Medicine and Health Sciences Commons^™

Developing And Validating A Type 2 Diabetic Patient Drug Telephone Reminder Program, Perpetua E. Okoh

Walden Dissertations and Doctoral Studies

Research has shown that telephone drug reminder scripts can be an effective way to increase drug adherence and decrease health care costs for persons with Type 2 diabetes. The purpose of this project was to develop and validate a telephone drug reminder script for Type 2 diabetes patients based on evidence-based practice. Following a review of the literature, a telephone drug reminder script was developed for Type 2 diabetic patients to educate and improve drug adherence. Five local experts with at least 10 years' experience in diabetes treatment, education, and or research were asked to participate in the validation of …

H2h Strategies Associated With Reduced Heart Failure Readmission Rates In Georgia Hospitals, Carisa Sellers

Walden Dissertations and Doctoral Studies

Reducing heart failure risk standardized readmissions rates (RSRRs) continues to be a challenge in the United States. Among Medicare beneficiaries, the U.S. national rate for heart failure RSRRs is 23, and Georgia only has 3 hospitals with heart failure RSRRs that are better than the national rate. The hospital component of the chronic care model (CCM) was the theoretical framework used in this study because the model was designed to assist heath care organizations in improving chronic care outcomes. Researchers have indicated that the Hospital to Home Initiative (H2H), a national quality improvement campaign launched in 2009, is effective in …

Effects Of Nicotinic Acetylcholine Receptor Agonists In Assays Of Pain-Stimulated And Pain-Depressed Behavior In Rats, Kelen Freitas

Theses and Dissertations

Though a host of analgesics have been developed to alleviate pain, especially acute pain, significant side effects and a lack of long-term efficacy have encouraged research attempts to pursue novel targets that may be associated with fewer side effects or a more sustained efficacy. Among these new targets are members of the nicotinic family of acetylcholine receptors (nAChRs). The non-selective nAChR agonists nicotine and epibatidine have been shown to function as potent antinociceptive drugs in many acute and chronic preclinical pain models, while nicotine has produced analgesic effects in humans. However, these non-selective nAChRs agonists also produce various side effects, …

Evaluation And Comparison Of Theoretical Models’ Abilities To Explain And Predict Colorectal Cancer Screening Behaviors, Anthony J. Molisani

Theses and Dissertations

BACKGROUND: Colorectal cancer (CRC) is the fourth most common and second most deadly cancer in the United States. However, it is highly preventable and treatable if detected at the precancerous or local stage of development. There exists multiple screening methods each with varying sensitivity, required effort, and recommended frequency of use. Complete adherence to screening guidelines by the recommended, at-risk population would halve the current mortality rate. Unfortunately, screening adherence remains the lowest of all screened cancers with a median state screening adherence rate of about 65%. To understand what individual-level factors influence an individual’s decision to be screened, health …

Functional Local Renin-Angiotensin System In Human And Rat Periodontal Tissue, Carlos Ferreira Santos, Ana Carolina Morandini, Thiago José Dionísio, Flávio A. Faria, Marta C. Lima, Caio M. Figueiredo, Bella L. Colombini-Ishikiriama, Carla Renata Sipert, Rubens P. Maciel, Ana P. Akashi, Gabriela P. Souza, Gustavo P. Garlet, Camila O. Rodini, Sandra L. Amaral, Christiane Becari, Maria C. Salgado, Eduardo B. Oliveira, Isaac Matus, Daniela N. Didier, Andrew S. Greene

All Dugoni School of Dentistry Faculty Articles

The initiation or progression of periodontitis might involve a local renin-angiotensin system (RAS) in periodontal tissue. The aim of this study was to further characterize the local RAS in human and rat periodontal tissues between healthy and periodontally-affected tissue. Components of the RAS were investigated using in vitro, ex vivo and in vivo experiments involving both human and Wistar rat periodontium. Although not upregulated when challenged with P. gingivalis-lipopolysaccharide, human gingival and periodontal ligament fibroblasts expressed RAS components. Likewise, healthy and inflamed human gingiva expressed RAS components, some of which were shown to be functional, yet no differences in expression …

