Medicine and Health Sciences Commons^™

El Baloncesto Es Vida: A Look Into Strength And Conditioning, Physical Therapy, And Coaching During My Internship Abroad, Jessica Doublesin

2020 Honors Symposium

An experience abroad can help a person grow in confidence and knowledge and allow them to immerse themselves in a new culture. During my time in Valencia, Spain, I was able to work at a youth basketball club, CB L’Horta Godella, alongside the club’s strength and conditioning coaches and the physical therapist and be a coach for the young athletes. The fact that I lived with a Spanish family and had an open mindset towards making friends and exploring new things allowed me to grow closer to the culture in Spain. By using my knowledge and passion for sports and …

Social Conformity And The Line Judgment Task For Adolescents With Asd, Jamie Mcclendon

2020 Honors Symposium

The primary intent of this study is to address the conformity rates exhibited by individuals with Autism Spectrum Disorder (ASD).

• The Solomon Asch line judgement task is used to test the effects of peer pressure on social conformity.
• There is a discrepancy in the conformity exhibited by typically developing individuals (TD) and ASD individuals.
• This study seeks to address the degree to which ASD individuals are affected by social influence and how likely they will be to conform.
• Conformity rates will be compared to that of TD college age students as well as students with various intellectual disabilities (ID).

This …

Parental Nutrition Health Literacy, Sheila F. Towson

Regis University Student Publications (comprehensive collection)

Executive Summary

Parental Nutrition Health Literacy and Children’s Health

Problem: The problem identified in the following study is that overweight and obesity is associated with comorbidities that contribute to chronic diseases such as depression, decreased academic performance, type 2 diabetes, cardiac disease and others (Allesio, 2018; Barlow & Expert Committee, 2007). Demographics reveal obesity prevalence among children and adolescents to be 18.9% in the lowest income group, 19.9% in the middle-income group, and 10.9% in the highest income group (CDC, 2018). School and home environments are especially influential in affecting school-age children’s health behaviors (Luesse, Paul, Koch, Contendo, & Marsick, …

A Modular Framework For Early-Phase Seamless Oncology Trials, Philip S. Boonstra, Thomas M. Braun, Elizabeth C. Chase

The University of Michigan Department of Biostatistics Working Paper Series

Background: As our understanding of the etiology and mechanisms of cancer becomes more sophisticated and the number of therapeutic options increases, phase I oncology trials today have multiple primary objectives. Many such designs are now 'seamless', meaning that the trial estimates both the maximum tolerated dose and the efficacy at this dose level. Sponsors often proceed with further study only with this additional efficacy evidence. However, with this increasing complexity in trial design, it becomes challenging to articulate fundamental operating characteristics of these trials, such as (i) what is the probability that the design will identify an acceptable, i.e. safe …

Mental Health Advocacy: Building An Interdisciplinary Program For Agriculture Professionals, Abby E. Blankenship, Erica E. Nason, Olivia Hayes, Sebastian Bliss

Contemporary Rural Social Work Journal

The suicide rate among agriculturalists is 3.5 times higher than the general population. A number of external factors related to the farming and veterinary work put individuals in agricultural populations at risk for poor mental health outcomes, including economic variables (e.g. tariffs, market prices), environmental factors affecting yield (e.g. drought, pests), and exposure to difficult or traumatic life events (e.g., mistreatment of animals, loss of crop). Rural values including self-reliance, work orientation, and individualism combined with logistical and systemic barriers to competent behavioral health care further increase risk. Project GROW (Generating Resilience in Our Workforce) is a multifaceted full semester …

The Scope Of Telepsychiatry On Health Care Services In The United States, Abdulmajeed Alropaish, Itzamna Kukulkan Castaneda Medina

Theses, Dissertations and Capstones

Background and purpose: A fifth of the U.S. population suffers from some mental illness, and their need for attention is increasing, new technologies have permitted telepsychiatry to allow remote attention to this population. This study explores the impact of telepsychiatry on the cost and access of community patients to mental health services.

