Medicine and Health Sciences Commons^™

Interactions Between Descending And Somatosensory Inputs In Humans, Lisa Krivis, Ann Mackey, Maureen Mcdonough, Denise Uttaro

Dissertations, Theses, and Capstone Projects

In this study, we assessed the corticospinal integration in healthy people while seated. Corticospinal integration was assessed by establishing the latency and amplitude of motor evoked potentials (MEPs) evoked following transcranial magnetic stimulation (TMS) of the primary motor cortex area representing the leg muscles, and the latency and amplitude of spinally-mediated reflex responses. Further, the modulation pattern of the spinally-mediated reflex responses were determined following subthreshold and suprathreshold TMS. All compound muscle action potentials, descending motor or spinally-mediated reflexes were recorded from the leg muscles through surface electromyography. Both subthreshold and suprathreshold TMS induced a similar modulation pattern on the …

Attitudes Of Normal Hearing Listeners Towards Personal Sound Amplification Products: Etymotic Bean, Jennifer Rhoades

Dissertations, Theses, and Capstone Projects

Despite the remarkable prevalence of hearing loss in the United States, only a small percentage of these individuals utilize hearing aids. Many factors have been associated with the non-adoption of hearing aids, including financial reasons and the stigma associated with hearing aid use. Personal sound amplification products (PSAP) have been recently introduced as a more discrete and less costly type of assistive listening technology. While the Food and Drug Administration does not approve these devices for individuals with hearing loss, they are advertised as being useful for boosting soft sounds and amplifying speech in the presence of background noise.

The …

Cochlear Implantation As A Treatment Option For Adults With Post-Lingual Single Sided Deafness: A Systematic Review Of The Literature, Elvera Bader

Dissertations, Theses, and Capstone Projects

Adults with post lingual single sided deafness experience a myriad of issues as a result of their condition. Speech perception in noise and localization are well documented as being compromised in this population due to the loss of binaural auditory input. Cochlear implantation was introduced in the 2000s as an experimental treatment option for suppression/abatement of tinnitus in individuals with SSD, with consistent demonstration in reduction of tinnitus severity. Most recently, the focus has shifted to the potential reintroduction of binaural effects, and subsequently, improvements in speech in noise and localization performance through this treatment modality. The present systematic review …

Age, Cognition, And Listening Effort, Sapna Mehta

Dissertations, Theses, and Capstone Projects

Older adults are reported to have more difficulty understanding degraded speech than younger adults. This may be due to greater recruitment of cognitive resources in adverse listening conditions. The purpose of this study was to examine the relationship between listening effort as measured by a dual task paradigm and cognitive abilities, specifically, working memory and selective attention, in normal-hearing older and younger adults in various background noise conditions. Results revealed that speech recognition scores were poorer for older adults, and speech recognition scores declined with decreasing signal-to-noise ratio. Stroop test scores suggested better selective attention ability in the younger participants, …

Effect Of Absent Tactile Sensation On Multi-Digit Coordination Underlying Hand Control, Michael P. Alcorn, Bruce Faulkner, Matthew Macina, Brian Sherman

Dissertations, Theses, and Capstone Projects

We investigated the effect of anesthesia, causing absent tactile sensation feedback, on multi-digit coordination underlying hand control. The purpose of the study is to expand our understanding on the essential role of tactile sensation feedback in the sensorimotor integration process by examining the motor coordination patterns during multi-digit forces production tasks. We hypothesized that absent tactile sensation feedback would interrupt the force sharing pattern at local and non-local digits. Twelve participants were utilized for data collection and statistical analysis (25.6 ± 4.1 years old, 6 males and 6 females), right-handed (according to their preferred hand use for writing and eating) …

Discerning Between Types Of Otitis Media And Their Evidence Based Treatments: A Review For The Audiologist, Hadassah Norowitz

Dissertations, Theses, and Capstone Projects

Otitis media is an inflammatory pathology of the middle ear and middle ear mucosa which accounts for the majority of cases of childhood hearing loss diagnosed by audiologists. However, considerable confusion exists regarding the distinction between otitis media with effusion, also known as middle ear effusion or “glue ear”, and acute otitis media, the quintessential ear infection. Since many children are referred for audiological evaluation in the process of determining the course of treatment and outcomes of treatment, audiologists must be knowledgeable of the evidence of efficacy for various treatment options as they field questions from parents with incomplete information …

