Medicine and Health Sciences Commons^™

Management Of Pediatric Headaches In The Emergency Department At Connecticut Children’S Medical Center, Chevaughn Wellington

Honors Scholar Theses

Headaches are a common complaint for children presenting to the Emergency Department (ED) at Connecticut Children’s Medical Center (CCMC). Currently, there is little published regarding a standard treatment plan for pediatric headaches. The purpose of this study is to determine which medications are most commonly utilized and which are most effective in managing pediatric headaches. Differences in management of acute and chronic headaches in the ED at CCMC were examined. A retrospective chart review was conducted of all children who presented to the ED from January 1 to March 31, 2013 with a chief complaint or discharge diagnosis of “headache” …

Pathological Effects Of Repeated Concussive Tbi In Mouse Models: Periventricular Damage And Ventriculomegaly, Richard H. Wolferz Jr.

Honors Scholar Theses

Repeated concussive traumatic brain injury (rcTBI) is the most prominent form of head injury affecting the brain, with an estimated 1.7 million Americans affected each year (Kuhn 2012). Neurologists have been concerned about the danger of repeated head impacts since the 1920’s, but researchers have only begun to understand the long-term effects of rcTBI (McKee 2009). Although symptoms can be as mild as dizziness, current research suggests that multiple concussions can lead to a progressive degenerative brain disease known as chronic traumatic encephalopathy (CTE) (Luo 2008, McKee 2009, Kane 2013). Research on the brain is just beginning to scratch the …

Manipulation Of The Microbiome And Its Impact On Functional Recovery Following Ischemic Stroke, Michal Jandzinski

Honors Scholar Theses

Each year, nearly 800,000 individuals residing in the United States will have a stroke. Of these, about 130,000 cases will prove fatal while many of the survivors will be forced to live with disability for the remainder of their lives. Out of all strokes over 87% are ischemic strokes. The widespread incidence of this debilitating condition costs the United States an estimated $36.5 billion dollars every single year. Despite this, clinicians are armed with very little to combat the disease. Recent research developments have brought about the rise in awareness about the importance of the microbiome, the various gut flora …

Design And Development Of Two Component Hydrogel Ejector For Three-Dimensional Cell Growth, Thomas Dunkle, Jessica Deschamps, Connie Dam

Honors Scholar Theses

Hydrogels are useful in wound healing, drug delivery, and tissue engineering applications, but the available methods of injecting them quickly and noninvasively are limited. The medical industry does not yet have access to an all-purpose device that can quickly synthesize hydrogels of different shapes and sizes. Many synthesis procedures that have been developed result in the formation of amorphous hydrogels. While generally useful, amorphous hydrogels exhibit limited capability in tissue engineering applications, especially due to their viscous properties. This endeavor aims to modulate the appropriate gelation parameters, optimize the injection process, and create a prototype that allows for the extrusion …

Methylphenidate And Dexmethylphenidate Formulations In Children With Attention-Deficit/Hyperactivity Disorder, David Sugrue

Honors Scholar Theses

Purpose: To review the current literature on the various extended-release methylphenidate stimulant preparations regarding safety and efficacy in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).

Summary: The literature reviewed establishes the efficacy of the different long-acting methylphenidate stimulant formulations in treating children and adolescents with ADHD. Comparing and contrasting the different extended-release preparations allows for clinicians to help tailor ADHD treatments to individual patients. The extended release methylphenidate products provide the same efficacy as the immediate release formulations, but add the convenience of less frequent dosing. There are a few options for patients with difficulty swallowing tablets or capsules, including …

Oscillatory Activity In The Subthalamic Nucleus And Motor Cortex In A Pharmacological Model Of Parkinsonian Tremor, Aileen F. Haque

Honors Scholar Theses

Parkinson’s Disease (PD) is a motor disorder with symptoms including resting tremor, akinesia, bradykinesia, and rigidity. A major neuropathological feature of PD is degeneration of nigrostriatal dopamine (DA) neurons. The resulting DA depletions lead to the production of severe motor deficits. Pharmacological agents that reduce DA transmission can also induce these motor abnormalities. In addition to the involvement of DA, drugs acting on acetylcholine, namely cholinomimetics, can induce or exacerbate Parkinsonian symptoms. In humans, one of the main motor symptoms associated with PD is resting tremor, occurring at a frequency of 3-7 Hz. This can be modeled in rodents using …

Central Auditory Processing And The Link To Reading Ability In Adults, Lisa M. Brody

