Medicine and Health Sciences Commons^™

Use Of Behavior Strategies In Speech-Language Therapy: A Survey Of Virginia School Based Speech-Language Pathologists, Gillian Withers

Senior Honors Projects, 2010-2019

In the public schools, Speech-Language Pathologists (SLPs) serve as clinicians to children with various language, articulation, and communication disorders. Often times, these conditions are present in children who also have disruptive or inattentive behaviors. SLPs in the school system are required to provide effective treatment to each child; however, too often the effectiveness of treatment is hindered by behavior outbursts from the children. Although there are empirically supported plans and strategies for behavior management in general elementary school classrooms, little is known about the knowledge and implementation practices of SLPs who serve school-age children. The purpose of this honors thesis …

Establishing Effective Amplitude Criterion For Transcranial Direct Current Stimulation, Lindsey Michele Schwenger

Senior Honors Projects, 2010-2019

My honors project will document and reflect on my experiences as a member of a research team that is studying transcranial direct current stimulation (tDCS) as a treatment for dysphagia, or difficulty swallowing, which affects a vast, diverse group of individuals. There is substantial need for more efficient and effective rehabilitation strategies used to restore abilities and reduce the risks associated with dysphagia. Recent studies have addressed these risks by exploring tDCS as a treatment for central nervous system damage caused by stroke, traumatic brain injury, and Parkinson's disease. Research has recently been conducted to test its effectiveness, but has …

Pupillometry As A Test Of Infant Word Recognition, Kierra Lynch

Senior Honors Projects, 2010-2019

By 11 months of age, infants recognize commonly occurring word forms in their environment. The Head Turn Preference Paradigm (HTPP) is the one method of measuring infant word form recognition. The HTPP uses looking times as judged by a head turn of the infant towards or away from a speaker. This method is thus subject to infant attention, which can make it difficult to get accurate results when infants are not paying attention due to external factors (for example, teething). Pupillometry is a non-invasive, physiological measurement that uses pupil dilation to assess cognitive processes. Pupil dilations have been found to …

Does Emg Monitoring In A Cvemp Matter?, Kimberly Fleck

Senior Honors Projects, 2010-2019

To determine if EMG monitoring or the use of amplitude normalization would significantly reduce the amplitude variability and amplitude asymmetry of the cVEMP in children ages 3 and under, we first needed to create a control group with young, healthy adults to compare the pediatric group to. We also wanted to replicate earlier studies that showed EMG monitoring and amplitude normalization does not have an impact on the VEMP in young, healthy adults. We tested two different positions, sitting and supine. Supine is the optimal position to generate EMG, but we wanted to have control data in case the pediatric …

Conversational Speech Characteristics During Entrainment, Pamela Molnar

Senior Honors Projects, 2010-2019

This study examined the acoustic characteristics of conversational speech associated with entrainment, which is the tendency for communicative behaviors of individuals engaged in a given communication context to become alike (Borrie & Liss, 2014). The study adopted a within-speaker approach to evaluate changes in speech production characteristics relative to the given individual, defined as the repeated speaker. Across experiment sessions, the repeated speaker interacted with different communication partners, who were defined as the non-repeated speakers. In each session, the repeated speaker and one non-repeated speaker engaged in a series of tasks in the following order: conversation, interactive picture description task, …

Comparing Two Naturalistic Pragmatic Assessments: The Celf-5 Pragmatic Activities And The Yale In Vivo Pragmatic Protocol (Yipp), Rebecca Reid

Senior Honors Projects, 2010-2019

Pragmatics, or the social use of language, is a dimension of communication skills that is very difficult to assess due to its dependence on cultural norms, situational context, and speaker differences. Of the current methods for evaluating pragmatic language skills in children, the literature most frequently recommends naturalistic assessment because it allows the clinician to most closely simulate a real-life interaction. Despite these recommendations, limited information exists to guide clinicians in making decisions about which activities yield the most representative pragmatic language sample. This preliminary study compared two naturalistic pragmatic assessments, the Pragmatic Activities from the Clinical Evaluation of Language …

Evolution Of Bordetella Pertussis Genome May Play A Role In The Increased Rate Of Whooping Cough Cases In The United States, Kevin Loftus

