Medicine and Health Sciences Commons^™

Can Technological Advances, And Better Perioperative Care, Shift Total Knee Arthroplasty To A Younger Age Range?, Shaun M. Ring

Physician Assistant Capstones

Some of the advances could increase the life span of knee prosthetic implants to 20-25 years. Typical life span for most knee replacements is speculated to be around 15-20 years. This raises the question, that with the increase in technology, why is total knee arthroplasty not able to be performed in a younger population, 40-55 years of age, on a regular basis? It is frequently assumed that performing a TKA is not medically responsible in a patient younger than 55-60 years old, because of the possibility that they could need a costly revision in the future. Most of the studies, …

Patellar Tendonopathy In Collegiate Volleyball Athletes, Justine Benner, Heidi Cooke, Colby Critchfield, Samantha Dunn, Sarah Eddy, Linda Foremming

Student-Faculty Research - College of Physical Therapy

Purpose: The first purpose was to identify the prevalence of patellar tendon abnormality in female collegiate volleyball players. The second purpose was to identify a potential association between kinetic measures during the drop vertical jump between those with tendon abnormality and those without in female collegiate volleyball athletes

Scale-Invariance-Based Pre-Processing Drastically Improves Neural Network Learning: Case Study Of Diagnosing Lung Dysfunction In Children, Nancy Avila, Julio Urenda, Nelly Gordillo, Vladik Kreinovich

Departmental Technical Reports (CS)

To adequately treat different types of lung dysfunctions in children, it is important to properly diagnose the corresponding dysfunction, and this is not an easy task. Neural networks have been trained to perform this diagnosis, but they are not perfect in diagnostics: their success rate is 60%. In this paper, we show that by selecting an appropriate invariance-based pre-processing, we can drastically improve the diagnostic success, to 100% for diagnosing the presence of a lung dysfunction.

Mucormycosis - Dual Therapy With Prolonged Survival, Maydelin Pecchio, Yariela Osabio, Yariela Morales, Forest W. Arnold

Journal of Refugee & Global Health

Mucorales fungal infection is a fungal disease with potentially fatal outcomes. The most frequent involvement in humans comes from the orders known as Mucorales and Entomophthorales. Mucorales is more acute and has a predilection for immunocompromised patients. Mucorales are associated with an affinity for vessels, which leads to invasion and infarction of tissue. Mucormycosis is a devastating complication that can be a life threatening fungal invasion in many patients in an immunocompromised state.

Multistate Hepatitis A Outbreak: Vaccination Of Food Service Workers As Part Of The Kentucky Outbreak Response, Ruth M. Carrico, Dawn Balcom, Delanor Mason, Audria G. Denker, Alyson Holland, Kimberley A. Buckner, Stephen P. Furmanek, Wesley Trail

Journal of Refugee & Global Health

Background: In August 2017, a local outbreak of Hepatitis A was identified among homeless individuals in Louisville, Kentucky. This marked the first cases in what has now become recognized as the largest Hepatitis A outbreak in the US. When infection was identified in a Food Service Worker (FSW), vaccination efforts were expanded to target this group.

Objective: The purpose of this study was to describe: 1) the processes used to provide access to Hepatitis A vaccine for FSWs, 2) results from the immunization activities, and 3) lessons learned from the outcomes.

Methods: Through a partnership between the Louisville Metro Department …

Trident - March 2019, Dugoni School Of Dentistry

Trident

The newsletter of the Pacific Orthodontic Alumni Chapter at University of the Pacific, Arthur A. Dugoni School of Dentistry.

