Medicine and Health Sciences Commons^™

Momentum 2019, Stephanie Clarke

Momentum

A journal of undergraduate research

Redmond (2002) Revisited: Have Standardized Behavioral Rating Scales Gotten Better At Accommodating For Overlapping Symptoms With Language Impairment?, Kirsten M. Hannig, Sean M. Redmond, Amy Wilder

Faculty Publications

Seventeen years ago, Redmond ¹ reviewed five standardized behavioral rating scales and identified several aspects of their design that made them prone to mischaracterize language impairments as socioemotional behavioral disorders. The purpose of this report is to provide an update and extension of the original audit. We consulted test manuals to evaluate: (1) representation of children with language impairments in their standardization samples; (2) presence of language, or academic items within their inventories; (3) accommodations for administering the measure to children with language impairments; and (4) procedures for identifying inordinately punitive ratings. Overlapping language and academic symptoms continued to be …

Characterization Of The Microbial Phosphonate-Activating Pntc Enzymes, Kyle Rice

Theses and Dissertations (Comprehensive)

New strategies are urgently needed to combat infectious diseases in an era of rising antibiotic resistance. Furthermore, an emerging appreciation for the human microbiome’s role in maintaining health motivates discovery of species-specific antibiotics that minimally disrupt our native bacterial communities. Small molecule modifications to bacterial cell surfaces represent a potentially rich source of new targets for next generation antibiotics, as these molecules mediate virulence and evasion of the host immune response. Phosphocholine (PCho) is a rare cell surface modification that contributes to virulence, and modifications with phosphonates like 2-aminoethylphosphonate (AEP) are even more unusual and therefore provide opportunities for species- …

An Intensive Book Camp Approach To The Remediation Of Speech Sound Disorders: A Case Report, Shawn L. Nissen, Melanie E. Peris, Kristine Tanner

Faculty Publications

Background: Understanding treatment dose is essential to optimizing therapeutic frequency and intensity for speech sound disorders. Intensive therapies, known as boot camp approaches, have proven efficacious in certain speech therapy contexts such as voice disorder treatment. However, few data exist regarding intervention intensity for developmental speech sound disorders. Method: This investigation examined the effects of an intensive boot camp speech therapy approach to remediate interdental /s/ production over two consecutive days. Treatment occurred in morning and afternoon blocks for a total of 5.5 h per day. Auditory-perceptual ratings were used to evaluate /s/ productions pre-treatment, immediately post-treatment, and one week …

Reducing Return Of Disease Activity In Patients With Relapsing Multiple Sclerosis Transitioned From Natalizumab To Teriflunomide: 12-Month Interim Results Of Teriflunomide Therapy., Stanley Cohan, Keith Edwards, Lindsay Lucas, Tiffany Gervasi-Follmar, Judy O'Connor, Jessica Siuta, Vineetha Kamath, Lore Garten, Chiayi Chen, James Thomas, Kyle E Smoot, Kiren Kresa-Reahl, Kateri Spinelli

Articles, Abstracts, and Reports

Background: Natalizumab is an effective treatment for relapsing multiple sclerosis. Return of disease activity upon natalizumab discontinuance creates the need for follow-up therapeutic strategies.

Objective: To assess the efficacy of teriflunomide following natalizumab discontinuance in relapsing multiple sclerosis patients.

Methods: Clinically stable relapsing multiple sclerosis patients completing 12 or more consecutive months of natalizumab, testing positive for anti-John Cunningham virus antibody, started teriflunomide 14 mg/day, 28 ± 7 days after their final natalizumab infusion. Physical examination, Expanded Disability Status Scale, laboratory assessments, and brain magnetic resonance imaging were performed at screening and multiple follow-up visits.

