Medicine and Health Sciences Commons^™

A Program To Support Kangaroo Care Of Preterm Infants In The Nicu For The Caregivers, Katherine Blake Carby Cooksey, Mary Jan Greer, Debbie Johnson

Fall 2024 OTD Capstone Symposium

This presentation is about an educational program developed to help educate the caregivers about kangaroo care while their baby is in the neonatal intensive care unit (NICU). This program is to emphasis in the occupations of social interaction and family involvement with kangaroo care. Caregivers/parents are able to learn about the what kangaroo care is, the different type methods of kangaroo care, the benefits of kangaroo care, the importance of kangaroo care while being in the NICU. This program development for the caregivers is able to help with their journaling experience while in the NICU and adjusting kangaroo care into …

Community, State And Professionalism: Negotiating The Experience Of Community Health Workers In The Provision Of Maternal And Child Health Services In Tanzania, Chakupewa Joseph Mpambije

Journal of Humanities and Social Sciences

Research on community health workers (CHWs) has been on the increase in the past decades in Tanzania, focusing on the provision of maternal and child health (MCH) services. While performing their tasks, CHWs work within three constructs: the community, the state, and their professionalism. However, as CHWs work within these constructs, there exists scanty literature which discourses their experiences within the realm of the community, the state and their professionalism. This review aimed to articulate how these constructs facilitate or inhibit CHWs’ performance in improving MCH services. It employed a scoping review method in which peer-reviewed articles and grey literature …

Mild Traumatic Brain Injury In Justice-Involved Individuals And Executive Function Consequences On Transition And Reintegration Into The Community, Alaina L. Randerson

Student Capstone Papers

The United States has the highest documented incarceration rate in the world (Carson, 2022), with an increasing number of justice-involved individuals (JII) potentially affected by mild traumatic brain injury (mTBI). Despite the high prevalence of mTBIs in the general population, limited research exists on the prevalence and impact of mTBIs in JII. Preliminary evidence suggests that the prevalence of mTBIs in incarcerated individuals is 50 times higher than in the general public (Siegler et al., 2017). This study aimed to explore the lived experiences of JII with mTBI, focusing on the origin of mTBIs, executive dysfunction, and the occupational barriers …

Transforming Growth Factor-Beta Is Increased In Sputum From Individuals With Rheumatoid Arthritis-Associated Pulmonary Fibrosis, Timothy M. Wilson, Matthew Bolt, Andrew Stahly, Joyce S. Lee, Tami J. Bang, Peter B. Sachs, Kevin D. Deane, Stephen M. Humphries, Joshua J. Solomon, M. Kristen Demoruelle

Division of Rheumatology Faculty Papers

BACKGROUND: Interstitial lung disease (ILD) develops in 5-10% of patients with RA and contributes significantly to morbidity and mortality, particularly in those with a fibrotic phenotype. Yet, biomarkers to reliably identify RA patients with underlying pulmonary fibrosis are inadequate. Herein, we used sputum to identify lung-based biomarkers that distinguish RA patients with underlying pulmonary fibrosis and may better inform underlying pathogenesis in RA-ILD.

METHODS: We included 37 RA patients with pulmonary fibrosis (RA-PF) and 30 RA patients without ILD (RA-no-ILD). Induced sputum and serum were tested for TGF-β levels by immunoassay. DNA was extracted to determine presence of the MUC5B …

Factors Affecting Sport-Related Concussion Non-Disclosure In Women's Rugby-A Multi-Country Qualitative Analysis, Lisa Ryan, Ed Daly, Katherine Hunzinger

Department of Exercise Science Faculty Papers

Background and Objectives: Collision-sport athletes, such as rugby players, are at risk of sport-related concussion (SRC). Women are known to be at higher risk of SRC and may experience more severe and chronic symptomology than men. Knowledge of the factors that affect a player’s disclosure of their concussive symptoms could help to inform strategies to improve compliance with reporting and management of head injuries. The aim of this study was to investigate the factors that may impact women rugby players’ disclosure of a concussion. Methods: Twenty-eight adult (≥18 years of age) elite and semi-elite women rugby players from the UK …

Exploring The Relationship Between Hand Grip Strength And Handwriting Proficiency, Chloe Fields, Rebecca King

Fall 2024 OTD Capstone Symposium

Handwriting remains essential for a child's academic performance despite the rise of technology in classrooms, but overuse of digital tools can hinder the development of essential hand muscles and fine motor skills. This capstone project explores the relationship between handwriting proficiency, hand grip strength, and the impact of excessive technology use on young students.