The Inhibitory Effects Of Opioids On Voltage-Gated Calcium Influx In Neonatal Rat Carotid Body Type I Cells, Ellen M. Ricker

Browse all Theses and Dissertations

It is known that opioids inhibit the hypoxic ventilatory response, but little is known about the mechanisms that underpin this. This study's objectives were to examine which opioid receptors are located on the oxygen-sensing carotid body type I cells and determine whether selective agonists inhibit cellular excitability.

Immunocytochemistry revealed the presence of μ and κ opioid receptors on type I cells. The μ-selective agonist DAMGO (10μM) and the κ-selective agonist U50-488 (10μM) significantly (p<0.0025 and p<0.0095 respectively, unpaired student's t-test) inhibited high K+ induced rises in intracellular Ca2+ compared with controls. After a three-hour incubation with pertussis toxin, a Gi protein-coupled inhibitor, DAMGO and U50-488 (10μM) has no significant effect on the responses to K+.

These results indicate that opioids acting at μ and κ receptors inhibit voltage-gated Ca2+ influx in carotid body type I cells. This mechanism may explain, in …

Angiotensin-Ii Receptor Blocker And Its Effects On Depressive-Like Behavior During Maternal Separation, Evan D. Xanthos

Browse all Theses and Dissertations

Maternal separation has been shown to promote the onset of adult depression. This early life stressor produces a biphasic response marked by an active "protest" phase followed by a passive "despair" phase in humans and other species. In infant guinea pigs, active phase behaviors include increased locomotion and distress vocalizations, whereas the passive phase is marked by depressive-like behaviors including a crouch stance, eye closure and piloerection. Separation elicits physiological responses including increased core body temperature and proinflammatory cytokine expression suggesting fever. Angiotensin-II receptor blockers (ARB's) inhibit inflammation both peripherally and centrally following peripheral administration. The goal of the present …

Is Polyvinylidene Diflouride (Pvdf) Film Biocompatible In The Murine Cochlea?, Robert Maxwell Jaggers

Browse all Theses and Dissertations

Polyvinylidene fluoride (PVDF) film, a biomaterial that is an integral part of a Totally Implantable Sustainable Hearing Aide (TISHA) device, was examined to determine its biocompatibility within the murine cochlea. The biofilm was implanted in the ear using a round window cochleostomy in 7-9 week old male C57BL/6 mice. Three test groups containing seven mice each were implanted with PVDF film. Each mouse received a sham surgery on the non-implanted cochlea. Three test groups were examined at 48 hours, 3 weeks, and 3 months. At the end of this time the mouse was euthanized, the tissue containing the cochlea was …

Lowering The Number Of False Positive Responses To Electric Pulp Tests By Qualifying Patient Response, Katherine Js Lee

Theses and Dissertations

The electric pulp test (EPT) has been shown to be a valuable tool in assessing pulp vitality. One of its drawbacks, however, is its high number of false positives. The purpose of this study was to determine if qualifying the type of sensation elicited by the test could lower the percentage of false positive responses. A retrospective chart review of an eleven-month period was conducted, examining all patients with necrotic teeth tested with the EPT. Of 189 teeth, when the patient responded to EPT at first sensation 23.3% of teeth were incorrectly identified as vital. When the patient was asked …

Predicting Depression Symptoms Among College Students: The Influence Of Parenting Style, Sarah Whitmire Clark

Theses and Dissertations

This study examined parenting style variables in predicting college students’ depression symptoms. Participants were 989 college students who participated in the first wave of the Spit for Science project (Dick et al., 2011). This study described the prevalence of depression symptoms, including the percentage of the sample endorsing various depression symptoms, and the frequency depression scores were elevated at multiple time points. A hierarchical multiple regression was conducted to examine whether two dimensions of parenting style, Autonomy Granting and Parental Involvement, would interact in predicting depression symptoms in the Junior year. The present study demonstrates that parenting style predicts a …