Cultural Competence Among Nursing Faculty, Colleen Marzilli

Nursing Theses and Dissertations

Research of culture and cultural competence in nursing faculty is vitally important when considering the state of the United States health care system and health disparities that can be reduced through culturally competent care. Recent studies address cultural competence among nurses, but there is limited information exploring cultural competence in nursing faculty. A concept analysis of "cultural competence" using Rodger's method further established the need to examine cultural competence from the perspective of nursing faculty, who are responsible for educating future nurses in culturally competent care. The purposes of this study were to determine the level of cultural competence in …

Women's Contraceptive Choices: A Look Into The Women Of Warren And Allen Counties, Kentucky, Mollie M. Berger

Mahurin Honors College Capstone Experience/Thesis Projects

According to the 2013 Census, 76.2 million US women of childbearing age (15 to 50). About half (51%) of the 6.6 million pregnancies in the United States each year (3.4 million) are unintended. Although there is an overwhelming need for contraceptives, not everyone has access. This study seeks to gain information on the motivation behind women’s contraceptive choices in Warren and Allen County, KY. A questionnaire was created and distributed to patients in the clinic waiting rooms of Barren River District Health Department and Allen County Health Department, and additional surveys were sent to Western Kentucky University students enrolled in …

Attitudes Of Normal Hearing Listeners Towards Personal Sound Amplification Products: Sound World Solutions Cs50, Marisa Viets

Dissertations, Theses, and Capstone Projects

Over 23 million individuals in the United States have some degree of hearing loss but do not own hearing aids. Individuals may choose not to adopt hearing aid technology for an assortment of reasons, including the stigma associated with hearing aids, cost of the devices, or denying the effects of hearing loss. Prevalence of hearing aid usage remains low despite research indicating that untreated hearing loss is correlated with decreased quality of life and accelerated cognitive decline. In recent years, personal sound amplification products (PSAPs) have entered the market as simple, low cost, discreet devices in attempt to reach non-users …

Electrocardiographic Patch Devices And Contemporary Wireless Cardiac Monitoring, Erik Fung, Marjo-Riitta Järvelin, Rahul N. Doshi, Jerold S. Shinbane, Steven K. Carlson, Luanda P. Grazette, Philip M. Chang, Rajbir S. Sangha, Heikki V. Huikuri, Nicholas S. Peters

Dartmouth Scholarship

Cardiac electrophysiologic derangements often coexist with disorders of the circulatory system. Capturing and diagnosing arrhythmias and conduction system disease may lead to a change in diagnosis, clinical management and patient outcomes. Standard 12-lead electrocardiogram (ECG), Holter monitors and event recorders have served as useful diagnostic tools over the last few decades. However, their shortcomings are only recently being addressed by emerging technologies. With advances in device miniaturization and wireless technologies, and changing consumer expectations, wearable “on-body” ECG patch devices have evolved to meet contemporary needs. These devices are unobtrusive and easy to use, leading to increased device wear time and …

Assessment Of Physical Performance In Adolescents Of Varying Body Weight, Nicholas Dalonzo, Nicole Liquori, Nicole Savarese

Dissertations, Theses, and Capstone Projects

Fifty-one healthy adolescents of both gender without any neuromuscular, musculoskeletal or cardiopulmonary disorders and between the ages of 12 and 17 with a mean age of 14.09 years (SD: 1.45 years) were recruited to participate in the 6-minute walk test. Several measurements such as height, weight and leg length were taken before testing, along with heart rate, blood pressure and oxygen saturation (SPO2) before, after and 10 minutes post 6-minute walk test. Walk distance was also quantified and used as an outcome measure. The adolescents were divided into two groups prior to statistical testing. The first group was classified as …

Attitudes Towards Music Levels At Orthodox Jewish Weddings, Evan Hirschhorn

Dissertations, Theses, and Capstone Projects

Noise induced hearing loss is a deficit in the sensorineural part of the hearing mechanism, produced by the damaging effects of overstimulation by high intensity sound levels, usually over a period of time. Much of the noise literature has focused on occupational noise; however, the noise levels measured at non occupational and recreational settings have been found to be notably high as well. Attitudes and behaviors may vary based on demographics as such hearing conservational practices may benefit by honing in on demographic information. In the Orthodox Jewish community, weddings have a central role in community life, attended by many …