Mild Traumatic Brain Injuries In Justice-Involved Individuals And Executive Function Consequences On Transition And Reentry Into The Community ​, Alaina L. Randerson, Michael Sutcliffe, Cassandra Nelson, Ariana Gonzalez

Fall 2024 OTD Capstone Symposium

The United States has the highest documented incarceration rate in the world (Carson, 2022), with an increasing number of justice-involved individuals (JII) potentially affected by mild traumatic brain injury (mTBI). Despite the high prevalence of mTBIs in the general population, limited research exists on the prevalence and impact of mTBIs in JII. Preliminary evidence suggests that the prevalence of mTBIs in incarcerated individuals is 50 times higher than in the general public (Siegler et al., 2017). This study aimed to explore the lived experiences of JII with mTBI, focusing on the origin of mTBIs, executive dysfunction, and the occupational barriers …

Agot: Agricultural Guide For Occupational Therapy Practitioners, Kara Smallegan, Meghan Skidmore Otd, Otr, Cns, Angela Labrie Blackwell Phd, Otr

Fall 2024 OTD Capstone Symposium

As agriculture is a hazardous occupation, this project discusses agricultural workers with health conditions/disabilities, experiencing disruption to occupational performance and participation, increasing risk of secondary injuries, and impacting overall well-being and how occupational therapy practitioners can improve these factors through the development of a guidebook. The guide covers population insights, risk factors, assessment guide, conditions, and resources to aid occupational practitioners when assisting the agricultural worker population.

Preoperative Education For Total Hip And Knee Replacements, Molly Whitehead, Cassandra Nelson, Gwen Morris

Fall 2024 OTD Capstone Symposium

An educational program has been developed to implement with total hip or knee replacement patients prior to their procedure to improve function with ADLs, lessen the need for caregiver assistance, and to increase patient satisfaction.

Navigating Life After The Nicu: A Developmental Guide For Preterm And High-Risk Infants And Toddlers, Reagan Lachaussee, Mary Jan Greer Phd, Otr, Theresa Mensi

Fall 2024 OTD Capstone Symposium

Premature and medically fragile infants are at high risk for developmental delays and benefit from ongoing support. Parents often feel overwhelmed and uncertain about how to support their child’s development at home. This project addressed gaps in caregiver education and support by developing the PEARLS Program (Promoting Early Achievements, Resilience, and Life Skills), a practical resource tailored to the needs of families and healthcare providers.

A needs assessment and provider feedback guided the program’s development, identifying challenges such as information overload, confusion around corrected age, and feeding difficulties. The PEARLS Program empowers families with digestible, actionable resources, including …

Older Adult's Fall Prevention Program, Myles Butler, Rebecca King

Fall 2024 OTD Capstone Symposium

The decline in bodily functions with aging increases older adults' vulnerability to falls, which is a leading cause of death within this population. The poster presents an educational based fall prevention program focused on safety awareness and risk management for older adults. In conclusion, implementing a fall prevention program leads to increased awareness regarding risk factors that are detrimental to the safety and well-being of the older adult community

Ergonomics & Environmental Changes Within The Beauty Industry To Decrease Musculoskeletal Conditions, Jessika Eiland, Rebecca King

Fall 2024 OTD Capstone Symposium

Ergonomics, adaptation, and environmental changes within the beauty industry to decrease musculoskeletal conditions in the upper extremities. Musculoskeletal disorders and their effects may limit a hairdressers ability to complete their job duties. For individuals within the beauty industry, health management can become an important factor.

