Medicine and Health Sciences Commons^™

Caregiver Perspectives On Telehealth: A Service Delivery For Occupational Therapy, Rebecca Johnston

Student Capstone Papers

Telehealth; also known as telerehabilitation, telecare, telemedicine, teletherapy, and telepractice; is an emerging healthcare service that is utilized in various healthcare facilities with a span of ages, conditions, and locations (World Federation of Occupational Therapy [WFOT], 2014). Telehealth utilizes information and communication technologies to deliver services to a patient when the healthcare provider is not in the same location (WFOT, 2014). Telehealth can provide an online platform for evaluations, consultations, monitoring, supervision, and intervention with patients and other professionals (WFOT, 2014).

Telehealth is an emerging method of delivering occupational therapy (OT) services to various populations, including: children and youth; productive …

Lifestyle Management For Vestibular Disorders, Michelle Pock

Student Capstone Papers

Individuals with vestibular disorders have concerns that impact lifestyle including limiting activities of daily living, limiting participation in social events, difficulty driving, and difficulty working (Cohen, 2014). Occupational therapists are able to help individuals with vestibular disorders by task analyzing symptom provoking activities, assessing the impact of symptoms on occupations, providing adaptations, and providing ways to modify environments (Gronski, Neville, Kannenberg, & Cohen, 2017). While occupational therapists are qualified to provide services to sustain and improve the occupational performance of individuals with vestibular disorders, occupational therapy is not well represented in this area particularly in addressing lifestyle components for vestibular …

Delivery Of Small Molecule And Rna Using Synthetic Polymeric Micelles And Multifunctional Exosomes For The Treatment Of Type 1 Diabetes, Yang Peng

Theses & Dissertations

Type 1 diabetes is one of the most challenging chronic autoimmune diseases. The destruction and dysfunction of insulin-secreting β cells are the results of inflammatory infiltration and the synergistic effect of multiple immune cells. The aim of this dissertation is to develop novel and reliable therapeutic approaches to advance the treatment of T1D: including chemical modification of a broad-spectrum immunosuppressant, co-application of small molecule based immune intervention and siRNA based β cell preservative therapy, and administration of a PI3K-δ/γ dual inhibitor to specifically target immune cells, utilizing synthetic polymeric micelles or natural produced multi-functional exosomes derived from human bone marrow …

Charge-Based Optimization Of Neurotensin For Neurotensin-Receptor-1 Targeting Utilizing A One-Bead One-Compound Peptide Library Approach, Trey Neeley

Theses & Dissertations

Neurotensin-receptor-1 (NTSR1) is regularly overexpressed in various cancers and contributes to the proliferation, survival, migration, invasion, and angiogenesis of tumors. NTSR1-targeting vectors have demonstrated promise in both diagnostic and therapeutic aspects. Unfortunately, the relatively poor in vivo metabolic stability and high renal uptake and retention of NTSR1-targeted compounds have hampered the translation to the clinic. In this research, we utilized a one-bead one-compound (OBOC) peptide library approach to make targeted modifications at the naturally charged residues of an NTS (4-13) sequence to discover an NTS derivative with comparable affinity to NTSR1, acceptable in vivo stability, and tolerable renal retention. Subsequent …

Synthesis And Characterization Of Long Acting Darunavir Prodrugs, Mary Banoub

Theses & Dissertations

Patient adherence is critical for ART success to ensure adequate viral suppression, therefore, long-acting antiretrovirals are soon replacing current daily regimens. In recent years, two drugs were successfully transformed into long-acting injectables; CAB LA and RPV LA. These long-acting nanoformulations made it possible to abandon the daily pill burden, instead approximately a bimonthly injection of both drugs is enough to suppress and maintain viral load suppression. Our laboratory has been instrumental in transforming FDA-approved and experimental-HIV medications into long-acting slow effective release drugs, also known as LASER ART. LASER ART consists of slow drug metabolism and high permeability and retention …

