Medicine and Health Sciences Commons^™

Discovery Of Selective Probes Targeting Rna Polymerase I, Xiao Tan

Theses and Dissertations--Chemistry

RNR Polymerase I (RNA Pol I) is a “factory” that orchestrate the transcription of ribosomal rRNA for constructing ribosomes as a primary workshop for protein translation to sustain cell growth. Misregulation of RNA Pol I can cause uncontrolled cell proliferation, which leads to the development of cancer. Yeast (Saccharomyces cerevisiae) is a valuable model system to study RNA Pol I. Recently, the X-ray crystal structure of the yeast homologue of RNA Pol I was elucidated, offering the structural basis to selectively target this transcriptional machinery. The approach to selective RNA Pol I targeting was to disrupt the interaction …

A Case Of Multisystem Langerhans Cell Histiocytosis Presenting As Central Diabetes Insipidus, P. Daniel Nicholas Iii, Ian Garrahy

Reading Hospital Internal Medicine Residency

Langerhans cell histiocytosis (LCH) is a rare malignancy most commonly characterized by histiocytic infiltration of bone. LCH lesions in the skull place the adjacent central nervous system (CNS) at risk for involvement, which can manifest as central diabetes insipidus (CDI) when there is infiltration of the hypothalamic-pituitary axis. We present a case of a 39-yearold female who presented with polyuria and polydipsia for 1 year and left-sided hearing loss, gait instability, and nystagmus for 5 days. She was found on laboratory evaluation to have CDI and underwent left cortical mastoidectomy for a destructive peripherally enhancing mastoid lesion seen on MRI …

Using Cirupa To Help Foster Communication With Families About Brain Death In Sub‑Saharan Africa, Sayed Karar, Anthony Ochola, Fatima Juma, Feroza Daroowalla

Internal Medicine, East Africa

Brain death, with a functioning cardiovascular system, remains a difficult issue to grasp for most families. Furthermore, conversations about brain death remain challenging even for the most experienced physicians. We developed an acronym, CIRUPA, to further improve the goals of care conversations in patients diagnosed with brain death. To our knowledge, this is the first acronym within Sub‑Saharan Africa, which helps provide a structured method on how to foster conversations centered around brain death.

The Effects Of Parenting Style And Feeding Style On Child Weight Status: A Systematic Review, Rahaf A. Alahmadi

Masters Theses

Childhood obesity is a global health concern. According to the World Health, prevalence of obesity decupled in the last four decades, where 124 million children and adolescents are now considered obese (“Commission on Ending Childhood Obesity”, 2019). Organization Interactions between parenting styles and feeding styles play a critical role in the development of a child's lifestyle habits, which may impact their weight status. The purpose of this study was to identify how parenting and feeding styles impact a child’s weight status. A systematic review of the literature, guided by The Academy of Nutrition and Dietetics Evidence Analysis Manual protocol, was …

Women's Empowerment And Its Impact On Reproductive Health Outcomes: Evidence From Nepal, Samyukta Ghimire

Masters Theses

The percentage of women utilizing maternal health care services in Nepal is relatively less than women in other South Asian countries. Moreover, large socio-economic and regional disparities have been the root causes for lower utilization of health care leading to increasing maternal mortality. Using a national representative sample of 9,475 women (2011) and 9,875 women (2016) from Nepal, I examine the impact of women empowerment in relation to prenatal care, place of delivery and postnatal care (3Ps) outcomes. A composite Women’s Empowerment Index (WEI) based upon responses is also constructed to include three empowerment domains namely, attitude toward violence, social …

Targeting The Bcl-2 Family In B Cell Lymphoma., Clare M. Adams, Sean Clark-Garvey, Pierluigi Porcu, Christine M. Eischen

Department of Medical Oncology Faculty Papers

Although lymphoma is a very heterogeneous group of biologically complex malignancies, tumor cells across all B cell lymphoma subtypes share a set of underlying traits that promote the development and sustain malignant B cells. One of these traits, the ability to evade apoptosis, is essential for lymphoma development. Alterations in the Bcl-2 family of proteins, the key regulators of apoptosis, is a hallmark of B cell lymphoma. Significant efforts have been made over the last 30 years to advance knowledge of the biology, molecular mechanisms, and therapeutic potential of targeting Bcl-2 family members. In this review, we will highlight the …

Clinical Experts Statement: The Definition, Prescription, And Application Of Cupping Therapy, S. Andrew Cage, Diana M. Gallegos, Brian Coulombe, Brandon J. Warner

Clinical Practice in Athletic Training

No abstract provided.