The Effects Of Maximal Strength Training On Gait And Balance In Persons With Multiple Sclerosis: A Pretest Posttest Pilot Study, Janet Klein, David Park, Charles Wright, Michael Zervas

Dissertations, Theses, and Capstone Projects

Background: Physical Therapy strength training programs utilizing mild to moderate intensity are commonly prescribed to address many of the deficits found in multiple sclerosis, but studies examining the effectiveness of higher intensity strength training in gait and balance have not been performed. Maximal strength training (MST), which involves lifting nearly maximal weights (85-95% of an individual’s one repetition maximum [1RM]) with low repetitions, has been shown to improve functional abilities in both healthy and non-MS impaired populations. The higher intensity training used in MST may result in greater activation of the CNS, providing a greater stimulus to improvement than …

The Lived Experience Of Family Nurse Practitioners Performing Sexual Health Assessments, Madeleine Mary Lloyd

Dissertations, Theses, and Capstone Projects

Sexuality incorporates a multitude of feelings including beliefs, fantasies, and aspects of pleasure, intimacy, and reproduction. In addition, sexuality involves rights to gender identity and role, sexual acts and orientation. Sexual and reproductive health and rights is a global health, development, and human rights priority. Universal access to sexual and reproductive health is essential. Negative sexual health outcomes are increasing in the United States and sexuality is often a neglected area for health providers including nurses. With an increasing share of the primary care services nationally, family nurse practitioners (FNPs) have the means to provide quality sexual health care across …

Diagnostic Procedures Using Radiation And Risk Of Thyroid Cancer: Causal Association Or Detection Bias? An Examination Of Population Cancer Trends And Data From The Nyc Fire Department, Rachel Zeig-Owens

Dissertations, Theses, and Capstone Projects

Background: Thyroid cancer (TC) is a common cancer diagnosis in the United States, whose incidence is increasing. Disaster and radiation treatment studies show high doses of radiation can cause TC. Some diagnostic procedures, whose use is increasing, expose individuals to low-dose radiation but can also incidentally detect subclinical TC. Evidence regarding low-dose radiation risk is limited.

Objectives: To investigate the possible association of greater use of diagnostic procedures with TC, either causally through radiation exposure or via incidental detection.

Methods: Two data sources were used: National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) data and Fire Department of the …

Content Analysis Of Applied Learning From High Fidelity Patient Simulation Orientation To Critical Care, Patricia M. Span

Dissertations, Theses, and Capstone Projects

The Institute of Medicine (IOM) reported that over 98,000 deaths occur in hospitals from medical errors in the United States. In a follow-up IOM report, it was noted that nurses have a direct impact on patient morbidity and mortality and are often the last line of defense for patient safety. The challenge for nurse educators in hospitals is to ensure that as newly licensed nurses enter the workforce, orientation outcomes reflect acquisition of knowledge and skills, which are applied in practice. When newly licensed registered nurses are hired into critical care units, this puts them in a position where they …

Hearing Conservation Attitudes And Behaviors At Orthodox Jewish Weddings, Audrey Margulies

Dissertations, Theses, and Capstone Projects

Previous research has shown that prolonged exposure to noise can cause permanent hearing loss. Noise levels at Orthodox Jewish weddings can reach extremely high and damaging levels, yet the hearing conservation attitudes and behaviors of the attendees are unknown. The objective of this study is to identify the attitudes and behaviors of Orthodox Jewish wedding attendees toward hearing conservation. The major questions are: 1. What are the sound exposure levels at Orthodox Jewish weddings? 2. Do attendees hold positive attitudes toward the need for hearing conservation at Orthodox Jewish weddings? 3. What hearing conservation is being practiced at weddings among …

Retrospective Chart Review Of Patients Following Unilateral Total Knee Replacement To Assess Achievement Of Functional Milestones Based On Type Of Anesthetic Used Intra-Operatively, William S. Benish, Lolline Chong, Elana Kram, Danielle Krieger

Dissertations, Theses, and Capstone Projects

PURPOSE: Given the large number of Total Knee Replacements (TKR) performed annually in the US and the prediction that those numbers will increase, providing optimal analgesia during TKR is an important strategy for reducing cost and improving patient outcomes. Currently, no standard analgesia protocol for TKR exists and facilities in the US and world-wide use varied methods of analgesia. The purpose of the present study is to determine which analgesic technique; femoral nerve block (FNB), saphenous nerve block (SNB) or periarticular injection (PAI), within the context of a multi-modal pain management regimen, results in optimal TKR patient outcomes and achievement …

Anisotropic Smoothing Improves Dt-Mri-Based Muscle Fiber Tractography, Amanda K W Buck, Zhaohua Ding, Christopher P. Elder, Theodore F. Towse, Bruce M. Damon

Peer Reviewed Articles

Purpose

To assess the effect of anisotropic smoothing on fiber tracking measures, including pennation angle, fiber tract length, and fiber tract number in the medial gastrocnemius (MG) muscle in healthy subjects using diffusion-weighted magnetic resonance imaging (DW-MRI).

