An Investigation Into The Nature Of The Knee Pain Experience In People With Knee Osteoarthritis, Gemma Mary Orange

Theses

Knee osteoarthritis poses a substantial and escalating socioeconomic burden globally, exacerbated by demographic trends towards an aging population, sedentary lifestyles and increasing obesity rates. Defined by knee pain and functional limitations (Wood et al., 2023; Zhang, Doherty, et al., 2010), traditional approaches have viewed knee OA related pain and disability primarily through a biomedical lens, linking symptoms directly to structural damage and advocating surgical interventions such as total knee arthroplasty to address presumed causative pathology (Bunzli et al., 2019; Darlow et al., 2018). Despite the capacity of surgery to ameliorate structural pathology, patient centred outcomes vary considerably. Up to 30% …

The Impact Of Treatment Dosage On Cognitive-Linguistic Outcomes Of Patients With Aphasia: An Investigation Of Three Service Delivery Models, Adele J. Derendinger

Graduate Student Theses, Dissertations, & Professional Papers

This study addresses the gap in literature by directly comparing the effectiveness of Intensive Comprehensive Aphasia Programs (ICAPs) and modified ICAPs (mICAPs) to usual care service delivery models for people with aphasia. Through a prospective study design, cognitive-linguistic function change scores across different service delivery models were examined. The findings reveal significant within-group improvements in cognitive-linguistic function for participants in ICAPs, with some improvement seen in mICAPs and usual care conditions. Intensive models demonstrated greater improvement compared to non-intensive usual care models, particularly evident in the Western Aphasia Battery – Revised and the Boston Naming Test – Second Edition. …

Perspectives On Using Pharmacogenomics To Guide Tobacco Cessation: Survey Results From An American Indian Community, Daniela Mariana Wall

Graduate Student Theses, Dissertations, & Professional Papers

Pharmacogenomics research has predominantly focused on populations of European ancestry, limiting the application for diverse populations such as American Indian and Alaska Native (AIAN) communities. Our community-centric study aims to understand perspectives of utilizing pharmacogenomics to guide tobacco cessation in an AIAN community using a survey with qualitative and quantitative components. We assessed participant (n=273) tobacco usage and cessation history, pharmacogenomics knowledge, and perceptions of utilizing pharmacogenomics in the context of tobacco cessation. We found that the majority of participants (92%) were aware of risks associated with tobacco usage and believe it to be a problem within their community (76%). …

The Relationship Between Moral Thought-Action Fusion And Scrupulosity Across Judaism, Christianity, And Islam, Kelsey Evey

Graduate Theses, Dissertations, and Problem Reports (ETD)

Scrupulosity is a subtype of obsessive-compulsive disorder (OCD) where individuals are upset by intrusive thoughts related to religious or moral issues. Current research suggests that scrupulosity occurs across the major world religions—including the Abrahamic religions (i.e., Judaism, Christianity, and Islam). Some research suggests that moral thought-action fusion (moral TAF), a dysfunctional belief that thinking something is equal to doing it, may only be pathological under certain circumstances (e.g., if it is not culturally normative). If this is true, the current cognitive model of scrupulosity may need to be amended to reflect how cultural differences impact the role of moral TAF …

The Impact Of Normal Growth On The Ap Relationships Of The Jaws And Incisors To The Forehead: A Serial Cephalometric Analysis Of Untreated Individuals, Adam Joseph Rudmann Dr

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

The Impact of Normal Growth on the AP Relationships of the Jaws and Incisors to the Forehead: A Serial Cephalometric Analysis of Untreated Individuals

Adam Rudmann D.D.S. M.S.