Methods: A review of the literature in different electronic databases such MEDLINE, PubMed and ScienceDirect was carried out to investigate the scope of telepsychiatry in the community care of patients with mental illness, identifying 479 related articles, of which 35 were included in this study. The …

Impact On Hospital Profitability Due To Covid Safety Guidelines, Khaja Umair Shariff, Anna Noel Franklin

Theses, Dissertations and Capstones

Introduction: The pandemic of COVID 19 presented a unique challenge to hospitals and healthcare systems that they have been struggling to function in. Operating costs had increased with new protocols, planning, operating space, supplies, and staffing. This coupled with the loss of revenue has led to approximately 10% - 20% salary reductions, furloughs, and loss of benefits such as PTO and vacation days to employees. Hospital’s cash reserves are being depleted due to increased operations costs and reduced revenue. Government funding, such as the CARES Act provided by the sanction of the Department of Health and Human Services Office, …

Barriers In Cancer Related Experiences: Where Can Ots Fill In The Gaps, Zoe Hoberman-Kelly

OT Student Capstones

Over the last two decades, oncology has made vast improvements in the treatment and management of cancer. Medical advancements in diagnostic imaging, treatment agents and improved surgical techniques have transformed the effectiveness of cancer delivery and care. However treatment related obstacles and health concerns of survivors trails behind that of the treatment for the actual cancer. The literature identified a growing need for increased psychosocial and self-management services to help provide a more cohesive spectrum of care. The inclusion of occupational therapy services within the cancer care continuum can strengthen functional practice and help treat physical and psychosocial barriers. This …

Multidisciplinary Concussion Rehabilitation Team Referral Demographics, Assessments And Intervention Focus: A Retrospective Analysis, Angela A. Tauer

OT Student Capstones

Objective To review the demographic factors, mechanism of injury, assessments, and treatment by health professionals on a multidisciplinary concussion rehabilitation team in an outpatient clinic setting. Methods: Retrospective chart review of 360 patients attending the outpatient concussion clinic over a 15-month period. Patient data was included for 139 patients meeting inclusion criteria. Data collected on an electronic database was reviewed and analyzed. Results Patients aged 16-82 years (n=139; mean 42 years of age, 65.5% female) were evaluated on average 48 weeks following initial head injury. Patients referred by a physician had a mechanism of injury prevalence of motor vehicle accident …

Experiences Of Caregivers And Healthcare Practitioners Working With Children With Histories Of Family Trauma And Substance Abuse, Alexandra Contreras

OT Student Capstones

While the number of infants born with substance abuse exposure continues to grow, the United States lacks a national monitoring system (CDC, 2019). This may contribute to the discrepancy of services and supports available to those working with children with histories of family trauma and substance abuse. The purpose of this study was to investigate the needs and challenges of caregivers and healthcare practitioners working with children with histories of family trauma and substance abuse. To obtain a better understanding and well-rounded image of the challenges and needs, information was gathered from various perspectives of those involved. This OT doctoral …

Outcomes Of Capstone Experience: Playing Together: Outcomes Of An Online Telehealth Sensory-Motor Development Program For Parents With Children Between The Ages Of 1.0-6.11 Years, Sarah Cunningham

OT Student Capstones

Children with developmental delays or cognitive impairments are more at risk for trauma, attachment, and adverse childhood experiences. The purpose of this pilot study of the telehealth program entitled “Playing Together” is to analyze whether an occupational therapy telehealth parent-training play program is an effective way to deliver services and potentially mitigate the effects of for trauma, attachment, and adverse childhood experiences. Quantitative data was gathered via the standardized assessments of the Short Child Occupational Profile and the Canadian Occupational Profile Measure and qualitative data was gathered using parent interviews, researcher journals, and session observation notes. Participants completed five one- …

Supporting Successful Community Reintegration For Maricopa Reentry Center Residentsjustine, Justine C. Gonzales

OT Student Capstones

In 2018, the combined state and federal imprisonment rate was 431 sentenced prisoners per 100,000 U.S. residents (BJS, 2020). Arizona is #5 in the nation with the highest imprisonment rate, 559 sentenced prisoners per 100,000 state residents (BJS, 2020). As of May 2020, there are currently approximately 5,300 offenders under community supervision in Arizona with a majority (4,600 offenders) serving a Truth in Sentencing (TIS) (ADC, 2020).

Barriers to reintegration: laws and legal restrictions, societal stigma and employer attitudes, limited education, limited cognitive skills, limited work experience, inadequate job skills, unstable housing, inadequate social services, lack of a state-issued identification …

Occupational Therapy For A Child With Food Protein Induced Enterocolitis In An Outpatient Multidisciplinary Intensive Feeding Program: A Case Report, Kristel Ferrer

OT Student Capstones

Objective: This article presents a case report of a child with food protein induced enterocolitis,

various feeding difficulties, and poor sensory processing. It discusses the significance of occupational therapy in a multidisciplinary feeding therapy team and describes the outpatient occupational therapy-based plan and interventions during 14 weeks of an intensive feeding therapy program.