Clinician-Administered Versus Self-Administered Suboccipital Release On Superficial Backline Function, Colin Wilhite, Kristin A. Paloncy, Karen Rawkowski, Todd Daniel

Clinical Practice in Athletic Training

The effectiveness of trigger point release in the suboccipital region to improve hamstring mobility has been established in the literature, but the research has not clarified whether self-administered soft tissue techniques produce the same improvements to mobility as when the clinician delivers the manual trigger point release. The purpose of the study was to assess whether the same increase in hamstring mobility within the superficial backline function that is achieved with a clinician-administered suboccipital trigger point release can also be obtained through a patient/self-administered method. The study employed a randomized, descriptive laboratory design in which 60 participants reported for a …

Regionally Interdependent Applications Of Total Motion Release® And Active Rotational Shoulder Range Of Motion In Overhead Athletes, R. Ross Dexter, Terylan K. Loftis, Russell T. Baker, Timothy E. Speicher

Clinical Practice in Athletic Training

Healthy athletes commonly engage in pre-participation warm-up strategies designed to physiologically and mechanically prepare the body for training and competition. Alterations in rotational range of motion (ROM) of the dominant shoulder in overhead athletes, resulting in total rotation ROM loss, correlate with performance deficit, injury risk, and lost training time. Researchers have suggested that interventions using Total Motion Release® (TMR®) increase shoulder ROM more effectively than traditional warm-up methods. A randomized pre-test post-test trial was used to explore the effects of a regionally interdependent application of TMR® via a forward flexed trunk twist (FFTT) and seated straight leg raise (SLR) …

Exercise Induced Laryngeal Obstruction In A Collegiate Runner: A Case Report Of A Novel Therapy, Cody Inskeep, Todd Olin, Robert Arthur

Clinical Practice in Athletic Training

A 23-year-old male Division I distance runner presented with several years of exertional stridor (high-pitched inspiratory noise caused by airflow obstruction), previously diagnosed as exercised-induced laryngeal obstruction (EILO), a condition formerly known as vocal cord dysfunction and exercised-induced paradoxical vocal fold motion. Over the course of roughly 3 years, the patient had previously failed conventional and invasive respiratory therapies for EILO including respiratory retraining, inspiratory muscle training, reflux suppression, allergy suppression, amitriptyline, performance psychology, and injection of botulinum toxin to the larynx. At a referral center that specializes in the treatment of EILO, the patient's diagnosis was confirmed through the …

Optimizing Return To Learn Following A Sport-Related Concussion: A Quality Improvement Project, Dawn Ranns, Tamara Valovich Mcleod

Clinical Practice in Athletic Training

Sport-related concussion (SRC) has been at the forefront of the sports medicine literature and media; however only recently has return to learn (RTL) been recognized as an important piece of a concussion management plan (CMP). A student’s successful transition back to the classroom following SRC depends on the support, resources, and effective communication among the multidisciplinary team. This project focused on the assessment of current faculty knowledge, attitudes, and beliefs about concussion, the development of an RTL policy, and implementation of educational resources at a Division II institution. This project ran for 6 months, using 2 cycles of the plan, …

Point-Of-Care Assessment At A Free, Out-Of-Hours Orthopedic Clinic, Whitney M. Graves, Zachary K. Winkelmann, Kenneth E. Games

Clinical Practice in Athletic Training

Access to healthcare is a challenge for many Americans living in rural communities. Hospital systems have created programs and developed models to improve access to care. However, documentation of the role of these clinics serving different populations and various types of communities is quite scarce. The purpose of this article is to describe the patient satisfaction and procedures assessed at the point-of-care during a 14-week, out-of-hours free orthopedic clinic in the Southeastern United States. One hundred and twenty-nine patients attended the orthopedic clinic and completed a patient satisfaction survey following their patient encounter. At the end of the 14-week, 89% …