Background and Objectives

Growth of the craniofacial complex is a critical factor to consider when treatment planning an orthodontic case. The ability to predict how the forehead and jaws will change over time depends on the ability to find predictable landmarks either radiographically or clinically, and use them to gauge the relative growth of various facial structures. This data can then be integrated with other diagnostic information such as occlusion and …

E-Cigarette Aerosol’S Effect On The Force Degradation Of Elastomeric Chain: An In Vitro Study, Joshua D. Lokant

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

E-Cigarette Aerosol’s Effect on the Force Degradation of Elastomeric Chain: An in Vitro Study

Joshua Lokant D.D.S.

Background and Objectives

Orthodontic elastomeric chain is used in orthodontic treatment for various applications such as closing spaces, aligning teeth, correcting midlines, promoting even spaces, and retracting teeth. Ideally, this force is light, continuous, and maintains a constant force between orthodontic appointments. There are many companies that manufacture polyurethane power chain, and their proprietary formulas give rise to different force levels and constancy of force. When the power chain is in the mouth, it is subject to food, liquids, temperature changes, pH …

Effectiveness Of Peer Support Groups For Mothers At Risk For Postpartum Depression, Natalie Paige Gates

Graduate Theses, Dissertations, and Problem Reports (ETD)

Motherhood requires a role transition, new maternal responsibilities, and changes in everyday life, which can impact the mother’s mental health, possibly leading to postpartum depression. Postpartum depression can, in turn, create additional challenges for the mother in engaging in her daily routines and occupations. Therefore, a peer support group for mothers at risk for postpartum depression was developed in hopes of improving the mothers’ management of routines, ultimately improving maternal mental health. The effectiveness of the peer support group was measured through quantitative and qualitative online self-report surveys, where the mothers reported their current mental health status, self-efficacy, and occupational …

Dance Intervention For Stroke Rehabilitation: Restoring Occupational Performance Through Creative Movement, Olivia Paige Allen

Graduate Theses, Dissertations, and Problem Reports (ETD)

Thousands of individuals are affected by cerebral vascular accidents, (CVA), also known as strokes in the United States each year, (CDC, 2023). Cerebral vascular accidents are one of the leading causes of death among the elderly population in the U.S. each year, (NIH et al., 2023). The deficits caused by a CVA can be global, from hemiparetic limbs and sensory loss to psychosocial impacts on an individual and their support system. In occupational therapy, the goal is to regain as much function and independence as possible for the individual who has experienced a CVA. Although many evidence-based intervention tools are …

Community Resource Programs Impact On Marginalized Communities Access To Health Care Services: A Program Development Project, Alexis N. Foehrkolb

Graduate Theses, Dissertations, and Problem Reports (ETD)

Caring for children and meeting their needs comes with a variety of considerations regarding temperament, developmental progress, and socioeconomic impact. For children with special healthcare needs (CSHCN), those considerations become more complex. Community resource programs are designed to help families of CSHCN get access to the resources they need regarding general and healthcare services. A program was developed in collaboration with Parents Place of Maryland (PPMD) to create materials effective in educating parents of CSHCN on desired topics of interest, create a virtual environment where parents felt safe asking questions regarding specific topics of interest, and determine the most effective …

Machine Learning And Rna Bioinformatics, Jason Rafe Miller

Graduate Theses, Dissertations, and Problem Reports (ETD)

The applied science of bioinformatics encompasses computational analysis of molecular biology data. Advances in genomics and DNA sequencing technology have enabled computational analysis of ribonucleic acids (RNAs), which play diverse and critical roles in most cells. To assist the study of human RNA, we trained machine learning models on RNA nucleotide sequences, devoid of domain knowledge. We built models that distinguish long non-coding lncRNA from protein-coding mRNA, and models that predict the cytoplasmic vs. nuclear preferences of lncRNAs. In a review of published lncRNA subcellular localization classifiers, we show that the commonly used validation protocol generates optimistic performance measures, and …

Life After Sport: A Program Development Plan For Student-Athletes, Loryn Shawn Frame

Graduate Theses, Dissertations, and Problem Reports (ETD)