Senior Honors Projects, 2010-2019

Bordetella pertussis is the bacterium responsible for pertussis, a disease commonly referred to as whooping cough. Recently, pertussis has made a resurgence in the U.S. despite high-vaccination coverage. Possible causes of the increased number of pertussis cases include genetic evolution of B. pertussis, increased awareness of the disease, better laboratory diagnostics, and the switch from a whole-cellular (wP) vaccine to an acellular vaccine (aP) in the 1990s. Fortunately, just as B. pertussis is evolving, so is the arsenal of technologies used to understand and combat this pathogenic bacterium. Whole genome sequencing is one technology that helps researchers better understand …

Rapid Assessment Of Adults With Traumatic Brain Injuries, Pedro Colio

Doctor of Nursing Practice Final Manuscripts

The aim of this evidence-based project was to improve the medical screening process, enhance medical decision-making, and standardized the utilization of an adult traumatic brain injury neuroimaging guideline among advanced practice providers in a rural emergency department. Neuroimaging, specifically computed tomography (CT) scans, help to identify life-threatening intracranial injuries when clinically appropriate. The literature supports the utilization of neuroimaging guidelines, clinical exam, and provider expertise when identifying the need for a head CT scan. Although head CT scans are clinically useful, they increase healthcare costs and pose potential cancer risks from radiation exposure. Eight advanced practice providers (i.e., nurse practitioners, …

Translation Control By P53, Justina Kasteri, Dibash K. Das, Xuelin Zhong, Leah Persaud, Ashleigh Francis, Hilal Muharam, Moira Sauane

Publications and Research

The translation of mRNAs plays a critical role in the regulation of gene expression and therefore, in the regulation of cell proliferation, differentiation and apoptosis. Unrestricted initiation of translation causes malignant transformation and plays a key role in the maintenance and progression of cancers. Translation initiation is regulated by the ternary complex and the eukaryotic initiation factor 4F (eIF4F) complex. The p53 tumor suppressor protein is the most well studied mammalian transcription factor that mediates a variety of anti-proliferative processes. Post-transcriptional mechanisms of gene expression in general and those of translation in particular play a major role in shaping the …

Electrophysiological Biomarkers Of Chemotherapy-Related Cognitive Impairment In Hematological Malignancy Patients, David E. Anderson

Theses & Dissertations

Multiple cancer populations frequently report cognitive impairment following treatment with chemotherapy agents (“chemo-brain”). Impaired neuropsychological performance is commonly reported in cognitive domains of attention and executive function. Understanding neural mechanisms underlying cognitive impairments is essential to developing prevention and rehabilitation strategies. Brain imaging studies frequently show chemotherapy-related impairments within the attentional control network, which is comprised of a constellation of cortical regions that govern reportedly impaired cognitive functions. In the current dissertation research, I developed a novel electrophysiology battery aimed at recording near-instantaneous neural activity within the attentional control network during cognitive task performance. Cancer patients diagnosed with hematological malignancy …

Next Generation Of Translational Long-Acting Cabotegravir, Tian Zhou

Theses & Dissertations

Recent development of long-acting antiretroviral therapeutic regimens has opened a new chapter for HIV/AIDS management. Cabotegravir (CAB), as one of the very first long-acting antiretroviral regimens, has drawn tremendous attention. However, the remaining challenges include suboptimal dosing intervals, large injection volume, injection site reactions, lack of tissue penetration, etc. As one of the pioneers in this field, our lab was successful in harnessing mononuclear phagocytes as “Trojan horses” for antiretroviral drug delivery and transportation to viral reservoirs. We proposed this targeted delivery strategy could address the limitations of current CAB formulation. To this end, we developed folic acid decorated CAB …

Validation Of A Revised Food Frequency Questionnaire In A Population Of Elderly Men And Women With Fragility Fractures And Correlation With Bone Mineral Density And Biochemical Markers, Laura Graeff-Armas

Theses & Dissertations

Assessing food intake is important to estimate nutrient intake and counsel patients regarding their diet patterns and supplement use. The purpose of this study was to revise a validated Block Calcium/Vitamin D Screener to include protein for use in elderly patients with a history of fragility fracture. The Block Calcium/Vitamin D Screener food list was refined by adding protein foods and culling the calcium and vitamin D food items based on 2003-2006 NHANES survey. A nutrient database for the revised FFQ was developed from the United States Department of Agriculture Agricultural Research Service National Nutrient Database. Validation of the revised …