Results: Fifty-five patients were enrolled …

Law, Technology And Patient Safety, Kathryn Zeiler, Gregory Hardy

Faculty Scholarship

Medical error is the third leading cause of death in the United States, In an effort to increase patient safety, various regulatory agencies require reporting of adverse events, but reported counts tend to be inaccurate. In 2005, in an effort to reduce adverse event rates, Congress proposed a list of “never events,” adverse events, such as wrong-site surgery, that should never occur in hospitals, and authorized CMS to refuse payment for care required following such events. CMS has since pushed for further regulation, “such as putting more payment at risk, increasing transparency, increasing frequency of quality data reviews, and stepping …

The Relationship Between Psychological Factors And The Gait Analysis Of A Total Knee Arthroplasty Patient: A Case Study, Tyler S. Rogers

Honors Program Theses

Rehabilitation through the use of physical therapy for the total knee arthroplasty (TKA), or knee replacement,procedure can be an arduous process. The purpose of this study is to identify any relationships between various psychological factors and angular variables observed during the functional activity of gait for TKA patients. Application of these results may be utilized by physical therapists to maximize the quality of personal patient care provided while allowing patients the opportunity to successfully return to the functional activity of walking. Psychological factors that were examined included those noted in the self-determination theory studied by Ryan & Patrick (2009): motivation, …

The Effect Of Arch Height On Variances In Gait Phases: A Kinematic Analysis, Mackenzie J. Haag

Honors Program Theses

Millions of individuals suffer from pain or injury as a result of structural abnormalities of the medial longitudinal arch of the foot and/or improper footwear. A majority of the research on abnormalities of the medial longitudinal arch is focused on how the arch alters foot kinematics during gait but does not ask how abnormalities may contribute to deviations in knee kinematics as well. The purpose of this study was to determine the effect of foot arch types on deviations in healthy biomechanical gait in addition to the implications of orthotics in order to ultimately aid in the decrease of arch-attributed …

Informed Hearing Loss Prevention For Theatre Uni, Mallory Park

Honors Program Theses

This study explores the opinions and behaviors related to hearing loss and hearing loss prevention in the demographic of theatre workers at Theatre UNI. Data was collected through a survey dispersed in a department-wide email and by measuring sound level in the scene shop and the costume studio. Survey responses from 11 participants indicated that theatre workers at Theatre UNI may be at risk for noise-induced hearing loss and that further education may aid in prevention of hearing damage.

The Utility Of Neuropsychological Measures On The Differential Diagnosis Of Adhd-Inattentive Type Versus Anxiety In A Pediatric Outpatient Behavioral Health Population, Emily Stapleton

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This study examined the differences in inattention and executive function between a group of children diagnosed with ADHD and a group diagnosed with anxiety disorders to establish differential profiles for these two disorders. This study evaluated the differences among children with ADHD and anxiety disorders, using parent-report and performance-based measures of inattention and anxiety. A retrospective chart review was completed for a total of 58 patients who met the criteria for an anxiety disorder or for ADHD-C and ADHD-I at the completion of the neuropsychological assessment. Analyses compared the ADHD group and the Anxiety group on select scales and subscales …

Training As An Intervention To Decrease Medical Record Abstraction Errors Multicenter Studies., Meredith Nahm Zozus, Leslie W. Young, Alan E. Simon, Maryam Garza, Lora Lawrence, Songthip T. Ounpraseuth, Megan Bledsoe, Sarah Newman-Norlund, J Dean Jarvis, Mary Mcnally, Kimberly R. Harris, Russell Mcculloh, Rachel Aikman, Sara Cox, Lacy Malloch, Anita Walden, Jessica Snowden, Irene Mangan Chedjieu, Chester A. Wicker, Lauren Atkins, Lori A. Devlin

Manuscripts, Articles, Book Chapters and Other Papers

Studies often rely on medical record abstraction as a major source of data. However, data quality from medical record abstraction has long been questioned. Electronic Health Records (EHRs) potentially add variability to the abstraction process due to the complexity of navigating and locating study data within these systems. We report training for and initial quality assessment of medical record abstraction for a clinical study conducted by the IDeA States Pediatric Clinical Trials Network (ISPCTN) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network (NRN) using medical record abstraction as the primary data …