Materials and Methods

3T DW-MRI data were used for muscle fiber tractography in the MG of healthy subjects. Anisotropic smoothing was applied at three levels (5%, 10%, 15%), and pennation angle, tract length, fiber tract number, fractional anisotropy, and principal eigenvector orientation were quantified for each smoothing level.

Results

Fiber tract length increased with pre-fiber tracking smoothing, and local heterogeneities in fiber direction …

Successful Implementation Of A Packed Red Blood Cell And Fresh Frozen Plasma Transfusion Protocol In The Surgical Intensive Care Unit, Benjamin E. Szpila, Tezcan Ozrazgat-Baslanti, Jianyi Zhang, Jennifer Lanz, Ruth Davis, Annette Rebel, Erin Vanzant, Lori F. Gentile, Alex G. Cuenca, Darwin N. Ang, Huazhi Liu, Lawrence Lottenberg, Peggy Marker, Marc Zumberg, Azra Bihorac, Frederick A. Moore, Scott Brakenridge, Philip A. Efron

Anesthesiology Faculty Publications

BACKGROUND: Blood product transfusions are associated with increased morbidity and mortality. The purpose of this study was to determine if implementation of a restrictive protocol for packed red blood cell (PRBC) and fresh frozen plasma (FFP) transfusion safely reduces blood product utilization and costs in a surgical intensive care unit (SICU).

STUDY DESIGN: We performed a retrospective, historical control analysis comparing before (PRE) and after (POST) implementation of a restrictive PRBC/FFP transfusion protocol for SICU patients. Univariate analysis was utilized to compare patient demographics and blood product transfusion totals between the PRE and POST cohorts. Multivariate logistic regression …

Astrocyte Morphology, Heterogeneity, And Density In The Developing African Giant Rat (Cricetomys Gambianus), Matthew A. Olude, Oluwaseun A. Mustapha, Oluwatunde A. Aderounmu, James O. Olopade, Amadi O. Ihunwo

Brain and Mind Institute

Astrocyte morphologies and heterogeneity were described in male African giant rats (AGR; Cricetomys gambianus, Waterhouse) across three age groups (five neonates, five juveniles, and five adults) using Silver impregnation method and immunohistochemistry against glial fibrillary acidic protein. Immunopositive cell signaling, cell size and population were least in neonates, followed by adults and juveniles, respectively. In neonates, astrocyte processes were mostly detected within the glia limitans of the mid and hind brain; their cell bodies measuring 32 ± 4.8 μm in diameter against 91 ± 5.4 μm and 75 ± 1.9 μm in juveniles and adults, respectively. Astrocyte heterogeneity in …

What's Happening May 25, 2015, Maine Medical Center

What's Happening

No abstract provided.

La Souffrance Animale À Distance: Des Vétérinaires Dans L’Action Humanitaire, Frédéric Keck, Miriam Ticktin

Publications and Research

Résumé

Cet article étudie le rôle des vétérinaires dans l’humanitaire à partir de deux types de pratique : la défense des animaux contre la cruauté et la surveillance des animaux touchés par les épidémies. En suivant l’extension de l’action humanitaire aux animaux comme nouvelles figures de victimes innocentes, nous cherchons à dépasser l’approche compassionnelle de l’humanitaire pour étudier les nouvelles formes scientifiques impliquant des non-humains, comme la médecine vétérinaire légale, les neurosciences et l’immunologie. Nous soutenons finalement que ces sciences produisent de nouveaux collectifs d’humains et de non-humains.

Abstract

This article traces the role of veterinarians in humanitarian action, focusing …

2015 Annual Nsqip Conference Erin (Enhanced Recovery In Nsqip) Session, Michael D. Pasquale Md, Facs, Fccm, Pat Toselli Do, Richard Kolesky Md, Robert J. Sinnott Do, Cathleen Webber Rn, Mshs, Sharon Pustilnik Rn, Bs, Justina A. Momah Rn, Crnp

Department of Surgery

No abstract provided.