Making An Easy Return To School After An Extended Illness Diagnosis, Ashlyn Eads, Mary Jan Greer, Julie Boykin

Fall 2024 OTD Capstone Symposium

This poster provides information on the capstone program created at a pediatric site. This program addresses how play-based therapy can help children with an extended illness transition back into the school setting. Both the children and their caregivers need support before, during, and after the return to school. The goals of this program were to educate caregivers on how to advocate for their child for positive outcomes, provide caregivers with resources to promote successful transition to school, provide play-based strategies for children addressing handwriting, social Skills, upper body strength, education, fine Motor Skills, and provide the site and caregivers with …

Development Of A Virtual Reality Program To Promote Occupational Participation And Decreased Psychosocial Deficits In Persons With A Brain Injury, Nicole Arneson, Rebecca King

Fall 2024 OTD Capstone Symposium

Stroke is one of the leading causes of disabilities including problems with balance, muscle weakness, abnormal muscle tone, mental health, as well as deficits in visual function and sensory function The purpose of this capstone is to develop a virtual reality program that will be used with the stroke population to address ADLs, IADLs, and quality of life.

Occupational Therapy Role In Aiding Health Management For Caregivers Of Children With Neurological Conditions, Peyton Mcgee, Mary Jan Greer, Caitlin Boyd

Fall 2024 OTD Capstone Symposium

Neurological disorders are identified as a dysfunction on any part of the nervous system that cause disability (Kumar et al., 2022). In order to enhance the outcome of children with neurological conditions, there should be an emphasis on the role and well-being of their caregivers. Common symptoms of neurological disorders among children include delayed developmental milestones, seizures and epilepsy, regression of skills, abnormal movements and behaviors, headaches, sensory processing issues, and communication difficulties. Adjusting to a new normal can be overwhelming for caregivers, especially when children transition out of rehab. The aim of the proposed capstone project is to aid …

Improving Adls, Iadls, And Qol In Breast Cancer Survivors, Tincy Samuel, Rebecca King

Fall 2024 OTD Capstone Symposium

Breast cancer and its treatment can significantly impact breast cancer survivor’s ability to perform Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), and Quality of Life (QoL). Physical activity programs have been found to positively impact various aspects of quality of life in breast cancer patients, including physical condition, state of mind, and selfesteem. However, there is a gap in the OT practice and the literature regarding how to improve independence in ADLs, IADLs, and overall quality of life in breast cancer survivors. A program was created to improve Activities of Daily Living (ADLs), Instrumental Activities of …

Type 2 Diabetes Mellitus Health Management Within The Adult Population: A Road Toward Occupational Engagement, Valeria Martinez, Cassandra Nelson, Otd, Otr/L, Mba, Cns, Ceas I

Fall 2024 OTD Capstone Symposium

Approximately 37 million Americans have been diagnosed with Type 2 Diabetes Mellitus (T2DM) (CDC, 2023). As a result, DM is ranked as the eighth leading cause of mortality in the United States, yet the management of symptoms and overall condition is frequently neglected by a significant portion of the American population (CDC, 2023). A contributing factor to this issue is the insufficient access to resources for underserved communities, particularly among the Hispanic population with low health literacy. This capstone project focuses on health management and educating the adult population with a goal of enhancing activities of daily living (ADL) and …

Unraveling The Relationship Between Sleep Behaviors And Physical Activity In The United States: Insights From 2015 To 2020 Nhanes Data, Deepali K Ernest, Bipin Singh, Fathimath Shamna, Elizabeth A Onugha, Shreela V Sharma

Faculty, Staff and Student Publications

Background: Physical activity is an important component of metabolic health. However, little is known about the impact of specific types/intensities of physical activity on sleep health, especially among ethnically diverse populations. We examined the association of various sleep behaviors with moderate to vigorous work/recreational activity.

Methods: Self-reported data from the National Health and Nutrition Examination Survey 2015-2020 were cross-sectionally analyzed for a sample of 11,039 participants in the United States (U.S.). Weighted univariate logistic regressions determined unadjusted associations, while weighted multivariable regression models adjusting for age, sex, ethnicity, BMI categories, and socio-economic status assessed the multivariable associations with moderate and …

Oculomotor Nerve Palsy Recovery Following Microsurgery Vs. Endovascular Treatment Of Posterior Communicating Artery Aneurysms: A Comparative Meta-Analysis Of Short- And Long-Term Outcomes, Rahim Abo Kasem, Conor Cunningham, Sameh Samir Elawady, Mohammad Mahdi Sowlat, Sofia Babool, Saad Hulou, Zachary Hubbard, Atakan Orscelik, Basel Musmar, Alejandro Spiotta

