Medicine and Health Sciences Commons^™

Education Models For Teaching Adults About Modifying Dietary Carbohydrate And Controlling Weight, Vincient Cleamons

Walden Dissertations and Doctoral Studies

The prevalence of diabetes and other pathophysiological conditions has been correlated with the incidence of obesity. A large portion of an adult community in the northwestern United States suffers from excessive weight that has been linked to premature mortality rates and certain forms of diabetes. Excess calories from carbohydrate have been shown to increase weight. Therefore, diets that are modified in carbohydrate and calories may help mitigate weight and obesity comorbidities. This qualitative, single case study's purpose was to explore the methods health care professionals use for teaching adults about controlling weight. Altheide and Johnson's analytic realism theory, in which …

Relationship Between The U.S. Air Force Physical Fitness Assessment And Healthcare Utilization, Elena Arushanyan

Walden Dissertations and Doctoral Studies

Escalating health care costs in the military health system are not sustainable long term. Regular physical activity has been shown to improve health and reduce health care costs. Military members serving in the United States Air Force (USAF) are encouraged to maintain physical fitness year-round and undergo mandatory physical fitness assessments (PFAs) annually. The purpose of this quantitative correlational study was to determine the nature of the relationship between the timing of the PFA and health care utilization (HU) by active duty service members assigned to the United Kingdom's USAF military treatment facility. Donabedian's framework and the logic process model …

Snac_Oshc: Exploring A Multifaceted Approach To Develop Outside Of School Hours Care As A Health Promoting Setting, Karen Forde

Theses : Honours

Background: Outside of school hours care (OSHC) services are underutilised as health promoting settings, yet are well positioned to influence health behaviours. OSHC Professionals are ideally placed to become positive influencers in this setting, although may require training to confidently perform this role.

Aim: This research trialed a multifaceted intervention strategy to increase OSHC Professional’s confidence and competencies, to support a health promoting OSHC environment with a nutrition and PA activity focus.

Design and Methods: This exploratory study adopted a mixed methods approach. The three-pronged, multifaceted intervention included: a workshop, a closed Facebook group, and a website. 19 OSHC Professionals, …

Parent Satisfaction With Outpatient Pediatric Endoscopy Procedures At University Of New Mexico Children's Hospital, Kalyan Ray Parashette, Marianne Cox, Vani Parashette, Brandon R. Bell, Pankaj Vohra, Rajmohan Dharmaraj, Richardo Castillo, Jacqueline L. Fridge

Pediatrics Research and Scholarship

As a part of endoscopy quality improvement (EQI) project, we decided to measure parent satisfaction about pediatric endoscopy service at University of New Mexico Children's Hospital.

Assessing The Educational Environment Of A Flipped Physical Therapy Course: Utilization Of The Dundee Ready Education Environment Measure (Dreem), Brad W. Willis, Evan L. Prost, Stephen P. Sayers

Internet Journal of Allied Health Sciences and Practice

Purpose: Using valid and reliable measures to assess curricula within health professions programs has gained significant attention in recent years. The educational environment is considered a key domain for student success. The primary aim of this study was to measure the educational environment following the addition of a flipped classroom model within a physical therapy course as measured by the Dundee Ready Education Environment Measure.

Methods: A first year doctorate of physical therapy course, “Physical Agents”, was redesigned to include a flipped classroom model, incorporating 24 videos that students reviewed independently, prior to hands-on laboratory learning. Following the conclusion of …

Food Allergy In Youth: A Primer For Allied Health Professionals, Philip Welch, Lauren Maziarz, Macy Mccartney, Chelsea Raker

Internet Journal of Allied Health Sciences and Practice

Purpose: Many youth struggle with the physical, mental, and social burdens of food allergy. The exact cause of food allergies is unknown, but several theories exist such as the “couch potato theory”, “hygiene hypothesis”, “microflora theory”, and “alarmins” theory. This non-systematic literature review summarizes the problem of youth food allergy and provides guidance to allied health professionals.

Method: A literature search of the relevant literature from years 2000 through 2017 was conducted using PubMed with the key words “food allergy”, “youth”, and “management”.