Method: Chart review of assessments and daily treatment notes and clinical observations were examined. Progress towards goals was obtained through daily treatment notes and informal parental interviews. Results: Improvement in occupational performance and participation in mealtime and play is captured through daily treatment notes and clinical observations. …

Pet Pals Program: Experiences Of Volunteer Residents Providing Friendly Pet Visits To Individuals In A Memory Support Unit, Kelsey Odell

OT Student Capstones

Studies show that animal-assisted therapy modalities have an effect on motivation for participation, behavioral or psychosocial regulation, and physical and cognitive functions in individuals with dementia. Dementia is a progressive neurocognitive disorder that affects cognition and memory. As the disease progresses, skills needed to participate in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), community engagement and socialization decrease, making maximal independence more difficult. The Pet Pals Program provides educational and teaching concepts to volunteers and their pets to provide friendly pet visits to those in the memory support units. The program emphasizes the benefits of …

Use Of Intentional Play On Emotional Self-Regulation In Children With Trauma Histories, Erin Sullivan

OT Student Capstones

The purpose of this Capstone research project was to examine the impact of intentional play as a means to increase emotional self-regulation skills in children with traumatic histories and explore how Occupational therapists (OTs) can use such strategies while working with this population. The research was conducted at an emergency children’s shelter and consisted of an educational component for staff and direct contact with the children. Eight staff members participated, and data was gathered on 22 children (N=22) over a span of five weeks. An outcome measurement adapted from the Short Child Occupational Profile (citation needed) was used to obtain …

Incorporating Functional Hand Assessments As Outcome Measures In Burn Rehabilitation: A Pilot Study, Kristin Hazak

OT Student Capstones

Purpose: To incorporate the use of two hand function assessments, the Sollerman Hand Function Test (SHT) and the Brief-Michigan Hand Outcomes Questionnaire (bMHQ), in the outcomes measure protocol at a regional burn center for improving functional assessment and recovery progress tracking of burn injured hands. Methods: Seven participants were included in this pilot study. Inclusion criteria were individuals 10 years of age and older with current admission to the Arizona Burn Center with a primary diagnosis of partial thickness (2nd degree) to full thickness (3rd degree) burn injury, including at least one hand, with no restriction on TBSA or agent. …

Occupational Therapy’S Role In Self-Determination And Transition To Adulthood For High School Students In Special Education Programming, Kylee A. Read

OT Student Capstones

The Individuals with Disabilities Education Act Amendments of 1997 list occupational therapists (OT) as transition service providers in schools under the related services category (PL 105-117, 1997) able to provide interventions to help students develop skills to access the school curriculum and transition-related activities (Cleary, Persh, & Spencer, 2015). However, OTs are currently not fully participating in providing appropriate services in the areas of secondary education, vocational training, employment, community participation, and independent living to the extent allowed by the law (PL 108-446, 2004). Self-determination is the best predictor of successful transition to adulthood in students with disabilities. Self-determination can …

Mohs Micrographic Surgery In A Pediatric Patient With Squamous Cell Carcinoma, Cameron Nichols, Shields W. Callahan Md

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

An 11-year old boy presented with biopsy proven squamous cell carcinoma (SCC) of the left cheek. Pathology demonstrated moderate to well-differentiated SCC with positive deep and peripheral margins and no signs of definitive perineural invasion. Past medical history was significant for radiation therapy, chemotherapy, and stem cell transplant seven years prior for the treatment of a spinal embryonal tumor with multilayered rosettes with no signs of recurrence. He never had any direct radiation therapy to the site of his SCC. Mohs micrographic surgery (MMS) was ultimately selected as the treatment of choice for his SCC.

The main concern with MMS …

Hip Labral Injury Worsens After Platelet Rich Plasma Injections: A Case Report, Brennan M. Wright, Carmen Wong

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Case Description

A 47-year-old active male presented with 2.5 years of right hip pain suggestive of labral pathology. Ice, heat, celecoxib, ibuprofen, diclofenac gel, and physical therapy provided minimal relief. A diagnostic intra-articular bupivacaine injection resolved the pain. A subsequent MR arthrogram revealed a non-displaced tear of the right anterior superior acetabular labrum.

