Medicine and Health Sciences Commons^™

Implementation Of Modified Constraint-Induced Therapy In Upper Limb Stroke Rehabilitation In An Inpatient Rehabilitation Hospital, Umana W. Udoeyop

Occupational Therapy Doctorate Capstone Projects

Background: Despite increasing and strong evidence of modified constraint-induced therapy (mCIT) as an effective intervention approach for patients with chronic and subacute stroke in outpatient settings, it is still not widely used for the rehabilitation of patients with acute stroke who are typically admitted to inpatient rehabilitation hospitals.

Purpose: The purpose of this study is to implement an evidence-based approach using mCIT in the upper extremity rehabilitation of patients with acute stroke in an inpatient rehabilitation hospital and to demonstrate its feasibility and efficacy in increasing the motor recovery, and the amount and quality of arm use when compared to …

Exploring Fieldwork Educators' Expectations Of Occupational Therapy Students' Professional And Technical Skills, Jessica A. Mason

Occupational Therapy Doctorate Capstone Projects

Background: This capstone project focused on professional and technical skills of occupational therapy students beginning Level II Fieldwork. Fieldwork educators are essential personnel to the development of successful occupational therapy students. The education provided by the fieldwork educators is vital to the growth of each occupational therapy student in the profession.

Purpose: The purpose of this capstone project was to explore perceptions held by Level II Fieldwork educators of occupational therapy students’ professional and technical skills at the beginning of Level II Fieldwork. By identifying these perceptions, academic occupational therapy educators can assist students to develop these skills while they …

Leadership Roles: Creating Inclusiveness Within A Worship Environment, Susan L. Morreau

Occupational Therapy Doctorate Capstone Projects

This Capstone Project sought to investigate and measure the process of social change in the community setting of a Christian church. A committee of stakeholders came together with a common passion to engage and integrate individuals of varying disabilities at all levels of church participation. As a new committee, stakeholders agreed to use the cyclical process of Participatory Action Research (PAR) to guide them in creating an action plan for promoting this congregational change. The occupational therapist served on the committee as both a co-facilitator and researcher.

While the primary purpose of the project was to objectively measure the degree …

Investigating The Effectiveness Of Web-Based Recommended Practice Tutorials For Caregivers Of Children In Early Intervention Programs, Terri L. Beard

Occupational Therapy Doctorate Capstone Projects

The purpose of this mixed-method investigational pilot study is two-fold: are web-based tutorials effective for caregivers of children in early intervention programs to learn recommended practice content and 2) examine caregiver attitudes towards using online training tutorials. The problem addressed will be “Is using an online learning platform an effective adjunct way for caregivers of young children in early intervention programs to learn recommended practice information?” In early intervention programs, practitioner time, resources, and availability is often limited. Frequently, children in early intervention programs are taken care of by multiple caregivers. To improve carryover, this study focuses on determining if …

The Value Driven Pharmacist: Basics Of Access, Cost And Quality, Carriann Smith, Annette Mcfarland, Chad Knoderer, Joseph Jordan, Trish Devine, Jessica Wilhoite

Butler University Books

No abstract provided.

Proton Pump Inhibitors (Ppis): A Review Of The Efficacy, Usage, And Current Literature Recommendations, Travis M. Booke

Physician Assistant Scholarly Project Posters

• As Klepser, Collier, and Cochran (2013) noted, PPIs are a class of agents that reduce acid secretion by parietal cells in the stomach by irreversibly blocking H+/K+ adenosine triphosphate. They are commonly prescribed for many gastrointestinal (GI) conditions including gastric and duodenal ulcers, gastroesophageal reflux disease (GERD), upper gastrointestinal bleeding, and Helicobacter pylori infections. They are frequently utilized in the primary care setting. The purpose of this study was to examine the efficacy, usage, and current literature on PPIs.

