bluuebunny/crossref_metadata_2025 huggingface dataset:
Perfil alimentar e inatividade física em mulheres universitárias na cidade de Brasília
Authors: Monteiro Luciana Zaranza , Oliveira Divina Marcia Soares de , Parente Mayara Vinnie Souza Soares , Silva Esther de Oliveira , Varela Andrea Ramírez
Published: July 2021

Resumo Objetivo Analisar a associação entre perfil alimentar, atividade física e estado nutricional entre mulheres universitárias. Método Estudo transversal com 1500 mulheres. O questionário abordava questões sobre a vigilância de fatores de risco e proteção para doenças crônicas. As associações foram analisadas pelo teste qui-quadrado e análise de correspondência múltipla. Resultados Das 1500 mulheres, 64,3% tinham entre 20 e 29 anos. Aquelas fisicamente ativas consumiram mais frutas (p<0,01), salada (p<0,01) e vegetais/verduras (p<0,01), enquanto as fisicamente inativas consumiram mais refrigerantes (p<0,01), carne com gordura visível (p=0,03) e leite com gordura (p=0,04). As mulheres fisicamente inativas também apresentaram maior prevalência de diabetes mellitus (p<0,01), colesterol elevado (p<0,01) e dislipidemia (p=0,04). Conclusão e implicação para a prática As universitárias apresentaram comportamentos de risco a sua saúde, onde o consumo de álcool, baixo consumo de alimentos saudáveis e a alta prevalência de inatividade física contribuíram para o aumento dos fatores de risco para doenças crônicas. Ações preventivas com a participação de uma equipe multidisciplinar ajudará na melhora da saúde no ambiente acadêmico.
O discurso de controle de doenças da Organização Mundial da Saúde e a produção de espacialidades nacionais
Authors: Darsie Camilo , Hillesheim Betina , Weber Douglas Luís
Published: July 2021

A globalização ocasionou a circulação de vírus e bactérias em escala global, fazendo autoridades sanitárias atentarem às relações entre espaço e doenças. Assim, a Organização Mundial da Saúde (OMS) desempenha papel central na produção de conhecimentos e na divulgação de informações que regulam normas sanitárias. Por meio da análise de práticas discursivas ligadas ao controle de doenças, discutem-se, aqui, estratégias biopolíticas e a produção de espacialidades, tendo em conta a análise de documentos publicados pela OMS em que são apresentados os preceitos da instituição. Neles, destaca-se a produção de espacialidades nacionais que passam a ser valoradas de acordo com as capacidades de prevenção e controle de doenças de cada país membro, especialmente em momentos de crise.
Avaliação da ocorrência do evento adverso flebite em pacientes de uma Unidade de Internação Clínica
Authors: Furlan Maryana da Silva , Lima Antônio Fernandes Costa
Published: July 2021

RESUMO Objetivo Analisar as causas e os motivos associados à ocorrência de flebite na Unidade de Internação Clínica de um hospital geral, que é de grande porte e privado. Método Pesquisa quantitativa, exploratório-descritiva, retrospectiva e documental, realizada a partir da consulta aos formulários eletrônicos de notificação da ocorrência de flebite referentes ao ano de 2017. Resultados Foram notificadas 107 flebites relativas a 96 pacientes, a maioria (91,7%) com uma flebite, do sexo masculino (53,1%), na faixa etária de 60-69 anos (23,0%) e com tempo de permanência inferior a quatro dias (30,2%). A maioria (68,2%) das notificações foi realizada por enfermeiros, tendo predominado a ocorrência de flebite nos dispositivos com tempo inferior a 24 h (38,3%), a classificação flebite grau 2 (45,8%), a infusão de antibióticos (46,7%), a localização do leito distante do posto de enfermagem (52,3%) e a presença de acompanhante (82,2%). A classificação de danos indicou que 93,5% dos pacientes sofreram danos leves, 4,7%, danos moderados e 1,9% não sofreram danos. Conclusão Conhecer as causas e os motivos associados à ocorrência de flebite poderá subsidiar os processos decisórios, gerencial e assistencial, quanto aos investimentos em estratégias preventivas ou de mitigação de riscos.
Implementação da Política Nacional de Atenção Integral à Saúde do Homem: desafios vivenciados por enfermeiras
Authors: Sousa Anderson Reis de , Oliveira Josias Alves de , Almeida Marcio Soares de , Pereira Álvaro , Almeida Éric Santos , Vergara Escobar Oscar Javier
Published: July 2021