Medical School Watercooler Newsletter - May 24, 2015, Lindsey Lyle

Watercooler Newsletter

This is the May 24, 2015 edition of the Frederick P. Whiddon College of Medicine's Newsletter - Watercooler.

Contents Include:

Jacqueline Gonner Recognized for Customer Service

USA College of Medicine Researchers Awarded Abraham A. Mitchell Cancer Research Fund Grants

Medical Students Form Preventive Medicine Team

Dr. Adams Presents Frazer/Leigh Memorial Lecture

Sport And It's Female Fans, Kristy Mccray

Health and Sport Sciences Faculty Scholarship

A book review on Sport and It's Female Fans.

Ventilation Heterogeneity In Ex-Smokers Without Airflow Limitation., Damien Pike, Miranda Kirby, Fumin Guo, David G Mccormack, Grace Parraga

Medical Biophysics Publications

RATIONALE AND OBJECTIVES: Hyperpolarized (3)He magnetic resonance imaging (MRI) ventilation abnormalities are visible in ex-smokers without airflow limitation, but the clinical relevance of this is not well-understood. Our objective was to phenotype healthy ex-smokers with normal and abnormally elevated ventilation defect percent (VDP).

MATERIALS AND METHODS: Sixty ex-smokers without airflow limitation provided written informed consent to (3)He MRI, computed tomography (CT), and pulmonary function tests in a single visit. (3)He MRI VDP and apparent diffusion coefficients (ADCs) were measured for whole-lung and each lung lobe as were CT measurements of emphysema (relative area [RA] with attenuation ≤-950 HU, RA950) and …

Sera From Patients With Active Systemic Lupus Erythematosus Patients Enhance The Toll-Like Receptor 4 Response In Monocyte Subsets, Tiago Carvalheiro, Diane Gomes, Ligia A. Pinto, Luis Inês, Ana Lopes, Ana Henriques, Susana Pedreiro, António Martinho, Hélder Trindade, Howard A. Young, José António Pereira Da Silva, Artur Paiva

United States Public Health Resources

Background: Systemic Lupus Erythematosus (SLE) is an auto-immune disease whose complex pathogenesis remains unraveled. Here we aim to explore the inflammatory ability of SLE patients' sera upon peripheral blood (PB) monocyte subsets and myeloid dendritic cells (mDCs) obtained from healthy donors. Methods: In this study we included 11 SLE patients with active disease (ASLE), 11 with inactive disease (ISLE) and 10 healthy controls (HC). PB from healthy donors was stimulated with patients' sera, toll-like receptor (TLR) 4 ligand - lipopolysaccharide or both. The intracellular production of TNF-α was evaluated in classical, non-classical monocytes and mDCs, using flow cytometry. TNF-α mRNA …

Wecan Implementation For Parents Of At-Risk Hispanic Adolescents In Middle School, Shannon Leigh Devita

Doctor of Nursing Practice Final Manuscripts

Abstract

CDC-reported childhood obesity rates have tripled in the past three years. Among children in grades five, seven and nine, 30% are overweight or obese, with Hispanic students more likely to be overweight than White students. This evidence-based project examined the effectiveness of NHLBI’s WeCan! for at-risk middle-school-age Hispanic children and parents. The program was implemented at school in two weekly sessions, and its effectiveness was evaluated using the WeCan! survey. The program resulted in improved knowledge, behaviors, and attitudes related energy balance, portion size, healthy foods, physical activity, and screen time and may be useful in other school settings.

Evaluating Physical Therapy For Adolescent Patients With Low Back Pain, Kelly Denise Gonzales

Doctor of Nursing Practice Final Manuscripts

Background: Low back pain is a condition affecting many people worldwide. The age of onset is variable, affecting all patient populations from childhood throughout the lifespan. Aims/Purpose: The efficacy of physical therapy for adolescent patients with back pain seen in a pediatric orthopedic clinic was evaluated through comparison of pre and post-intervention pain scores. Patient compliance with physical therapy was monitored and evaluated against outcomes.

Design: A six-month retrospective chart review of adolescent patients with a diagnosis of low back pain. Patients with a diagnosis of low back pain were referred for physical therapy and provided with a home exercise …