In pursuit of conservative treatment, the patient agreed to a series of 3 right hip intra-articular PRP (platelet rich plasma) injections. When he presented for the second injection, he reported his pain had decreased by 20% and he was tolerating light running. Due to improvement in symptoms, …

Reduced Length Of Stay In Major Hepatectomy Surgery After Implementation Of An Enhanced Recovery Pathway In The United States Veteran Population, Yvonne Nguyen Md, Marilyn Mcnulty Np, Leopoldo Fernandez Md, Michael R. Kazior Md

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Introduction

Enhanced recovery after surgery (ERAS) pathways are associated with better postoperative recovery, however, evidence is lacking in major liver surgery, .This study aimed to evaluate the impact of an ERAS pathway in U.S. veterans undergoing major hepatectomy surgery. We hypothesized that the adoption of an ERAS pathway reduces decreased length of stay (LOS).

Methods

After approval from the Hunter Holmes McGuire VA Medical Center IRB, we compared data from consecutive patients undergoing elective open hepatectomy within an ERAS pathway (January 2019-December 2019) to a previous cohort of patients before introduction of ERAS (July 2016-December 2017). One surgeon performed all …

Budd-Chiari Syndrome As The Initial Manifestation Of Behcet’S Disease​, Yashswee Kc, Abhishek Nandan, Nishant Desai

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.

Telemedicine Hcv Treatment In Department Of Corrections Results In High Svr In Era Of Direct-Acting Antivirals (Daa), Taseen A. Syed, Reena Cherian, Lewis Shawn, Richard K. Sterling

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.

Energy Compensation With Exercise Is Not Dependent On Dose, H. Michael Hays

Theses and Dissertations--Nutrition and Food Systems

Background: Exercise induced weight loss is often less than expected due to a coordinated set of compensatory mechanisms that serve to maintain energy homeostasis. The extent to which exercise frequency, duration, intensity and exercise energy expenditure (ExEE) influences the compensatory response to an exercise-induced energy deficit (energy compensation) is controversial. Determining how these variables impact energy compensation would help health care providers prescribe exercise with greater probability of creating a sustained negative energy balance and subsequent weight loss.

Methods: 44 Overweight/obese men and women (BMI=25-35kg/m²) aged 18 to 40 years were randomized to perform aerobic exercise 2 or 6 days/week …

Severe Drug-Induced Gingival Enlargement And Periodontitis: A Case Series With Clinical Presentation And Management, Janina Golob Deeb, Denver J. Lyons, Daniel M. Laskin, George R. Deeb

Periodontics Publications

Gingival enlargement (GE) is a condition in which the size of the gingiva increases in response to inflammation, systemic disease, or certain medications including anticonvulsants, calcium-channel blockers, and immunosuppressants. This report describes the management of two cases involving severe gingival enlargement related to the use of an anti-hypertensive calcium-channel blocker and an immunosuppressant. Besides taking amlodipine, one patient had undergone a heart transplantation seven years prior and has been taking two immunosuppressant drugs, mycophenolate and tacrolimus. The extent of the destruction of periodontal support, aggravated by gingival enlargement, resulted in extensive tooth loss. Periodontitis and gingival enlargement exacerbate and accelerate …

The Role Of Dental Hygienist In Hpv Prevention And Education In Parents Of Adolescents, Kelsey Dore, Sari Sweet

Dental Hygiene Student Scholarship

Objectives/Aims: Today the Human Papillomavirus (HPV) infects nearly 14 million people each year in the United States alone. HPV is responsible for several cancers, including oropharyngeal, which is currently on the rise. Each year an estimated 53,000 cases of oropharyngeal cancers are diagnosed, with 70% of the cases related to HPV. The significance of educating dental providers and patients of the correlations between HPV and oropharyngeal cancers involves increased prevention strategies in dental practices. The aim is to begin offering multi-level education to adolescents’ parent’s in routine dental care visits, in order to provide an innovative approach to reduce HPV-related …

The Role Of Rassf5 On Cell Growth And Hippo Signaling In Rhabdomyosarcoma, Megan Garver, Lee Helman, Md, Katrina Slemmons, Phd

Phase 1

Introduction: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma of childhood. Dysregulation of the Hippo pathway, a signaling cascade that regulates many biological processes, is associated with many human cancers. The goal of my project was to delete RASSF5, a regulator of the Hippo pathway, in RMS cells utilizing CRISPR/Cas9 and then to evaluate how the absence of RASSF5 affects RMS cell growth and Hippo signaling, with and without DNMTi Tx.