Use Of The Simplified Diet Method To Improve Metabolic Control Among Teens And Adults With Phenylketonuria: A Mixed Methods Approach, Jill Skrabal

Theses & Dissertations

Phenylalanine hydroxylase (PAH) deficiency, commonly known as phenylketonuria (PKU), is an inborn error of metabolism that causes the accumulation of phenylalanine and results in intellectual disability if left untreated. The primary treatment for PKU is a lifelong diet that selectively restricts phenylalanine intake and is aimed at keeping blood phenylalanine in the therapeutic range of 120-360 μmol/L. Qualitative research in PKU is limited, but research has stressed the challenges individuals face in following a diet so different than their peers Previous attempts in Europe and Australia have been successful in allowing free use of certain fruits and vegetables, as well …

Healthcare Utilization For Behavioral Health Disorders: Policy Implications On Nationwide Readmissions, And Outcomes In The States Of Nebraska And New York, Rajvi J. Wani

Theses & Dissertations

The main goal of this dissertation was to estimate national-level inpatient readmissions and state-level hospital-based emergency department (ED) visits with behavioral health (BH) conditions in the states of Nebraska and New York. The dissertation aims to assess the impact of the policy mandates under the Patient Protection and Affordable Care Act on these state and national estimates. The Nationwide Readmissions Database and the State Emergency Department databases maintained by the Healthcare Cost and Utilization Project were used for this dissertation. US Adult population with high-risk of readmissions in the inpatient departments for alcohol-related disorders (ARD) and of visiting ED for …

Alcohol Drives Oxidation-Dependent Desensitization Of Airway Cilia Motility Responsiveness, Michael Price

Theses & Dissertations

Alcohol abuse, which can impair clearance of pathogens and debris from the airway, is associated with an increase in complications and a higher mortality rate during the progression of pneumonia. With prolonged alcohol exposure, mucociliary clearance (MCC), which depends on the coordinated beating of cilia, is dysfunctional. Effective MCC relies on cAMP-dependent protein kinase (PKA) activation of ciliary beat frequency (CBF). PKA activation and stimulation of CBF are blunted with chronic exposure to alcohol. This phenomenon is known as alcohol-induced ciliary dysfunction (AICD). Previous studies have shown that concomitant feeding of mice with alcohol and antioxidants prevents AICD, suggesting a …

Selective Generation Of Dopaminergic Precursors From Human Fibroblasts By Direct Lineage Conversion, Miao He

Theses & Dissertations

Transplantation of dopaminergic precursors (DPs) is a promising therapeutic strategy of Parkinson’s disease (PD). However, limited cell source for dopaminergic precursors has become a major obstacle for transplantation therapy. In the first part of the study, we demonstrated that Foxa2 is superior to Lmx1a in inducing dopaminergic neuronal differentiation from induced neural progenitor cells (iNPCs). Based on the results above and some other published results, our group demonstrated that mouse fibroblasts can be reprogrammed into induced dopaminergic precursors (iDPs) through ectopic expression of transcription factors Brn2, Sox2 and Foxa2(1). In the current study, we hypothesized that similar strategy …

Functional Signature Ontology-Based Identification And Validation Of Novel Therapeutic Targets And Natural Products For The Treatment Of Cancer, Beth Neilsen

Theses & Dissertations

Multiple studies have revealed that Ras-driven tumors acquire vulnerabilities by adapting cellular mechanisms that promote uncontrolled proliferation and suppress apoptosis. Kinase Suppressor of Ras 1 (KSR1) modulates ERK activation downstream of oncogenic Ras, and knockdown of KSR1 selectively kills malignant, Ras-driven cancer cells, but does not kill immortalized, non-transformed human colon epithelial cells (HCECs). KSR1^-/- mice are fertile and phenotypically normal, but resistant to Ras-driven tumor formation suggesting KSR1 represents a vulnerability in cancer cells.