College athletics stakeholders have had growing concerns regarding student-athletes’ transition out of collegiate athletics. Research specific to student-athletes following college athletics has explored mental health, role identity, and occupational participation. This program development plan addresses occupational therapy’s role in assisting student-athletes transition out of collegiate athletics. The needs assessment conducted with West Virginia University athletic staff revealed two gaps in programming: athletic identity including leisure exploration, and a program to help student-athletes who want to enter health professional programs. Life After Sport comprises two programs, one to help student-athletes transition into a health professional program, titled Athletes in Medicine (AIM), …

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 …

Burnout In Forensic Psychology Related To Personal Traits And Vicarious Trauma, Olivia Shae Bruno

Theses and Dissertations

Burnout is described as having three components: emotional exhaustion, depersonalization, and feelings of ineffectiveness (Maslach et al., 1997). Burnout is considered a major occupational hazard due to the consequences for the afflicted and the population they work with (Leka & Jain, 2012) including low quality care, job dissatisfaction, absenteeism, and high turnover rates (Maslach et al., 2001). Previous research has identified some occupations and settings which are linked to high rates of burnout, including psychologists (Rodriguez & Carlotta, 2017) and those working in a high stress field, such as police officers (Vazquez et al., 2021), corrections officers (Herlickson, 2010) or …

On The Area-Averaged Effective Sound Absorption Coefficient Of Porous Materials Excited By A Monopole, Franck Sgard, Noureddine Atalla, Olivier Robin, Alain Berry

Études primaires

The area-averaged effective sound absorption coefficient (SAC) of a rigid-backed homogeneous porous material subjected to a monopole excitation is calculated as the absorbed-to-incident sound power ratio. Using Allard's model to describe the sound propagation above the porous material, an analytical model for this power-based SAC is proposed and proves to give a good approximation of the sound absorption performance under monopole excitation of sufficiently large areas of material. The impact of factors on the power-based SAC, such as monopole height, material radial dimension used to calculate the sound powers, and material properties is discussed. The power-based SAC frequency-dependent behavior is …

Work Characteristics, Workplace Support, And Mental Ill-Health In A Canadian Cohort Of Healthcare Workers During The Covid-19 Pandemic, Nicola Cherry, Anil Adisesh, Igor Burstyn, Quentin Durand-Moreau, Jean-Michel Galarneau, France Labrèche, Shannon Ruzycki, Tanis Zadunayski

Études primaires

Objective The aim of the study was to identify determinants of mental health in healthcare workers (HCW) during the COVID-19 pandemic. Methods A cohort of Canadian HCW completed four questionnaires giving details of work with patients, ratings of workplace supports, a mental health questionnaire, and substance use. Principal components were extracted from 23 rating scales. Risk factors were examined by Poisson regression. Results A total of 4854 (97.8%) of 4964 participants completed ratings and mental health questionnaires. Healthcare workers working with patients with COVID-19 had high anxiety and depression scores. One of three extracted components, 'poor support,' was related to …

Excess Risk Of Covid-19 Infection And Mental Distress In Healthcare Workers During Successive Pandemic Waves: Analysis Of Matched Cohorts Of Healthcare Workers And Community Referents In Alberta, Canada, Jean-Michel Galarneau, France Labrèche, Quentin Durand-Moreau, Shannon Ruzycki, Anil Adisesh, Igor Burstyn, Tanis Zadunayski, Nicola Cherry

Études primaires

Objectives: To investigate changes in risk of infection and mental distress in healthcare workers (HCWs) relative to the community as the COVID-19 pandemic progressed. Methods: HCWs in Alberta, Canada, recruited to an interprovincial cohort, were asked consent to link to Alberta’s administrative health database (AHDB) and to information on COVID-19 immunization and polymerase chain reaction (PCR) testing. Those consenting were matched to records of up to five community referents (CRs). Physician diagnoses of COVID-19 were identified in the AHDB from the start of the pandemic to 31 March 2022. Physician consultations for mental health (MH) conditions (anxiety, stress/adjustment reaction, depressive) …

