Medicine and Health Sciences Commons^™

Outcomes And Solutions For Children And Families Affected By Type 1 Diabetes Mellitus, Melissa A. Gray

Senior Honors Projects, 2010-2019

Caring for children with chronic medical conditions, such as type 1 diabetes mellitus (T1DM) has negative implications for the psychosocial wellbeing of the family. Through this project, the negative affects of T1DM on the family were addressed by the formation of the Life’s Too Sweet: A Workshop for a Brighter Future With Type 1 Diabetes (LTS) event, which creates community support for affected families. During LTS workshops, parents collaborated with each other, while the children participated in fun, educational activities about nutrition, fitness, and overall health in relation to T1DM. Supporting interdisciplinary professionals, such as nurses, social workers, registered dietitians, …

Champion Teams: An Implementation Strategy To Drive Practice Improvement, Jodi Polaha, Leigh Johnson, Millie Wykoff, J. Montgomery, S. Peace, D. Sloan, Reid Blackwelder

ETSU Faculty Works

Developing collaborative practice is an ongoing process requiring frequent upgrades as team members and processes are added. Recently, faculty in ETSU’s Department of Family Medicine have been experimenting with a mechanism for iterative upgrades to team care practice known as Champion Teams. Champion Teams are based on the Institute of Medicine’s "learning health care system" approach in which practitioners develop an internal strategy for implementing new evidence based practices on an ongoing basis. In this presentation, our interprofessional team will describe team-based education and practice at ETSU as it relates to the Champion Team concept including its origins, evidence-base, and …

Targeted Delivery Of Drug Combinations Via Nanocarriers For Cancer Treatment, Kruti Soni

Theses & Dissertations

Combination therapy is preferred over monotherapy to treat cancer as it can show better therapeutic outcomes and also delay the onset of resistance by targeting multiple cell-survival pathways in cancer cells. Rationally developed combinations with monoclonal antibodies and small molecule drugs in the form of antibody-drug conjugates or antibody nanoparticle conjugates allow us to take advantage of the cellular targeting of the potent cytotoxic agents, thereby widening the scope for dose reduction while maintaining the required therapeutic response. This can in turn improve patient tolerability by reducing the off target toxicities. For the therapy of ErbB2 positive breast cancer, the …

Vitamin D Supplementation In Allo-Hsct Patients, Bailey Nelson

Theses & Dissertations

BACKGROUND: Bone health is a serious concern for long-term survivors of Allo-HSCT due to multiple risk factors including steroids, chemotherapy, immunosuppressive drugs, and poor nutrition status1. Steroids have been long proven to have negative impact on bone health and the National Osteoporosis Foundation (NOF) lists steroids as a contributing factor to osteoporosis and fractures. NOF guidelines recommend providing adequate daily vitamin D as a safe and inexpensive way to help reduce fracture risk1. Therefore, proper supplementation of vitamin D may increase the quality of life for patients post Allo-HSCT.

PURPOSE: The purpose of this study is to determine if Allo-HSCT …

Sex And Sexuality Of Breast Cancer Survivors, Aja D. Kneip Pelster

Theses & Dissertations

With new diagnostic technologies and treatment modalities available, more people than ever are living as cancer survivors in the United States. A large group of this population consists of breast cancer survivors. The purpose of this research was to explore the intersection of breast cancer survivorship, at points beyond the termination of treatment, and sexuality, including expressions and performance of gender, relationships, and sexual behavior. The current study used semi-structured interviews, conducted with 21 Midwestern women at least 6-months post-treatment, to better understand the intersection of these two concepts. Following traditions of narrative and phenomenological qualitative research, the women’s own …

A Cadaveric Study Of Coronary Artery Variations, Mitchell Lee Milanuk

Theses & Dissertations

Coronary artery diseases, such as angina or myocardial infarction, are extremely prevalent and impact millions of people worldwide. Underlying the diseases, and how they affect each individual in a distinct manner, is the individual’s coronary artery anatomy. The aim of the present study is to have an intimate knowledge of the normal and variant anatomy of the coronary arteries. As an attempt to gain such knowledge, complete analysis of the anatomical variations of coronary arteries was performed. Classical cadaveric dissection of sixty human hearts was performed in the gross anatomy laboratory at the University of Nebraska Medical Center (UNMC). Precise …

