyperpolarized 129xe Magnetic Resonance Imaging Of Radiation-Induced Lung Injury, Ozkan Doganay

Electronic Thesis and Dissertation Repository

Lung cancer is the largest contributor to cancer-related mortality worldwide. Only 20% of stage III non-small cell lung cancer patients survive after 5-years post radiation therapy (RT). Although RT is an important treatment modality for lung cancer, it is limited by Radiation-Induced Lung Injury (RILI). RILI develops in two phases: (i) the early phase (days-weeks) referred to radiation pneumonitis (RP), and (ii) the late phase (months). There is a strong interest in early detection of RP using imaging to improve outcomes of RT for lung cancer. This thesis describes a promising approach based on ¹²⁹Xe gas as a contrast …

Inter-Rater Reliability Of The Mckenzie System Of Mechanical Diagnosis And Therapy In The Examination Of The Knee, Sean Willis

Electronic Thesis and Dissertation Repository

Objective: The purpose of this thesis was to investigate the inter-rater reliability of the McKenzie System of Mechanical Diagnosis and Therapy (MDT) when classifying patients with musculoskeletal knee pain using clinical vignettes. Methods: This study was divided into two phases. First, ten clinicians experienced in the use of MDT were randomly recruited to write a total of 60 clinical vignettes based upon the initial assessment of past patients with knee pain. Second, six different MDT raters were recruited to rate 53 selected vignettes and reliability was determined using Fleiss Kappa. Results: There was “substantial agreement” among six MDT raters …

Lpcoms: Towards A Low Power Wireless Smart-Shoe System For Gait Analysis In People With Disabilities, Ishmat Zerin

Master's Theses (2009 -)

Gait analysis using smart sensor technology is an important medical diagnostic process and has many applications in rehabilitation, therapy and exercise training. In this thesis, we present a low power wireless smart-shoe system (LPcomS) to analyze different functional postures and characteristics of gait while walking. We have designed and implemented a smart-shoe with a Bluetooth communication module to unobtrusively collect data using smartphone in any environment. With the design of a shoe insole equipped with four pressure sensors, the foot pressure is been collected, and those data are used to obtain accurate gait pattern of a patient. With our proposed …

Quantification Of Blood Flow Velocity Using Color Sensing, Aditya Deepak Sanghani

Master's Theses

Blood flow velocity is an important parameter that can give information on several pathologies including atherosclerosis, glaucoma, Raynaud’s phenomenon, and ischemic stroke [2,5,6,10]. Present techniques of measuring blood flow velocity involve expensive procedures such as Doppler echocardiography, Doppler ultrasound, and magnetic resonance imaging [11,12]. They cost from $8500-$20000. It is desired to find a low-cost yet equally effective solution for measuring blood flow velocity. This thesis has a goal of creating a proof of concept device for measuring blood flow velocity.

Finger blood flow velocity is investigated in this project. The close proximity to the skin of the finger’s arteries …

T2 Relaxation Time In Men And Women Following Eccentric Elbow Flexor Exercise, Patrick A. Moull

Electronic Thesis and Dissertation Repository

Previous research suggests that estrogen exhibits a protective effect on skeletal muscle and may help curb the effects of induced damage. Eccentric (ECC) exercise has been shown to provide the greatest levels of exercise induced muscle damage (EIMD) and with indirect markers of muscle damage including decreases in strength, increased inflammation, and higher magnitudes of delayed onset muscle soreness (DOMS). Studies have shown that elevations of the T2 relaxation times of activated muscles coincide with these other indirect measures of muscle damage. The purpose of this study was to compare the effects of a high intensity ECC elbow flexor exercise …

Interpretation Of Mutations, Expression, Copy Number In Somatic Breast Cancer: Implications For Metastasis And Chemotherapy, Stephanie Dorman

Electronic Thesis and Dissertation Repository

Breast cancer (BC) patient management has been transformed over the last two decades due to the development and application of genome-wide technologies. The vast amounts of data generated by these assays, however, create new challenges for accurate and comprehensive analysis and interpretation. This thesis describes novel methods for fluorescence in-situ hybridization (FISH), array comparative genomic hybridization (aCGH), and next generation DNA- and RNA-sequencing, to improve upon current approaches used for these technologies. An ab initio algorithm was implemented to identify genomic intervals of single copy and highly divergent repetitive sequences that were applied to FISH and aCGH probe design. FISH …

Physical Therapy After Triangular Fibrocartilage Injuries And Ulnar Wrist Pain, Mohamed A. Abdelmegeed

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The ulnar side of the wrist has been referred to as the “black box” of the wrist because of its complex structures and sophisticated anatomy, disorders at this anatomical site have been compared to those of low back pain