Occupational Pressures Of Frontline Workers Enforcing Covid-19 Pandemic Measures In Ontario And Quebec, Canada, Pamela Hopwood, Ellen Maceachen, Daniel Côté, Samantha B. Meyer, Shannon Majowicz, Ai-Thuy Huynh, Meghan K. Crouch, Joyceline Amoako, Yamin T. Jahangir, Amelia León Correal, Antonela Ilic

Études primaires

BACKGROUND:During the COVID-19 pandemic, low-wage public-facing frontline workers (FLWs), such as grocery store clerks, were required to monitor retail customers and enforce COVID-19 protocols. OBJECTIVE:This analysis aimed to examine FLWs experiences of enforcing COVID-19 pandemic measures. METHODS:Between September 2020 and March 2021, in Ontario and Quebec (Canada), we conducted in-depth interviews about customer-related work and health risks with FLWs who interacted with the public (n = 40) and their supervisors (n = 16). Using a lens of situational analysis, verbatim transcripts were coded according to recurring topics. RESULTS:We found that enforcing public health measures placed already-precarious workers in difficult occupational …

What Are The Perceptions And Lived Experiences Of Canadian Injured Workers About The Provision Of Physiotherapy Services Using Telerehabilitation?, Anne Hudon, Maxi Miciak, Teri Slade, Stacey Lovo, Jackie L. Whittaker, Daniel Côté, Debbie E. Feldman, Dahlia Kairy, Marie Laberge, Beverley Mckeen, Lynn Cooper, Douglas P. Gross

Études primaires

Purpose

Despite evidence of efficacy, the effectiveness of telerehabilitation in real-world clinical settings is still largely unknown. Telerehabilitation requires a substantial transformation of the organization and delivery of traditional services. Considering that a virtual setting can create unique challenges for providing physiotherapy services and given the physical and potential hands-on nature of evidence-based assessments and interventions, it is important to investigate what injured workers think of receiving physiotherapy care via telerehabilitation and to examine if rehabilitation needs are adequately met.

Methods

A qualitative interpretive description study was conducted to explore the perspectives and experiences of 17 injured workers receiving physiotherapy …

The Influence Of Relational Frames On Climate Purchasing And Policy, Lauren Rose Hutchison

Graduate Theses/Dissertations

Evaluative conditioning refers to the effect that occurs when two stimuli are paired together, resulting in a change in the evaluation or function of one of the stimuli. Evaluative conditioning has been researched in various fields of study, such as advertisement and public administration, but synthetization efforts of these results with a relational frame theory approach, and vice versa, have been limited. This thesis used de-identified data from prior approved research to integrate and discusses two manuscripts that provide a relational frame theory perspective to evaluative conditioning effects. Study 1 extends a previous experiment by Matthews et al. (2022) through …

Effect Of P2y2 Receptors On Leukocyte Behavior Under Acute Inflammation In Transgenic Male Mice In Vivo, Corynn D. Knight

Graduate Theses/Dissertations

P2Y₂ receptors, G-protein coupled receptors and transmembrane proteins, are present on most cells in the body and hold a wide variety of roles. Previous research indicates that under resting conditions, P2Y₂ receptors suppress the movement of leukocytes but it is unknown how inflammation will alter this in the body. The objective of this project was to determine the effect of P2Y₂ receptors on leukocyte behavior in vivo under acute inflammation using Intravenous Microscopy (IVM) in post-capillary venules of the cremaster skeletal muscle. Lipopolysaccharide was injected into the scrotum of transgenic male mice to cause localized acute inflammation. …

Management Protocol For Uncomplicated Peritonsillar Abscess: Standardizing Care And Improving Emergency Medicine Resident Confidence., John Casey, Scott Keidel, Marissa Kudo, Miriam Chan

Medical Education Articles

INTRODUCTION: A peritonsillar abscess (PTA) is a frequent reason for a visit to the emergency department. As there are no current published guidelines for medical versus surgical management, attending physicians vary among management tendencies, generating uncertainty among resident physicians. This project established a standard of care for managing patients with PTA and provided clear management guidelines to the emergency department, in collaboration with the otolaryngology department, at a community academic hospital.