Insulin Pump Adherence Behaviors Do Not Correlate With Glycemic Variability Among Youth With Type 1 Diabetes (T1d)., Emily Paprocki, Vincent S. Staggs, Susan Patton, Mark A. Clements

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

The Copy Number Variation Landscape Of Congenital Anomalies Of The Kidney And Urinary Tract., Miguel Verbitsky, Rik Westland, Alejandra Perez, Krzysztof Kiryluk, Qingxue Liu, Priya Krithivasan, Adele Mitrotti, David A. Fasel, Ekaterina Batourina, Matthew G. Sampson, Monica Bodria, Max Werth, Charlly Kao, Jeremiah Martino, Valentina P. Capone, Asaf Vivante, Shirlee Shril, Byum Hee Kil, Maddalena Marasà, Jun Y. Zhang, Young-Ji Na, Tze Y. Lim, Dina Ahram, Patricia L. Weng, Erin L. Heinzen, Alba Carrea, Giorgio Piaggio, Loreto Gesualdo, Valeria Manca, Giuseppe Masnata, Maddalena Gigante, Daniele Cusi, Claudia Izzi, Francesco Scolari, Joanna A E Van Wijk, Marijan Saraga, Domenico Santoro, Giovanni Conti, Pasquale Zamboli, Hope White, Dorota Drozdz, Katarzyna Zachwieja, Monika Miklaszewska, Marcin Tkaczyk, Daria Tomczyk, Anna Krakowska, Przemyslaw Sikora, Tomasz Jarmoliński, Maria K. Borszewska-Kornacka, Robert Pawluch, Maria Szczepanska, Piotr Adamczyk, Malgorzata Mizerska-Wasiak, Grazyna Krzemien, Agnieszka Szmigielska, Marcin Zaniew, Mark G. Dobson, John M. Darlow, Prem Puri, David E. Barton, Susan L. Furth, Bradley A. Warady, Zoran Gucev, Vladimir J. Lozanovski, Velibor Tasic, Isabella Pisani, Landino Allegri, Lida M. Rodas, Josep M. Campistol, Cécile Jeanpierre, Shumyle Alam, Pasquale Casale, Craig S. Wong, Fangming Lin, Débora M. Miranda, Eduardo A. Oliveira, Ana Cristina Simões-E-Silva, Jonathan M. Barasch, Brynn Levy, Nan Wu, Friedhelm Hildebrandt, Gian Marco Ghiggeri, Anna Latos-Bielenska, Anna Materna-Kiryluk, Feng Zhang, Hakon Hakonarson, Virginia E. Papaioannou, Cathy L. Mendelsohn, Ali G. Gharavi, Simone Sanna-Cherchi

Manuscripts, Articles, Book Chapters and Other Papers

Congenital anomalies of the kidney and urinary tract (CAKUT) are a major cause of pediatric kidney failure. We performed a genome-wide analysis of copy number variants (CNVs) in 2,824 cases and 21,498 controls. Affected individuals carried a significant burden of rare exonic (that is, affecting coding regions) CNVs and were enriched for known genomic disorders (GD). Kidney anomaly (KA) cases were most enriched for exonic CNVs, encompassing GD-CNVs and novel deletions; obstructive uropathy (OU) had a lower CNV burden and an intermediate prevalence of GD-CNVs; and vesicoureteral reflux (VUR) had the fewest GD-CNVs but was enriched for novel exonic CNVs, …

Weaning Of Moderately Preterm Infants From The Incubator To The Crib: A Randomized Clinical Trial., Seetha Shankaran, Edward F. Bell, Abbot R. Laptook, Shampa Saha, Nancy S. Newman, S Nadya J Kazzi, John Barks, Barbara J. Stoll, Rebecca Bara, Jenna Gabrio, Kirsten Childs, Abhik Das, Rosemary D. Higgins, Waldemar A. Carlo, Pablo J. Sánchez, David P. Carlton, Lara Pavageau, William F. Malcolm, Carl T. D'Angio, Robin K. Ohls, Brenda B. Poindexter, Gregory M. Sokol, Krisa P. Van Meurs, Tarah T. Colaizy, Ayman Khmour, Karen M. Puopolo, Meena Garg, Michele C. Walsh, Eunice Kennedy Shriver National Institute Of Child Health, And Human Development Neonatal Research Network, William E. Truog, Eugenia K. Pallotto, Howard Kilbride, Cheri Gauldin, Anne Holmes, K Johnson

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To assess whether length of hospital stay is decreased among moderately preterm infants weaned from incubator to crib at a lower vs higher weight.