Department of Neurosurgery Faculty Papers

Recent advancements in endovascular treatment (EVT) and different views on optimal management for posterior communicating artery (PComA) aneurysms with oculomotor nerve palsy (ONP) highlight a need to compare recovery timelines between microsurgery and EVT; heterogeneous outcomes and influencing factors may also affect results. A comprehensive systematic review and meta-analysis were conducted by searching PubMed, Embase, Scopus, and Web of Science databases. The extracted data encompassed patient demographics, details on treatment modalities and timing, and characteristics of PComA aneurysms ONP caused by either unruptured or ruptured aneurysms. The primary outcome was ONP favorable recovery, defined as the resolution of admission symptoms, …

Aspiration Of Left Atrial Masses Using The Large-Bore Manual Aspiration System: The Aspirate La Procedure, Shaurya Srivastava, Hussam Al Hennawi, Ahmad Abulshamat, Appa Bandi, Mohammed Qintar

Abington Jefferson Health Papers

Transcatheter mass extraction of left-sided cardiac masses has gained popularity in recent years, with scarce data on effectiveness, safety, and types of devices used. Mostly, left-sided aspirations use mechanical and continuous-flow–mediated devices (the AngioVac [AngioDynamics] and Penumbra systems [Penumbra]). To our knowledge, the use of manual aspiration devices has not been reported yet. Here, we report the first case series on the use of the AlphaVac (AngioDynamics) (a large-bore manual aspiration device) system for left-sided intracardiac masses.

Influenza Knowledge And Barriers To Vaccination In Immunosuppressed Patients In The Pediatric Rheumatology Clinic., Julia G. Harris, Leslie Favier, Jordan T. Jones, Maria Ibarra, Michael J. Holland, Emily Fox, Kelly Jensen, Ashley K. Sherman, Ashley M. Cooper

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Most patients with a pediatric rheumatic disease are at increased risk of influenza due to immunosuppressive medication use. Despite initial quality improvement efforts, our influenza vaccination rate plateaued at 72%, which prompted a survey of patients and families to assess provider vaccine recommendations, influenza knowledge, and barriers to influenza vaccination.

METHODS: Patients on immunosuppressive medication or their parent were eligible to complete a survey between July 2019 and January 2020. Survey questions assessed demographics, rheumatology diagnosis, immunosuppressive medication(s), influenza vaccination recommendation, patient/parent influenza knowledge, and barriers to influenza vaccination. Influenza vaccination rates for immunosuppressed patients were acquired each influenza …

Embolic Stroke In A Patient With Left Atrial Myxoma, Muhammad Sabri, Sheraz Qamar, Naila Ijaz, Mark Decaro

Division of Cardiology Faculty Papers

We present a case of a patient with a left atrial myxoma who presented with an ischemic stroke. Her cardiac myxoma had an irregular contour and was highly mobile, both features that have been associated with a greater risk of thrombo- embolism. She was treated with prompt surgical resection

Functional Properties Of Corticothalamic Circuits Targeting Paraventricular Thalamic Neurons, Guillermo Aquino-Miranda, Dounya Jalloul, Xu O Zhang, Sa Li, Gilbert J Kirouac, Michael Beierlein, Fabricio H Do Monte

Faculty, Staff and Student Publications

Corticothalamic projections to sensorimotor thalamic nuclei show modest firing rates and serve to modulate the activity of thalamic relay neurons. By contrast, here we find that high-order corticothalamic projections from the prelimbic (PL) cortex to the anterior paraventricular thalamic nucleus (aPVT) maintain high-frequency activity and evoke strong synaptic excitation of aPVT neurons in rats. In a significant fraction of aPVT cells, such high-frequency excitation of PL-aPVT projections leads to a rapid decay of action potential amplitudes, followed by a depolarization block (DB) that strongly limits aPVT maximum firing rates, thereby regulating both defensive and appetitive behaviors in a frequency-dependent manner. …