Graston Technique® As A Treatment For Patients With Chronic Plantar Heel Pain, Troy R. Garrett, Peter J. Neibert

Clinical Practice in Athletic Training

Use of Instrument-Assisted Soft Tissue Massage has increased in popularity, and the plantar fascia is a superficial tissue that may benefit from this treatment. The objective of this study was to determine the effectiveness of Graston Technique® (GT) for decreasing pain and increasing function in participants with chronic plantar heel pain over a six-week period. A single blind, pretest-posttest control/comparison group design, with a sample of 22 adults (5 males, 17 females) was utilized. Participants were assigned to three groups: GT/stretching, effleurage/stretching, and stretching only. After completion, effleurage/stretching and stretching only groups were later offered GT with posttest scores recorded. …

Treatment Of Scapular Dyskinesis With Reflexive Neuromuscular Stimulation: A Case Report, Alli Z. Powell, Russell T. Baker

Clinical Practice in Athletic Training

Scapular dyskinesis is an abnormal movement of the scapula due to poor motor control of the surrounding musculature and can lead to other glenohumeral pathologies. The pathology results in the lateral tilting of the scapula during many glenohumeral joint movements and weight-bearing activities of the upper extremity (i.e., plank). The typical conservative treatment protocol focuses on strengthening surrounding musculature and is often a lengthy protocol. A weakness of strengthening protocols is the failure to address the motor function of targeted muscles at the level of the central nervous system (CNS) to restore dynamic stability and motor control. Reactive Neuromuscular Stabilization …

Mesenchymal Stem Cells: Sources, Clinical Applications And Outcomes For Common Musculoskeletal Conditions, Steven Boyton, Lindsey Clemensen

Clinical Practice in Athletic Training

Background: The clinical use of Mesenchymal Stems Cells (MSC) in musculoskeletal medicine has become increasingly recognized in the medical field as a promising treatment modality. MSCs have been defined as spindle shaped cells that are capable of rapid proliferation and self-renewal contained within several tissues including bone marrow, synovial and adipose tissue, blood and periosteum. MSCs are currently being used in clinical trials for musculoskeletal purposes including the enhancement of tissue regeneration, bone and cartilage defects and tissue repair. Currently a variety of stem cell products, methods and applications are being used which can provide many misconceptions for the most …

Unique Shoulder Arthroscopies: Snapping Scapula Syndrome And Scapular Nerve Entrapment, Erica L. Taylor, Spero Karas

Clinical Practice in Athletic Training

Anatomy Review: The scapula provides the stable base for glenohumeral motion and provides origins and insertions for 17 muscles. The scapulothoracic (ST) joint lacks synovial lining and cartilaginous interface. The anterior scapula glides over the thoracic wall between several bursal and soft tissue planes.1,2 The suprascapular nerve emerges from the superior trunk of the brachial plexus (C5, C6) and travels across the posterior triangle of the the neck of the scapula trough the suprascapular and spinoglenoid notches. The suprascapular nerve innervates half of the rotator cuff musculature, the infraspinatus and supraspinatus. Snapping Scapula Syndrome (SSS) occurs when the ST articulation …

A Qualitative Study Exploring Motivation And Engagement Among Millennial Volunteers In Nonprofit Organizations, Joanne Quinones

Theses and Dissertations

This applied dissertation focused on capturing the lived experiences of Millennials and explore their motivation and engagement for volunteering in a nonprofit organization. This study illustrates the importance of civic and social engagement in our society. The Millennials have been labeled as “Genme or the me generation” (Twenge, Campbell, Hoffman, & Lance, 2010, p. 1117; Twenge, 2006, p. 1), as they have been criticized for focusing on their own self-interest. While millennials have been considered as being technologically savvy, since they grew up with the internet. The millennials, have a social interest in offering support to a cause versus an …

Aadej Comm 50 3 2019

AADEJ - The Communicator

The Communicator is the official journal of the American Association of Dental Editors and Journalists (AADEJ). It is published quarterly, distributed digitally via email to members, and posted on the Association's website, AADEJ.org. Each issue includes regular updates from the editorial team and AADEJ board, as well as feature articles on current issues in the field.