To identify additional vulnerabilities in cancer, a screening approach termed Functional Signature Ontology (FUSION) was used to screen 14,355 genes and 1,200 natural product …

A Study Of Acoustically Activated Nanodroplets, Songita Choudhury

Theses & Dissertations

Current treatment of acute myocardial infarction (AMI), which is the main pathophysiological event leading to death in the United States, has advanced considerably with the introduction of emergent percutaneous interventions, but there remains an urgent need for novel techniques to rapidly and accurately detect infarcted or ischemic tissue that results from AMI. Ultrasound contrast agents, also known as microbubbles (MB), have become commonplace in echocardiography. However, MBs are purely intravascular tracers and unable to cross endothelial barriers due to size. The limitations of MBs, namely size and short circulation times within the human body, led to the development of phase-change …

Elucidation Of The Functions Of Neuropilin 2 In Osteoclasts In Promoting Prostate Cancer Bone Metastasis., Navatha S. Polavaram

Theses & Dissertations

Bone metastasis is one of the major clinical concerns that causes skeletal related malignancies and increased mortality. Bone is one of the preferred sites for metastatic prostate cancer. The metastatic prostate cancer cells interact with bone cells (osteoblasts and osteoclasts) resulting in an imbalance in the bone homeostasis leading to increased activation of osteoblasts over osteoclasts. Our preliminary data indicated a non-tyrosine kinase receptor Neuropilin 2 (NRP2) is expressed in osteoclasts induced by metastatic prostate cancer cells and acts as a negative regulator of osteoclast differentiation and function. We hypothesize that prostate cancer -induced NRP2 expression in osteoclasts is necessary …

The Effect Of Dust Mite Extract On Esophageal Tight Junctions In Eosinophilic Esophagitis, Kyle Hinz

Theses & Dissertations

Eosinophilic Esophagitis (EE) is a chronic inflammatory disease that effects individuals of all ages. EE is mediated by an allergen response, causing the release of thymic stromal lymphopoietin (TSLP), and subsequent inflammation and eosinophil migration and infiltration of the esophagus through the activation of the JAK/STAT pathway and CD4+ T-cells. EE has typically been associated with food allergies, but studies have shown that aeroallergens can cause EE as well. Current treatments of EE have primarily focused on nonspecific methods, though anti-TSLP is beginning to be tested as a possible treatment for EE. The aim of this study was to see …

Pandemic Planning: Estimating Disease Burden Of Pandemic Influenza To Guide Preparedness Planning Decisions For Nebraska Medicine, Angelia Wimberly

Theses & Dissertations

This year marks the 100^th anniversary of the 1918 “Spanish Flu” outbreak that killed 50-100 million people worldwide. If a pandemic of this proportion happened today, the federal pandemic influenza plan predicts that 30 percent of the population could become infected with up to 50 percent seeking outpatient care. With Nebraska Medicine currently operating at nearly full capacity (95-97%), surge capacity for hospital space, staff, and supplies would be in severe demand and would quickly overwhelm the organization. To assess the impact of pandemic influenza in Douglas County Nebraska and Nebraska Medicine, pandemic modeling tool FluAid and FluSurge 2.0 …

The Survival And Treatment Refusal Of Lung Cancer Patients: Analyses Of National Cancer Registries, Poppy Deviany

Theses & Dissertations

Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer mortality of both genders in the United States. A recent report suggests that the relative five-year survival rate of lung cancer is only 18%. Studies indicate many factors are associated with the survival of lung cancer patients, including age at diagnosis. It is widely known as a disease of older people, but the literature shows a substantial number of young people have been diagnosed with lung cancer. The literature also indicates that the refusal of recommended treatment contributes to cancer-related death and poorer survival. The …

The Effect Of Treatment Delay, Non-Adherence To Treatment Guidelines, And Never-Smoking Status On The Survival Of Lung Cancer Patients, Trisari Anggondowati

Theses & Dissertations

Despite many significant medical advances, lung cancer continues to cause more deaths than any of the other cancers in the United States (US), and worldwide. Timeliness of care and evidence-based guidelines are among the components of quality of care that are expected to improve patient outcomes. However, evidence on the effect of timeliness of care and adoption of evidence-based guidelines on patient survival remains lacking. In addition, there has been increasing concern on the fact that smokers are not the only group that suffers from lung cancer. Never-smokers comprise at least 10% of lung cancer patients in the US, or …

Muc4 Based Immunotherapy For Pancreatic Cancer, Kasturi Banerjee

Theses & Dissertations

Pancreatic Cancer (PC) is a lethal disease claiming approximately 45000 lives in the US in 2018, and it establishes an elaborate immunosuppressive tumor microenvironment that aids in disease pathogenesis. Immunotherapy has emerged as a strategy to target tumor cells by reprogramming patient’s immune system. Challenges present in PC immunotherapy are: i) identifying a tumor-associated antigen that could be targeted, ii) identifying adjuvants that could efficiently deliver antigens, iii) eliciting robust anti-tumor responses and iv) overcoming peripheral tolerance and immunosuppression elicited by the tumor.