The Role Of Leukocyte-Platelet Rich Fibrin In Human Alveolar Ridge Preservation: A Randomized Clinical Trial, Thomas F. Glazier, Thomas C. Waldrop, John C. Gunsolley, Robert Sabatini

Theses and Dissertations

PURPOSE: The aim of this study is to examine the healing of intact extraction sockets grafted with leukocyte-platelet rich fibrin (L-PRF) as compared to sockets grafted with freeze-dried bone allograft (FDBA) and a resorbable collagen barrier membrane (RCM).

METHODS: This prospective randomized, examiner blinded pilot study included 17 subjects randomized to two treatment groups. Serum total cholesterol, low density lipoprotein (LDL), 25-hydroxyvitamin-D₃, and platelet counts were determined preoperatively in all subjects. The experimental arm consisted of 8 posterior tooth-bounded intact extraction sites receiving L-PRF plugs. The control group consisted of 9 posterior tooth-bounded intact extraction sites receiving FDBA …

A Qualitative Study Of Stress In Individuals Self-Employed In Solo Businesses, Irvin Sam Schonfeld, Joseph J. Mazzola

Publications and Research

This qualitative study involved 54 individuals who were self-employed in a variety of solo businesses. All participants were administered a semistructured interview that inquired into various aspects of their work experience with the data subject to reliability and validity checks. The study identified stressful incidents, coping strategies, and emotional strains arising from those stressful incidents. Uncertainty about income was a common background stressor. Recent specific stressors included dramatic slowdowns in business, reputational threat, betrayal, unreasonable customers, and medical problems. Commonly occurring strains included apprehension/anxiety, frustration, anger, and sadness/depression. The self-employed used problem-focused coping much more often than emotion-focused coping. We …

Growing Up In Ireland: Factors Impacting Sleep Patterns Of Preterm Infants, Joanne Fallon

Theses and Dissertations

GROWING UP IN IRELAND: FACTORS IMPACTING SLEEP PATTERNS OF PRETERM INFANTS

By Joanne Fallon MS, OT, PhD

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University

Virginia Commonwealth University, 2015.

Major Director: Shelly J. Lane, PhD, Professor, Department of Occupational Therapy

Preterm infants represent the largest child patient group in the European Union (EU), accounting for 5.5-11.4% of all births (European Foundation for the Care of Newborn Infants, 2011b). Preterm birth is defined as birth prior to 37 weeks gestation. Infants born late preterm (34-36 weeks) are considered more …

Efficacy Of Mastery-Based And Autonomy-Supportive Neuroanatomy Curriculum In Graduate Level Human Neurobiology Course, Corin Wolfgang Magee

Browse all Theses and Dissertations

Anatomy provides scientists with a common vocabulary for discussing the human body, and is, therefore, an important aspect of science education. Literature shows that traditional teaching methods may be enhanced by the employment of mastery-based learning in an autonomy-supportive environment. The present study sought to determine the effects of these teaching strategies on the learning of neuroanatomy in a graduate neurobiology course.

These results show students learned and reportedly enjoyed learning a large amount of neuroanatomy. Experimentally taught students who completed the curriculum did well on the 30-item neuroanatomy quiz (mean score 81%), which was administered at the end of …

Mechanisms Of Hyperglycemia-Induced Ros Production In Osmotically Swollen Glial Cells, Augusta K. Eduafo

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Cerebral edema is a potentially fatal complication of diabetes. There is evidence for increased Reactive Oxidative Species (ROS) production during cerebral edema in diabetics. This can lead to oxidative stress, thought to contribute to the onset and progression of diabetes and can cause cell injury and cell death. ROS, in moderate amounts, are involved in physiological processes within the body that produce favorable cellular responses. Unfortunately, high levels of ROS can lead to cellular damage of lipids, membranes, proteins and DNA. Hyperglycemia can cause an increase in ROS production due to activation of NADPH oxidases. The purpose of this study …