Program Review Of Naloxone Training Within The Wisconsin Department Of Corrections’ Community Corrections Division, Chelsea Calhoon

All Graduate Theses, Dissertations, and Other Capstone Projects

One of the fastest growing drug problems in the United States is the abuse of opioids (United States Department of Health & Human Services, 2018). With the rising overdose rates, the criminal justice system may offer a pivotal role in the decrease of overdose deaths through opioid overdose recognition and naloxone administration training (World Health Organization, 2014). Training evaluation based on the Effectiveness Theory find significant predictors of training effectiveness and retention to be correlated with the training program, age, and employment tenure (Cowman & McCarthy, 2016). This thesis’ research question is, “Do demographics correlate to training retention for opioid …

Certified Nursing Assistant Turnover & Impacts On Rural Skilled Nursing Facilities A Qualitative Study & Recommendations For Practitioners, Marisa E. Hansen

All Graduate Theses, Dissertations, and Other Capstone Projects

The cumulative growth in the aging population in the U.S. calls for a high demand for long-term care (LTC) facilities. Furthermore, the LTC (e.g., nursing homes and assisted living facilities, etc.) consumers have become widely diverse (i.e., not just limited to older groups but now included children and adults with disabilities); demand for wide range of needs and support services. In coping with this changing environment, the LTCs, especially operating in rural settings, are faced with multifaceted challenges related to direct care staffing and turnover. In response to this outlook, the present study explores a research question to understand, how …

Impact Of A Primary Care Pharmacist Utilizing A Team-Based Model Of Care, Priya Verma Pharmd, Rachel Steele Pharmd, Bcacp, Ashley Parrott Pharmd, Mba, Bcps, Bcacp

Parkview Pharmacy Department

2019 ASHP Midyear Clinical Meeting / Las Vegas, Nevada / Poster 11-134

Objective: To characterize the impact of a primary care pharmacist working in a team-based care model, by determining: • The acceptance rate for all recommendations • The total number of each recommendation type • The number of referrals to the primary care pharmacist, if the patient was an appropriate candidate for comprehensive medication management

Assessing Appropriateness Of Inpatient Rifaximin Use In A Community Health System, Alissa Keillor Pharmd, Sarah Pfaehler Pharmd, Mba, Bcps, Lorin Yolch Pharmd, Bcgp, Bcac

Parkview Pharmacy Department

2019 ASHP Midyear Clinical Meeting / Las Vegas, Nevada / Poster # 11-135

Objective: To evaluate the appropriateness of inpatient rifaximin use and healthcare resource utilization best-practices within a community health-system.

Impact Of Atypical Antipsychotics On Sedation Requirements In Mechanically Ventilated, Critically Ill Patients, Michael Genday Pharmd, Dustin D Linn Pharmd, Bcps, Bcccp, Jim Roy Pharmd, Bcps, Bcccp

Parkview Pharmacy Department

2019 ASHP Midyear Clinical Meeting / Las Vegas, Nevada

Objective: To determine if atypical antipsychotics lower continuous infusion sedation requirements while also assessing risk

Standardized Approach To Implementation Of Infusion Pump Interoperability, Tara Jellison Pharmd, Mba, Fashp, Rebecca S. Mahuren Bsn, Rn

Parkview Pharmacy Department

2019 ASHP Midyear Clinical Meeting / Las Vegas, Nevada / Poster #708041 08-105

Purpose: Describe the process to implement smart pump–electronic health record (EHR) interoperability technology throughout a multi-facility community health system to improve intravenous (IV) medication safety and efficiency with auto-programming, reducing keystroke errors and edits from 17 step manual process to 7 steps.