Results: Youth with food allergy may experience anxiety, social isolation, bullying, and depression, in addition to life-threatening …

Can Women Live With More Symptoms Than Men?: Defining Gender Differences In The Patient Acceptable Symptom State (Pass) In Orthopaedic Foot And Ankle Surgery, Judith Baumhauer, Adolph Flemister, Irvin Oh, Benedict Digiovanni, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Over the last few years an increasing focus has been directed to define cut-off points for important health improvement. Minimal clinically important difference (MCID) values have traditionally been used to determine if a statistical change translates to a clinical improvement to the patient. Although MCID is helpful, it may be even more important to identify if the current treatment is adequate or that the patient has achieved an acceptable symptom state (symptoms minimal enough to live with). The purpose of this study was to determine if gender influenced patient reported outcomes (patient acceptable symptom state (PASS) and PROMIS Physical …

Ability Of Patient-Reported Outcomes To Characterize Patient Acceptable Symptom State (Pass) After Attending A Primary Care Physical Therapist And Medical Doctor Collaborative Service: A Cross-Sectional Study, Jeff Houck, Daniel Kang, Tyler Cuddeford, Sarah Rahkola

Faculty Publications - College of Physical Therapy

Objectives: To determine if the Patient-Reported Outcome Measurement Information System (PROMIS) physical function, pain interference, self-efficacy, and global rating of normal function (GRNF) scales are able to accurately characterize a patient’s acceptable symptom state (PASS).

Design: A cross-sectional analysis, using receiver operator curves and chi-square analysis to explore criteria to determine thresholds (80% and 95% sensitivity/specificity) for PASS that are applicable to PROMIS and GRNF scales.

Setting: Phone survey after primary care. Participants: Patients (NZ94) attending primary care for musculoskeletal problems. Interventions: Not applicable. Main Outcomes Measures: Accuracy and proportion of patients classified as PASS Yes or No.

Results: Receiver …

Comparison Of Jump And Hop Test Measures Between Naia And Division Iii Male Collegiate Basketball Players, Jason Brumitt, Amy Engilis, Alma Mattocks, Natalie Ellis, Jordon Reyes

Faculty Publications - College of Physical Therapy

Purpose: To report normative data for two functional performance tests (FPTs) (the standing long jump [SLJ] and the single-leg hop [SLH]) in a population of male collegiate basketball players and to identify differences in measures between athletes based on level of competition, starter status, and position.

Methods: Eighty-six male collegiate basketball players from six teams were recruited for this study. Each athlete performed three SLJs and three SLHs (bilaterally).

Results: Mean (± SD) FPT measures (normalized to height) for all basketball players were: SLJ = 1.0 ± 0.1, right SLH = 0.84 ± 0.1, and left SLH = 0.85 ± …

Asymmetry After Hip Fracture: A Multi-Factorial Problem, Andrew J. Meszaros, Cindy Zablotny, Paul A. Shew, Bret Reordan

Faculty Publications - College of Physical Therapy

Background and Purpose: Sit-to-stand (STS) and static standing mechanics are related to fall risk and function after hip fracture. Often, these patients avoid weight bearing on the fracture side after rehabilitation. The purpose of this study was to use a novel clinically-relevant protocol to examine standing and STS vertical ground reaction force (vGRF) in light of perceptual measures of loading symmetry and muscle torque production in this population. Methods: A person post hip fracture performed 3 different STS conditions and 2 simple load-matching tasks. Motion, force plate, and perceptual data on weight distribution and load were collected. Findings: Standing and …

What Maximum Ankle Torque Is Appropriate For Training Patients With Non-Insertional Achilles Tendinopathy?, Tyler Cuddeford, Jeff Houck, Derek Palmer, Jason Beilstein, Jordan Visser

Faculty Publications - College of Physical Therapy

Background and Purpose: The capacity of the Achilles tendon during a 1-repetition eccentric maximum contraction is largely unknown. This study examined the maximum ankle torque during a concentric/ eccentric heel raise/lowering task and while running in healthy individuals and participants with chronic Achilles tendinopathy. These findings were applied to a 10-week training program for a patient with chronic Achilles tendinopathy.

Methods: A total of 13 subjects (9 healthy and 4 with Achilles tendinopathy) participated in this study. Subjects were asked to perform a maximum eccentric contraction wearing a weighted vest while collecting 3-dimensional biomechanical variables. Subjects also ran along an …

A Study Of Outcomes Following Collaborative Medical Doctor/Physical Therapist Primary Care Service For Musculoskeletal Problems, Daniel Kang, Sarah Rahkola, Catherine Vandehaar, Andrea Mulligan, Kevin Morikawa, Amador Marcano, Tyler Cuddeford, Jeff Houck

Faculty Publications - College of Physical Therapy

Background and Purpose: Collaborative medical doctor/physical therapist primary care services are not described in the literature. The 2 purposes of this observational study were to describe a collaborative medical doctor/physical therapist primary care service, and to describe simple, one question, outcomes including patient acceptable symptom state (PASS), global rating of normal function (GRNF), and success of treatment (SOT) at intake, 1 to 7 days, and 45 to 60 days follow-up. Methods: Patients were seen for 1 to 2 visits and typically received exercise, hands on treatment, ie, manual therapy, and education. Medical doctor/physical therapist collaborative encounters and provider training are …