Honors Scholar Theses

What makes someone a good reader? What makes someone a poor reader? The root biological marker of reading ability has yet to be determined. Many scientists agree that phonological awareness, the understanding of speech sounds, and phonological decoding are key components of reading ability (Melby-Lervag, Lyster, & Hulme, 2012). In addition to this, new research suggests that the auditory system, specifically the timing of auditory processing in the brain, provides a crucial platform that supports the development of reading ability (Banai et al., 2009). This thesis provides empirical data to support the link between reading skill …

Connecticut's Elderly Population: An In-Depth Analysis Of Current And Future Trends In Elder Care, With A Focus On Dementia And Cognitive Decline, Emily J. Snodgrass

Honors Scholar Theses

The aging population in Connecticut currently represents ~15% of the state’s population but is anticipated to rapidly increase over the next 20 years. My thesis is an examination of the types of interventions and programs currently available for elderly persons with memory impairment and cognitive decline, as well as the challenges associated with caring for a larger elderly population. Data collected from interviews with CT healthcare and research professionals representative of the diverse specialties of aging together with an analysis of current research literature are used to demonstrate the importance of continued research and expansion of appropriate and accessible services …

Knowledge And Behaviors Surrounding A Gluten-Free Diet Between Medically And Self-Diagnosed Individuals, Sara Andrea Quinteros-Fernandez

Theses - ALL

Objective: Gluten, a protein found in wheat, rye and barley has been linked to the inflammatory response of the GI tract in individuals with Celiac Disease, non-celiac gluten sensitivity, and in some cases irritable bowel syndrome (IBS). Several factors have contributed to the increase in these gluten-related disorders in recent years, including improved medical diagnosis, public awareness of the disease, changes in the composition of wheat due to modern agricultural technologies and perceived health benefits from following a gluten-free diet. The purpose of this research was to examine the knowledge, behaviors and adherence to a gluten-free diet by individuals with …

Reverse Genetics Of Mononegavirales: How They Work, New Vaccines, And New Cancer Therapeutics., Christian K Pfaller, Roberto Cattaneo, Matthias J. Schnell

Department of Microbiology and Immunology Faculty Papers

The order Mononegavirales includes five families: Bornaviridae, Filoviridae, Nyamaviridae, Paramyxoviridae, and Rhabdoviridae. The genome of these viruses is one molecule of negative-sense single strand RNA coding for five to ten genes in a conserved order. The RNA is not infectious until packaged by the nucleocapsid protein and transcribed by the polymerase and co-factors. Reverse genetics approaches have answered fundamental questions about the biology of Mononegavirales. The lack of icosahedral symmetry and modular organization in the genome of these viruses has facilitated engineering of viruses expressing fluorescent proteins, and these fluorescent proteins have provided important insights about the molecular and cellular …

The Scoop, Vol. 2 Issue 2, May 2015, Health Sciences Library

Volume 2

Latest news and events from the Health Sciences Library in our monthly newsletter for May 2015.

Participants' Perceptions Of Factors In Preventing Falls, Rajvinder K. Bains, Jaclyn A. Fok, Nadine M. Marcelo, Tamara Vileshina

Dissertations, Masters Theses, Capstones, and Culminating Projects

Falls pose a serious threat to older adults, often resulting in physical, emotional, and financial consequences. The use of multifactorial fall prevention programs has provided community-dwelling older adults with strategies to decrease the risk of falling. Outcomes for these programs are measured in terms of such factors as fear of falling, balance and self-efficacy. One outcome of fall prevention programs that is less well understood is what the older adults themselves perceive as most beneficial. For this program evaluation project, five women participated in semi-structured interviews to understand which aspects of a multifactorial fall prevention program they found to be …

A Matter Of Balance: Program Outcomes For Community-Dwelling Older Adults, Tiffany Lau, Victoria Reyes, Adrienne Angeles, Leslie Hollaway

Dissertations, Masters Theses, Capstones, and Culminating Projects

Aims: The purpose of this program evaluation was to determine if A Matter of Balance with volunteer lay leaders (AMOB/VLL) was effective in increasing fall self-efficacy, fall control, and fall management in community-dwelling older adults.

Methods: Participants included community-dwelling older adults over the age of 60 who were concerned about falls and attended at least five of the eight AMOB/VLL program sessions. Fear of falling, pretest, posttest, and 3-, 6-, and 12- month follow-up data were collected from program participants between 2012 and 2013.