Structural Variant Allelic Heterogeneity In Mecp2 Duplication Syndrome Provides Insight Into Clinical Severity And Variability Of Disease Expression, Davut Pehlivan, Jesse D Bengtsson, Sameer S Bajikar, Christopher M Grochowski, Ming Yin Lun, Mira Gandhi, Angad Jolly, Alexander J Trostle, Holly K Harris, Bernhard Suter, Sukru Aras, Melissa B Ramocki, Haowei Du, Michele G Mehaffey, Kyunghee Park, Ellen Wilkey, Cemal Karakas, Jesper J Eisfeldt, Maria Pettersson, Lynn Liu, Marwan S Shinawi, Virginia E Kimonis, Wojciech Wiszniewski, Kyle Mckenzie, Timo Roser, Angela M Vianna-Morgante, Alberto S Cornier, Ahmed Abdelmoity, James P Hwang, Shalini N Jhangiani, Donna M Muzny, Tadahiro Mitani, Kazuhiro Muramatsu, Shin Nabatame, Daniel G Glaze, Jawid M Fatih, Richard A Gibbs, Zhandong Liu, Anna Lindstrand, Fritz J Sedlazeck, James R Lupski, Huda Y Zoghbi, Claudia M B Carvalho

Faculty, Staff and Students Publications

BACKGROUND: MECP2 Duplication Syndrome, also known as X-linked intellectual developmental disorder Lubs type (MRXSL; MIM: 300260), is a neurodevelopmental disorder caused by copy number gains spanning MECP2. Despite varying genomic rearrangement structures, including duplications and triplications, and a wide range of duplication sizes, no clear correlation exists between DNA rearrangement and clinical features. We had previously demonstrated that up to 38% of MRXSL families are characterized by complex genomic rearrangements (CGRs) of intermediate complexity (2 ≤ copy number variant breakpoints < 5), yet the impact of these genomic structures on regulation of gene expression and phenotypic manifestations have not been investigated.

METHODS: To study the role of the genomic rearrangement structures on an individual's clinical phenotypic variability, we employed a comprehensive …

Centering Autonomy And Choice To Support Oral Prep Utilization Among People Who Inject Drugs: Qualitative Lessons From Hptn 094 Integra, Amaya Perez-Brumer, Rose Schmidt, Rebecca Kennedy, Jordan E Lake, Yolanda R Villarreal, Sydney Bornstein, Irene Kuo, Omar Nieto, Julie Franks, Cecile Denis, Nabila El-Bassel, Steve Shoptaw, Peter Davidson, Laramie R Smith

Faculty, Staff and Student Publications

Background: Oral Pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission. However, despite high rates of HIV risk behaviors among people who inject drugs (PWID), this population remains underserved by current HIV prevention efforts in the United States. To address this challenge, we conducted an in-depth exploration of perspectives on using oral PrEP among PWID engaged in the HIV Prevention Trials Network (HPTN) 094 INTEGRA Study.

Methods: Guided by the Practical, Robust, Implementation, and Sustainability Model (PRISM), our qualitative study drew on semi-structured interviews conducted as part of the embedded implementation science evaluation of HPTN 094 INTEGRA. Seventy-seven PWID participants …

Targeting Corticotropin-Releasing Hormone Receptor Type 1 (Crhr1) Neurons: Validating The Specificity Of A Novel Transgenic Crhr1-Flpo Mouse, Mason Hardy, Yuncai Chen, Tallie Z Baram, Nicholas J Justice

Faculty, Staff and Student Publications

Corticotropin-releasing hormone (CRH) signaling through its cognate receptors, CRHR1 and CRHR2, contributes to diverse stress-related functions in the mammalian brain. Whereas CRHR2 is predominantly expressed in choroid plexus and blood vessels, CRHR1 is abundantly expressed in neurons in discrete brain regions, including the neocortex, hippocampus and nucleus accumbens. Activation of CRHR1 influences motivated behaviors, emotional states, and learning and memory. However, it is unknown whether alterations in CRHR1 signaling contribute to aberrant motivated behaviors observed, for example, in stressful contexts. These questions require tools to manipulate CRHR1 selectively. Here we describe and validate a novel Crhr1-FlpO mouse. Using bacterial artificial …