RESUMO Objetivo Analisar os desafios vivenciados por enfermeiras na implementação da Política Nacional de Atenção Integral à Saúde do Homem. Método Estudo descritivo, qualitativo, realizado com enfermeiras que atuam na Atenção Primária à Saúde em um município da Bahia, Brasil. Realizou-se entrevista individual, analisada pelo método do Discurso do Sujeito Coletivo, à luz das diretrizes da Política Nacional de Atenção Integral à Saúde do Homem. Resultados Participaram 40 enfermeiras. Os desafios para a implementação da política concentram-se na inoperância das ações governamentais, fragilidades da gestão municipal, subfinanciamento e descontinuidade das ações. Conclusão As enfermeiras enfrentam desafios complexos de macrogestão na implementação da Política Nacional de Atenção Integral à Saúde do Homem na Atenção Primária à Saúde.
Impulse-Based Computation of Policy Counterfactuals
Authors: Hebden James , Winkler Fabian
Published: July 2021

We propose an efficient procedure to solve for policy counterfactuals in linear models with occasionally binding constraints. The procedure does not require knowledge of the structural or reduced-form equations of the model, its state variables, or its shock processes. Forecasts of the variables entering the policy problem, and impulse response functions of these variables to anticipated policy shocks under an arbitrary policy, constitute sufficient information to construct valid counterfactuals. We show how to compute solutions for instrument rules and optimal discretionary and commitment policies with multiple policy instruments, and discuss various extensions, including imperfect information, asymmetric objectives, and limited commitment. Our procedure facilitates the comparison of the effects of policy regimes across models. As an application, we compute counterfactual paths of the U.S. economy around 2015 for several monetary policy regimes.
Biology and Conservation of the Freshwater Turtles and Tortoises of Peru
Authors: Ferronato Bruno O. , Morales Victor M.
Published: July 2021

Little information has been published on Peruvian chelonians. Here we have compiled the available literature pertaining to Peruvian freshwater turtles and tortoises on four topics: Human consumption and ethnobiology, habitat use, status and abundance, and reproduction. In addition, we provide a map of the regions of Peru showing the number of research records and the number of species that occur in each region. Reproduction was the topic most frequently studied, although investigations were concentrated on only three species (Podocnemis unifilis, P. expansa, P. sextuberculata). The regions where the most studies were implemented are the Departamentos de Loreto and Madre de Dios, with studies tending to be concentrated in the vicinity of  Iquitos, the Pacaya-Samiria National Reserve, and Manu National Park and its buffer zone. In general, regions in which more research effort was evident reported more turtle species, which suggests that the least-studied states could have more species, as they share the same types of habitats as the more intensely investigated regions. We identified major gaps in information and suggest future research in the following poorly studied Peruvian regions: Departaments of Junín, San Martín, Tumbes, Huanuco, Amazonas, Cusco, Ayacucho, Puno, Huancavelica, and Cajamarca. The status, distribution, and abundance of Peruvian populations of Podocnemis expansa, P. unifilis, Chelonoidis carbonaria, Peltocephalus dumerilianus, and Mesoclemmys heliostemma are in particular need  of study. Conservation priorities are also discussed.
Urban Amphibians of the Texas Panhandle
Authors: Ramesh Rasika , Griffis-Kyle Kerry , Perry Gad , Farmer Michael
Published: July 2021