Epidemiologic And Clinical Profiles Of Uterine Cancer In The Gharbiah Province Of Egypt, Saad Alshahrani

Theses & Dissertations

Background: Uterine cancer is one of the top-ranking cancers of women with wide international variations in incidence rates. Egypt has a lower incidence of uterine cancer than other countries in the Middle East. In addition to the international incidence variation, there are also wide variations in incidence by rural and urban areas within countries. Therefore, this research project focused on the Gharbiah province, north of Cairo in the Nile Delta, with the aims of investigating demographic and clinical characteristics of uterine cancer, assessing rural/urban variation in incidence rates, and evaluating the possible role of hysterectomy in under-estimating the disease incidence …

Dynamics Of Maternal And Infant Vitamin E Tocopherols During Nicu Hospitalization, Jana K. Wells

Theses & Dissertations

OBJECTIVE: The main objective of this prospective cohort is to investigate serum levels of vitamin E tocopherol isoforms (specifically alpha and gamma) in mothers and infants admitted to the Neonatal Intensive Care Unit (NICU) in relation to infant feeding modality.

METHODS: This was a prospective cohort of 34 mothers and their infants admitted to the neonatal intensive care unit (NICU). Samples of maternal and cord blood were collected at the time of delivery, and a food frequency questionnaire (FFQ) was administered to the mother to measure maternal vitamin E tocopherol intake. After nutrition treatment of each feeding modality had been …

Peer Intervention To Increase Physical Activity Among Working Women, Sheri A. Rowland

Theses & Dissertations

Most Americans do not engage in enough healthy physical activity (PA), with working women particularly at-risk for inactivity. Workplace PA interventions have been effective, however studies using peers as the central theoretical strategy, have not been found. Social cognitive theory and social comparison theory were used to develop a peer-modeling workplace PA intervention. The aims of this experimental, two-group, preliminary study were: 1) assess intervention feasibility, 2) determine the intervention effect on cardiorespiratory fitness (primary outcome), and PA behavior, cardiovascular risk, self-efficacy, motivation, and social comparison, and 3) describe participant perceptions of the intervention using qualitative focus-group data. Female employees …

Genetic Influence On Resilience To Potentially Traumatic Events, Kosuke Niitsu

Theses & Dissertations

Most individuals experience at least one potentially traumatic event (PTE), such as a natural disaster. When exposed to PTEs, some individuals are more vulnerable to develop psychopathology, such as Post-Traumatic Stress Disorder (PTSD). In contrast, others are less adversely affected by PTEs, who are often described as “resilient”. A concept analysis of resilience (Manuscript #1) revealed: the antecedent is PTE; the defining attributes are ego-resiliency, emotion regulation, heredity, and social support; and the consequences are none to mild psychopathological symptoms and positive adaptation. Based on a systematic review of genetic influence on resilience (Manuscript #2), the following 10 polymorphisms were …

The Rise And Fall Of The Bovine Corpus Luteum, Heather Talbott

Theses & Dissertations

This dissertation describes a study of the mechanisms regulating the genesis and subsequent involution of the temporary endocrine structure, the corpus luteum (CL), through the use of a bovine model. The CL is essential for maintaining a suitable uterine environment for embryo implantation and early development through secretion of the steroid hormone progesterone. The “Rise and Fall” of the CL occurs within each estrous cycle whereby the CL must form from the ruptured follicle, secrete sufficient progesterone for uterine maturation, and at the end of the cycle (or pregnancy) regress to allow new follicular development. During the rise of the …

A Meta-Analysis Of The Aftermath Of South Africa’S Apartheid On Its Health Care System, Caitlin Jaeckel

Senior Honors Projects, 2010-2019

The objective of the study was to access the possible problems of the quality of health care that whites and non-whites receive in South Africa. The research question was specific to how the residual effects of apartheid are affecting South Africa’s health care today and if citizens still feel the presence of apartheid in health care. Prior to the start of the study the researcher hypothesized that access, quality, and funding of South Africa’s health care system has not been able to recover from the effect of apartheid and South Africans still observe the effects of apartheid on an individual …