The Role Of Histone Chaperone Fact Complex In Base Excision Repair Pathway And Its Therapeutic Potential In Colon Cancer And Medulloblastoma, Heyu Song

Theses & Dissertations

Base excision repair (BER) pathway is required for the removal of damaged bases caused by alkylation, oxidation and ring-saturation. Human apurinic/apyrimidinic endonuclease 1 (APE1) plays a central role in BER pathway. Although repair of damaged bases by recombinant APE1 has been well investigated in vitro, how APE1 gains access to damaged bases in the context of chromatin is largely unknown. A prominent member of the histone chaperone family, FACT (Facilitates Chromatin Transcription) is thought to reorganize nucleosomes through the destabilization of multiple intra-nucleosome contacts. FACT complex is composed of two polypeptides identified as SPT16 (Suppressor of Ty 16) and SSRP1 …

Enhancing The Identification Of Rheumatoid Arthritis-Associated Lung Disease, Bryant England

Theses & Dissertations

Rheumatoid arthritis (RA) is a systemic autoimmune disease that predisposes afflicted individuals to reduced quality of life, physical disability, and premature mortality. While joint involvement is the primary manifestation of RA, extra-articular features including lung disease are responsible for a significant portion of the excess mortality. In this dissertation I demonstrate the contribution of chronic lung diseases to premature mortality in RA, contrasting with the more widely recognized comorbidity in RA of cardiovascular disease. Then, I establish that a novel serum biomarker, anti-malondialdehyde-acetaldehyde adduct (MAA) antibody, is associated with the presence of interstitial lung disease (ILD) in RA subjects. Further …

The Development Of Hyaluronan-Based Contract Agents For The Intraoperative Detection Of Pancreatic Tumors, Bowen Qi

Theses & Dissertations

Pancreatic ductal adenocarcinoma is highly lethal and surgical resection is the only potential curative treatment for the disease. Tumor-specific intraoperative fluorescence imaging could improve staging and surgical resection, thereby improving prognosis. In the first study, hyaluronic acid derived NPs with physico-chemically entrapped indocyanine green, termed NanoICG, were utilized for intraoperative near infrared fluorescence detection of pancreatic cancer. NanoICG accumulated significantly in an orthotopic pancreatic ductal adenocarcinoma model with safety profile both in vitro and in vivo. To maximize tumor signal, while minimizing signal in healthy pancreas and RES capture of macromolecules, in the next study, we describe the rational …

Hiv-1 Elimination In Humanized Mice, Hang Su

Theses & Dissertations

Human immunodeficiency virus type one (HIV-1) exclusively infects humans and chimpanzees. Therefore, animal models are required for all investigations of viral pathogenesis, therapy and cure. Immunodeficient mice transplanted with human hematopoietic stem cells, termed humanized mice, support the development of multiple human cell lineages throughout the cell’s life span. To this end, we used humanized mice to evaluate the dynamic changes of host immunologic and viral profiles during both acute and chronic HIV-1 infection. We identified the temporal and spatial distribution of HIV-1 cell and tissue compartment infections and outlined correlations made between viral progression and host immunity by comparing …

Engineering Hyaluronic Acid For Biomedical Applications, Deep S. Bhattacharya

Theses & Dissertations

This work presents research using the naturally available non- sulfated carbohydrate glycosaminoglycan hyaluronic acid (HA) for the synthesis of different chemical derivatives of HA for evaluation of binding kinetics with CD44 and P- selectin proteins for applications in fluorescence image-guided surgery. Chemical derivatives of HA such as deacetylated HA (deHA), sulfated HA (sHA), and deacetylated and sulfated HA (s-deHA) were synthesized by modulating sulfating and deacetylating reagents to alter binding specificities to CD44. Modified HA derivatives and CD44 biophysical interactions were assessed by fluorescence polarization. In silico techniques were also used to determine binding using molecular docking and MM-PBSA approaches. …

Orthodontically Induced External Root Resorption In Extraction Versus Non-Extraction Treatment Modalities – A Retrospective Cone-Beam Computed Tomography (Cbct) Study, Jaykishan Patel