METHODS: Pre- and post-interventional, anonymous surveys were given to assess resident physician confidence in the management of PTA. A proposed management protocol was developed based on existing literature and …

Family Medicine Resident Scholarly Activity Infrastructure, Output, And Dissemination: A Cera Survey., Bryce A Ringwald, Michelle Taylor, Dean A Seehusen, Jennifer L Middleton

Medical Education Articles

PURPOSE: Meeting scholarly activity requirements continues to be a challenge in many family medicine (FM) residency programs. Studies comprehensively describing FM resident scholarship have been limited. We sought to identify institutional factors associated with increased scholarly output and meeting requirements of the Accreditation Council for Graduate Medical Education (ACGME).

OBJECTIVES: Our goals were to: (1) describe scholarly activity experiences among FM residents compared with ACGME requirements; (2) classify experiences by Boyer's domains of scholarship; and (3) associate experiences with residency program characteristics and scholarly activity infrastructure.

METHODS: This was a cross-sectional survey. The survey questions were part of an omnibus …

Impact Of Repeated Reimbursement Penalties On Hospital Total Quality Scores, Alice Brewer, M. Courtney Hughes, Kunal N. Patel

Faculty Articles, Papers, and Other Scholarship

Objectives

The incidence of hospital-acquired conditions (HACs) is a serious public health issue with implications ranging from patient morbidity and mortality to negative financial impacts on patients and health care systems. Despite substantial efforts to address and reduce HACs, research into the effect of quality improvement programs is inconclusive. This study seeks to better understand the relationship between repeated reimbursement penalties and improvement in HAC quality scores.

Methods

A quantitative comparative analysis of U.S. health care data was conducted. Data on quality outcomes and hospital characteristics were sourced from the Hospital-Acquired Condition Reduction Program from fiscal years 2018 and 2019 …

Always Politically Correct: Supporting Seriously Ill Older Populations And Their Families, M. Courtney Hughes, Erin Vernon

Faculty Articles, Papers, and Other Scholarship

We have been researching outcomes related to seriously ill individuals for over a decade, critically examining countless research articles from around the world, and extensively interviewing various stakeholders in this space, including hospital leaders, hospice leaders, lobbyists, nurses, social workers, and informal caregivers. We have also experienced firsthand the heartwrenching difficulty of caring for seriously ill loved ones. While we have learned a tremendous amount along the way, two specific observations consistently stand out. First, regardless of culture, income level, or politics, most people can personally identify with caring for seriously ill individuals. Second, the research evidence indicates that not …

Financial Strain, Health Behaviors, And Psychological Well-Being Of Family Caregivers Of Older Adults During The Covid-19 Pandemic, Yujun Liu, M. Courtney Hughes, Heng Wang

Faculty Articles, Papers, and Other Scholarship

Objectives

Methods

Results

Hospice Capacity To Provide General Inpatient Care: Emergency Department Utilization And Live Discharge Among Cancer Patients, Kyusuk Chung, M. Courtney Hughes, Sara Rahmanian Koushkaki, Mia Richelle Risberg, Michelle Alcantara, Jennifer M. Amico

Faculty Articles, Papers, and Other Scholarship

General inpatient (GIP) hospice care is used only minimally for hospice patients, and more than a quarter of Medicare hospice facilities do not provide GIP care. To determine the impact of hospices’ capacity to provide on emergency department use during hospice enrollment and live discharge from hospice, we used Surveillance, Epidemiology, and End Results-Medicare linked data and CMS Provider of Services data from 2007 to 2013 from ten states and two metropolitan regions. Grouping hospices into three GIP care provision categories: 1) no-GIP; 2) GIP-contract; and 3) GIP-IHF where hospices directly provide GIP care in their own inpatient hospice facility …