Promoting Independent Movers: The Effect Of The Quadriciser On Range Of Motion (Rom), Kristen N. Frank

Senior Honors Projects, 2010-2019

Exercise and movement are pivotal in promoting optimal function for the human body. For individuals with severe orthopedic impairments, attaining the required minimum of 30 minutes of daily exercise is seemingly difficult. The Quadriciser (the “Q”) serves as an alternative method to therapy in attaining daily exercise through promoting passive-active movement of all four limbs. Five middle school and high school subjects with cerebral palsy, severe orthopedic impairments, and multiple disabilities are analyzed to determine if the Q produces increased range of motion (ROM) outcomes for the knee and shoulder joints. A single case AB, pre-post design was utilized where …

Crossing The Bridge: A Descriptive Pilot Study Of Sensory Tricks And Related Variables To Musician’S Dystonia Onset, Jamie Agee

Senior Honors Projects, 2010-2019

Silencing music across the globe, musician’s dystonia, a neurological condition with an unknown etiological basis, has played an integral role in terminating professional musician’s careers. While limited research has been conducted into internal/external factors which may potentially influence musician’s focal dystonia onset, this pilot study sought to identify specific instrumentalists’ behaviors and traits which may exhibit a potential relationship with disease onset and, consequently, the ability to utilize sensory tricks. This specifically included examination of practice approach, auditory/kinesthetic feedback, years played, personality, and approach to practice among the musicians being studied. To assess these characteristics within the dystonic musician population …

The Community 911 System: Sources Of Strain And Relief, Elizabeth Zulauf

Senior Honors Projects, 2010-2019

This thesis will identify best practices from other localities around the country and propose a set of possible solutions for Harrisonburg EMS. Because non-emergency 911 calls use resources, finances, equipment and time that contribute to the burden that the emergency system faces, communities have adopted programs that aim to ease this burden by limiting the amount of ambulance responses to calls that turn out to be non-emergency. It is not only in Harrisonburg, but across the country that “providers are overwhelmed with evaluation, treatment and transportation of patients who have minor medical conditions but who have nowhere else to turn …

How Income And Food Prices Influence Global Dietary Intakes By Age And Sex: Evidence From 164 Countries, Andrew Muhammad, Anna D'Souza, Birgit Meade, Renata Micha, Dariush Mozaffarian

Publications and Research

Background While income and prices are key drivers of dietary choices, how their influence varies by food category, nation, and demographics is not well established. Based on intake data for 164 countries and 11 food categories, we examined how income and food prices relate to food intake globally, including by world region, age, and sex.

Methods We used 2010 intake data from the Global Dietary Database, the first database of consumption estimates for major food categories by country, age, and sex. We combined these data with national per capita GDP and food price data. We estimated intake responsiveness to income …

Dermoscopy In Family Medicine, Alex Verdieck-Devlaeminck, Jim Holt, Richard Usatine

ETSU Faculty Works

Seminar objectives:
– Introduce dermoscopy as a method for dermatologic diagnosis
– Teach methods to identify melanoma using dermoscopy
– Introduce other methods to identify additional skin conditions
– Provide resources for learning dermoscopy

Diffusion Of Digital Breast Tomosynthesis Among Women In Primary Care: Associations With Insurance Type, Cheryl R. Clark, Tor Tosteson, Anna Tosteson, Tracy Onega, Julie Weiss, Kimberly A. Harris, Jennifer S. Haas

Dartmouth Scholarship

Digital breast tomosynthesis (DBT) has shown potential to improve breast cancer screening and diagnosis compared to digital mammography (DM). The FDA approved DBT use in conjunction with conventional DM in 2011, but coverage was approved by CMS recently in 2015. Given changes in coverage policies, it is important to monitor diffusion of DBT by insurance type. This study examined DBT trends and estimated associations with insurance type. From June 2011 to September 2014, DBT use in 22 primary care centers in the Dartmouth -Brigham and Women's Hospital Population-based Research Optimizing Screening through Personalized Regimens research center (PROSPR) was examined among …

