Medicine and Health Sciences Commons^™

Contracture Management For Acute Burn Injury Patients, Brianna Paige Pestrosky

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: The Occupational Therapists working within the burn unit at West Penn Hospital assess and treat patients utilizing the biomechanical approach FOR, as well as the support from MOHO and PEOP. The patients seen within the burn unit encompass a variety of injuries and occupational deficits that require an individualized and holistic approach to care.

Purpose: The purpose of the contracture management project is to provide an interdisciplinary approach to improve carryover and patient care within and out of the hospital.

Theoretical framework: The contracture management project is guided using the biomechanical frame of reference as well as supporting constructs …

Comparison Between Coronally Advanced Flap With Sub-Epithelial Connective Tissue Graft And Tunnel Technique With Sub-Epithelial Connective Tissue Graft In Achieving Mean Root Coverage At Multiple Recession Defects: A Retrospective Study, Christian Daniel Davila

Graduate Theses, Dissertations, and Problem Reports (ETD)

Aim: The primary objective is to retrospectively compare the mean root coverage (MRC) achieved using a coronally advanced flap and sub-epithelial connective tissue graft (CAF + CTG) with that achieved using the tunnelling technique and sub-epithelial connective tissue graft (TUN + CTG) for the treatment of multiple recession defects. The secondary objectives are to compare the proportion of complete root coverage (CRC) achieved with CAF + CTG compared to TUN + CTG, compare the proportion of CRC achieved in these two techniques with respect to level of training (American board-certified periodontist or Graduate periodontics residents) and to evaluate the …

Proceedings Of The 11th Annual Deep Brain Stimulation Think Tank: Pushing The Forefront Of Neuromodulation With Functional Network Mapping, Biomarkers For Adaptive Dbs, Bioethical Dilemmas, Ai-Guided Neuromodulation, And Translational Advancements, Kara A Johnson, Nico U F Dosenbach, Evan M Gordon, Et Al.

2020-Current year OA Pubs

The Deep Brain Stimulation (DBS) Think Tank XI was held on August 9-11, 2023 in Gainesville, Florida with the theme of "Pushing the Forefront of Neuromodulation". The keynote speaker was Dr. Nico Dosenbach from Washington University in St. Louis, Missouri. He presented his research recently published in Nature inn a collaboration with Dr. Evan Gordon to identify and characterize the somato-cognitive action network (SCAN), which has redefined the motor homunculus and has led to new hypotheses about the integrative networks underpinning therapeutic DBS. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers, and …

Impact Of Tiered Implementation Of Clinical Decision Support System For Acute Kidney Injury And Nephrotoxin Exposure In Cardiac Surgery Patients, Christopher M. Justice Ii

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Nephrotoxin exposure may worsen kidney injury and impair kidney recovery if continued in patients with acute kidney injury (AKI).

Objective: To determine if tiered implementation of a clinical decision support system (CDSS) would reduce nephrotoxin use in cardiac surgery patients with AKI.

Methods: We assessed patients admitted to the cardiac surgery intensive care unit at a tertiary care center from January 2020 to December 2021, and August 2022 to September 2023. A passive electronic AKI alert was activated in Jul 2020, followed by an electronic nephrotoxin alert in March 2023. In this alert, active nephrotoxic medication orders resulted in …

Increasing First-Attempt Endotracheal Intubation Success Rates In The Aeromedical Environment, Jared Copeland

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem Statement: In 2022, the first-attempt endotracheal intubation success rate of an aeromedical agency had steadily declined and was currently below the international average of 88.48%. This decreased success rate potentially placed patients at risk for adverse events that increase morbidity and mortality. Background: Patients who experience a failed first-attempt intubation are at greater risk of intubation related complications. These complications include hypoxemia episodes, severe arrhythmias, pulmonary aspiration, hypotension episodes, cardiac arrest, and death. Literature Review: Preoxygenation, patient positioning, maintenance of oxygenation, drug selection, and device utilization have been found to increase first-attempt endotracheal success rates. Project Aims: The project …

The Molecular Landscape Of Sepsis Severity In Infants: Enhanced Coagulation, Innate Immunity, And T Cell Repression, Susie Shih Yin Huang, Mohammed Toufiq, Pirooz Eghtesady, Nicholas Van Panhuys, Mathieu Garand

2020-Current year OA Pubs

INTRODUCTION: Sepsis remains a major cause of mortality and morbidity in infants. In recent years, several gene marker strategies for the early identification of sepsis have been proposed but only a few have been independently validated for adult cohorts and applicability to infant sepsis remains unclear. Biomarkers to assess disease severity and risks of shock also represent an important unmet need.