Firstly, we detected circulating autoantibodies to MUC4 present in PC patients and observed that IgM autoantibodies to …

Effects Of Two High-Frequency Physical Therapy Programs On Balance, Gait, Fatigue, And Quality Of Life In People With Multiple Sclerosis, Min Liu

Theses & Dissertations

Multiple sclerosis (MS) is an inflammatory disease involving the inflammation and demyelination in both brain and spinal cord. MS typically affects people in early adulthood in the range of 20-40 years old, and most patients with MS experience symptoms on a daily basis, such as walking difficulties, balance impairment, and fatigue, which can be disabling and impact the Quality of Life (QOL).

The main purpose of this investigation is to determine if our novel, adaptive, high-frequency physical therapy protocol, compared with the conventional therapeutic exercise protocol, has the potential to improve participants’ dynamic balance, gait, fatigue, and overall QOL based …

Unequal Partners: A Pilot Evaluation In Harrisonburg High School, Katherine Kowalk

Senior Honors Projects, 2010-2019

Background: Teens are considered a vulnerable population in regards to intimate partner violence with reported rates of 1 in 11 high school students being physically hurt by a significant other. Educational programs have been developed for teens to promote healthy relationships. This research examines whether “Unequal Partners: Teaching about Power, Consent and Healthy Relationships” by Sue Montfort and Peggy Brick provides relevant, engaging information to educate high school students on the importance of healthy relationships.

Methodology: Students at Harrisonburg High School were invited to attend a voluntary program consisting of “Unequal Partners” lessons during extended learning times. The program consisted …

An Athletic Training Portfolio: 3 Case Studies, Kristen Dawson

Senior Honors Projects, 2010-2019

The purpose of this portfolio is to convey the mechanism, evaluation process, and rehabilitation plan for three orthopedic injuries occurring over the course of the past two years. Each case presents patients with whom I played a role in their care, progressively increasing my involvement as I grew and learned professionally. The cases include background information and case descriptions of three individual patients, their evaluation and rehabilitation plans are included. The first case discusses an athlete with a lumbar disc herniation that underwent a microdiscectomy. This case study was revised from it’s original version and submitted to the National Athletic …

Exploring The Relationship Between Team Characteristics And Mental Health Symptoms Amongst Student Athletes, Dylan Owens

Senior Honors Projects, 2010-2019

Depression and anxiety are disabling conditions that are particularly prevalent amongst young adults (Wolanin, Hong, Marks, Panchoo, & Gross, 2016). Student athletes must cope with extensive time demands that go beyond those of ordinary young adults, consequently putting them at increased risk to experiencing mental health issues. Numerous factors may influence an athlete’s well being, such as gender, injury, and type of sport. This study tests these various factors but also extends previous literature by analyzing the effects of team dynamics on student athlete mental health. An anonymous multi-part questionnaire was sent out to all JMU athletes in the Fall …

Health Care Priorities In Developing Countries: A Systematic Review, Heather Mckay

Senior Honors Projects, 2010-2019

Countries around the globe are struggling to find an affordable health care system. Developing countries have it particularly challenging with a lack of health care professionals and funding to spend on health care. This systematic review analyzes five developing countries’ (China, Dominican Republic, Ghana, Peru and Turkey) health care systems to find what is working well and what needs improvement. The main findings that these countries could adopt are requiring medical student graduates to do their residency in rural areas, giving more power of health care to local governments rather than the federal government, making insurance companies non-profit, and providing …

Design Of A Homeopathic Solution For Chronic Cough, Jacob Ziemke

Senior Honors Projects, 2010-2019

Chronic cough is most commonly defined as a cough that persists for more than eight weeks and is estimated to affect more than 30 million people in the United States at any given time. Diseases contributing to the onset of chronic cough include asthma, pulmonary fibrosis, lung cancer, postnasal drip, gastroesophageal reflux disease (GERD), and bronchitis, and may include lifestyle choices such as smoking. For those who seek medical advice, pharmaceuticals and speech therapy are two common methods of combating chronic cough but serve to mask the symptoms rather than treat the problem; frequently, chronic cough is misdiagnosed or cannot …