A Word From The Writing Center (January 2018), Jennifer Wilson, Ms, Els

A Word From the Writing Team (Newsletter)

This issue includes:

• New Year, New Publishing Goals
• Grammar Time
• Writing Cafe

Does The Foundational Model Of Anatomy Ontology Provide A Knowledge Base For Learning And Assessment In Anatomy Education?, Melissa D. Clarkson, Mark E. Whipple

Institute for Biomedical Informatics Faculty Publications

Throughout the development of the Foundational Model of Anatomy (FMA) ontology, one of the use cases put forth has been anatomy education. In this work, we examine which types of knowledge taught to anatomy students can be supported by the FMA knowledge base. We first categorize types of anatomical knowledge, then express these patterns in the form “Given ____, state ____”. Each of the 33 patterns was evaluated for whether this type of knowledge is compatible with the modeling and scope of the FMA.

Developing Graphic Libraries To Accompany The Craniofacial Human Ontology, Melissa D. Clarkson

Institute for Biomedical Informatics Faculty Publications

I describe the development of two graphic libraries to accompany parts of the Craniofacial Human Ontology. One library depicts phenotypes of cleft lip. The other represents development of the human head between 4 and 8 weeks of gestation.

Identifying Foot And Ankle Patients At Risk To Fall Based On Patient Reported Outcomes Assessments, Judith Baumhauer, Jack Teitel, Allison Mciyntyre, David Mitten, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Each year approximately 30-40% of people over the age of 65 fall. Approximately one half of these falls result in an injury with the estimated annual direct medical costs of $30 billion. Pain, mobility issues, neuropathy and post- operative weight bearing limitations make foot and ankle patients particularly vulnerable to falls. Current approaches to determine at risk patients are cumbersome and time consuming requiring performance testing and “hands on” clinical assessment. The efficiency of obtaining PRO, such as PROMIS, in the clinical arena has been well documented. The purpose of this study is determine if patient reported outcomes (PROMIS) …

Intra-Arterial Nitroglycerin As Directed Acute Treatment In Experimental Ischemic Stroke, Michael E. Maniskas, Jill M. Roberts, Rebecca Trueman, Annastazia E. Learoyd, Amanda A. Gorman, Justin F. Fraser, Gregory J. Bix

Neuroscience Faculty Publications

BACKGROUND: Nitroglycerin (also known as glyceryl trinitrate (GTN)), a vasodilator best known for treatment of ischemic heart disease, has also been investigated for its potential therapeutic benefit in ischemic stroke. The completed Efficacy of Nitric Oxide in Stroke trial suggested that GTN has therapeutic benefit with acute (within 6 hours) transdermal systemic sustained release therapy.

OBJECTIVE: To examine an alternative use of GTN as an acute therapy for ischemic stroke following successful recanalization.

METHODS: We administered GTN IA following transient middle cerebral artery occlusion in mice. Because no standard dose of GTN is available following emergent large vessel occlusion, we …

Genotype-Phenotype Study In Patients With Valosin-Containing Protein Mutations Associated With Multisystem Proteinopathy, Ebaa Al-Obeidi, Sejad Al-Tahan, Abhilasha Surampalli, Namita Goyal, Annabel K. Wang, Andreas Hermann, Molly Omizo, Charles D. Smith, Tahseen Mozaffar, Virginia Kimonis

Neurology Faculty Publications

Mutations in valosin‐containing protein (VCP), an ATPase involved in protein degradation and autophagy, cause VCP disease, a progressive autosomal dominant adult onset multisystem proteinopathy. The goal of this study is to examine if phenotypic differences in this disorder could be explained by the specific gene mutations. We therefore studied 231 individuals (118 males and 113 females) from 36 families carrying 15 different VCP mutations. We analyzed the correlation between the different mutations and prevalence, age of onset and severity of myopathy, Paget's disease of bone (PDB), and frontotemporal dementia (FTD), and other comorbidities. Myopathy, PDB and FTD was present in …

Serum Tumor Necrosis Factor-Alpha Associates With Myocardial Oxygen Demand And Exercise Tolerance In Postmenopausal Women, Stephen J. Carter, David R. Bryan, William H. Neumeier, Stephen P. Glasser, Gary R. Hunter