METHODS: To elucidate characteristics driving sepsis in infants, we assembled a multi-transcriptomic dataset from public microarray datasets originating from five independent studies pertaining to bacterial sepsis in infant < 6-months of age (total n=335). We utilized a COmbat co-normalization strategy to enable comparative evaluation across multiple studies while preserving the relationship between cases and controls.

RESULTS: We found good concordance with only two out of seven …

Comparative Analysis Of Chemical Compounds And Metal Contaminants In Medical Grade Versus Over-The-Counter Sodium Hypochlorite Solutions, Abdulrahman Essaedi

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction:

Abstract

Endodontic treatment aims to prevent or address apical periodontitis by reducing intracanal bacterial populations to promote tissue healing, requiring thorough debridement and disinfection of the canal space. This study aims to examine the presence of trace metal elements and chemical compounds in over-the-counter (OTC) and medical-grade sodium hypochlorite (NaOCl) solutions.

Method

Over-the-counter NaOCl brands (Clorox® and Great Value®) and medical grade 6% NaOCl solutions (CanalPro® and Chlor-Xtra®) were purchased, stored in amber glass bottles, and tested in triplicate. Each was analyzed using mass spectrometry, identifying 7881 chemical compounds with statistical comparisons via adjusted p-values, fold-change, and heat maps. …

Dentin-Sealer Bond Strength. A Review: An In-Vitro Comparison Between Guttaflow 2 ®, Endosequence Bc High Flow ®, Tubli-Seal ®, Sealapex ®, And Ah Plus Jet ® Sealers., Zied Diab

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: One objective of non-surgical endodontic therapy is the formation of a hermetic seal with elimination of any portal of entry of bacteria and their byproducts into the root canal space from periapical tissue. Extensive research has been conducted to determine ideal endodontic sealers. Bioceramic sealers have risen to prominence due to reported decreased shrinkage, less toxicity, and superior bond strength to root dentin compared to zinc oxide eugenol, calcium hydroxide, and resin-based sealers. GuttaFlow2®, a new sealer on the market, is composed of calcium silicate in combination with gutta-percha particles. Researchers from Coltene (Altstätten, Switzerland), the manufacturer of GuttaFlow2® …

Improving Patient Self-Advocacy And Communication With Providers Through Diabetes Self-Management Education: Analyses From A Randomized Controlled Trial, Brenna Owens Kirk

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: West Virginia (WV), a rural state in Appalachia, has the highest type 2 diabetes mellitus (T2DM) prevalence in the United States. Open communication in the patient-provider relationship is an integral part of comprehensive chronic disease management. This is especially true for patients living with T2DM, a disease that requires many complex, daily self-management activities and is associated with increased emotional distress. However, patients living with T2DM are often reluctant to openly share their concerns regarding self-care with their provider. This study aimed to test the effectiveness of the Diabetes and Hypertension Self-Management Program (DHSMP), a 12-week group lifestyle …

Implementing A Nurse-Driven Clostridium Difficile Screening Protocol, Sandrela Magnuson

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: Clostridium difficile infection (CDI) is a prevalent infection often contracted in hospitals. CDI is also increasingly originating from community settings. In addition to the health risks associated with CDI, diagnosis of a hospital-acquired CDI can have a significant financial impact on hospital systems. When hospital acquired, hospital systems are no longer reimbursed by payers. Secondary to the increasing prevalence of community-acquired CDI, mechanisms for early detection and isolation are warranted.

Local Problem: J.W. Ruby Memorial Hospital has an integrated Clostridium difficile (C. difficile) electronic health record (EHR) screening questionnaire that requires updating to align with current guidelines.

Purpose: …

Translational Approaches To Address The Metastatic/Resistant (Mr) Phenotype Of Non-Small Cell Lung Cancer Brain Metastases, Kent L. Marshall

Graduate Theses, Dissertations, and Problem Reports (ETD)

Lung cancer remains the most frequently diagnosed malignant neoplasm shared in men and women worldwide, second only to the sexually dimorphic prostate cancer in men and breast cancer in women. Overall, lung cancer was responsible for 12.5% of new cancer cases globally in the year 2022. Of these cases, 80-85% are non-small cell lung cancer (NSCLC), a highly genotypically diverse sub-type of lung cancer. Over the past three decades, extraordinary improvement in screening, smoking cessation, early diagnosis and targeted therapy have been made, improving NSCLC survival markedly. However, as patients are surviving their primary disease better, there is a temporal …

Developing And Adapting An Art Therapy Mask Creation (Atmc) Intervention For Individuals With Traumatic Brain Injury (Tbi) Across Select Clinical And Non-Clinical Settings, Stephen John Heck