STUDY DESIGN: This trial was conducted in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants with gestational ages 29-33 weeks, birthweightg, and in an incubator were randomly assigned to a weaning weight of 1600 or 1800 g. Within 60 to 100 g of weaning weight, the incubator temperature was decreased by 1.0°C to 1.5°C every 24 hours until 28.0°C. The infants were weaned to the crib following …

Identifying Interactions Between Chikungunya Virus And Aedes Aegypti Salivary Gland Proteins, Alfred Jiang

Public Health Theses

Chikungunya virus (CHIKV), an emerging threat to global health, has been responsible for extensive arboviral epidemics in Southeast Asia and the Americas in recent years. In order to develop effective therapeutics and preventative measures, we must first gain a deeper understanding of both the host and vector factors that define the pathogen’s life cycle and transmissibility. Currently, the entry receptor and potential co-factors that facilitate CHIKV infection in the arthropod vector are unknown, highlighting a critical knowledge gap in our understanding of the viral life cycle. Furthermore, while secreted mosquito salivary proteins have been shown to modulate host infection through …

Putting The T In Mlp: The Role Of Trust In Medical Legal Partnerships, Jenny Ajl

Public Health Theses

The United States spends more on healthcare than any other country, while health outcomes lag behind many nations. This is often attributed to the disproportionately low spending on social services, and social determinants of health (SDOH) need to be addressed in order to improve the nation’s health. SDOH are increasingly understood to be key factors in predicting health outcomes. Medical legal partnerships (MLPs) are one intervention that seek to address SDOH. The MLP model comprises three core components: providing legal care for patients, improving systems of healthcare, and creating policy change outside the healthcare system. In this qualitative study, we …

Nicotine Dependence And Alternative E-Cigarette Use Behaviors: Dripping And Vape Tricks, Harmanpreet Bhatti

Public Health Theses

Background: E-cigarette use among youth is concerning due to the risk of exposure to hazardous chemicals and future combustible cigarette use. Alternative e-cigarette use behaviors, or dripping (i.e., applying drops of e-liquids directly onto heated coils) and vape tricks (i.e., blowing shapes or large clouds of visible exhaled aerosol), may also increase this risk. However, little is known about the risk of nicotine dependence among adolescents who engage in these behaviors. Therefore, the aim of this study was to determine the association between these alternative e-cigarette use behaviors and nicotine dependence among adolescents.

Research Design: Cross-sectional data were collected from …

So You Think You Can Exercise: The Gap Between Exercise Confidence And Physical Activity Among Samoan Adults, Diksha Brahmbhatt

Public Health Theses

Samoa is experiencing one of the highest prevalence of overweight and obesity in the world, placing its population at increased risk of developing several noncommunicable diseases including type 2 diabetes and cardiovascular disease. The role of physical activity in reducing the burden of these diseases and overweight is well-established. Exercise self-efficacy or confidence is a predictor, if not determinant, of recreational physical activity. The purpose of this study, therefore, is to assess the relationship between exercise confidence and levels of recreational physical activity among Samoan adults. We confirm that exercise confidence is correlated with time spent exercising. However, despite considerable …

Safety Of Opat In Older Versus Younger Adults, Kaylen Elizabeth Brzozowski

Public Health Theses

Introduction Outpatient parenteral antimicrobial therapy (OPAT) is considered practical, safe, and cost-effective, but roughly 20% of all adult patients on OPAT experience an adverse event (AE). Frequency of AEs and healthcare utilization, defined as emergency department visits and infectious disease office visits, phone calls, and emails, may be greatest in the first two weeks of OPAT. Given that older adults (age ≥ 65) have greater cognitive decline, ADL limitations, and comorbidities than younger adults, we sought to evaluate the frequency and timing of AEs in older adults on OPAT. We examine patients on OPAT at Yale New Haven Hospital (YNHH) …