Internal Medicine Faculty Publications

The functional implications of serum tumor necrosis factor-alpha (TNF-α), a marker of oxidative stress, on hemodynamic parameters at rest and during physical exertion are unclear. The aims of this investigation were to examine the independent associations of TNF-α on myocardial oxygen demand at rest and during submaximal exercise, while also evaluating the association of TNF-α on exercise tolerance. Forty, postmenopausal women, provided blood samples and completed a modified-Balke protocol to measure maximal oxygen uptake (VO_2max). Large artery compliance was measured by pulse contour analyses while rate-pressure product (RPP), an index of myocardial oxygen demand, was measured at rest …

Longitudinal Patterns Of Potentially Inappropriate Medication Use Following Incident Dementia Diagnosis, Christine M. Ramsey, Danijela Gnjidic, George O. Agogo, Heather Allore, Daniela Moga

Pharmacy Practice and Science Faculty Publications

Introduction: Potentially inappropriate medication (PIM) use in older adults with dementia is an understudied area. We assessed longitudinal changes in PIM exposure by dementia type following dementia diagnosis.

Methods: We followed 2448 participants aged ≥ 65 years (52% women, 85.5% Caucasian, mean age 80.9 ± 7.5 years) diagnosed with dementia after enrollment in the National Alzheimer's Coordinating Center (2005-2014). We estimated the association between dementia type and PIM annually for 2 years after diagnosis, using Generalized Estimating Equations.

Results:Participants with Lewy body dementia had more PIM use, and participants with frontotemporal dementia had less PIM use than participants with …

The Role Of The Public Health Nurse In Rural Areas Of Kerry And Cork, Hannah Healy

Theses

Aim of Research: To understand and gain insight into the role of the Public Health nurse in rural communities in Kerry and Cork.

Background: Public health nursing is the single largest group in community care, current figure employed by the HSE stands at 1,438. Demographic, changes such as the increase in population coupled with the shift in care from the acute sector to primary care has provided many challenges to the PHN service .

Objective: Whilst there have been substantial reviews on the role and workload of the PHN in Ireland, there is limited qualitative research available on what the …

Problematic Child Mealtime Behavior And Caregiver Mobile Phone Use, Libby Milkovich, Meredith Dreyer, Brooke Sweeney, Sarah Nyp, Ben Black

Posters

BACKGROUND

Problematic mealtime behaviors (PMB) (externalizing behavior at mealtime) have been seen anthropologically when adult caregivers are absorbed in their mobile phones. Parents with mobile phone problematic use (MPPU) are more likely to be absorbed in a mobile device. Neither the correlation of MPPU to PMB, nor the frequency of PMB to perceived impairment of problem behavior have been quantitatively studied.

OBJECTIVE

Evaluate correlation of caregiver MPPU and child PMB to improve understanding of the possible implications of caregiver MPPU

METHODS

Participants included caregivers of children ages 2-8 years being seen in a pediatric hospital clinic. Participants completed a survey …

Implementation Of Bedside Huddle To Improve Communication When Coordinating Care For Picu Patients With Newly Diagnosed Anterior Mediastinal Masses, Laura Mccarthy, Pam Nicklaus, Paul Sheeran, Tara Benton, Jenna Miller, Douglas C. Rivard, Melissa Gener, Susan Whitney, Keith August

Posters

No abstract provided.

Experimentally Investigating The Joint Effects Of Physical Activity And Sedentary Behavior On Depression: A Randomized Controlled Trial, Jeremiah Blough

Electronic Theses and Dissertations

Objective: To experimentally examine whether increasing sedentary behavior, among a young adult active population, for one week is still associated with increased depression symptomology even when allowing for a moderate engagement in physical activity (PA). Methods: Participants were confirmed as active via self-report and accelerometry during baseline and randomly assigned to one of three experimental groups. The Sedentary Intervention Group (n=19) reduced steps to less than 5000/day and were not alloto exercise for one-week; the Reduced MVPA (moderate-to-vigorous PA) Group (n=18) reduced steps to less than 5000/day but exercised for 50% of their previously reported vigorous PA for one-week; and …

Development And Characterization Of Fluocinolone Acetonide Loaded Nanosized Lipid Carriers For Ocular Delivery Via Subconjunctival Route: Synergistic Effect Of Vitamin A Palmitate, Bhavik Soneta

Electronic Theses and Dissertations

Though nanotechnology which exploits the use of nanoparticles for therapeutic application have embarked as an emerging tool for drug delivery applications, the delivery of therapeutic molecules into deep ocular compartments has always been a challenging task. In this regard, the main objective of our current investigation was to develop and evaluate the fluocinolone acetonide (FA) loaded nanostructure lipid carrier (FA-NLC) in situ gel for improved ocular bioavailability by subconjunctival injection. FA, a corticosteroid administered for inhibiting the ocular inflammation either as intravitreal injection or as intravitreal implants. The FA-NLCs were developed by using vitamin A palmitate as one of the …