Delivery Of Small Molecule And Rna For The Treatment Of Type 1 Diabetes And Prostate Cancer, Di Wen

Theses & Dissertations

The aim of this thesis is to develop combination therapy using a small molecule and RNA including siRNA, shRNA, or miRNA inhibitor for the treatment of type 1 diabetes and prostate cancer. New amphiphilic biodegradable polymers capable of co-delivering small hydrophobic molecules and RNAs or human bone marrow-derived mesenchymal stem cell (hBMSC) for co-delivery of an shRNA and a miRNA inhibitor were used as drug delivery platform. The drug delivery properties were evaluated in vitro and in vivo islet transplantation, subcutaneous and orthotopic prostate cancer models.

In Chapter 1, an overview of prostate cancer, the role of miRNA and …

Changes In Creep Behaviour And Microstructure Of Model Mozzarella Cheese During Working, Prateek Sharma, Peter A. Munro, Graeme Gillies, Peter G. Wiles, Tzvetelin T. Dessev

Nutrition, Dietetics, and Food Sciences Faculty Publications

The effect of shear work input on the microstructure, fat particle size and creep behavior of model Mozzarella type cheeses was studied. Cheese samples were prepared in a twin screw cooker at 70 °C by mixing protein and fat phases together with different amounts of shear work input. Major changes in cheese structure were observed while working at 150 rpm and 250 rpm screw speeds. Confocal microstructures plus macroscopic observations showed systematic changes in structure with increased shear work inputs with unmixed buttery liquid observed at kg−1, typical Mozzarella type microstructures (elongated fat-serum channels) at 6–15 kJ kg−1 and homogeneously …

Meaningful Use Of Electronic Health Records For Population Health Management In U.S. Acute Care Hospitals, Niodita Gupta

Theses & Dissertations

Population health management (PHM) is used to identify the needs of a population and to align strategies to improve the health of the population through care coordination. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 emphasized the meaningful use (MU) of electronic health records (EHRs) to improve clinical and population health outcomes. The American Recovery and Reinvestment Act (ARRA) of 2009 approved the EHRs incentives program for eligible hospitals to demonstrate the MU of EHRs. Further, eligible hospitals which failed to demonstrate the MU of EHRs could face payment adjustments. Given a heightened focus on …

Analysis Of Graded Gross Anatomy Dissections And Demonstrations As A Supplemental Educational Tool, Stephanie Leanne Cummings

Theses & Dissertations

Teaching and assessment modalities for human anatomy curriculums vary between schools. The University of Nebraska Medical Center utilizes an integrated gross anatomy lab curriculum including hands-on dissection, lecture, and 3-D models. The GCBA 909 course, Human Gross Anatomy Lab, just recently incorporated graded dissections and demonstrations into their master of medical anatomy (MMA) curriculum. Students were required to complete and demonstrate eight additional dissections compared to physician assistant (PA), physical therapy (PT) students. Upon completion of these dissections, students were assessed based on the quality of their dissections and were also required to demonstrate the cadaveric dissections to anatomy faculty …

Anatomical Variations Of The Sciatic Nerve Divisions In Relation To The Piriformis Muscle And Clinical Implications, Jonathan I. Van Erdewyk

Theses & Dissertations

The goal of this project was to identify and quantify the anatomical variations of the sciatic nerve divisions in relation to the piriformis muscle and compare the data collected to the primary literature. This was done in an effort to provide awareness of sciatic nerve entrapments within the subgluteal space that may be responsible for posterior hip and buttock pain. While the current means of diagnosis are through physical examination, imaging techniques, and surgery, the results of this present study indicate that new methods of diagnosis need to be explored.