Connectivity Of Monosynaptic Ia Afferents On Renshaw Cells In Neonatal Mice, Todd Joseph Rapetti

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Proprioception allows sensory information about muscle position and length to enter the CNS without the aid of visual cues. One type of fiber that carries this information is the Ia afferent, which innervates muscle spindles that respond to mechanical perturbation in muscle. Ia fibers are known to synapse with Ia interneurons (INs) and motor neurons (MNs), setting up important circuits which affect movement. Another type of IN is the Renshaw cell (RC), which is located in the ventral part of lamina VII of the spinal cord and is critical for the functionality of the recurrent inhibitory circuit. In addition to …

Do Restorative Home Care Programs Increase Independence In Adls And Iadls In Older Adults Receiving Home Health Services?, Adrienne Angeles, Shanee Ben-Haim, Amy Smith-Schwartz, Kitsum Li

Occupational Therapy | Critically Appraised Papers Series

There has been a worldwide shift from viewing aging as a dependent stage of life to one that increasingly encourages independence and a more active lifestyle for older adults. In Australia, where this study was conducted, restorative care that embraces active aging was not yet considered an essential component of home health care on the national level. However, restorative home care has been gaining more recognition as increasing importance is placed on independence and self-management in older adults.

The researchers of this study explored whether older adults’ participation in restorative home care programs reduced the need for ongoing personal care. …

For Low-Income Adults Who Experience Trouble With One Or More Activities Of Daily Living (Adl) Or Two Or More Instrumental Activities Of Daily Living (Iadl), Does The Community Aging In Place: Advancing Better Living For Elders (Capable) Improve Performance Of Adls And Iadls?, Noelle Bakken, Lauryn Banovitz, Abigail Lafrenz, Kitsum Li

Occupational Therapy | Critically Appraised Papers Series

The growing population of older adults has created a societal shift, with many older adults preferring to stay in their homes for a longer period of time. This trend, known as aging-inplace, may provide greater independence and autonomy to older adults compared with those living in nursing homes. However, physical and cognitive changes associated with age may affect the ability to safely perform activities of daily living (ADL) and instrumental activities of daily living (IADL). This study examined performance in ADLs and IADLs, fall efficacy, and quality of life in 40 low-income, community dwelling adults aged 65 and older. Participants …

Gearing Up For Guide Dogs: An Exercise Video, Valerie J. Deroos, Skyler Moon

Student Research Posters

According to the World Health Organization (2007), age-related visual impairment is increasing. It is estimated that 65% of people who are visually impaired are over age 50 and 82% of those visually impaired over age 50 are blind (WHO, 2014).

• Guide Dogs for the Blind (GDB) is a national training program that serves individuals with blindness or low vision. As a non-profit organization, GDB provides all services free of charge to participants. Training lasts for two weeks with a class size of 6-8 students and instructor/student ratio of 1:2. Participants learn how to perform daily tasks with their dogs …

Handwriting And Metacognition: The Relationship Between Self-Reflection And Penmanship, Rachel E. Malmquist, Chelsey M. Robinson, Kirsten L. Rogers, Andrea B. Sosa

Student Research Posters

The majority of school-based occupational therapy (OT) referrals are for handwriting. In fact, fine motor and handwriting concerns affecting educational performance make up 80-85% of OT referrals in schools. Occupational therapists use an abundance of interventions for remediating handwriting difficulties, but there is scant evidence of why specific strategies or combinations of strategies are effective.