Effectiveness Of Ultrasound (Us) On Adults With Lateral Epicondylitis (Le), Jensen Aubry, Ashley Ott

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background:

• Individuals diagnosed with LE often present with increased pain and decreased functioning in daily activities. LE, commonly referred to as "tennis elbow," which results from stress and pain to the lateral epicondyle or extensor carpi radialis brevis (ERCB). This can develop from a single incident, injury or trauma, which results in pain with gripping and lifting (Leadbetter, 2016).
• Ultrasound (US) utilizes wave production to cause thermal or nonthermal sound waves to stimulate tissue by increasing collagen extensibility and enabling the inflammatory process (Knight & Draper, 2013).
• Areas being treated by US require different depths; a 1.0 mHz sound head …

Effect Of Ability To Cross Midline On Performance Of Handwriting, Lindsey Richmond, Michaela Marks

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background

In the school setting, occupational therapists work with students to develop or improve handwriting skills, such as letter legibility, to support educational participation (Case-Smith, 2002). Handwriting is compromised of many essential skills and clinicians focus specifically on areas including motor planning, upper extremity range of motion, and bilateral integration (Giroux, Woodall, Weber, & Bailey, 2012) which are related to the ability to cross midline. Crossing body midline is the ability to reach across the center of one's body, which is essential for many everyday tasks.

Assessing And Predicting Safe Power Mobility Use In Adults, Vannessa Valadez, Cally Mcshane

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background:

The current body of knowledge is lacking criteria for vision, cognition, and psychological functioning and how they affect power wheelchair use. Assessment and training is a common issue for all clinicians working in the field during powered mobility rehabilitation. Research has shown that the skills required for safe powered wheelchair driving are consistent with the skills needed for safe automobile driving (Massengale et al., 2005).

For the first time instead of using task skills, process skills were introduced as part of a powered mobility assessment with the development of the Assessment of Learning Powered mobility (ALP) tool.

Benefits And Risks Of Botulinum Toxin-A Injections For Tone Management, Brittany Perlaki, Kate Soens

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background Information:

Botulinum Toxin-A (BoNT/A) is being used as an adjunct to therapy to reduce focal spasticity, increase range of motion (ROM), manage pain, improve function, and possibly delay surgical intervention (Hoare & Imms, 2004). BoNT/A inhibits acetylcholine release at the neuromuscular junction resulting in temporary denervation and decreased muscular activity. Reinnervation eventually restores muscle function. Adverse effects include excessive weakness and atrophy of injected muscle, unintended weakness in adjacent muscles, and immunoresistance to BoNT/A (Ghasemi, Salari, Khorvash, & Shaygannejad, 2013).

Impact Of Fall Prevention And Home Modification Programs For Older Adults, Alyssa Collins, Kate Weston

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background:

By 2030, the number of U.S. adults aged 65 or older will more than double to about 71 million (CDC, 2015). With these rapidly changing demographics, fall prevention and home modification programs provide preventative support for aging in place. The lack of fall prevention services is both costly and impacts quality of life for older adults. $50 million dollars were spent on medical costs due to falls in 2015 (Florence, et al., 2018). By reviewing the literature and critically evaluating the results of the research studies, conclusions can be made as to the most effective fall prevention methods for …

Effective Ot Interventions For Pain Management In Persons With Rheumatoid Arthritis, Danielle Rudd, Andra Stormer

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background:

• Chronic pain is recognized as pain persisting past normal healing time and that may last or recur for more than 3 to 6 months. It affects about 20% of individuals worldwide (Treede et al., 2015).
• Persons diagnosed with rheumatoid arthritis (RA) identify pain as the most common reason they seek medical attention and 68-88% of persons with RA rate pain as one of their top three priorities (Lee, 2013).
• Pain for RA is often treated using a pharmacological approach involving disease modifying antirheumatic drugs, glucocorticoids, non-steroidal anti-inflammatories, and opioids. Among rheumatoid arthritis patients, chronic opioid use increased from 7.4% …

Constraint-Induced Movement Therapy Vs. Bimanual Therapy For Children With Hemiplegic Cerebral Palsy, Rachael Harroun, Emily Wirtz

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background

About half the children with hemiplegic cerebral palsy (CP) experience limitations in activities of daily living and involvement in education, leisure, and other occupational activities due to impairment in hand and arm function (Tevahauta, Girolami, and Øberg, 2017).

Constraint-Induced Movement Therapy (CIMT) is a common intervention for children with hemiplegic cerebral palsy (Chen, Pope, Tyler, and Warren, 2014). By restraining the unaffected arm during functional participation, CIMT aims to increase spontaneous use of the affected arm (Dong, Tung, Siu & Fong, 2013).