Transcriptomic Clustering Of Chronic Lymphocytic Leukemia: Molecular Subtypes Based On Bruton’S Tyrosine Kinase Expression Levels, Gorkem Kismali, Ganiraju Manyam, Nitin Jain, Cristina Ivan, Betty Lamothe, Mary L Ayres, Lakesla R Iles, William G Wierda, Varsha Gandhi

Faculty, Staff and Student Publications

Historically, CLL prognostication relied on disease burden, reflected in clinical stage. Later, chromosome abnormalities and genomics suggested several CLL subtypes which were aligned with response to therapy. Gene expression profiling data identified pathways associated with CLL progression. We hypothesized that transcriptome and proteome may identify functional omics associated with CLL nosology. As a test cohort, we utilized publicly available treatment-naïve CLL transcriptomics data (n = 130) and did consensus clustering that identified BTK-expression-based clusters. The BTK-High and BTK-Low clusters were validated in public and our in-house databases (n = >550 CLL patients). To associate with functional relevance, we took samples …

Comparison Of Vendor-Pretrained And Custom-Trained Deep Learning Segmentation Models For Head-And-Neck, Breast, And Prostate Cancers, Xinru Chen, Yao Zhao, Hana Baroudi, Mohammad D El Basha, Aji Daniel, Skylar S Gay, Cenji Yu, He Wang, Jack Phan, Seungtaek L Choi, Chelain R Goodman, Xiaodong Zhang, Joshua S Niedzielski, Sanjay S Shete, Laurence E Court, Zhongxing Liao, Fredrik Löfman, Peter A Balter, Jinzhong Yang

Faculty, Staff and Student Publications

Background/objectives: We assessed the influence of local patients and clinical characteristics on the performance of commercial deep learning (DL) segmentation models for head-and-neck (HN), breast, and prostate cancers.

Methods: Clinical computed tomography (CT) scans and clinically approved contours of 210 patients (53 HN, 49 left breast, 55 right breast, and 53 prostate cancer) were used to train and validate segmentation models integrated within a vendor-supplied DL training toolkit and to assess the performance of both vendor-pretrained and custom-trained models. Four custom models (HN, left breast, right breast, and prostate) were trained and validated with 30 (training)/5 (validation) HN, 34/5 left …

Characterization Of An Inorganic Powder-Based Scintillation Detector Under A Uhdr Electron Beam, Daline Tho, Sam Beddar

Faculty, Staff and Student Publications

(1) Background: Ultra-high dose rate (UHDR) radiation therapy needs a reliable dosimetry solution and scintillation detectors are promising candidates. In this study, we characterized an inorganic powder-based scintillation detector under a 9 MeV UHDR electron beam. (2) Methods: A mixture of ZnS:Ag powder and optic glue was coupled to an 8 m Eska GH-4001-P polymethyl methacrylate (PMMA) optical fiber. We evaluated the dependence of the detector on dose per pulse (DPP), pulse repetition frequency (PRF), and pulse width (PW). Additionally, we determined the stability and the reproducibility of the detector. (3) Results: The signal ratio between the PMMA clear optical …

Deceased Donor Renal Allograft Utility In Adult Single And Multi-Organ Transplantation In The United States, Peter J. Altshuler, Adam S. Bodzin, Kenneth A. Andreoni, Pooja Singh, Anju Yadav, Jaime M. Glorioso, Ashesh P. Shah, Carlo B. Ramirez, Warren R. Maley, Adam M. Frank

Department of Surgery Faculty Papers

BACKGROUND: Deceased donor multiorgan transplants utilizing kidneys (MOTs) can improve outcomes for multiorgan recipients but reduces kidneys for chronic renal failure patients.

METHODS: We reviewed the Organ Procurement and Transplantation Network database from 2015 through 2019, for adult deceased donor kidney transplants. Recipients were classified as kidney transplant alone (KTA) (n = 62,252) or MOTs pancreas-kidney, simultaneous pancreas-kidney (n = 3,976), liver-kidney, simultaneous liver-kidney (n = 3,212), heart-kidney, simultaneous heart-kidney (n = 808), and "other"-kidney, simultaneous "other" kidney (n = 73).

RESULTS: Liver, heart, and lung-alone transplants were at least 7 times more frequent than their MOT correlate, whereas the …