Cognitive interventions have shown to be successful in the treatment of handwriting. Metacognitive skill, a component of cognition, allows a child to self-monitor and self-reflect on his or her handwriting skills to correct mistakes and generate goals for improvement. Therefore, a child’s ability to self-reflect …

Interprofessional Collaboration Between Occupational Therapists And Registered Nurses In Acute Care Settings: An Exploratory Study, Vincent P. O'Brien, Bethany J. Loy, Kelly Nguyen, Holly Micheff

Student Research Posters

Background. Collaboration between occupational therapists and nurses is key to a positive prognosis for their patients. Currently, there is a gap in the research on professional relationships between occupational therapists and registered nurses in acute care settings. Purpose. To examine interprofessional collaboration between registered nurses and occupational therapy in an acute care setting. Methods. A phenomenological, qualitative design with use of semi-structured interviews was used. Interviewees were four occupational therapists and four registered nurses who currently work in acute care settings in Northern California and were recruited through a snowball, convenience and purposive sampling. Themes and subthemes …

Does Therapeutic Horseback Riding Decrease Balance Deficits In Community-Dwelling Older Adults?, Salwa Yaser, Lisa Mrsny, Krystin Beeman, Skyler Moon, Kitsum Li

Occupational Therapy | Critically Appraised Papers Series

Hippotherapy and therapeutic riding (TR) provide pleasurable activity and physical exercise to individuals and yet limited study is available on its therapeutic value to improve balance in older adults. In this study, the researchers measured the benefit of TR on balance and quality of life in communitydwelling older adults. A convenience sample of individuals 65 years and older was recruited from a local community. The study is a single-blind, pretest-posttest, controlled study of a 10-session TR program with a Professional Association of Therapeutic Horsemanship (PATH) trained and certified TR instructor. Each TR session included grooming and tacking, mounting, a warm-up …

Facilitating Effective Communication Between First Responders And Older Adults During Fall Incidents, Krystin M. Beeman, Erica L. Berger, Isabel A. Cabezas, Nicole M. Mathews

Student Research Posters

PURPOSE. The purpose of this project was to provide first responders with communication strategies for older adults that may help when responding to fall- related calls. General information was also provided to First Responders on working with older adults with a focus on the aging process, fall risk factors, and communications strategies.

METHODS. A series of educational sessions to first responders at a local fire district were developed and presented by occupational therapy students. Materials were developed by presenters from evidence-based resources and tailored to the target population. Each presentation focused on statistics about older adults, the aging process, fall …

The Effect Of Therapeutic Listening(R) On Bilateral Coordination, Emily Smiley, Daryl Arora, Jiawen Liang, Melissa Ramirez

Student Research Posters

This study concludes a 2-year long randomized control pretest posttest design study examining the effects Therapeutic Listening® Bilateral Quickshift intervention, on bilateral coordination in typically developing children between the ages of seven to eleven. Participants were recruited from after school programs at Coleman Elementary and St. Anselm School located in Marin County, California, as well as word of mouth from the Dominican University community. Participants were randomly assigned to either the Therapeutic Listening® intervention or white noise control intervention. All participants completed a pretest to establish a baseline of bilateral coordination abilities. Participants then listened to 15-minutes of the intervention, …

Does A Multicomponent Home Intervention Reduce Functional Difficulties In Community-Dwelling Older Adults As Compared To No Intervention?, Laura Henty-Clark, Rosemarie Lion, Nadine Marcelo, Kitsum Li

Occupational Therapy | Critically Appraised Papers Series

Many older adults live with chronic conditions that may affect their ability to safely perform their daily occupations. Small decreases in ability of older adults to function independently can have profound effects, possibly leading to hospitalization, institutionalization, or death. However, preventative home-based interventions for older adults typically are not reimbursed by Medicare or other insurance carriers.

