Medicine and Health Sciences Commons^™

An Exploration Of Experiences That Influence Occupational Therapy Students' Motivations To Pursue Occupational Therapy As A Career, Kayla-Marie Bartolome Gigante, Alyssa Cantrell, Michelle Nguyen, Garrett Teagarden

Occupational Therapy | MSOT Capstone Projects

Occupational therapy (OT) is a client-centered healthcare profession that uses therapeutic activities to increase an individual’s, group’s, or population's participation in meaningful activities, otherwise known as occupations. The general underlying factors that motivate one’s decision to choose this career path is well established within the existing literature. However, research into the experiences of students working alongside an occupational therapist (OT) prior currently faces a significant gap. The aim of this study is to identify and understand what first-hand experiences of OT brought OT students to pursue a career in occupational therapy. Through the lens of narrative inquiry, participants were given …

Transgender College Student Equity And Inclusion Program, Allison Quintilla, Benji Harrington

Occupational Therapy | MSOT Capstone Projects

Understanding the inequities experienced by Transgender college students on university campuses is fundamental to promoting the occupational engagement of Transgender individuals. The Transgender community in the United States (U.S.) today is more widely varied and accepted than ever before in the recorded history of post-European colonialization of this country (Beemyn, 2014). Dowers, White, Kingsley and Swenson (2019) explain the risk for increased occupational injustice for Transgender college students due to their complex experience of occupations and the influencing factors. Current research has significant gaps in our understanding of how to counteract the effects of occupational injustice for Transgender college and …

Omega-3 Fatty Acid Fortification Of Marinara Sauce, Hannah Collie

Undergraduate Honors Theses

In westernized culture, there is a deficit of healthy fats in the average person’s diet. Decreased intake of omega-3 fatty acids has been correlated to many different conditions such as cardiovascular disease, cancer, and chronic inflammatory issues. The “Mediterranean Diet” has been proposed as an ideal way to combat these issues. This diet promotes fish as a protein source and as a way to increase intake of essential polyunsaturated fatty acids. Due to location and dietary trends, fish is less often the main component of Northeast Tennessee's diet. This study investigated ways to fortify a more commonly consumed food in …

Long-Term Patient-Reported Outcomes And Patient-Reported Outcome Measures After Injury: The National Trauma Research Action Plan (Ntrap) Scoping Review, Juan P. Herrera-Escobar, Samia Y. Osman, Sophiya Das, Alexander Toppo, Claudia P. Orlas, Manuel Castillo-Angele, Angel Rosario, Mahin B. Janjua, Muhammad Abdullah Arain, Adil H. Haider

Section of General Surgery

Background: The aim of this scoping review is to identify and summarize patient-reported outcome measures (PROMs) that are being used to track long-term patient-reported outcomes (PROs) after injury and can potentially be included in trauma registries.
Methods: Online databases were used to identify studies published between 2013 and 2019, from which we selected 747 articles that involved survivors of acute physical traumatic injury aged 18 years or older at time of injury and used PROMs to evaluate recovery between 6 months and 10 years postinjury. Data were extracted and summarized using descriptive statistics and a narrative synthesis of the results. …

Role Of Intra-Operative Ultrasound In Brain Tumour Surgeries, Mohammad Hamza Bajwa, Saqib Kamran Bakhshi, Muhammad Shahzad Shamim

Section of Neurosurgery

The use of intra-operative ultrasound remains a largely underutilized option in brain tumour surgeries. The widespread availability of neuronavigation may be the reason why such a useful modality has become less popular even though recent advances in ultrasound technology have greatly improved its utility. The available literature also clearly shows that it offers additional advantages especially when used with neuronavigation. Herein the authors have briefly touched upon the available literature on the role of intraoperative ultrasound in brain tumour surgeries.

Body Positivity: Coping With Stress And Exams, Bellas

Body Positivity

No abstract provided.

Nutrition And Gym: Maintaining Body Positivity, Bellas

Body Positivity

No abstract provided.