Theses & Dissertations

Purpose of this study was to evaluate orthodontically induced external apical root resorption using cone beam computed tomography in patients receiving orthodontic treatment with or without extractions. Records of 188 consecutively treated patients who received orthodontic treatment with or without extractions were evaluated. Pre-and post-treatment root lengths of maxillary incisors, volumes of maxillary central incisors, and apex displacement of either right or left maxillary central incisors were measured using Invivo 5.4 or ITK-SNAP 3.8.0 software. After adjusting for initial length, treatment duration, tooth, sex, race, bracket type, and malocclusion, maxillary incisor reduction of root length in extraction group was 0.37 …

Theranostics For Antiretroviral Biodistribution And Pharmacokinetics, Brendan M. Ottemann

Theses & Dissertations

RATIONALE: Our laboratories birthed the field of human immunodeficiency virus (HIV) theranostics. The new field allows simultaneous detection (diagnostics) and treatment (therapeutic) for the identification, treatment and inevitable elimination of virus in cell and tissue compartments. By employing theranostics, antiretroviral drugs (ARVs) can be tracked in lymph nodes, gut, spleen and liver. Cellular viral reservoirs including CD4+ T cell populations and mononuclear phagocytes (MP; monocytes, macrophages, microglia and dendritic cells) along with subcellular endosomal structures can now be targeted for drug delivery bringing therapeutics to areas where virus replicates. The overarching idea rests in improving precision targeted ARV delivery. …

Characterizing The Combination Of Rpa Inhibitors With Parp Inhibitors In High-Grade Serous Ovarian Cancer, Yat Tang

Theses & Dissertations

High-grade serous ovarian cancer (HGSC) is the most common and deadly gynecologic malignancy. HGSC patients with BRCA1/2 mutations have homologous recombination deficiency (HRD), requiring parallel pathways to maintain genome integrity (e.g., PARP1, PARP2). Approximately 50% of ovarian carcinomas are estimated to exhibit HRD. For the remaining 50% and the large percentage of HRD patients with acquired or innate resistance to single-agent PARP inhibitors, there is a need to develop alternative therapeutic strategies.

Replication Protein A (RPA) is a heterotrimeric protein crucial for genome maintenance. Phosphorylation of RPA in DNA damage response (DDR) is a negative regulator of DNA end resection. …

Identification Of More Potent And Efficacious Analogs Of The Novel Host-Derived Immunostimulant Ep67, Abdul Alshammari

Theses & Dissertations

EP67 is a human C5a-derived decapeptide agonist of C5a Receptor 1 (C5aR1/CD88) that selectively activates mononuclear phagocytes over neutrophils to stimulate protective innate and adaptive immune responses while potentially minimizing neutrophil-mediated toxicity. Two N-alkyl amino acids Pro⁷ and N-methyl-Leu⁸ (nme-Leu⁸) within EP67 induce structural changes that increase potency and selective activation of mononuclear phagocytes over neutrophils. Cis/trans isomerization at these positions, however, likely limits the activity of EP67 and low coupling efficiency between Pro⁷ and nme-Leu⁸ increases scale-up costs for clinical use. Thus, the goals of this study were to …

Evaluation Of A Technology-Based Survivor Care Plan For Breast Cancer Survivors: Pre-Post Pilot Study., Talya Laufer, Bryan Lerner, Anett Petrich, Anna Quinn, Leah Ernst, Alicin Roop, Janet Knoblauch, Nick C. Leasure, Rebecca J. Jaslow, Sarah Hegarty, Amy Leader, Andrea Barsevick

Department of Medical Oncology Faculty Papers

BACKGROUND: As of 2016, almost 16 million individuals were cancer survivors, including over 3.5 million survivors of breast cancer. Because cancer survivors are living longer and have unique health care needs, the Institute of Medicine proposed a survivor care plan as a way to alleviate the many medical, emotional, and care coordination problems of survivors.