Students Engaging In Public Health Research: An Opportunity To Enhance Education, M. Courtney Hughes, Sadia Afrin

Faculty Articles, Papers, and Other Scholarship

Society is on the heels of one of the largest public health crisis the world has experienced in over a century, the COVID-19 pandemic. Developing the next generation of adept public health researchers is paramount to protecting the world against future health threats and addressing legacy public health challenges. This article explores the transformative influence of research experience on education, presenting three major points: (1) students engaging in public health research is timely, (2) students can develop a variety of critical thinking skills and data-driven decision-making capabilities that prepare them for future careers, and (3) faculty and universities benefit from …

Clinical Characteristics Of Probands With Obsessive-Compulsive Disorder From Simplex And Multiplex Families, Monicke O Lima, Leonardo C Saraiva, Vanessa R Ramos, Melaine C Oliveira, Daniel L C Costa, Brazilian Research Consortium On Obsessive-Compulsive Spectrum Disorders, Thomas V Fernandez, James J Crowley, Eric A Storch, Roseli G Shavitt, Euripedes C Miguel, Carolina Cappi

Center for Medical Ethics and Health Policy Staff Publications

Genetic and non-genetic factors contribute to obsessive-compulsive disorder (OCD), with strong evidence of familial clustering. Genomic studies in psychiatry have used the concepts of families that are "simplex" (one affected) versus "multiplex" (multiple affected). Our study compares demographic and clinical data from OCD probands in simplex and multiplex families to uncover potential differences. We analyzed 994 OCD probands (501 multiplex, 493 simplex) from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinicians administered the Structured Clinical Interview for DSM-IV (SCID-IV) to diagnose, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to assess severity, and Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) to assess symptom dimensionality. …

A Use Case Of Chatgpt: Summary Of An Expert Panel Discussion On Electronic Health Records And Implementation Science, Seppo T Rinne, Julian Brunner, Timothy P Hogan, Jacqueline M Ferguson, Drew A Helmer, Sylvia J Hysong, Grace Mckee, Amanda Midboe, Megan E Shepherd-Banigan, A Rani Elwy

Center for Medical Ethics and Health Policy Staff Publications

Objective: Artificial intelligence (AI) is revolutionizing healthcare, but less is known about how it may facilitate methodological innovations in research settings. In this manuscript, we describe a novel use of AI in summarizing and reporting qualitative data generated from an expert panel discussion about the role of electronic health records (EHRs) in implementation science.

Materials and methods: 15 implementation scientists participated in an hour-long expert panel discussion addressing how EHRs can support implementation strategies, measure implementation outcomes, and influence implementation science. Notes from the discussion were synthesized by ChatGPT (a large language model-LLM) to generate a manuscript summarizing the discussion, …

Ethical Considerations For Integrating Multimodal Computer Perception And Neurotechnology, Meghan E Hurley, Anika Sonig, John Herrington, Eric A Storch, Gabriel Lázaro-Muñoz, Jennifer Blumenthal-Barby, Kristin Kostick-Quenet

Center for Medical Ethics and Health Policy Staff Publications

Background: Artificial intelligence (AI)-based computer perception technologies (e.g., digital phenotyping and affective computing) promise to transform clinical approaches to personalized care in psychiatry and beyond by offering more objective measures of emotional states and behavior, enabling precision treatment, diagnosis, and symptom monitoring. At the same time, passive and continuous nature by which they often collect data from patients in non-clinical settings raises ethical issues related to privacy and self-determination. Little is known about how such concerns may be exacerbated by the integration of neural data, as parallel advances in computer perception, AI, and neurotechnology enable new insights into subjective states. …