• There were several complications noted with PPI usage. Gomm et al. (2016) found that that use of PPI is …

Analysis Of Metabolic Syndrome As A Modifiable Risk Factor For Prostate Cancer, Michael Butler

Physician Assistant Scholarly Project Posters

• Prostate cancer and metabolic syndrome are both prevalent among men in developed countries with peak incidence after age 50.

• Prostate cancer has no known modifiable risk factors.

• Most risk factors for metabolic syndrome are modifiable.

• If metabolic syndrome is identified as contributing to the risk of prostate cancer it would give an element of self determination to men at risk for prostate cancer.

• Past studies provide conflicting results in the correlation between these two conditions.

• A literature review was performed to evaluate consistencies in current literature.

• Metabolic syndrome or its components do not …

Prolotherapy: Applications, Mechanism Of Action, Controversy And Evidence, Boris M. Davydov

Physician Assistant Scholarly Project Posters

Merriam-Webster defines prolotherapy (PROLO) as “an alternative therapy for treating musculoskeletal pain that involves injection of irritant substance (as dextrose) into a ligament or tendon to promote the growth of new tissue”. Experimental research and multiple clinical trials have generated evidence suggesting that PROLO is effective at treating a variety of musculoskeletal conditions, including tendinopathies, joint instability and ligament laxity. PROLO may also hold a potential to delay or avoid joint replacement and rotator cuff surgeries. Further research is needed to demonstrate the therapeutic effect of PROLO unequivocally.

Metformin And Vitamin B12 Deficiency: Consequences And Patient Monitoring, Kathryn Dietz

Physician Assistant Scholarly Project Posters

• The incidence of type 2 diabetes has been increasing at a rapid rate in the United States.

• Metformin is recommended as the first line treatment to be started at the time of diagnosis in all patients without contraindications and has been associated with vitamin B12 deficiency.

• There are currently no clinical guidelines for the routine monitoring of B12 levels in this population.

• The purpose of this scholarly project is to determine if there are consequences of this deficiency and to make recommendations for screening patients.

• It includes current research that focuses on the pathophysiology of …

Prescription Opioids: A Band-Aid For Chronic Low Back Pain, Rebekah Dunn

Physician Assistant Scholarly Project Posters

Pain is one of the most common reasons patients seek medical care in the outpatient clinic and emergency department setting.

 • In the last decade, per the Centers for Disease Control (CDC), prescription drug abuse and overdose, specifically opioids, has become the leading cause of injury and deaths in the United States.

• “Opioids—primarily prescription pain relievers and heroin—are the main driver of overdose deaths and were involved in 28,647 deaths in 2014…opioid overdoses have quadrupled (an increase of 200%) since 2000” (Rudd et al. 2016).

• In 2016 the CDC established guidelines of clinical practice regarding management of …

The Effect Of Statins In Primary Prevention On All-Cause Mortality, Brian Adams

Physician Assistant Scholarly Project Posters

During routine yearly physicals, primary care providers often evaluate serum laboratory lipid levels. Many of these patients have no past medical history of cardiovascular events related to atherosclerotic disease. Some patients do not have secondary risk factors, such as diabetes mellitus or smoking history.

Previous cardiovascular events provide stronger indications for the use of HMG-CoA reductase inhibitors (statins). In the absence of these, the provider may turn to current guidelines, in this case the 2013 the American College of Cardiology and the American Heart Association published the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular …

Sucrase-Isomaltase Deficiency, An Under Considered Diagnosis, Lindsay Venn

Physician Assistant Scholarly Project Posters

• Persistent gastrointestinal (GI) complaints are a common problem in patients presenting to family practice for care.

• Irritable bowel syndrome (IBS) is a diagnosis that adult patients are labeled with when clinicians have exhausted their differential list and no other cause of their GI symptoms can be confirmed.

• Sucrase-isomaltase deficiency (SID) has been historically shown to present early in life as a congenital disorder, but researchers are now recognizing occurrence later in life as a mild or secondary disorder.