Bimanual therapy (BIT) is also implemented with this population and includes intensive training in functional bimanual tasks …

Evidence-Based Ot Practice For Patients With Cancer Related Fatigue, Kelsey Spitzley, Laura Tatu

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Clinical Scenario: 38-year-old male diagnosed with Non-Hodgkins Lymphoma seeking outpatient occupational therapy services to address sleeplessness, pain, fatigue and return to work opportunities.

Standardized Comprehensive Measure To Guide Older Adult Discharge In Acute Care, Katlyn Agren, Madison Hirsch

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background:

• In the acute care setting, occupational therapists play an important role in providing recommendations for discharge. Striving for appropriate and safe discharge is critical in avoiding hospital readmission, reducing safety risks, and promoting optimal functioning in older adults.
• 3.3 million adults are readmitted into the hospital within 30 days after discharge in the U.S., costing $41.3 billion annually (LaPointe, 2019).
• The average patient stay in the acute care setting is 5.5 days in the United States, putting occupational therapists in a time crunch to evaluate, treat, and prepare patients for discharge (OECD, 2017).

Impact Of Touchscreen Technology On Children’S Fine Motor Development, Rachael Barbarich, Courtney Stewart

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Case

A five-year-old boy is being seen by his school occupational therapist (OT) to work on fine motor deficits which seem to be delaying his handwriting development. His mother met with the OT and informed her that she is a single parent and is often busy, so her son spends most of his time at home playing on his tablet. The OT is interested in understanding if there is a relationship between the tablet use and the client's fine motor skills.

A Comparative Review Of Cognitive Assessment Tools For Adults In The Acute Care Setting, Nicole Gagnet, Bethany Noffke

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

The MMSE and MoCA have the strongest psychometric properties for adults in the acute care setting.

Effectiveness Of Fall Prevention In Individuals With Dementia, Jeana Smith, Madison Kowalewski

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Case

Betty is an 82 year old woman living with dementia. She is beginning to experience impaired balance and deviated gait. She was recently hospitalized with fall related injuries. Since her impaired balance is progressing, her occupational therapist plans to implement fall prevention into her treatment plan.

The Effect Of Screen Time On Development In Elementary-Aged Children, Kelly Kislowski, Abigail Harpe

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Play and education are two primary occupations influencing development in elementary-aged children. As screen time has impacted these childhood occupations, the outpatient pediatric OT is noticing clients are struggling with motor, cognitive, and psychosocial skills. She wants to understand the relationship between increased screen time and child development.

Effectiveness Of The Alert Program For School-Aged Children, Collin Gatien, Jake Dowling

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Case:

A 9-year-old boy has been described by his teachers as impulsive, loud, unable to sit still, and a disruption to the class. An OT examines the case and believes that the ALERT Program is a possible solution to improve the student's ability to self-regulate in the classroom. The OT prefers to use of Evidence-Based Practice and wants to determine whether the ALERT Program is a viable option to improve the student's ability to self-regulate in the classroom.

Impact Of Socioeconomic Status On Adherence To Home Exercise Programs Among Children, Brooke Nuccio, Molly Milstein

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Case

A 6-year old boy diagnosed with Cerebral Palsy is receiving occupational therapy services to increase independence during daily activities. He has been given a home exercise program with stretches and exercises for him to complete daily. He comes from an under-resourced family who is struggling financially. The OT is interested in understanding the relationship between socioeconomic status and overall adherence/effectiveness of the home exercise program.

Januka, Januka, Tsos

TSOS Interview Gallery

After being raped by a soldier in Myanmar, Januka fled to Bangladesh with her father and later found out she was pregnant. She fears no one will want to marry her because she has been raped.

Current Normative Data For Grip, Pinch, And Fine Motor Control For Pediatrics And Adults, Jackie Kaiser, Kyle Richards

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background:

Fine motor control can be measured with the Functional Dexterity Test (FDT) and the 9 Hole Peg Test (Aaron & Jansen, 2003; Oxford Grice et al., 2003). Grip and pinch strength are measured with a dynamometer and pinch gauge respectively, which are tools that measure strength in both pounds and kilograms (McQuiddy, Scheerer, Lavalley, McGarth, & Lin, 2015). The normative data for these tools from the mid-1980s is still being used in practice today and that needs to change.