This study on intervention effectiveness contributes to a growing body of evidence for providing preventative home-based intervention to older adults to support their abilities to function independently in their communities. This study examined whether a preventative home-based intervention, including occupational therapy and physical therapy, …

The Relationship Between Somatosensory Processing And Handwriting Proficiency, Hillary Colby, Ani K. Courville, Sherin Thomas, Salwa Yaser

Student Research Posters

Handwriting proficiency is reliant on the skill and coordination of the sensory, motor, cognitive, and perceptual systems. One aspect of sensory processing for penmanship is somatosensation. The contribution of somatosensory processing to handwriting proficiency has not been adequately researched. Therefore, this study evaluated the contribution of somatosensory processing to handwriting proficiency. Seventy-four typically developing second grade children were assessed on their handwriting proficiency and their somatosensory processing. Measurement instruments included the Minnesota Handwriting Assessment (MHA), The Beery-Buktenica Developmental Test of Visual Motor Integration-Motor Coordination Subtest, Sixth Edition (VMI-MC), and Quick Neurological Screening Test, 3rd Edition (QNST-3). Results showed a small, …

Examining The Validity Of The Preschool Kitchen Task Assessment : An Exploratory Study, Christine Kim, Angelica Soltis

Student Research Posters

Executive functioning (EF) helps build a strong foundation for school readiness, play development, and social participation in children. EF includes attention, inhibitory control, working memory, emotional regulation, planning, and problem solving

Currently, there are few ecologically valid assessments that measure EF in children. The purpose of this exploratory research study was to validate the Pre-school Kitchen Task Assessment (PKTA) as an ecological tool to assess EF in preschool age children. The PKTA utilizes an age appropriate art craft activity and a standardized scoring system to determine the level of assistance (cues) each child needs to complete each step of the …

Cryptococcus Neoformans And Streptococcus Pneumoniae Co-Infection In Post-Traumatic Meningitis In A Patient With Unknown Hiv Status, Faryal Saleem, Naima Fasih, Afia Zafar

Department of Pathology and Laboratory Medicine

Meningitis is a serious disease associated with considerable morbidity and mortality. Mixed meningeal infections due to bacteria and fungi are exceptionally rare. Here we report a case of meningeal co-infection with cryptococcus neoformans and streptococcus pneumoniae in a patient with unknown human immunodeficiency virus status. Because of the rarity of such cases, stringent screening of every cerebrospinal fluid specimen to exclude the presence of multiple pathogens is imperative. Assessment of patients for immunodeficiencies in case of isolation of an opportunistic organism like cryptococcus is also needed.

Hospital Preparedness In Community Measles Outbreaks-Challenges And Recommendations For Low-Resource Settings, Sadia Shakoor, Fatima Mir, Anita Zaidi, Afia Zafar

Department of Pathology and Laboratory Medicine

We have reviewed various strategies involved in containment of measles in healthcare facilities during community outbreaks. The strategies that are more applicable to resource-poor settings, such as natural ventilation, mechanical ventilation with heating and air-conditioning systems allowing unidirectional air-flow, and protection of un-infected patients and healthcare workers (HCWs), have been examined. Ventilation methods need innovative customization for resource-poor settings followed by validation and post-implementation analysis for impact. Mandatory vaccination of all HCWs with two doses of measles-containing vaccine, appropriate post-exposure prophylaxis of immunocompromised inpatients, and stringent admission criteria for measles cases can contribute toward reduction of nosocomial and secondary transmission …

Clinical Isolates Of Salmonella Enterica Serovar Agona Producing Ndm-1 Metallo-Beta-Lactamase: First Report From Pakistan, Seema Irfan, Erum Khan, Kauser Jabeen, Pushpa Bhawan, Katie L. Hopkins, Martin Day, Amna Nasir, Daniele Meunier, Neil Woodford

Department of Pathology and Laboratory Medicine

We report two cases of infantile diarrhea due to multidrug-resistant, NDM-1 metallo-beta-lactamase-producing Salmonella enterica serovar Agona from Pakistan. This study alerts toward possible risk of NDM-1 transmission to enteric fever pathogens and encourages microbiologists to consider active screening of carbapenem resistance in nontyphoidal Salmonella isolates.