Graduate Theses, Dissertations, and Problem Reports (ETD)

The study aimed to explore the feasibility and adaptation of the Art Therapy Mask Creation (ATMC) technique in select clinical and non-clinical settings for individuals with traumatic brain injuries (TBIs). Utilizing the Consolidated Framework for Implementation Research (CFIR), qualitative interviews were conducted to assess barriers, facilitators, and feasibility of implementing the ATMC. Major findings included the ATMC’s adaptability across diverse settings, the flexibility and accessibility of art therapy as an intervention, and the significance of addressing emotional and psychological needs in individuals with TBIs. These insights contributed to understanding evolving healthcare practices, the role of technology, the importance of human …

Risk Factors Of Under-Five And Infant Mortality: An Umbrella Review Of Systematic Reviews And Meta-Analyses, Bereket Kefale, Jonine Jancey, Amanuel T. Gebremedhin, Sylvester Dodzi Nyadanu, Daniel G. Belay, Gavin Pereira, Gizachew A. Tessema

Research outputs 2022 to 2026

Background: Ensuring child survival is a critical global challenge, requiring a robust and comprehensive understanding of the risk factors contributing to under-five mortality (U5M). We aimed to synthesise and summarise the current available evidence on risk factors of U5M and infant mortality worldwide to inform global child health programmes.

Methods: We searched six major databases (Embase, Medline, Scopus, CINAHL, Web of Science, and Global Health) and repositories of systematic reviews, as well as grey literature sources to identify systematic reviews and meta-analyses that examined the associations between risk factors of U5M and infant mortality between 1 January 1990 and 4 …

The Development, Implementation And Evaluation Of A Novel Intervention For Delirium Prevention And Management In An Adult Intensive Care Unit: A Mixed Methods Study, Gideon Ugochukwu Johnson

Theses: Doctorates and Masters

Background: Delirium is a prevalent acute brain dysfunction in patients within intensive care units. Delirium is marked by a fluctuating mental state, inattention, and altered consciousness. This condition affects a substantial proportion of patients in intensive care units, and which leads to increased mortality, severe physiological and psychological consequences, and a significant economic burden on healthcare systems. Despite the evidence that supports the use of non-pharmacological interventions to prevent or minimise the impact of delirium such as orientation, sensory stimulation, early mobilisation, and family involvement, their implementation in intensive care units remains inconsistent. The involvement of family members in the …

An Athlete's Perspective: Comparing Talent Development Environments For Boys And Girls In Western Australia Youth Soccer, Mikayla J. Lyons, Jenny A. Conlon, Sophia Nimphius, Brad S. Keller, Christopher Joyce

Research outputs 2022 to 2026

This study aimed to compare the perceptions of boys and girls regarding their gender-specific talent development environments (TDEs) in state-level youth soccer. Seventy-one players (girls, n = 35; boys, n = 36) aged 11–18 years completed the Talent Development Environment Questionnaire (TDEQ-5), Sports Motivation Scale (SMS-6), Coach-Athlete Relationship Questionnaire (CART-Q), and Self-Efficacy and Outcome Expectancies (SEOE) of strength training questionnaire. Mann–Whitney U tests and Hedges’s g effect sizes were used to identify group differences. Boys scored higher for TDEQ-5 subdimensions: long-term development focus, alignment of expectations, and holistic quality preparation. For the CART-Q, boys perceived greater coach commitment, whilst girls …

Developmental Origins Of Psycho-Cardiometabolic Multimorbidity In Adolescence And Their Underlying Pathways Through Methylation Markers: A Two-Cohort Study, Priyanka Choudhary, Justiina Ronkainen, Jennie Carson, Ville Karhunen, Ashleigh Lin, Phillip E. Melton, Marjo-Riitta Jarvelin, Jouko Miettunen, Rae-Chi Huang, Sylvain Sebert

Research outputs 2022 to 2026

Understanding the biological mechanisms behind multimorbidity patterns in adolescence is important as they may act as intermediary risk factor for long-term health. We aimed to explore relationship between prenatal exposures and adolescent’s psycho-cardiometabolic intermediary traits mediated through epigenetic biomarkers, using structural equation modeling (SEM). We used data from mother–child dyads from pregnancy and adolescents at 16–17 years from two prospective cohorts: Northern Finland Birth Cohort 1986 (NFBC1986) and Raine Study from Australia. Factor analysis was applied to generate two different latent factor structures: (a) prenatal exposures and (b) adolescence psycho-cardiometabolic intermediary traits. Furthermore, three types of epigenetic biomarkers were included: …