• The literature emphasizes the disconcerting prevalence of sucrase-isomaltasedeficiency (SID), the persistent symptoms associated with it, and the need …

Folate As An Adjunctive Therapy For Treatment Resistant Depression, Katherine Mcfarland

Physician Assistant Scholarly Project Posters

Numerous medications are available to treat depression, yet many patients do not achieve remission or recovery of their symptoms with traditional therapies alone. Folate supplementation has been shown to be beneficial in the treatment of depression when used in addition to traditional prescription therapy. A literature review was conducted to determine the effect of low folate levels on depression and if supplementation with either folic acid or L-methylfolate benefits this patient population. Key search terms including folate, folate deficiency, methylfolate, nutrition, and depression were used to perform searches of multiple databases and journals including PubMed, CINAHL, PsycInfo, and the American …

The Postnatal Management Of Gestational Diabetes, Savannah Prodzinski

Physician Assistant Scholarly Project Posters

• Diabetes mellitus is growing substantially in our nation. Between its natural progression and effects on other body systems, this epidemic is costing us billions of dollars a year.

• Although gestational diabetes typically resolves after pregnancy, women who have had gestational diabetes in the past have a largely increased risk for the development of diabetes mellitus in the future.

• Several things contribute to the development of GDM and DM: decline in β-cell function, lower adiponectin levels and HgbA1C levels in the third trimester.

• Intervening during the critical time after delivery in women with gestational diabetes, will theoretically …

The Association Between Antipsychotic Medication And Weight Gain, Brian Steen

Physician Assistant Scholarly Project Posters

• Antipsychotic medications are utilized for patients with many mental health problems including schizophrenia, attention deficit hyperactivity disorder, autism, bipolar mania, and psychotic depression. The antipsychotic medications treat the symptoms associated with these mental health disorders.

• Antipsychotic medications, while being efficacious to these symptoms, can have unwanted side effects, including weight gain. The purpose of this study was to determine if there is a strong relationship with antipsychotic medication use and weight gain.

• The review of literature was conducted with an online search of Cochrane, PubMed, and PsycInfo for journal articles, research studies, and other scholarly reviews. Articles …

Language Concordance: Overcoming Language Barriers, Pamela Flavin-Lee

Physician Assistant Scholarly Project Posters

• Language discordance is a growing problem facing health care today. Communication barriers can be cultural or language based and are commonly cited as a major contributor to poor patient compliance and health outcomes.

• This research project seeks to identify promising developments aimed at overcoming language discordance through analysis of different translation implementation methods and correlating these with health outcomes.

Opioid Maintenance Treatment: Methadone, Buprenorphine, And Naltrexone, Nicole Lemieux

Physician Assistant Scholarly Project Posters

Opioid dependence plagues the United States with millions of people suffering from the effects. Throughout recent years, there has been a surge in research in treatment options for patients suffering from opioid dependence. Three medications have stood out: methadone, buprenorphine, and naltrexone. The purpose of this study was to investigate the three and decipher which provides the best outcomes for patients. Research was conducted by reviewing literature via PubMed, PsychInfo and Cochrane. A review of the literature found that methadone has been used the longest and has been shown to be efficacious, but can be severely limiting for patients due …

Treatment Options For Patients With Irritable Bowel Syndrome & Comorbid Depression, Elizabeth Morton

Physician Assistant Scholarly Project Posters

• Irritable bowel syndrome & depression are common comorbidities, however there is a wide variability regarding the appropriate treatment regimens for these patients.

• IBS is classified as a functional bowel disease in which patients suffer from recurrent abdominal pain or discomfort associated with alterations in bowel habits.