Methods: A lipofectamine transfection was performed in two different RMS cell lines, Rh30 & RD, in which two different CRIPSR/Cas9 vectors with RASSF5 guide RNA were introduced. …

Characteristics And Outcomes Of Patients Discharged Directly Home From A Medical Intensive Care Unit, Michele Fiorella, Ms, Preeyal M. Patel, Ann Zheng, Lauren Mcdonnell, Msn, Acnp, Mina Yasuoka, Msn, Erika J. Yoo, Md

Phase 1

RATIONALE: Discharging patients directly from ICUs is an increasingly common practice, largely due to decreased availability of ward beds. The purpose of this study was to describe the population and evaluate the outcomes of patients discharged directly from the MICU.

METHODS: We conducted a retrospective chart review of direct discharges to home from June 2018 to June 2019 from two MICUs. Patients were separated into two groups based on wait time (<24 hours or ≥ 24 hours) between ward transfer order and actual discharge. The primary outcome was 30-day hospital readmission. Risk was adjusted using Mortality Probability Model (MPM-III); ICU workload at admission and discharge was estimated using the nine equivalents of nursing manpower use score (NEMS). Patient characteristics were compared using t-test and Fisher exact or X².

RESULTS: There was no difference in severity-of-illness or admission NEMS between the two groups. Patients who waited <24 hours for discharge were more likely to be admitted from home. Patients who waited ≥24 hours prior to discharge had significantly longer mean hospital LOS compared to those who waited <24 hours (4.63 days vs. 2.65 days, p<0.001). There was no significant difference in 30-day readmission between patients who were discharged after waiting <24 hours vs. waiting ≥24 hours (p=0.70).

CONCLUSION: Patients who returned directly home from the MICU …

Helping Continuing Care Retirement Communities Determine The Best Level Of Care For Each Patient, Austin Klein, Nicholas Safian, Grant Schultheis, Sopuru Ezeonu, Danielle Snyderman, Md

Phase 1

Background: The vast majority of healthcare costs are spent on the last decade of life. Older patients often have complex medical histories complicated further by physical, mental and social limitations. High levels of hospital readmittance and nonadherence further complicate care for senior adult patients. Continuing Care Retirement Communities (CCRCs) are long term care facilities that attempt to support this diverse array of problematic patients. Residents can live in several different groupings called “Levels of Care” (LOC). To maximize safety, quality of care, and patient satisfaction, it is important to place residents in the right context. This project seeks to drive …

Treatment Of Persistent Air Leaks Using Endobronchial Valves, Michael Zimmerman, Cole Zingas, Achala Donuru, Scott W. Cowan, Nathaniel Evans Iii, Boyd Hehn

Phase 1

Introduction: Persistent air leaks (PAL) are from bronchopleural fistula resulting from communication between the bronchial tree and pleural space. Endobronchial valves (EBVs) are unidirectional valves placed bronchoscopically preventing airflow to the diseased lung lobe. For non-operable patients with PALs, EBVs offer a potential non-invasive treatment approach to stop air leak and allow lung healing. The purpose of this study is to retrospectively analyze EBV placement to treat non-operable adult patients with PALs.

Methods: We retrospectively analyzed all adult patients that underwent EBV placement for PAL treatment at our institution from January 2016 to June 2019. All patients failed conservative …

Late Complications Of Free Flaps In Head And Neck Microvascular Reconstruction, Swapna Vasudevan, Cory Bovenzi, Md

Phase 1

Introduction: Late free flap complications (LFFC) in head and neck reconstructive surgery occur over 72 hours postoperatively and result in flap loss in 97% of cases. Due to the rarity of LFFC, there is minimal research regarding risk factors for their development. Identifying risk factors for LFFC will result in improved monitoring of patients to prevent flap loss. This study aims to identify risk factors for the development of LFFC.

Methods: The target population of this retrospective cohort study was 116 patients who had undergone an Orbital Exenteration at Thomas Jefferson University Hospital (TJUH) and had LFFC. Data was …