Purposes: The purpose of this study was to apply the Brief International Classification of Functioning (ICF) Core Set for Hand Conditions to the physical therapy outcome measures, and to evaluate the contribution of these measures to overall health in subjects with ulnar wrist pain. A secondary purpose was to investigate the effect of wrist orthotics and strengthening exercise on …

Engineering Novel Detection And Treatment Strategies For Bacterial Therapy Of Cancer, Jan T. Panteli

Doctoral Dissertations

Finding and treating cancer is difficult due to limited sensitivity and specificity of current detection and treatment strategies. Many chemotherapeutic drugs are small molecules that are limited by diffusion, making it difficult to reach cancer sites requiring high doses that lead to systemic toxicity and off-target effects. Tomographic detection techniques, like PET, MRI and CT, are good at identifying macroscopic lesions in the body but are limited in their ability to detect microscopic lesions. Biomarker detection strategies are extremely sensitive and able to identify ng/ml concentrations of protein, but are poor at discriminating between healthy and disease state levels due …

Investigation In To The Effect Of Spin Locking On Contrast Agent Relaxivity, Julian Saunders Haigh

Dissertations and Theses

The current trend in magnetic resonance imaging (MRI) is towards higher external magnetic field strengths (B₀) to take advantage of increased sensitivity and signal to noise ratio (SNR). Unfortunately, as (B₀) increases the effectiveness (relaxivity) of clinical gadolinium (Gd³⁺⁾-based contrast agents (CAs) administered to enhance image contrast is significantly reduced. Excellent soft tissue contrast can be generated with current agents despite their non-optimum relaxivities but necessitates large doses. The limits of detection of a CA at high B₀ fields can be lowered by recovering the lost relaxivity and is a pre-requisite to the …

Impact Of Standardized Oral Health Assessment On Preventing Ventilator-Associated Events, Juana Ambriz De Williams

Evidence-Based Practice Project Reports

Ventilator-associated pneumonia (VAP) is a common but preventable health-care associated infection that affects up to 20% of mechanically ventilated adult patients, resulting in estimated mortality rates ranging from 13% to 55% (Chahoud, Semaan, Almoosa, 2015; Melsen et al., 2013). In an effort to reduce morbidity, mortality and related costs, the Centers for Disease Control and Prevention (CDC) and the National Healthcare Safety Network (NHSN), proposed ventilator-associated pneumonia prevention as a national patient safety goal. In 2014, amid growing concerns that the subjectivity of existing definitions had led to inconsistent reporting, thereby impeding efforts to reduce VAP, the CDC refocused surveillance …

Assessment Of Uncertainty In Planning And Dose Delivery Of Proton Therapy In An Iroc- Houston Qa Phantom Due To Variable Ct Technique And Proton Energy, Mattie M. Mcinnis

Dissertations & Theses (Open Access)

As proton therapy increases in popularity, so does the need for effective quality assurance. Proton therapy institutions participating in NCI funded clinical trials rely heavily on the credentialing and auditing services of IROC-H and therefore the process must be well understood. The purpose of this project is to understand the uncertainties in proton therapy treatment planning for the IROC-H proton phantom QA program due to variations in CT technique and proton energy. It was hypothesized that variations in CT technique and proton energy will alter the delivered dose distributions of typical proton treatments by reducing the percent of passing pixels …

The Effectiveness Of Implementing Standard Of Care Best Practices Including Use Of Daily Incentive Spirometry To Improve Dyspnea And Quality Of Life In Adults With Chronic Obstructive Pulmonary Disease (Copd), Christine Gallagher

Doctor of Nursing Practice (DNP) Program

Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease characterized by symptoms of dyspnea, cough, and wheezing. Many patients with COPD are on daily medications for their symptoms yet these symptoms continue to persist, impairing their quality of life. Patients with COPD experience respiratory muscle weakness that contributes to dyspnea and an inability to participate in daily activities. GOLD (2014) guidelines state that the goal of therapy in these patients is to reduce symptoms, increase participation in activities, and restore the highest level of independent functioning. The guidelines recommend the use of inspiratory muscle training (IMT) in …

Kinematic And Kinetic Effects Of Alterations In Lumbar Lordosis In People With Tight Hamstrings, Dema Assaf

Theses and Dissertations (ETD)

The etiology of nonspecific low back pain is sparsely understood. To better understand the contributing factors to nonspecific low back pain, there are often common concurrent pathologies that are investigated to determine their functional relationship to low back pain. One such pathology, investigated further in this thesis, is tight hamstrings. Specifically, the effect of hamstring length on pelvic position during gait and activities of daily living under normal and altered spinal position were investigated as part of this study in a motion analysis lab.