Effect Of Sampling Frequency On A Unilateral Isometric Hamstring Strength Assessment Using Force Plates, Nicholas J. Ripley, J. J. Mcmahon, Paul Comfort

Research outputs 2022 to 2026

The purpose of this study was to determine the effect of sampling frequency on the 90–90° (90-degrees hip and knee flexion) isometric hamstring assessment. Thirty-three elite female soccer players (age: 18.7 ± 3.7 years; height: 158.3 ± 5.9 cm; body mass: 62.8 ± 5.5 kg) performed three unilateral trials on a single occasion of the 90–90° isometric hamstring assessment. Force-time data were collected using force plates at 1000 Hz and down sampled to 500-, 250-, and 100 Hz. Peak force (N), force (N) at 100- and 200 ms and average rate of force development (aRFD) (N/s) over a 100- and …

How Do Professional Connections And Relationships Impact Midwives’ Well-Being And Career Sustainability? A Grounded Theory Study Protocol, Lynnelle Moran, Sara Bayes, Kim Foster

Research outputs 2022 to 2026

Significant attrition and projected workforce shortages within the midwifery profession are global issues. Extensive research has identified that high levels of workplace adversity, chronic stress, and increasing rates of vicarious trauma and moral injury experienced by midwives, underpin this situation. Researchers have explored midwives’ intention to stay in the midwifery workforce and identified ways to support students’ transition to professional practice. Supportive collegial relationships have been reported to be protective for new and early career midwives’ well-being and resilience. However, there is a gap in knowledge and understanding of the impact and significance of professional connections and relationships for midwives …

Mitigating Intensive Care Unit Noise: Design-Led Modeling Solutions, Calculated Acoustic Outcomes, And Cost Implications, Emil E. Jonescu, Benjamin Farrel, Chamil E. Ramanayaka, Christopher White, Giuseppe Costanzo, Lori Delaney, Rebecca Hahn, Janet Ferrier, Edward Litton

Research outputs 2022 to 2026

Objectives, Purpose, or Aim: The study aimed to decrease noise levels in the ICU, anticipated to have adverse effects on both patients and staff, by implementing enhancements in acoustic design. Background: Recognizing ICU noise as a significant disruptor of sleep and a potential hindrance to patient recovery, this study was conducted at a 40-bed ICU in Fiona Stanley Hospital in Perth, Australia. Methods: A comprehensive mixed-methods approach was employed, encompassing surveys, site analysis, and acoustic measurements. Survey data highlighted the importance of patient sleep quality, emphasizing the negative impact of noise on work performance, patient connection, and job satisfaction. Room …

Parent Implementation Of A Treatment For Late Talkers Based On Cross-Situational Statistical Learning Principles: Treatment Fidelity And Acceptability, Suzanne J. Meldrum, Jennifer Fisk, Jennifer Stopher, Emily F. Hunt

Research outputs 2022 to 2026

Purpose:

Early intervention based on principles of cross-situational statistical learning (CSSL) for late-talking children has shown promise. This study explored whether parents could be trained to deliver this intervention protocol with fidelity and if they found the intervention to be acceptable.

Method:

Mothers of four English-speaking children aged 18–30 months who scored < 10th centile for expressive vocabulary were recruited to an 8-week group training program. Parents were taught principles of CSSL and asked to perform 16 home treatment sessions (30 minutes each) in total, providing auditory bombardment of target words in full sentences at high dose number and syntactic variability, using a range of physical exemplars. Home diaries and two videotaped sessions measured treatment fidelity. Pre- and post-treatment questionnaires measured acceptability. Result: One parent discontinued the study after the second group training session. Three parents completed 15/16 group training sessions and reported completing 87% of home sessions. Two parents demonstrated implementing the intervention as per the target dose number by the first fidelity session (Weeks 2/3), and the third parent was very close to meeting target dose number by the second fidelity session (Weeks 7/8).

Conclusion:

Parents can be trained to deliver an intervention based on cross-situational statistical learning principles.