Detecting And Mapping Real-Time Influenza-Like Illness Using Twitter Stream Data, Elisha D. Brunette

EWU Masters Thesis Collection

Influenza has been identified by the World Health Organization as a global issue that could be more effectively served through an accelerated and widely-accessible public health surveillance tracking process. The ability to map and predict influenza outbreaks in a real-time heat map would be invaluable to health care systems to prepare for influenza outbreaks. In this study, the Twitter stream data is filtered to identify potential influenza-like illness (ILI) cases. Then the tracking of real-time influenza cases is further explored and analyzed through various machine-learning models. Among seven learning models developed to identify ILI tweets, the ELMo deep neural network …

Prevalence Of Low-Energy Availabilty Amongst Female Paralympic Athletes, Alicia Difolco

All Master's Theses

The prevalence of low-energy availability (LEA) in able-bodied female athletes has been extensively examined; however, research has yet to examine LEA in Paralympic athletes. Therefore, the purpose of this study was to examine the risk of LEA and related symptoms including menstrual health, hormonal profiles, and bone mineral density (BMD) in female para-athletes. Female national para-athletes (n = 9) completed 7-day food and activity logs, Low Energy Availability in Females Questionnaire (LEAF-Q) and Eating Disorder Examination Questionnaire (EDE-Q), Dual energy X-Ray Absorptiometry (DXA) scans, and hormonal profile blood spot testing. LEAF-Q results suggested that 78% of athletes were considered …

Examining Injury Trends In Wildland Firefighters To Develop An Injury Screening Assessment Pilot Project, Isabella Grace Callis

Graduate Student Theses, Dissertations, & Professional Papers

Fire suppression is an arduous profession that poses many work hazards and risks for wildland firefighters (WLFF) on a daily basis. One of the major threats to WLFF health on the line is musculoskeletal injury. Injury on the fire line and during personal training inhibits WLFF from performing their job to their full capacity. Currently there are no prevention strategies utilized to reduce the number of injuries this tactical population is experiencing. By accurately tracking injuries in WLFF, development of prevention strategies could assist in reducing the cost of injuries, maintain overall health in WLFF, and decrease work-related disability.

A …

Speech-Language Pathology And Psychology Students' Perceptions Of An Interprofessional Autism Intervention: An Exploratory Case Study, Haley Marie Nelson

Graduate Student Theses, Dissertations, & Professional Papers

The purpose of this qualitative case study was to understand how the interprofessional collaboration (IPC) experience of Youth Engagement Through Intervention (YETI) changes perceptions and knowledge regarding scope of practice of pre-service professionals in the Communicative Sciences and Disorders (CSD), School Psychology, and Clinical Psychology programs. Semi-structured interviews were conducted with pre-service professionals participating in YETI as student clinicians at three different time periods. The results contribute to the existing literature base affirming that interprofessional experiences during pre-professional programs are beneficial. For the Departments of Communicative Sciences and Disorders and Department of Psychology at University of Montana, findings have the …

Patient Satisfaction With Athletic Trainers Working In A Physician Practice Setting, Nathaniel P. Acree, Forrest Q. Pecha, Joshua B. Lavigne, Esther C. Nolton

Clinical Practice in Athletic Training

Background: Recent changes in healthcare administration via the introduction of the Triple Aim by the Institute of Healthcare Improvement have challenged healthcare institutions to improve the efficiency and effectiveness with which services are provided, while also enhancing patient experience. These changes have facilitated the hiring of clinical support staff from varying backgrounds with the aim of ensuring the goals of the triple aim are met within the clinical environment. Recently orthopedic practices have begun to include certified athletic trainers in the healthcare delivery team due to their advanced base of musculoskeletal knowledge. Previous literature has observed increased efficiency and revenue …

Five-Year Follow Up Of A Low Glycaemic Index Dietary Randomised Controlled Trial In Pregnancy—No Long-Term Maternal Effects Of A Dietary Intervention, E.C. O'Brien, Aisling A. Geraghty, Elizabeth O'Sullivan, J.A. Riordan, Mary K. Horan, Elizabeth Larkin, John Mehegan, P.J. Twomey, Fionnuala M. Mcauliffe

Articles

Objective: To determine whether a dietary intervention in pregnancy had a lasting effect on maternal outcomes of diet, HbA1c and weight retention 5 years post-intervention; and to establish whether modifiable maternal behaviours were associated with these outcomes. Design: Randomised control trial of low glycaemic index (GI) diet in pregnancy with longitudinal follow up to 5 years post-intervention. Setting: Dublin, Ireland (2007–2016). Population: In all, 403 women of 759 (53.1%) were followed up at 5 years. A total of 370 (intervention n = 188; control n = 182) were included in this analysis. Methods: Fasting glucose was measured at 13 and …