Results: Participants demonstrated overall improvements in fall self-efficacy, fall control, and fall management. Qualitative analysis also …

Therapeutic Listening® And Bilateral Coordination In Typically Developing Children, Shanee Ben-Haim, Cassandra Debonis, Jane Schwartz, Amy Smith-Schwartz

Dissertations, Masters Theses, Capstones, and Culminating Projects

Abstract

This study examined the effects of a 15-minute Therapeutic Listening Quickshift® series intervention on 8-10 year-old typically developing children. A convenience sample was used for 8 participants in Marin County, California. Participants were randomly assigned to either the Therapeutic Listening® intervention or white noise control intervention. All participants participated in a pretest to establish a baseline of bilateral coordination abilities. Participants then listened to 15-minutes of the Therapeutic Listening® or white noise interventions. Following this intervention period, participants then participated in a posttest identical to the pretest. Movement assessment measures from the bilateral coordination subtest of the Bruininks-Oseretsky Test …

The Preschool Kitchen Task Assessment (Pkta): Assessing Validity Of A Performance-Based Assessment Of Executive Function, Emily Fry, Hayley Gilligan, Liza Henty-Clark, Jennifer Weissensee

Dissertations, Masters Theses, Capstones, and Culminating Projects

Background and purpose. Executive function (EF) deficits is a growing area of focus in pediatric occupational therapy practice. However, there is a lack of performance-based assessments of EF in preschool-aged children. This study sought to establish preliminary criterion-related validity of the Preschool Kitchen Task Assessment (PKTA), a test of EF in preschoolers developed by Christine Berg, Ph.D., OTR/L, in which children complete a multi-step craft project.

Subjects. Fifteen typically developing preschool-aged children participated in this study.

Methods. An exploratory design was used to assess criterion-related validity of the PKTA. Participants completed the PKTA along with several established neuropsychological assessments of …

Bridge/Adapt: A Systematic Cognitive Rehabilitation Curriculum, Julie S. Bergen, Natalie Repin, Amy Bennet, Abigail Lafrenz

Dissertations, Masters Theses, Capstones, and Culminating Projects

Cognitive impairment, including deficits in memory, attention, visual perception, executive functioning, and self-awareness, is a common consequence of acquired brain injury (ABI). Subsequently, these cognitive impairments result in functional impairments in daily life activities for clients with ABI. Rehabilitation efforts are categorized under two broad approaches: remediation and adaptation. Computer-assisted cognitive retraining (CACR) is a remediation approach using a computer platform to deliver cognitive exercises. CACR therapy can lead to improvements in memory and attention for adults with chronic ABI. However, memory and attention improvements from CACR may not carry over to functional improvements in occupational performance. Research suggested that …

Standardized Patients In Occupational Therapy Education, Andrea E. Battle, Jessica M. Borceguin, Joanna P. Dizon, Lai Zan Saechao

Dissertations, Masters Theses, Capstones, and Culminating Projects

The use of standardized patients (SPs) in occupational therapy (OT) education has greatly increased in recent years; however, there is limited research on the perceptions of student’s clinical readiness utilizing SPs and whether or not the utilization of SPs prepare students for fieldwork. The purpose of this study was to examine the perceptions of SPs in OT education and the perceived clinical readiness of students. The use of SPs has been thoroughly researched in other healthcare related fields. It is important that the same critical attention be given to their use in our own field, which emphasizes the importance of …

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

Dissertations, Masters Theses, Capstones, and Culminating Projects

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 that emerged from …

Oral Wellness: Using Occupational Therapy To Enhance Oral Hygiene Delivery In Long-Term Care, Lauryn J. Banovitz, Liberty Bellah, Rosemarie Lion

Dissertations, Masters Theses, Capstones, and Culminating Projects

Based on current literature, oral health in long-term care (LTC) facilities is frequently of low priority and does not follow evidence-based best practices. Poor oral health reduces the quality of life of older adult residents and patients and can lead to systemic diseases, such as cardiovascular disease, stroke, and pneumonia, the leading cause of death in LTC. Occupational therapists can play an instrumental role as oral care consultants, and educators, and can act as resource guides to raise the standards of oral care in LTC facilities.

This capstone project explored ways in which occupational therapy, a profession traditionally designated for …

Fret: Validity Of A Fall Risk Evaluation Tool For Individuals With Acquired Brain Injuries, Desiree Shaver, Colon Mikaela, Irene Leung, Melanie Shea

Dissertations, Masters Theses, Capstones, and Culminating Projects

Objective: The purpose of this study is to evaluate the predictive validity of the Fall Risk Evaluation Tool (FRET) for individuals with acquired brain injuries (ABIs).