Latent Sensitization In A Mouse Model Of Ocular Neuropathic Pain, Jooyoung Cho, Nicholas Bell, Gregory Botzet, Paras Vora, Benjamin J. Fowler, Renee R. Donahue, Heather M. Bush, Bradley K. Taylor, Romulo J. C. Albuquerque

Ophthalmology and Visual Science Faculty Publications

Purpose: Chronic ocular pain is poorly understood and difficult to manage. We developed a murine model of corneal surface injury (CSI)–induced chronic ocular neuropathic pain. The study focuses on changes in corneal nerve morphology and associated short- and long-term pain-like behavior after CSI.

Methods: CSI was induced in mice by local application of an alkali solution (0.75 N NaOH). Corneal nerve architecture, morphology, density, and length were studied. Eye-wiping was evaluated before and after CSI in response to hypertonic saline (2 M NaCl). Naltrexone (NTX) or Naloxone-methiodide (NLX-me), opioid receptor antagonists, were given subcutaneously (s.c., 3 mg/kg) or …

College Of Health Sciences E-Newsletter, March 2019, Irvin B. Harrell (Editor)

Ellmer College of Health Sciences Newsletters

March 2019 issue of Old Dominion University's College of Health Sciences Newsletter.

Air Quality Modelling For Ireland, Aoife Donnelly, Bruce Misstear, Brian Broderick

Reports

Air pollution is the primary environmental cause of premature death in the EU (European Commission, 2013) and the most problematic pollutants across Europe have consistently been oxides of nitrogen (e.g. nitrogen dioxide (NO₂)), particulate matter (e.g. PM₁₀, PM_2.5) and ozone (O₃). While measurements form an important aspect of air quality assessment, on their own they are unlikely to be sufficient to provide an accurate spatial and temporal description of the pollutant concentrations for exposure assessment and moreover they cannot provide information regarding future air quality. Annex XVI of 2008/50/EC requires member states …

Best Approach To Treating Distal Radius Fractures, Ashley Godawski, Caceti Dobrowolski

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background Information:

Distal Radius Fractures (wrist) are commonly caused by falling on an outstretched hand. The two treatments for distal radius fractures are surgical intervention through Open Reduction Internal Fixation (ORIF) or conservative non-surgical treatment. The ORIF surgery includes reducing the broken bone and then setting it back in place with screws, plates, rods or pins. Conservative treatment includes casting or immobilization of the wrist in order to promote natural healing.

The Effects Of A Driving Simulator On Driving-Related Skills Necessary For Adl And Iadl Function, Rebecca Pope, Haley Szpara

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background

Returning to driving is often a goal for an individual following a neurological impairment. Critical skills for success in returning to driving include intact cognition, visual, and visual-perceptual skills which are skills that are commonly compromised in individuals who have had a neurological accident. In addition, these skills are necessary for other areas of instrumental activities of daily living (IADLS), as well as activities of daily living road driving performance (Crotty & George, 2009). Emerging evidence has shown the use of driving simulator training as an intervention to increase and the generalizability this may have on ADL function and …

Benefits Of Group Therapy For Traumatic Brain Injury (Tbi), Victoria Vaughan, Kristyn Bickley

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background Information: According to the CDC:

• The economic cost of TBI in 2010, including direct and indirect medical costs, was estimated to be approximately $76.5 billion.
• Effects of TBI can include impaired thinking or memory, movement, sensation (e.g., vision or hearing), or emotional functioning (e.g., personality changes, depression).
• Those who survive a TBI can face effects that last a few days, or the rest of their lives.

Objective Measures Of Iadl Kitchen Safety Of Individuals With Cognitive And Visual Impairments, Kylie Townsley, Marisa Gonzalez

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Case Study:

72 year old woman fell donning pants, acquiring a moderate traumatic brain injury (TBI), scoring 9 on the Glasgow Coma Scale (GCS). Symptoms include confusion, headaches, memory loss, and fatigue. Comorbidities include age-related macular degeneration. She is in acute rehabilitation to be evaluated on her ability to complete kitchen tasks independently to determine her discharge plan.