Medication And Pharmacy-Related Outcomes As Part Of The Seniors At Risk For Falls After Emergency Room Visit (Safer) Project, Hyesoo Chae, Sharon Leigh, Colleen M Casey

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2021

Background

The United States is comprised of an aging population; adults over the age of 85 are the fastest-growing age group in the United States and will reach approximately 9 million in 2030.1 25% of patients ≥ 65 years old in the United States report falling each year.1 There are over 3 million emergency department visits related to falls in the United States, totaling approximately 50 billion dollars in total medical expenditures.2 Falls are a major threat for older adults as they can lead to increased risk of further injury, loss of independence, decreased mobility, and premature death.1,2 Despite numerous …

Review Of Prophylactic Anticoagulation Strategies And Outcomes For Covid-19 Patients (Research In Progress), Caleb Galindo, Pamela Levine, Melanie Geer

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2021

Background

In March of 2020, the World Health Organization (WHO) declared the spread of COVID-19 a global pandemic. •Though largely considered a respiratory disease, research continues to demonstrate additional impacts of COVID-19 on other organ systems.2, 3 •A key characteristic of COVID-19 is marked inflammation leading to hypercoagulability.2, 3, 6 •Infected patients are at a higher risk of developing thromboembolic events (VTE and stroke) compared to healthy adults. 2, 3, 6 •Some clinicians have trialed varying anticoagulation strategies for patients with COVID-19 based on coagulation parameters such as D-dimer.4, 5, 6 •Multiple expert groups have released preliminary guidance on anticoagulation …

Evaluation Of Medication History Technician (Mht) Expansion At A Large Tertiary Medical Center, Sarah Auer, Rochelle Castrillo, Tony Lucchi

Providence Pharmacy PGY1 Program at Providence Milwaukie and Providence Newberg Medical Centers 2021

Background

• The yearly joint commission National Patient Safety Goals for 2020 and 2021 stress the importance of using medications safely which includes an emphasis on medication reconciliation and decreasing medication discrepancies. 1,2 o Pharmacy Medication History Technicians (MHTs) work as an integral part of the medication reconciliation process to gather complete medication histories o The goal of medication reconciliation is to decrease medication discrepancies  decreased medication related adverse events  improve patient outcomes • Pharmacist run medication reconciliation programs have shown decreased medication errors by over 80% when compared to standard medication reconciliation performed by nurses or other …

The Requirements Of Immunosuppressive Therapy And Clinical Features In Patients With Myasthenia Gravis Who Undergo Thymectomy Versus Non Thymectomy Management In East Africa, Nyawara Anthony Ochola

Master of Medicine in Internal Medicine

Background: Myasthenia gravis is an acquired autoimmune neuromuscular disease leading to fatigability of skeletal muscles. The thymus produces autoantibodies that target receptors to Acetylcholine or Muscle Specific Kinase. The resultant fatigability is generalized or limited to the ocular or bulbar muscles. Therapy has been targeted to reduce the autoimmune process by use of immunosuppressive agents or by thymectomy. In the African population, MG involves younger patients, more ocular involvement, is more aggressive and more resistance to immunosuppressive therapy. Methods: We conducted a retrospective study between January 2009 and December 2019 at Aga Khan University Hospital, Nairobi. Medical records of patients …

Characterization Of Young Hypertensive Patients Aged Between 18 – 40 Years, Kelvin Orare Nyanchoka

Master of Medicine in Internal Medicine

Background: Hypertension is the world’s most significant risk factor for morbidity and mortality. Sub-Saharan Africa has the highest prevalence of hypertension worldwide. In Kenya, the estimated overall prevalence of hypertension is at 24.5%. Young adult hypertensive patients have a lower proportion of controlled blood pressure compared to older adults. Uncontrolled hypertension, irrespective of age, increases cardiovascular risk. Methods: A total of 401 patients aged between 18 and 40 years were identified from the records department based on the ICD-10 codes for hypertension. Using their hospital identification numbers, files were sorted and analyzed including laboratory data on the hospital information management …

Bleeding Complications In Patients On New Oral Anticoagulants For Venous Thromboembolism In Kenya, Antonina Zebby Obayo

Master of Medicine in Internal Medicine

Background: The past five years have seen an increase in the use of new oral anticoagulants (NOACS) for treatment and prophylaxis against venous thromboembolism. These agents are as effective as warfarin, with much fewer bleeding complications. The incidence of bleeding complications in patients with venous thromboembolism on NOACS (New oral anticoagulants) has not been widely studied in Africa's contemporary practice. The purpose of this study is to determine the rates of major bleeding and clinically relevant non-major bleeding (CRNM) associated with new oral anticoagulant use in daily contemporary clinical practice. Methods: A retrospective review of adult patients diagnosed with venous …

Neonatal Toxic Stress And Long-Term Neurodevelopment In Premature Infants, Rachelle Sey

Dissertations

Background: Evidence suggests the presence of complex biologic connections between the social environment, neurologic development, and long-term health. Premature infants spend many months in the Neonatal Intensive Care Unit (NICU) often separated from their parent(s). Decrease in the age of viability threshold allows extremely preterm infants to benefit from lifesaving therapies; however, they are frequently exposed to significant stressors that increase their risk for adverse neurodevelopmental outcomes.