Habitat loss, degradation, and fragmentation due to urbanization are implicated in amphibian declines worldwide. Conservation efforts require information on resident species and their habitat interactions, but amphibian ecology is largely  unstudied in urban centers of the Southern High Plains. Here, we gathered baseline data on amphibian presence, species richness, and habitat preferences at site-specific and landscape scales during a severe drought year in the city of Lubbock, in northwestern Texas. Ephemeral playa wetlands are characteristic of this landscape. During urbanization, these have been extensively modifiied for stormwater drainage,  agriculture, and construction of roads, buildings and neighborhoods. A semi-arid climate with frequent droughts, together with urbanization, could have an adverse effect on resident amphibians. In 2011, we sampled 23 urban lakes for amphibian presence, using a combination of audio, visual, and larval surveys. We detected five amphibian species at seven lakes; Texas Toads (Anaxyrus speciosus) and Spotted Chorus Frogs (Pseudacris clarkii) were the most frequently encountered species. We found significant negative effects of nearby road density on amphibian species presence and richness. We also detected significant negative effects of basic pH on amphibian species richness. These data can be used for prioritizing lakes for amphibian conservation strategies, to monitor ecosystem function in urban wetlands, and to guide future development and restoration efforts.
The Turtle Head Immobilization System (THIS)
Authors: Munscher Eric C. , Butterfield Brian P. , Carstairs Sue , Dupuis-Désormeaux Marc , Munscher Jessica , Osborne Wayne , Hauge Brian
Published: July 2021

The turtle head immobilization tool (THIS) is an efficient and cost effective tool to aid in the processing of large, aggressive turtles such as the Eastern Snapping Turtle (Chelydra serpentina). THIS aids in the reduction of aggressive behaviors by calming the animal during processing and minimizing injuries to the turtle and handlers. This simple tool also streamlines the processing itself, by allowing researchers to focus on measurements and markings, instead of having to maintain the constant vigilance often needed to work safely around these animals.
Results of the 2015 Mugger Crocodile (Crocodylus palustris) count at Vadodara, Gujarat, India
Authors: Vyas Raju
Published: July 2021

This report documents the Mugger Crocodile census conducted on 20–21 January 2015 at Vadodara City, Gujarat. This is a periodic procedure and part of an ongoing study designed to monitor this urban population with the help of public participation. The results show gradual increase in the Mugger populaion within the demarcated stretch of the River Vishwamitri. The night-count numbers indicated the presence of 250 individuals of various sizes (<1 m to > 4 m in total length). Mugger Crocodiles are wild, aquatic, carnivorous animals that have been flourishing in close proximity to humans, allowing for a noteworthy case study of the human-Mugger relationship. However, direct and indirect conflict data from the year 2014 are alarming – 24 documented Mugger attacks (12 of which were fatal) within the state, seven (three fatal) within the city limits, and 48 Muggers of various sizes rescued from the area. These numbers are indicative of a unique, complicated, and delicate relationship between humans and crocodiles as a balance is sought between Mugger conservation and a steadily rising urban population.
Reptilian diversity of the Bhopal Region in the State of Madhya Pradesh in central India
Authors: Manhas Amit , Raina Rajni , Wanganeo Ashwani
Published: July 2021

The wide range of habitats in the Bhopal Region of Madhya Pradesh in central India support a rich reptilian fauna. Conducting visual surveys, we recorded 34 species of reptiles (2 species of crocodilians, 3 species of turtles, 13 species of lizards, 16 species of snakes). Observations were made during the monsoon period from mid-June to mid-September in 2014-2015. Herein, we present baseline data regarding the reptilian fauna of the Bhopal Region.
Lecturas cruzadas entre Freire y Foucault. A propósito de aleturgias escolares y prácticas de libertad
Authors: Gallo Silvio , Espinel Oscar
Published: July 2021