• While the cause of IBS is multifactorial, studies have revealed that the dysfunction of the brain-gut pathways are a culprit to disease appearance and progression, as seen in the biopsychosocial model of IBS. This model proposes that abdominal symptoms secondarily impact anxiety & depression symptoms and that psychological factors influence physiologic …

Alpha-1 Deficiency: Better Detection May Improve Outcomes For Copd Patients, Angela Schuster

Physician Assistant Scholarly Project Posters

Alpha-1 antitrypsin deficiency (AATD) is a genetic disorder that results in debilitating illnesses like: emphysema, COPD, liver disease, and panniculitis. AATD is highly under-diagnosed based on epidemiologic and population studies that suggest that fewer than 10% of the 60,000-100,000 individuals in the U.S. suspected to have severely deficient alleles have been identified ( Rahaghi et al., 2012). This study examines strategies aimed at improving detection of AATD. The findings indicate that utilizing flags to alert providers of the need for AATD testing initiated by RTs or automated within EMR systems are effective strategies for increasing testing rates and potentially improving …

Pharmacogenetic Testing In The Treatment Of Major Depressive Disorder, Brianna Strube

Physician Assistant Scholarly Project Posters

• Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders in the United States and is a large cause of disability. Antidepressants take weeks/months to become effective which can lead to noncompliance. Treatment has a high failure rate which increases medical costs and leads to decreased patient outcomes.

• Pharmacogenetic testing is the practice of analyzing genetic differences to predict a patient’s response to medications to improve efficacy and decrease adverse side effects. The purpose of this study was to investigate if pharmacogenetic-guided treatment, specifically in the use of antidepressants in MDD, has resulted in improved patient …

Components In Aqueous Hibiscus Rosa-Sinensis Flower Extract Inhibit In Vitro Melanoma Cell Growth, Karina H. Goldberg, Ariel C. Yin, Archana Mupparapu, Edward P. Retzbach, Gary S. Goldberg, Catherine F. Yang

College of Science & Mathematics Departmental Research

Skin cancer is extremely common, and melanoma causes about 80% of skin cancer deaths. In fact, melanoma kills over 50 thousand people around the world each year, and these numbers are rising. Clearly, standard treatments are not effectively treating melanoma, and alternative therapies are needed to address this problem. Hibiscus tea has been noted to have medicinal properties, including anticancer effects. Extracts from Hibiscus have been shown to inhibit the growth of a variety of cancer cells. In particular, recent studies found that polyphenols extracted from Hibiscus sabdariffa by organic solvents can inhibit melanoma cell growth. However, effects of aqueous …

Incentives To Change: Effects Of Performance-Based Financing On Health Workers In Zambia, Gordon C. Shen, Ha Thi Hong Nguyen, Ashis Das, Nkenda Sachingongu, Collins Chansa, Jumana Qamruddin, Jed Friedman

Publications and Research

Background: Performance-based financing (PBF) has been implemented in a number of countries with the aim of transforming health systems and improving maternal and child health. This paper examines the effect of PBF on health workers’ job satisfaction, motivation, and attrition in Zambia. It uses a randomized intervention/control design to evaluate before–after changes for three groups: intervention (PBF) group, control 1 (C1; enhanced financing) group, and control 2 (C2; pure control) group.

Methods: Mixed methods are employed. The quantitative portion comprises of a baseline and an endline survey. The survey and sampling scheme were designed to allow for a rigorous impact …

Perceived Discrimination And Self-Rated Health In The Immigrant Population Of The Basque Country, Spain, Elena Rodriguez-Alvarez, Yolanda Gonzalez-Rabago, Luisa N. Borrell, Nerea Lanborena

Publications and Research

Objective

To examine the effect of perceived discrimination and self-rated health among the immigrant population in the Basque Country, Spain, and determine whether this effect varies according to region of origin, age, sex and education. Methods

Descriptive cross-sectional study. The study population included immigrants aged 18 and older residing in the Basque Country. Data from the 2014 Foreign Immigrant Population Survey (n=3,456) were used. Log-binomial regression was used to quantify the association between perceived discrimination and self-rated health before and after checking for the selected characteristics. Results