Purpose: The purpose of this study is to examine the relationship among socio-demographic factors, exposure to stressors in the NICU environment, stress modifiers/buffers, neonatal morbidities at discharge, and 1. 2-year neurodevelopmental outcomes and …

Molecular And Genetic Studies Of Robo2 Transcriptional Regulation In The Central Nervous System Of Drosophila Melanogaster, Muna Abdal Rahim Abdal Rhida

Graduate Theses and Dissertations

Drosophila Robo2 axon guidance receptor is a member of the evolutionarily conserved Roundabout (Robo) protein family that is involved in directing axons that cross the midline to the other side of the animal body. Robo2 roles mainly depend on two factors: The functional domains of the Robo2 protein, which is extensively studied, and the dynamic transcription of robo2 in various subsets of cells throughout embryogenesis which is not fully understood. Thus, knowing robo2 enhancers that transcriptionally regulate robo2 during embryogenesis is significant. To investigate robo2 potential enhancers, we screened 17 transgenic lines of Drosophila that were generated by Janelia Research …

Facilitating Implementation Of In-Room Whiteboards In The Skilled Nursing Environment Using The Parihs Framework, Ashley Lubbers

Dissertations

The application of research to practice is a difficult task to successfully carry out for many healthcare professionals and organizations. The Promoting Action on Research Implementation in Health Services (PARIHS) framework is a tool that acts as an implementation guide for translating research evidence to practice. This study explored the use of an adapted version of the PARIHS framework as a guide to implementing in-room whiteboards in a skilled nursing facility (SNF) on their short-term rehabilitation wing. While the utility of in-room whiteboards has been demonstrated in the acute care setting, there are few studies of their use in SNFs. …

Psychological Wellbeing And Sense Of Community Among African Americans: Does Purpose In Life Matter?, Yatesha D. Robinson

Dissertations

This dissertation examined the relationships between sense of community, purpose in life, and psychological wellbeing among African Americans. It investigated whether purpose in life moderated the relationship between sense of community and psychological wellbeing. Although previous studies have linked a sense of community and purpose in life with wellbeing, few studies have examined these relationships among African Americans using a multidimensional model. The data for the current analysis were drawn from the third wave of the National Survey of Midlife Development in the United States study (MIDUS 3), collected between 2013–2014. The sample included 98 African American men (n …

The Neuroanatomical, Neurochemical, And Phenomenological Correlates Of Social Bonding, Empathy, And Flow In Music Improvisation, Edward A. Roth

Dissertations

The three studies in this dissertation explore the biological and phenomenological under-pinnings of music improvisation related to bonding, empathy, and flow. Musical improvisation is a multi-dimensional behavior encompassing motor, cognitive, affective, and often social domains, and as such, it is reasonable to consider that music improvisation shares many characteristics with other forms of non-musical extemporaneous behavior, such as carrying on a verbal dialogue. The primary aims of this three-study dissertation were to (1) determine the feasibility of the study designs and interdisciplinary methods; (2) examine potential differences in the neuroanatomical and neurophysiological correlates of improvisation between non-musicians and musicians; and …

A Study Of Communication Practices Between Office And Field-Based Personnel In Home Healthcare Agencies, Ruth M. Bates-Hill

Dissertations

The population of developed countries is rapidly aging. People want to age in their residence, and as they advance in years, most people will need assistance with activities of daily living and perhaps medical assistance to remain at home. Home health aides provide a large portion of such care. However, the annual turnover rate of home health aides exceeds 60% due to factors such as low wages, poor benefits, and a challenging work environment. Many studies have been conducted to elucidate the factors contributing to job satisfaction in the home health aide population, yet despite decades of research, turnover among …