Postpartum Weight Trajectories In A Cohort Of 127 Samoan Women: Does Breastfeeding Protect Against Postpartum Weight Retention?, Grace Castillo

Public Health Theses

Rising global obesity rates impact every aspect of health, including maternal-fetal health. Samoa has a disproportionate burden of obesity, with more than half of Samoan women entering pregnancy obese. Given Samoan women’s high parity (4), postpartum weight retention (PPWR) may be a significant source of weight gain over women’s lifetimes. Little is currently known about PPWR among Samoan women, so this analysis sought to document PPWR trajectories, assess factors – like breastfeeding -- associated with PPWR. Data of 127 mother-infant dyads from the 2017 Foafoaga O le Ola cohort were used in analysis. Researchers collected demographic and lifestyle data, as …

Attachment Security And Psychological Health In Adult Child Caregivers And Their Parents With Alzheimer’S Disease And Related Dementias, Wei Aiko Chang

Public Health Theses

Objective: Attachment theory is a helpful framework for examining one of the most fundamental needs in parent-child dyads across the lifespan and how attachment security might protect both dyad members’ psychological health, especially in times of crisis. In this study of adult child caregivers and their parents with early stage Alzheimer’s disease and related dementias (ADRD), we examined the associations between both dyad members’ attachment security, the adult child’s depressive symptoms, and quality of life of the parent with ADRD.

Method: Thirty-four individuals (parents) with ADRD and their 34 adult-child caregivers each completed the 12-item Experiences in Close Relationship Scale …

Persistence Of Ebola Virus In Survivors & Risks Of Sexual Transmission: A Systematic Review, Allison Cheung

Public Health Theses

Background: Longitudinal cohort studies of Ebola virus disease (EVD) survivors from the 2014-2016 West African outbreak have found evidence of Ebola virus (EBOV) and EBOV RNA persistence in the bodily fluids of survivors, particularly in semen. This new evidence has raised the possibility of sexual transmission of EBOV by EVD survivors. The current interim guidance issued by the World Health Organization (WHO) recommends safer sex practices for at least 12 months after acute disease onset (ADO). However, based on new evidence, these recommendations may require revision.

Objective: The main aim of this article is to present and evaluate evidence on …

Estimating Mortality After Natural Disasters In Low- And Middle-Income Countries: A Systematic Review, Joseph Clingerman

Public Health Theses

Background

The outcomes of natural disasters produce many complex uncertainties and statistics, many of which have no metrics to assess how accurate they are. In particular, mortality estimates in low- and middle-income countries encompass many variables in their inherently challenging physical, political, and logistical landscapes. Given that there has been no known systematic review of assessing mortality estimation methodologies, the author aimed to provide a systematic review of known methodologies and provide a framework to assess mortality estimation methodologies.

Methods

The author performed a systematic search of electronic databases from the past two decades up to January 2019. In addition, …

Exposure To Atmospheric Metals Using Moss Bio-Indicators And Neonatal Health Outcomes In Portland, Oregon, Saskia Comess

Public Health Theses

Background: Exposures to certain metals are associated with adverse birth outcomes, including inhibited fetal growth and congenital defects. Previous studies focused on metals such as lead and arsenic, and primarily assessed exposure using biological monitoring, which does not provide insights into sources. Examining exposure to metals via atmospheric pathways is challenging due to a lack of high-resolution air-pollution data. We applied a unique map of atmospheric metal pollution, derived from bio-indicator moss samples, as a screening tool to study neonatal health risks of atmospheric metal pollution in Portland, Oregon, a city of 640,000 people with several metal-emitting industrial sources.