Methods: Ten participants were included for the study. Inclusion criteria for participants included: age 18 and older, English speaking, 6-months post ABI, ambulatory with or without an assistive device, and uses a wheelchair less than 25% of the day. Exclusion criteria for participants included: global confusion and degenerative neurological conditions. Following the administration of the FRET, participants recorded falls that occurred over the following 3-month study period.

Results: Data was analyzed using the Pearson’s …

Helping Parents Navigate Occupational Therapy In The Iep Process, Noelle Bakken, Kelly Calton, Molly Hyland, Shannon Landau

Dissertations, Masters Theses, Capstones, and Culminating Projects

At the request of Matrix Parent Network and the Marin Autism Collaborative, the project developers have gathered information in order to help parents of children with Autism Spectrum Disorder (ASD) better understand Occupational Therapy (OT) in the school setting. The development of the resource guide consisted of three needs assessments to identify areas of occupational therapy in which parents required further clarification. After meeting with the director of parent services from Matrix Parent Network, and receiving the online survey results from twenty-eight parents in Marin County, who have children with ASD, the project developers identified areas of OT to focus …

Clozapine For Treatment-Resistant Bipolar Disorder: A Systematic Review, Xian-Bin Li, Yi-Lang Tang, Chuan-Yue Wang, Jose De Leon

Psychiatry Faculty Publications

Objective

To evaluate the efficacy and safety of clozapine for treatment-resistant bipolar disorder (TRBD).

Methods

A systematic review of randomized controlled studies, open-label prospective studies, and retrospective studies of patients with TRBD was carried out. Interventions included clozapine monotherapy or clozapine combined with other medications. Outcome measures were efficacy and adverse drug reactions (ADRs).

Results

Fifteen clinical trials with a total sample of 1,044 patients met the inclusion criteria. Clozapine monotherapy or clozapine combined with other treatments for TRBD was associated with improvement in: (i) symptoms of mania, depression, rapid cycling, and psychotic symptoms, with many patients with TRBD achieving …

Caffeine Consumption In A Long-Term Psychiatric Hospital: Tobacco Smoking May Explain In Large Part The Apparent Association Between Schizophrenia And Caffeine Use, Manuel Arrojo-Romero, Carmen Armas Barbazán, Javier D. López-Moriñigo, Ramón Ramos-Rios, Manuel Gurpegui, José M. Martinez-Ortega, Dolores Jurado, Francisco J. Diaz, Jose De Leon

Psychiatry Faculty Publications

This study further explores the association between schizophrenia and caffeine use by combining two prior published Spanish samples (250 schizophrenia outpatients and 290 controls from the general population) with two Spanish long-term inpatient samples from the same hospital (145 with schizophrenia and 64 with other severe mental illnesses). The specific aims were to establish whether or not, after controlling for confounders including tobacco smoking, the association between schizophrenia and caffeine is consistent across schizophrenia samples and across different definitions of caffeine use. The frequency of caffeine use in schizophrenia inpatients was not significantly higher than that in non-schizophrenia inpatients (77%, …

Investigation Of Genetic Alterations In Emt Suppressor, Dear1, Through Pan-Cancer Analysis And Ultra-Deep Targeted Sequencing In Ductal Carcinoma In Situ, Jacquelyn Reuther

Dissertations and Theses (Open Access)

Ductal carcinoma in situ (DCIS) is thought to be one of the earliest pre-invasive form of and non-obligate precursor to invasive ductal carcinoma (IDC). There is an urgent need to identify predictive and prognostic biomarkers for breast cancers with a heightened risk of progression from DCIS to IDC. Our laboratory has previously discovered a novel TRIM family member, DEAR1 (Ductal Epithelium Associated Ring Chromosome 1, annotated as TRIM62) within chromosome 1p35.1, that is mutated and homozygously deleted in breast cancer and whose expression is downregulated/lost in DCIS. Previous work has shown that DEAR1 is a novel tumor suppressor …

Igfbp2 Potentiates Egfr-Stat3 Signaling In Glioma, Yingxuan Chua

Dissertations and Theses (Open Access)

Gliomas are clinically challenging brain tumors with dismal survival rates due to its infiltrative nature and ineffective standard therapy. Insulin-like growth factor binding protein 2 (IGFBP2) is a pleiotropic oncogenic protein that has both extracellular and intracellular functions. Despite a clear causal role in cancer development, the contributions of intracellular IGFBP2 to tumor development and progression are poorly understood. Here we present evidence that both exogenous IGFBP2 treatment and cellular IGFBP2 overexpression lead to aberrant activation of EGFR, which subsequently activates STAT3 signaling. Furthermore, we demonstrate that IGFBP2 augments the nuclear accumulation of EGFR to potentiate STAT3 transactivation activities, via …