First, a marker validation study was conducted to ensure the accuracy of sagittal spinal measures of …

Adverse Effects Of Asparaginase In Pediatric Patients With Acute Lymphoblastic Leukemia, Chengcheng Liu

Theses and Dissertations (ETD)

Acute lymphoblastic leukemia (ALL) is the most common type of childhood cancer. Asparaginase is a critical treatment component for ALL. However, its use is complicated by adverse effects, such as hypersensitivity, osteonecrosis and pancreatitis.

Hypersensitivity to asparaginase typically requires discontinuation of current formulation and substitution with other formulations, but the differential diagnosis can be challenging, and the diagnostic utility of antibody tests is unclear. We comprehensively analyzed anti-Elspar (native E.coli asparaginase) IgG antibodies in 410 pediatric patients treated on an asparaginaseintensive front-line clinical trial. Of 169 patients (41.2%) who exhibited clinical allergy, 147 (87.0%) were positive for anti-Elspar antibody. Of …

College Student Understanding Of Informed Consent Terminology, Kishore Garapati

Master's Theses and Doctoral Dissertations

A good, understandable informed consent form (ICF) is key to ethical medical research, and the ICF is necessary according to United States federal regulation. Since they may be written in complex technical language, ICFs are often difficult for subjects to understand. The purpose of this research was to evaluate students' understanding of terminology commonly used in the ICF. An online research survey was sent to active students of Eastern Michigan University (EMU) during the winter 2015 semester. Questions were asked to evaluate the students' understanding of the correct meaning of the terms used in medical research. The majority of students …

Functional Analysis Of The Molluscum Contagiosum Virus Mc160 Death Effector Domain-Containing Protein Rxdl Motif, Sarah Weber

Seton Hall University Dissertations and Theses (ETDs)

The Molluscum contagiosum virus (MCV) is a member of the Poxviridae family that causes benign skin lesions. MCV lesions persist on average for 8-12 months in otherwise healthy individuals. MCV lesions are characterized by reduced inflammation. The persistence and reduction of inflammation at the site of MCV lesions have been attributed to MCV immune evasion genes. MCV encodes two death effector domain (DED) containing proteins, MC159 and MC160. DEDs are found in cellular proteins such as FADD and procaspase-8. These cellular proteins are involved in several innate immune responses such as apoptosis and activation of interferon (IFN). Presumably, MC159 and …

Using Education And A Prevention Protocol Tool To Decrease The Incidence Of Pressure Ulcers In A Nursing Home, Kristina L. Scalzitti

Evidence-Based Practice Project Reports

Over 1.3 million persons are residents in nursing homes (NHs); one in ten have pressure ulcers. The purpose of this evidence based practice project was to determine if implementation of a pressure ulcer prevention tool, along with staff education, decreases the incidence of pressure ulcers within the NH. Florence Nightingale’s Environmental Model and the Stetler Model were used to guide this project. The setting was a NH in northwest Indiana. Eleven nurses attended a 15 minute educational session on pressure ulcer prevention and implementation of the Pressure Ulcer Prevention Protocol Intervention (PUPPI) tool. PowerPoint slides were distributed and flyers about …

The Effect Of An Educational Intervention On Oral Anticoagulation Therapy Knowledge In Primary Care, Elizabeth D. Deck

Evidence-Based Practice Project Reports

It is estimated that three million people in the United States are on oral anticoagulation therapy (warfarin). Populations studied have been found in therapeutic range 64% of the time (Pernod, Labarere, & Bosson, 2008). The low percentage of therapeutic range is attributable to (a) adherence, (b) monitoring infrequency, (c) Vitamin K antagonists, and (d) the effects of aging and comorbidities. The purpose of this evidence-based practice (EBP) project was to examine whether an educational intervention would improve the knowledge of patients receiving warfarin therapy. Roy’s model for patient adaptation and the Stetler Model for EBP were used as frameworks for …

Diabetes Type 2 Self-Management Education Program: Short Messaging From Patient Portal To Web-Enabled Device, Lynn S. Holcomb

Evidence-Based Practice Project Reports

Only one in eight adults with diabetes reaches target goals for disease management, which can lead to clinical complications, costly both economically and in quality and duration of human life. The standard of care is a quarterly 15-minute face-to-face visit-- arguably inadequate to impart self-care knowledge. The purpose of this EBP project was to deliver a 30-day diabetes self-management education program (DSMEP) utilizing widely accessible web-based technology to facilitate adults with diabetes to reach targeted goals. Using the Chronic Care Model as a framework, the DSMEP design was based on an extensive literature review of the delivery of DSMEP in …