On Prediction Of Early Signs Of Alzheimer’S— A Machine Learning Framework, Abdalrahman Alsaedi

Dissertations

Dementia is a collective term used to indicate a loss of memory functions with the presence of at least one additional loss of a major cognitive ability that hinders a person’s previous level of functioning. Studies show that dementia is highly age- associated and that the most common cause of dementia is Alzheimer’s disease. Early recognition of Alzheimer’s disease, before irreversible damage to the brain has already occurred, is paramount to slowing or preventing the disease. Therefore, algorithms for the prediction of early signs of dementia are essential. Machine learning approach has been reported to use several data sources such …

Parental Knowledge And Attitudes Towards Food Allergy, Namuli Jane Francis

Master of Medicine in Paediatrics and Child Health

Background: Food allergy and other allergen-induced diseases are an increasing problem globally. This has been documented in studies done in Western countries as well as some parts of Africa. The prevalence of food allergy is highest during the first 2 years of life. For allergen-induced illness, avoidance of triggers and prevention of fatal reactions are the mainstay of treatment. Unnecessary withdrawal of suspected protein-rich foods at a time that is critical for children’s growth may lead to malnutrition and its related complications. This study aimed to understand the gaps in knowledge and misconceptions about food allergy among parents as these …

Impact Of Pharmacist Led Provider Education On Outpatient Copd Management, Erica Dominguez, Ben Rosati, Trevor Laursen

Providence Pharmacy PGY2 Program at Providence Medical Group 2021

Purpose

To evaluate the efficacy of provider education on adherence to guideline directed therapy in outpatient chronic obstructive pulmonary disease (COPD) management in South Oregon PMG clinics.

Background

• COPD is the third most common cause of death in the US • The CDC reports costs attributable to COPD in 2010 were $32.1 billion projected to have increased to $49 billion by 2020 • Direct healthcare costs include detection, prevention, physician office visits, hospitalizations, home care, and medications hospitalizations accounting for about 45 50% of these direct costs • Clinical burden of uncontrolled COPD has been shown to impact quality …

The Study Of High Intensity Interval Training's Effect On Enjoyment, Keali Mari

Theses/Capstones/Creative Projects

This study assessed participant’s level of enjoyment in high-intensity training over moderate intensity-training. High intensity interval training is defined as short bouts of exercise performed at a near-maximal effort with rest periods or light activity in between. High intensity interval training involves repeatedly exercising at a high intensity for 30 seconds to several minutes, separated by 1-5 minutes of recovery. This type of exercise has sparked the interest of many active people due to its decreased time commitment and the benefits it elicits. The results of this study show that high intensity interval training induces a higher enjoyment rate pre- …

Power Training Improves The Sensorimotor Cortical Oscillations In Youth With Cerebral Palsy, Morgan Busboom, Anna Reelfs, Mike Trevarrow, Brad Corr, Heidi Reelfs, Sarah Baker, Hannah Bergwell, Tony W. Wilson, Max J. Kurz

Child Health Research Institute Pediatric Research Forum

Background: Our magnetoencephalographic (MEG) brain imaging studies have shown that youth with cerebral palsy (CP) demonstrate altered sensorimotor beta (18-24Hz) cortical oscillations when controlling their leg motor actions and these anomalous cortical oscillations are linked with the extent of their mobility impairments. Current therapeutic trends for improving mobility have shifted from strength training to high-velocity power training, which has shown improvements in isokinetic strength, power production and mobility of youth with CP. However, no studies have assessed whether these clinically relevant improvements are linked with changes in the sensorimotor cortical oscillations. The objective of this study was to utilize MEG …

Novel Mouse Model For Analysis Of Macrophage Function In Neuroblastoma, Gabrielle L. Brumfield, Shelby M. Knoche, Alaina C. Larson, Brittany Poelaert, Benjamin T. Goetz, Poomy Pandey, Don W. Coulter, Joyce C. Solheim

Child Health Research Institute Pediatric Research Forum

Background: Neuroblastoma is the third most common childhood cancer and accounts for 12% of cancer-associated deaths in children under the age of 15. Patients with high risk neuroblastoma have a poor 5-year survival rate of less than 50%. Neuroblastoma tumors treated with the histone deacetylase inhibitor (HDACi) vorinostat have increased infiltration of macrophages with upregulated immune cell-surface receptors. Neuroblastoma cells release VEGF and M-CSF, which may alter intratumoral macrophage populations. VEGF has also been implicated in alteration of amyloid precursor protein family processing. Our lab demonstrated that amyloid precursor protein 2 (APLP2), a member of the amyloid precursor protein …