OBJECTIVE: This pilot study for breast cancer survivors was undertaken to: (1) examine self-reported changes in knowledge, confidence, and activation from before receipt to after receipt of a survivor care plan; and (2) describe survivor preferences for, and satisfaction with, a technology-based survivor care plan. …

: Examining How Factors Associated With Patients, Physicians, Hospitals, And Surrounding Communities Affect Primary And Repeat Cesarean Delivery Through A Social-Ecological Lens, Christina Ventura-Dipersia

Dissertations and Theses

Background: Childbirth is one of the most common reasons for hospitalization in the U.S., and Cesarean delivery (i.e., surgical childbirth) is costlier and has a higher likelihood of birth-related complications, maternal rehospitalization, and postpartum medical care utilization than vaginal delivery. The rate of Cesarean delivery in the United States (U.S.) has increased in recent years by over 60%, from 20.7% of all births in 1996 to 32.9% of all births in 2011. As Although this increasing trend of Cesarean delivery incidence has also been seen in other countries, the rate of Cesarean delivery has been rising more steadily within …

Leader At The Bedside: A Mixed Methods Study Establishing Clinical Staff Nurse Leadership Competencies, Sherron Denise Franks-Meeks

Nursing Theses and Dissertations

Significance and Background

Leadership competencies were established for formal nursing roles (i.e. nurse executives), but not for informal nurse leader roles (i.e. clinical staff nurse leader). A set of comprehensive clinical staff nurse leader (CSNL) competencies would facilitate evaluation of the CSNL role in providing safe, quality, and efficient patient care.

Purpose

The purpose of this pilot was to establish a preliminary set of CSNL competencies with associated set of knowledge, skills, and attitudes (KSAs) for each competency identified through the CSNL’s voice. Theory & Design Underpinned by the Authentic Leadership Theory, this pilot was a multiphase sequential explanatory mixed …

Computational Studies And Design Of Pparγ And Glut1 Inhibitors, Suliman Almahmoud

Theses & Dissertations

The peroxisome proliferator-activated receptor gamma (PPARγ) is a ligand-dependent transcription factor of the nuclear receptor superfamily that controls the expression of a variety of genes involved in fatty acid metabolism, adipogenesis, and insulin sensitivity. PPARγ is a target for insulin-sensitizing drugs, and it plays a significant function in prostate cancer. PPARγ antagonists have anti-proliferative effects in a broad range of hematopoietic and epithelial cell lines. The ligand binding domain (LBD) of PPARγ is large and has orthosteric and allosteric binding sites. Several PPARγ-ligand co-crystal structures show two bound molecules, one to the orthosteric pocket and a second to the allosteric …

The Effectiveness Of Resin-Modified Glass Ionomer Varnish In Preventing White Spot Lesions During Fixed Appliance Orthodontic Therapy: An In Vitro Study, Bradley Herman

Theses & Dissertations

The purpose of this investigation was to evaluate the efficacy of a glass ionomer varnish in preventing demineralization of enamel adjacent to and some distance away from an orthodontic bracket. Forty extracted human molars were divided into four different treatment groups (varnish in distilled water, varnish in acetic acid, enamel in acetic acid, and enamel in distilled water). Two 3 x 3 mm graphite windows were drawn on the tooth, one adjacent to the bracket and one 3 mm away from the first window, indicating the scanning area. Varnish was applied to the teeth in the varnish groups and all …

The Ethical Justification Of Increasing Awareness Of Preventive Medicine Among Healthcare Professionals, Patients And The General Public In The United States, Karishma Ether Moazzam

Electronic Theses and Dissertations

While practiced for centuries, preventive medicine has received increased attention during the recent times. Preventive medicine has a distinct mission to protect, promote, and maintain health as well as to prevent diseases, disabilities, and premature deaths. It aims to fulfill its mission through the combined form of clinical intervention and health promotion. In the recent years, preventive medicine has begun to lean more towards the clinical interventions, taking away from the health promotion. This imbalance has caused preventive medicine to lose its effectiveness in fulfilling its mission. One of the leading causes for such imbalance is the lack of proper …