Epigenetic Modifications Of Human Placenta Associated With Preterm Birth, Drissa Toure

Theses & Dissertations

Preterm birth is a complex multifactorial process. Despite the well-known role of the placenta in supporting the fetal development and maternal-fetal tolerance, the placental epigenetic modifications and preterm birth (PTB) remains poorly understood and under investigated. Various maternal and environment factors can influence epigenetic programming during fetal development to affect the functioning and structures of organs, including the placenta, which can lead to adverse pregnancy outcomes, including PTB. The understanding of the placental epigenetic alterations and maternal determinants associated with PTB are apparently indispensable for the development of actual diagnosis and methods of prevention and treatment of premature labor. The …

Ua61/16 White Coat Ceremony Program, Wku Physical Therapy

WKU Administration Documents

White coat ceremony program for WKU Physical Therapy class of 2017.

Universal Connection Through Art: Role Of Mirror Neurons In Art Production And Reception., Bartlomiej Piechowski-Jozwiak, François Boller, Julien Bogousslavsky

Neurology Faculty Publications

Art is defined as expression or application of human creative skill and imagination producing works to be appreciated primarily for their aesthetic value or emotional power. This definition encompasses two very important elements—the creation and reception of art—and by doing so it establishes a link, a dialogue between the artist and spectator. From the evolutionary biological perspective, activities need to have an immediate or remote effect on the population through improving survival, gene selection, and environmental adjustment, and this includes art. It may serve as a universal means of communication bypassing time, cultural, ethnic, and social differences. The neurological mechanisms …

How An Alloreactive T-Cell Receptor Achieves Peptide And Mhc Specificity, Yuan Wang, Nishant K. Singh, Timothy T. Spear, Lance M. Hellman, Kurt H. Piepenbrink, Rachel H. Mcmahan, Hugo R. Rosen, Craig W. Vander Kooi, Michael I. Nishimura, Brian M. Baker

Food for Health: Publications

T-cell receptor (TCR) allorecognition is often presumed to be relatively nonspecific, attributable to either a TCR focus on exposed major histocompatibility complex (MHC) polymorphisms or the degenerate recognition of allopeptides. However, paradoxically, alloreactivity can proceed with high peptide and MHC specificity. Although the underlying mechanisms remain unclear, the existence of highly specific alloreactive TCRs has led to their use as immunotherapeutics that can circumvent central tolerance and limit graft-versus-host disease. Here, we show how an alloreactive TCR achieves peptide and MHC specificity. The HCV1406 TCR was cloned from T cells that expanded when a hepatitis C virus (HCV)-infected HLA-A2− individual …

The Relationship Between Just Culture, Trust And Patient Safety, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

PROBLEM: Medical errors are now considered to be the third leading cause of death in the United States, estimated at more than 250,000 deaths per year. The Institute of Medicine’s landmark report, To Err is Human, identified that errors are not the fault of individuals, but systems, processes, and various conditions. In healthcare, the cornerstone of the process by which we learn from errors has been voluntary reporting. The primary barrier to reporting errors is the negative response from administrators, and the potential risk of disciplinary action. An environment of trust and fairness is known as “Just Culture” and …

An Analysis Of Risk Behaviors In High School Students That Affect Memory, Concentration, And Decision Making, Charles Guenther

Senior Theses

The youth population is a large portion of the total population in the United States, making up approximately 25% of all people. Youth, especially as they reach high school age, are prone to partaking in risk behaviors, or behaviors that put them at increased risk of morbidity and mortality. The Centers for Disease Control and Prevention (CDC) conducts a survey every other year to collect data on these risk behaviors called the National Youth Risk Behavior Survey (YRBS). For this study, data was pulled from the survey regarding tobacco use, alcohol use, marijuana use, physical activity, television watching, breakfast eating, …

Common Histories And Common Failures: How The Historical Events Of Ireland And The United States Have Led To Their Vastly Different, Equally Failing, Health Care Systems, Kimberly Narro

Senior Theses

The United States healthcare system is a constant source of debate and public interest, with the only common ground between political parties being that the current system is deeply flawed and needing improvement. Individuals often point to European single-payer systems as the answer, neglecting to mention the flaws also inherent in these systems. This thesis aims to suss out the successes and failings of the Irish and American healthcare systems through a thorough scholarly literature review, with an emphasis on the two countries’ origins and development, to lead to a discussion about why two countries with similar historical beginnings have …