Evaluation Of Brain Cholesterol Metabolism After Neonatal Hypoxic-Ischemic Brain Injury, Amanda Dave, Luke Allen, Zeljka Korade, Eric Peeples

Child Health Research Institute Pediatric Research Forum

Introduction

Neonatal hypoxic-ischemic brain injury (HIBI), resulting from impaired cerebral blood flow and oxygen delivery to the brain, affects at least 1.5 per 1,000 live births each year in the United States. Altered levels of cholesterol and cholesterol metabolites have been identified in brain tissue and in serum after adult brain injury such as traumatic brain injury and stroke. We hypothesized that there would be temporal and brain region-specific alterations in cholesterol and sterol precursors after neonatal HIBI.

Methods

Postnatal day 9 CD1 mouse pups were anesthetized with isoflurane and randomized to HIBI induced by carotid artery ligation or controls …

Comparison Of Postoperative Pain Scores Following Bilateral Erector Spinae Versus Bilateral Transversus Abdominis Plane Blocks In Parturients Undergoing Elective Caesarean Delivery Under Spinal Anaesthesia At The Aga Khan University Hospital, Nairobi, Rawlings Thuranira

Master of Medicine in Anaesthesiology

Background: Good pain control following lower segment caesarean section (LSCS) is essential to facilitate early mobilization and to enable adequate care of the new-born by the mother. Inadequate analgesia after caesarean delivery has been associated with increased incidences of deep venous thrombosis, chronic pain, greater opioid use and postpartum depression. Peripheral or trunk nerve blocks have become popular as part of a multimodal approach, together with opioids and non-steroidal analgesics, in controlling post caesarean pain. While the transversus abdominis plane (TAP) block has emerged in recent years as the most widely performed block for post caesarean pain the novel erector …

Randomised Trials At The Level Of The Individual, Jay J H. Park, Nathan Ford, Denis Xavier, Per Ashorn, Rebecca F. Grais, Zulfiqar Ahmed Bhutta, Herman Goossens, Kristian Thorlund, Maria Eugenia Socias, Edward J. Mills

Centre of Excellence in Women and Child Health

In global health research, short-term, small-scale clinical trials with fixed, two-arm trial designs that generally do not allow for major changes throughout the trial are the most common study design. Building on the introductory paper of this Series, this paper discusses data-driven approaches to clinical trial research across several adaptive trial designs, as well as the master protocol framework that can help to harmonise clinical trial research efforts in global health research. We provide a general framework for more efficient trial research, and we discuss the importance of considering different study designs in the planning stage with statistical simulations. We …

Reducing Alarm Burden By Promoting Judicious Ordering Of Continuous Pulse Oximetry, Kathleen Berg, David Johnson, Ginny Nyberg, Andrew Ausmus, Christine Claeys, Emily Wilkinson, Nicholas Clark

Presentations

Background: Overutilization of continuous pulse oximetry (CPO) contributes to overdiagnosis and prolonged supplemental oxygen utilization. It may also negatively impact patient sleep, mobility, length of stay (LOS), and cost. Response times to actionable alarms increase with the number of non-actionable alarms. Our baseline data revealed an average of 29.6 pulse oximetry monitor alarms sounded for each admitted patient each day of their hospitalization. Most notably, 38.7% of pulse oximetry alarms were for ≥88% which is generally considered non-actionable.

Objective: We aimed to decrease both total pulse oximetry alarms per patient day and alarms for ≥88% per patient day by 20%, …

Temperature-Dependent Macrophage Activity In Rainbow Trout, Danica Mcgrevey

Biological Sciences Undergraduate Honors Theses

Fever is an essential component of the immune response. Fever enhances immune responses as well as creates an environment in which the body has advantages over pathogens. Macrophages are often the first cells that come in contact with pathogens, as they reside in tissues. They are important for their engulfment of pathogens that results in the digestion of the pathogen, but they also produce nitric oxide and cytokines that contribute to immune response in a variety of ways, including initiating adaptive immunity and directing the production and activity of other immune cells. We were curious about macrophages from other temperature …