The Histone Deacetylase Inhibitor Tubacin Mitigates Endothelial Dysfunction By Up-Regulating The Expression Of Endothelial Nitric Oxide Synthase., Jihui Chen, Jian Zhang, Noor F. Shaik, Bing Yi, Xin Wei, Xiao-Feng Yang, Ulhas P. Naik, Ross Summer, Guijun Yan, Xinyun Xu, Jianxin Sun

Center for Translational Medicine Faculty Papers

Endothelial nitric oxide (NO) synthase (eNOS) plays a critical role in the maintenance of blood vessel homeostasis. Recent findings suggest that cytoskeletal dynamics play an essential role in regulating eNOS expression and activation. Here, we sought to test whether modulation of cytoskeletal dynamics through pharmacological regulation of histone deacetylase 6 (HDAC6)-mediated tubulin deacetylation affects eNOS expression and endothelial function in vitro and in vivo.Wefound that tubulin acetylation inducer (tubacin), a compound that appears to selectively inhibit HDAC6 activity, dramatically increased eNOS expression in several different endothelial cell lines, as determined by both immunoblotting and NO production assays. Mechanistically, we found …

Determining Levers Of Cost-Effectiveness For Screening Infants At High Risk For Peanut Sensitization Before Early Peanut Introduction, Matthew Greenhawt, Marcus Shaker

Dartmouth Scholarship

Importance Early peanut introduction reduces the risk of developing peanut allergy, especially in high-risk infants. Current US recommendations endorse screening but are not cost-effective relative to other international strategies.

Objective To identify scenarios in which current early peanut introduction guidelines would be cost-effective.

Design, Setting, and Participants This simulation/cohort economic evaluation used microsimulations and cohort analyses in a Markov model to evaluate the cost-effectiveness of early peanut introduction with and without peanut skin prick test (SPT) screening in high-risk infants during an 80-year horizon from a societal perspective. Data were analyzed from April to May 2019.

Exposures High-risk infants with …

The Role Of Occupational Therapy For Survivors Of Human Trafficking, Margaux Mariano

Student Capstone Papers

Human trafficking involves sex trafficking, labor trafficking, and trafficking of children. The needs of survivors of human trafficking are widespread due to the traumatic experiences they face. Concerns that may arise include decreased participation in meaningful activities in an individual's life, possibly due to anxiety, depression, suicidal ideation, memory loss, posttraumatic stress disorder, and social isolation. Individuals who have been subjected to human trafficking often experience occupational deprivation and occupational therapy has yet to establish its role in the recovery process for survivors. This capstone project consists of the process towards the development of an occupation-based, trauma-informed, evidence-based, and survivor-centered …

Perspectives Of Occupational Therapy Practitioners On Benefits And Barriers On Providing Occupational Therapy Services Via Telehealth, Taylor Corey

Student Capstone Papers

The purpose of this project is to gain a better understanding of the provider’s perspectives about the strengths and barriers of occupational therapy (OT) services provided via telehealth. Based on the evidence that will be collected through surveys and interviews, this research can help determine specific factors on whether or not therapist choose to provide services through telehealth. Centered around those perspectives of telehealth, the results can help explore more in depth on the issues and concerns therapists have regarding telehealth as a service delivery model.

“Everybody Is Scared To Eat The Food”: Exploring Food Sovereignty Applications In A Refugee Agricultural Program, Cheyenne Rose Schoen

Theses - ALL

This research documents some of the goals and challenges of refugee farmers and gardeners who participated in an organized agriculture project in Syracuse, New York. During the 2018 harvest season I observed and interviewed nine refugee farmers from Somalia, Bhutan, Nepal, and Democratic Republic of Congo, as well as four organizational staff members who were recruited through their affiliation with the Syracuse Refugee Agricultural Partnership Program (SyRAPP) and the Refugee and Immigrants Self-Empowerment (RISE) organization. Refugee farmers expressed distrust of the conventional food system, they valued control over the food supply through farming, and many desired to live at or …

Implementing A Fall Prevention Program: A Quality Improvement Project To Promote Patient Mobility On The Medical-Surgical Unit, Alba Araiza

Master's Projects and Capstones

Abstract

Implementing a fall prevention program is imperative in acute healthcare settings. Falls are one of the top reported events that occur in hospitals and it is a patient safety concern that requires the implementation of evidence-based practices to reduce falls. This quality improvement project will be developed by a master’s prepared clinical nurse leader (CNL) on a medical-surgical unit to improve patient safety.