Methods: …

The Contribution Of The Residential Environment To Indoor Air Pollutants, Jessica Deslauriers

Public Health Theses

Rationale: Little is known about the home environment and associated indoor exposures to brown carbon and black carbon, components that make up fine particulate air pollution.

Objective: Identify how features of the residential environment contribute to indoor measurements of brown and black carbon.

Methods: Between November 2012 and December 2014, 125 veterans who were part of a COPD cohort were recruited for this study. At roughly 3 month intervals, participants received a particle sampler to measure air pollutants in their home for a 1-week period. The filters within the samplers were analyzed for levels of black and brown carbon using …

Quantifying Influenza Exposure Within Hospitals And Nursing Homes, Drew Taylor Dickinson

Public Health Theses

Abstract

Background: Influenza acquisition in hospitals and nursing homes (NHs) highlights the need for infection prevention to protect patients from contagious diseases while under the care of a healthcare facility. We quantified influenza exposure in both settings and compared facility-onset influenza rates in order to determine if risks of acquiring influenza differed by type of healthcare facility since infection prevention practices are less standardized and less rigorous in NHs.

Methods: We conducted a retrospective cohort study of California hospital and NH inpatients during the 2015-2016 influenza season, defined as the peak influenza month, plus the two adjacent months, using claims …

Proximity To Nearest Major Road And Time To Pregnancy In The Early Pregnancy Study, Nina Hatch

Public Health Theses

Purpose: Current literature suggests that air pollution may affect reproductive outcomes, but little research has evaluated the association between air pollution and fertility. Our aim is to further examine the relationship between distance to major roadway, a proxy for traffic-related air pollution, and fecundability.

Methods: Our analysis was conducted within the North Carolina Early Pregnancy Study (n=221). Our outcome was pregnancy attempt time, an estimate of fecundability, or the per cycle probability of conception. Our primary definition of conception included early pregnancy loss, spontaneous miscarriage, ectopic and molar pregnancy, and singleton or twin pregnancies. In a secondary analysis, we defined …

Gaps In Mental Healthcare Use And Perceived Quality Between Privately Insured Lgb And Heterosexual Individuals In The United States, Yuki Hayashi

Public Health Theses

Previous research has identified significantly heightened levels of mental health issues and psychological distress among lesbian, gay, and bisexual (LGB) individuals in the U.S., as well as greater mental health service utilization among this population. Using a nationally representative sample of privately insured adults in the U.S., we investigate differences in mental healthcare utilization, characteristics of mental healthcare received, and perceived quality of care between LGB and heterosexual individuals. Key results find that privately insured LGB men and women are significantly more likely than their heterosexual counterparts to have used outpatient mental healthcare as well as out-of-network (OON) outpatient mental …

Multi-State Analysis Of Unconventional Oil And Gas Development And Rates Of Sexually Transmitted Infections In The United States, Nicholaus Peter Johnson

Public Health Theses

Background

Advances in unconventional oil and gas development (UOGD), including hydraulic fracturing and horizontal drilling, have helped position the United States as a world leader in the production of both crude oil and natural gas hydrocarbons. This significant increase in production would not have been possible, however, without the assemblage of a workforce that is predominantly young, male, and mobile. This is significant given that a number of studies have associated similar types of mobile workforces – especially those employed by resource extractive industries – with impacts on the sexual health of the host communities in which these workers operate …

Perspectives Of Type 2 Diabetes Patients On Their Interactions With Providers, Marleen Z. Jones-Pool

Public Health Theses

Effective patient-provider communication has been shown to help achieve optimal health results, particularly in patients with diabetes. While previous studies have identified patient-perceived barriers in communicating with their providers, this study highlights factors in the patient-provider interaction that may contribute to effective health communication. As part of a larger mixed-methods study, 10 semi-structured interviews were conducted with patients with self-reported diabetes at a primary health center. These interviews sought to understand patient-perceived communication factors that influenced their interactions with their providers. Interviews were recorded and transcribed verbatim. Interview transcripts were then coded and analyzed utilizing a grounded theory approach. Findings …