Feasibility Of Aquasolvetm Hpmc-As Lg Via Hot-Melt Extrusion: Effect Of Pressurized Co2 On Physico-Mechanical Properties, Mashan Almutairi

Electronic Theses and Dissertations

The objective of the current study was to investigate the processability of Aquasolve™ HPMC-AS LG via hot-melt extrusion, and to examine the effect of pressurized carbon dioxide (P-CO2) on the physico-mechanical properties of Efavirenz (EFA)-loaded extrudates (EXT). EFA is as a poorly water-soluble drug and HPMC-AS LG was chosen as a carrier for this study. To optimize the process parameters and formulations, various physical mixtures were prepared with the following composition: EFA (30-40-50% w/w) and HPMC-AS LG (70-60-50 % w/w) respectively. Physical mixtures were extruded through the co-rotating twin-screw extruder (16mm Prism Euro Lab, Thermo Fisher Scientific) utilizing a standard …

Synthesis And Characterization Of Redox-Sensitive Polymer And Prodrug For Targeted Drug Delivery, Chang-Hee Whang

Electronic Theses and Dissertations

Systemic administration of chemotherapeutics is associated with various side effects deriving from accumulation in off-target sites and acute toxicity of the drugs. In the past decade, engineering targeted drug delivery platforms arose as a novel paradigm to overcome such obstacles and ultimately achieve advanced forms of chemotherapy. This thesis reports successful syntheses of l-RSP, a redox-sensitive self-immolative polymer, and DNS-SN38, thiol-sensitive SN-38 prodrug, as potential candidates for targeted drug delivery platforms. By covalently conjugating a redox-trigger (p-nitrobenzyl alcohol) and self-immolative linker (p-hydroxybenzyl alcohol) to the cyclization spacer (n-2-(hydroxyethyl)ethylene diamine), a novel self-immolative monomer was obtained. Polymerization of the respective monomer …

Crystalline Salt Formation Of An Acidic Drug Indomethacin Using Hot Melt Extrusion Technology, Mustafa Bookwala

Electronic Theses and Dissertations

Although salt formation is the most ubiquitous and effective method of increasing the solubility and dissolution rates of acidic and basic drugs, it consumes large quantities of organic solvents and is a batch process. Herein, we show that the dissolution rate of indomethacin (a poorly water-soluble drug) can be increased by using hot melt extrusion of a 1:1 (mol/mol) indomethacin:tromethamine mixture to form a highly crystalline salt, the physicochemical properties of which are investigated in detail. Specifically, pH–solubility studies demonstrated that this salt exhibited a maximal solubility of 19.34 mg/mL (>1000 times that of pure indomethacin) at pH 8.19. …

A Novel Acetaminophen Soft-Chew Formulation Produced Via Hot Melt Extrusion With Inline Near-Infrared Monitoring As A Process Analytical Technology Tool, Pengchong Xu

Electronic Theses and Dissertations

People suffer dysphagia when swallowing hard tablets and capsules. Gelatin based soft chewable tablets was used as an alternative and novel drug delivery format to overcome dysphagia. But conventional method of producing gelatin based soft chewable tablets has many potential issues. The objective of this study is using glycerol and hot-melt extrusion technique to address potential issues and optimizing the formulation. Gelatin (15%), acetaminophen (30%), saccharin (1.5%), xylitol (6.5%), sodium chloride (2%) and six different ratios of water (45-0%) and glycerol (0-45%) were used in seven formulations. The extrusion process temperature of formulation 1-6 and formulation 7 were 90 ëšc …

Mapping Opioid Mortality Rates Across Treatment Capacity To Identify Need And Access, Garrett K. Wong, Justin R. Chang, Chase Greco, Yadunandan Pillai, Mohammad A. Shahrezaei, Melissa H. Burton, Rob Lawrence, Alan Dow

Graduate Research Posters

Background: The opioid and heroin overdose epidemic is a public health emergency in the state of Virginia, resulting in the death of more than 1,100 people in 2016. In order to overcome this epidemic, we need to match the places with the greatest need for services related to substance use disorders with the appropriate healthcare workforce.

Aims: As the data about the overdose outbreak and related socioeconomic factors grow in size and complexity, data scientists have attempted to utilize big data techniques to identify communities and risk factors contributing to addiction.

Methods: Using data obtained from the …