Problem

Maintaining patient safety is the most important priority in health care. Health care organizations implement protocols, policies and procedures to ensure that care is provided in a safe manner to minimize preventable harms. However, falls …

Salutogenesis And The Prevention Of Social Death: Cross-Cultural Lessons From Genocide-Impacted Rwandans And Indigenous Youth In Canada, Jobb D. Arnold

Genocide Studies and Prevention: An International Journal

Combining trans-disciplinary theories with cross-cultural ethnographic research, this paper explores community-based approaches to genocide prevention among Canadian-Indigenous groups as well as with Rwandan student genocide survivors. A Salutogenic framework is used to examine community responses to the micro-foundations of genocide (Antonovsky 1987). These processes are explored using first-hand accounts from “New Family” networks of student genocide survivors in Rwanda and members of a Canadian urban-Indigenous “Village.” These perspectives shed light on how locally adaptive, socially networked practices can help promote emergent forms of genocide prevention (Williams 1977). This paper focuses on three areas of local practice that have helped build …

Pbrm1 Acts As A P53 Lysine-Acetylation Reader To Suppress Renal Tumor Growth., Weijia Cai, Liya Su, Lili Liao, Zongzhi Z Liu, Lauren Langbein, Essel Dulaimi, Joseph R Testa, Robert G Uzzo, Zhijiu Zhong, Wei Jiang, Qin Yan, Qing Zhang, Haifeng Yang

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

p53 acetylation is indispensable for its transcriptional activity and tumor suppressive function. However, the identity of reader protein(s) for p53 acetylation remains elusive. PBRM1, the second most highly mutated tumor suppressor gene in kidney cancer, encodes PBRM1. Here, we identify PBRM1 as a reader for p53 acetylation on lysine 382 (K382Ac) through its bromodomain 4 (BD4). Notably, mutations on key residues of BD4 disrupt recognition of p53 K382Ac. The mutation in BD4 also reduces p53 binding to promoters of target genes such as CDKN1A (p21). Consequently, the PBRM1 BD4 mutant fails to fully support p53 transcriptional activity and is defective …

Validity Study Of The R-Pla, A Resilience Scale For People Living With Hiv, Jinxiang Hu, Julianne M. Serovich, Monique J. Brown, Judy A. Kimberly, Yi-Hsin Chen

Faculty Publications

This study provides psychometric assessment of a resilience scale with a sample of women living with HIV. Baseline data were used from a longitudinal HIV disclosure study of 124 women aged between 18-63 collected between 2001 and 2004 in a large Midwestern city. The Rasch model was used to examine the psychometric properties of the resilience scale. Results indicated that the resilience instrument meets the Rasch model application assumptions. Evidence of validity suggested the resilience instrument demonstrated good item and person fit, as well as good item and person reliability. Most items showed measurement invariance across different age and racial …

Implementing A Fall Prevention Program: A Quality Improvement Project To Promote Patient Mobility On The Medical-Surgical Unit, Alba Araiza

Master's Projects and Capstones

Implementing a fall prevention program is imperative in acute healthcare settings. Falls are one of the top reported events that occur in hospitals and it is a patient safety concern that requires the implementation of evidence-based practices to reduce falls. This quality improvement project will be developed by a master’s prepared clinical nurse leader (CNL) on a medical-surgical unit to improve patient safety.

Problem

Maintaining patient safety is the most important priority in health care. Health care organizations implement protocols, policies and procedures to ensure that care is provided in a safe manner to minimize preventable harms. However, falls are …