El artículo de investigación propone continuar la labor de pensar la educación, esta vez, desde el diálogo entre dos autores y dos perspectivas como las expuestas por Michel Foucault y Paulo Freire. Para ello hace uso de las nociones foucaultianas de aleturgia, prácticas de libertad y heterotopía como instrumentos de análisis con el objeto de guiar la discusión, animar las tensiones y pensar posibilidades de fuga para la educación y la escuela. Las diferencias y posturas de cara a conceptos freireanos como prácticas de la libertad y utopía buscan dar forma a nuevas herramientas teórico-metodológicas a fin de problematizar la escuela, la educación y las prácticas hegemónicas desplegadas sobre ellas. En este ejercicio se asume, junto con Freire, la lectura como acto de pensar, de pensarnos e interrogarnos abriendo horizontes de indagación. Una lectura crítica como la reescritura permanente que practicó, vivificó y propició el mismo Freire.
Possibilities of skin ultrasound examination in the management of patients with localized scleroderma
Authors: Krakhaleva Yulia A. , Kolerova Anastasia V. , Sorokina Elena D. , Mikailova Daria A. , Krinitsyna Yulia M. , Filimonov Pavel N. , Sergeeva Irina G.
Published: July 2021

With the help of ultrasound examination (ultrasound), it is possible to visualize the skin of patients with suspected localized scleroderma, as well as to objectively determine the stage of the disease and assess the effectiveness of therapy.
Three patients with linear, plaque forms of scleroderma, as well as lichen sclerosus, underwent skin ultrasound using a Skinscanner DUB TPM device with a 75 MHz transducer, 4 mm penetration, 21 m resolution in the area of lesions and in adjacent areas of healthy skin, using their ratio coefficient (RC) for comparative evaluation. The thickness of the epidermis and dermis, their echogenicity were determined.
With a linear form of scleroderma, an increase in the thickness of the epidermis in the area of the focus (RC 0.850.0125) and a decrease in its echogenicity (RC 1.580.46) were observed. The echogenicity of the dermis was significantly reduced in the lesion (RC 3.021.17). The dermis thickness was slightly less in the center of the lesion (RC 1.09), at the periphery of the lesion it was moderately increased (RC 0.86). In the plaque form of scleroderma, a decrease in the echogenicity of the epidermis was observed in the foci (RC 1.320.49); an increase in the thickness of the dermis (RC 0.790.16) and a decrease in its e echogenicity (RC 1.260.57). In 7 of 11 foci, a subepidermal hypoechoic band was visualized. With lichen sclerosis in the foci, an increase in the thickness of the epidermis (RC 0.420.12) and its acoustic density (RC 0.630.0793), a decrease in the thickness and echo density of the dermis (RC 1.320.00943 and RC 1.550.6, respectively).
With different forms of LS, a different ultrasound picture was observed, depending on the stage and activity of the process. The changes identified during treatment reflect the effectiveness of the therapy and the rate of restoration of the skin structure during therapy.
Clinical case of acne inversa
Authors: Teplyuk Natalya P. , Pirogova Anna S.
Published: July 2021

Acne inversa is a rare skin disease characterized by recurrent nodules and abscesses that rupture with suppurative discharge and lead to sinus tracts and scarring. The disease is chronic and debilitating. In typical cases, it is diagnosed at late stages, when more aggressive therapeutic treatment is obligatory. There is not generally any accepted therapeutic algorithms, therefore, it is a difficult-to-manage disease, which determines the necessity for further study.
We present a clinical case of acne inversa with non-classical phenotypic features and the results of its treatment with systemic retinoids, and metformin. We also provide a review of the literature on the etiology, pathogenesis, and diagnosis of acne inversa.
Currently, there is no reliable algorithms of diagnostics and effective treatment for patients with acne inversa, which underlines the importance of further study of this disease.
Self-induced dermatosis: a diagnostic problem at the intersection of two specialties
Authors: Olisova Olga Yu. , Teplyuk Natalia P. , Kayumova Lyailya N. , Smirnova Lyudmila M. , Anpilogova Ekaterina M. , Nikulina Alena S.
Published: July 2021