Almost 1 in 10 immigrant adults reports perceiving discrimination. In adjusted analyses, the …

Countermarketing Alcohol And Unhealthy Food: An Effective Strategy For Preventing Noncommunicable Diseases? Lessons From Tobacco, P. Christopher Palmedo, Lori Dorfman, Sarah Garza, Eleni K. Murphy, Nicholas Freudenberg

Publications and Research

Countermarketing campaigns use health communications to reduce the demand for unhealthy products by exposing motives and undermining marketing practices of producers. These campaigns can contribute to the prevention of noncommunicable diseases by denormalizing the marketing of tobacco, alcohol, and unhealthy food. By portraying these activities as outside the boundaries of civilized corporate behavior, countermarketing can reduce the demand for unhealthy products and lead to changes in industry marketing practices. Countermarketing blends consumer protection, media advocacy, and health education with the demand for corporate accountability. Countermarketing campaigns have been demonstrated to be an effective component of comprehensive tobacco control. This review …

Posttraumatic Growth As It Relates To Family Environment, Brian Keller

Online Theses and Dissertations

The current study sought to explore the relationship between one's family environment and reported posttraumatic growth. Participants were 197 EKU undergraduate intro to psychology students. They voluntarily took an online survey for course credit. Types and frequency of trauma was recorded using the Life Events Checklist. The Posttraumatic Growth Index was used to measure posttraumatic growth, the Family environment scale was used to assess qualities of family life, and the Big Five Inventory was used to control for personality traits. Results did not support the hypothesis, however, significant correlations with the Moral Religious subscale of the FES as well as …

Dental Care For Older Adults: Regulatory Requirements In Long Term Care Settings, American Dental Association

Action for Dental Health

No abstract provided.

The Relationship Of A Healthy Mouth To General Health And Illness, American Dental Association

Action for Dental Health

No abstract provided.

Leonard Bagalwa, Leonard Bagalwa, Tsos

TSOS Interview Gallery

Leonard was forced to join the military at the age of 17 in his home country of the Congo. A Catholic priest smuggled me out of the country and I lived in refugee camps in several different countries until 2004 when he came to the United States.

In 2005, a couple came to Leonard when he was homeless in the Provo library. They found out that he needed help and offered to let me live with them. They ended up paying my tuition for my education and I went to college for five years.

Leonard uses his experiences to teach …

Mrsa Induced Pulmonary-Renal Syndrome, Mohammed Megri, Majdi Al-Dliw, Yousef Shweihat, Zeid Khitan

Internal Medicine

We present a rare case of pulmonary-renal syndrome secondary to recurrent MRSA spondylodiscitis. The mechanism of involvement of each organ system is unique. The organs, lung and kidneys, have been affected by different pathologic processes that were induced, we think, by the chronic MRSA infection.

Trends In Management Of Overweight And Obesity In Obstetrics & Gynecology, Family Medicine And Pediatrics 2011-2015, Steven Lindheim, Stephanie Welsh, Nan Jiang, Amanda Hawkins, Lisa Kellar, Rose Maxwell, Leah D. Whigham

Obstetrics and Gynecology Faculty Publications

Purpose: To assess for improvement in the screening and management of overweight and obesity in the past 5 years among Obstetrician-Gynecologists (OB-GYN), Family Physicians (FP), and Pediatricians (Peds).

Methods: A retrospective pilot study was conducted, reviewing 150 charts of patients with overweight (body mass index [BMI] 25-29.9 kg/m2) and class I (BMI 30-34.9 kg/m2), class II (BMI 35-39.9 kg/m2), and class III obesity (BMI ≥ 40 kg/m2) between 2011 and 2015. Patients were from OB-GYN (n=50), Family Medicine, adult (FP-A) (n=50) and pediatric (FP-P) (n=28), and Peds (n=22) offices.

Results: 75% of patients were female; 35.5% had overweight, 40% had …