Design, Development And Evaluation Of Erlotinib-Loaded Hybrid Nanoparticles For Targeted Drug Delivery To Nonsmall Cell Lung Cancer, Bivash Mandal

Theses and Dissertations (ETD)

The objective of this work was to design, develop and evaluate erlotinib-loaded coreshell type lipid albumin hybrid nanoparticles (CSLAHNPs) for targeted drug delivery to nonsmall cell lung cancer (NSCLC). Erlotinib (ETB) is a highly selective, potent and reversible inhibitor of epidermal growth factor receptor tyrosine kinase (EGFR) which is overexpressed (50-90%) in NSCLC. ETB is marketed as film coated tablets for oral delivery. However, poor survival rate along with life-threatening adverse effects were reported from oral administration. Nanoparticulate delivery system of ETB might be advantageous to target the tumor cells, thereby increasing therapeutic efficacy and reducing off-targeting toxicities of ETB …

Molecular Mechanisms Underlying Alcohol-Induced Cerebral Artery Smooth Muscle Bk Channel Inhibition And Eventual Cerebral Vasoconstriction, Guruprasad Kuntamallappanavar

Theses and Dissertations (ETD)

Introduction and Rationale: Ethanol (EtOH) at concentrations obtained in circulation during moderate to heavy episodic drinking, such as during binge drinking (30-60 mM) causes cerebral vasoconstriction in many species, including humans. Using rodents as a model to study ethanolinduced cerebral artery constriction, our laboratory demonstrated that ethanol-induced cerebral artery constriction is due to drug-induced reduction of STOCs (Spontaneous Transient Outward Currents) in cerebral artery smooth muscle. In this tissue, STOCs result from the activity of large conductance, calcium-and voltage-gated potassium (BK) channels. Indeed, ethanol (50 mM) decreases the steady-state activity (NPo) of vascular myocyte BK channels leading to an increase …

Functional Activity And Switching Of Novel Cannabinergic Ligands, Bret Alan Koertge

Theses and Dissertations (ETD)

Pursuant to the discovery of the cannabinoid receptors, research in this field has grown exponentially over the last 2 decades. With their utility in various disease states such as heart disease, cancer, stroke, neurodegenerative and inflammation, cannabinoids stand poised to become a great therapeutic agent. This research seeks to better understand the functional mechanism of cannabinoids, in the hopes of ascertaining which molecular attributes confer desirable selectivity and functional activity.

Looking first at classical benzchromene core analogues, we have shown that presence of an aromatic substitution at C-1' imparts a CB1 agonist, CB2 antagonist. This is a unique mechanism and …

Genetics Of Obesity In Starr County, Texas Mexican Americans, Heather M. Highland

Dissertations and Theses (Open Access)

Currently, over two-thirds of Americans are classified as over-weight or obese. Obesity increases risk for many other diseases including type 2 diabetes, heart disease, stroke, and cancer, making obesity the largest public health problem in America and most other Westernized nations. Hispanics have a higher rate of both obesity and type 2 diabetes, making them a particularly interesting population in which to study obesity. For the last 33 years, the Starr County Health Studies has collected an array of phenotypes and biological samples from residents of Starr County, along Texas-Mexico border. This study includes 825 subjects who were not known …

Transarterial Chemoembolization Is Ineffective For Neuroendocrine Tumors Metastatic To The Caudate Lobe: A Single Institution Review., Lawrence A Shirley, Megan Mcnally, Ravi Chokshi, Natalie Jones, Patrick Tassone, Gregory Guy, Hooman Khabiri, Carl Schmidt, Manisha Shah, Mark Bloomston

Oncology Articles

BACKGROUND: Caudate lobe liver metastases occur commonly in patients with neuroendocrine tumors. It is unknown, however, how these lesions respond to regional therapy and how their presence impacts outcomes. We reviewed our experience treating these lesions using transarterial chemoembolization (TACE).

METHODS: We reviewed radiographic response to TACE in 86 patients with metastatic neuroendocrine tumors to the liver. We determined the impact of caudate lesions on outcomes in comparison to the cohort of patients without caudate lesions, as well as response of caudate lesions to TACE versus lesions elsewhere in the liver.

RESULTS: Caudate lesions were identified in 45 (52%) patients. …