Parents’ Experiences Of Their Child’S Best Interests During A Hospital Stay In Australia, Angela A. Quaye, Mandie Foster, Lisa Whitehead, Inger K. Hallström

Research outputs 2022 to 2026

Determining the child’s best interests in a hospital setting will ideally involve the combined views of children, parents, and healthcare professionals. However, few studies have explored parents’ experiences of their child’s best interests when they engage with the healthcare system. Therefore, this study aimed to explore parents’ experiences of their child’s best interests during hospitalisation. A descriptive qualitative inductive design using face-to-face parent–child combined interviews, analysed by latent content analysis, was used. Sixteen parents recruited from a tertiary hospital in Western Australia were interviewed. Collaboration, development of trustworthy relationships, and effective communication were essential in shaping parents’ experiences of their …

Physical Health Of People With Mental Illness: A Snapshot Of Consumer Engagement In The Provision Of Care In Primary Care., Irene Ngune, Dianne Wynaden, Karen Heslop

Research outputs 2022 to 2026

Primary care is crucial to the health of people with mental illness. However, there is limited information on their reported engagement in this setting. This study surveyed 100 people with mental illness who had a general practitioner or a general practitioner and a case manager from a tertiary mental health service to determine their engagement level with their GP and what interventions they received to manage their health. Forty-four per cent had their psychotropic medications primarily prescribed by their GP, and 58% reported visiting their GP for physical health problems. Ninety-four point nine percent of participants aged 50 years and …

Vulnerable, Recalcitrant And Resilient: A Foucauldian Discourse Analysis Of Risk And Older People Within The Context Of Covid-19 News Media, Marjorie Skoss, Rachel Batten, Patricia Cain, Mandy Stanley

Research outputs 2022 to 2026

Risk is an innate and integral part of everyday life and is present in simple, everyday occupations and complex actions. Age-related stereotypes can mean older people have little opportunity to engage in activities that present some degree of risk. The present study explores the discourse around risk and older people in the context of the COVID-19 pandemic. We investigated news media as a reflection of the dominant public discourse around older people's behaviour to identify how risk is represented in relation to occupational engagement. Texts relating to older people and COVID-19 were sourced from the West Australian newspaper for a …

Transcriptional Precision In Photoreceptor Development And Diseases - Lessons From 25 Years Of Crx Research, Yiqiao Zheng, Shiming Chen

2020-Current year OA Pubs

The vertebrate retina is made up of six specialized neuronal cell types and one glia that are generated from a common retinal progenitor. The development of these distinct cell types is programmed by transcription factors that regulate the expression of specific genes essential for cell fate specification and differentiation. Because of the complex nature of transcriptional regulation, understanding transcription factor functions in development and disease is challenging. Research on the

Pathways To Health: Linking Accessible Green Space To Improved Health And Well‐Being In Rural Appalachia., Udday Shankur Datta

Graduate Theses, Dissertations, and Problem Reports (ETD)

Green spaces are essential for our physical health. The quality of its green space often determines the health of a community. The presence of green space in our lives is associated with reduced stress levels, better sleep, and increased feelings of safety. Lack of access to green space can lead to many health issues, such as high blood pressure, diabetes, and cardiovascular diseases, and has been linked to obesity and physical inactivity.

The Appalachian Regional Commission (ARC) defines Appalachia as a region covering 420 counties across 13 states in the eastern United States. A large part of this region is …

From Taboo To Legalization: Cannabis’S Complex Role During Crucial Maternal And Child Health Periods, Emmanuela Nwaonumah, Alisha Riggins, Sarah Sejoro, Joanne Chopak-Foss, Logan Cowan

Eagles Talking About the Public’s Health

No abstract provided.

Cultural Competency And “The Space Between Spaces”, Charles Wright, Ho-Jui Tung

Eagles Talking About the Public’s Health

No abstract provided.

Faculty Mentoring Of High School Students: Exploring Benefits And Drawbacks, Riya Daftari, Yelena Tarasenko

Eagles Talking About the Public’s Health

No abstract provided.

Cheers To Change: How Gen-Z Is Redefining Drinking Culture, Savannah Steedley, James Thomas

Eagles Talking About the Public’s Health

No abstract provided.

Sirtuin3 Ensures The Metabolic Plasticity Of Neurotransmission During Glucose Deprivation, Anupama Tiwari, Arsalan Hashemiaghdam, Marissa A Laramie, Dario Maschi, Tristaan Haddad, Marion I Stunault, Carmen Bergom, Ali Javaheri, Vitaly Klyachko, Ghazaleh Ashrafi

2020-Current year OA Pubs

Neurotransmission is an energetically expensive process that underlies cognition. During intense electrical activity or dietary restrictions, the glucose level in the brain plummets, forcing neurons to utilize alternative fuels. However, the molecular mechanisms of neuronal metabolic plasticity remain poorly understood. Here, we demonstrate that glucose-deprived neurons activate the CREB and PGC1α transcriptional program, which induces expression of the mitochondrial deacetylase Sirtuin 3 (Sirt3) both in vitro and in vivo. We show that Sirt3 localizes to axonal mitochondria and stimulates mitochondrial oxidative capacity in hippocampal nerve terminals. Sirt3 plays an essential role in sustaining synaptic transmission in the absence of glucose …