Self-induced dermatoses is a group of artificial skin injuries and its appendages caused by self-injuring by the patient in order to get rid of negative emotions and painful sensations or to simulate a well-known dermatitis because of the pathological desire to be hospitalized to meet emotional or financial needs.
A significant similarity of clinical manifestations of self-induced dermatoses and oorganic dermatoses (vasculitis, cystic medicine, gangrenous pyoderma, drug reactions, etc.), the inefficiency of dermatological treatment with the sudden appearance of new lesions, as well as the deliberate concealment by the patient the real causes of skin lesions and giving false anamnesis lead to difficulties in diagnosis of self-induced dermatoses. The article presents current data on the main diagnostic criteria and effective methods of treatment of this disease based on several foreign and russian publications; own clinical cases descriptions are also provided.
Self-induced dermatoses must be considered as a possible differential diagnosis in cases when no well-known dermatoses can explain the clinical picture and anamnesis does not match it; new destructive lesions appear spontaneously, despite the ongoing treatment.
Microneedling in the threatment of post-acne symptom complex
Authors: Bykanov Aleksandr S. , Snarskaya Elena S.
Published: July 2021

The review presents data from foreign and domestic clinical studies on the efficacy and safety of microneedling application in the treatment of post-acne symptom complex. An analysis of the database of systematic reviews of Russian, European, American researchers, comparative studies on the effectiveness of the microneedling therapy in patients with different skin types for the treatment of postacne symptom complex is presented. Possibilities of microneedling monotherapy and variants of combined treatment, in particular the combinations of microneedling with PRP-therapy, acid peels, non-ablative lasers, injection gels (PMMA-collagen, hyaluronic acid, sodium succinate) are shown.
Lyell´s syndrome provoked by external drug use
Authors: Krivosheev Alexandr B. , Ermachenko Tamara V. , Khavin Pavel P. , Krivosheeva Inga A. , Morozov Dmitry V.
Published: July 2021

Lyells syndrome is rare. Up to 10 cases are registered per million population per year. The mortality rate for Lyells syndrome is 512%.
Two patients were observed aged, respectively, 38 years and 72 years with Lyells syndrome. The disease manifested itself against the background of local application of drugs. In one case ― Dolobens gel as an analgesic at the site of a bruise of the right hand. In another case, a 20% solution of chlorohxidin biogluconate as a mouth rinse for stomatitis. The first symptoms of the disease occurred locally at the site of application of these medicines. In the first case, the skin of the right hand, in the second ― the mucous membrane of the mouth. The outcome of the disease depended on early diagnosis, urgent hospitalization in a specialized department, from the area of skin lesions, the appointment of adequate therapy.
Lyells syndrome can occur at any age, and the risk of developing the disease increases in those over the age of 40. In the elderly, SL in terms of the first symptoms and rate of disease progression, the nature of skin and mucous membrane lesions does not have any fundamental differences with those in younger patients. The distinctive features and risk factors of Lyells syndrome in the elderly include, firstly, its occurrence against the background of the already formed comorbid age-related pathology of internal organs, secondly, the concomitant age-related pathology during the development of an acute toxic-allergic reaction is decompensated, a multiorgan failure is formed, which is the cause of more severe Lyells syndrome and higher mortality. In young people, a comorbid viral infection can be considered a risk factor, especially the combination of HIV-infection and chronic hepatitis C.
A Quantitative Study Evaluating the Effects of Climate Change and Environmental Context Process Oriented Guided Inquiry Learning (POGIL) Curricula on Student Performance in a First-Year University Level Chemistry Classroom
Authors:   , Ibarrola Recalde Guillermo D. , Sondergeld Toni A. , King Daniel B.
Published: July 2021

This dissertation evaluates the effects of climate change and environmental context Process Oriented Guided Inquiry Learning (POGIL) curricula on student performance in a first-year university level chemistry classroom through correlational, causal-comparative, and quasi-experimental quantitative research designs. These Context-Based POGIL curricula were implemented over a period of three years in a private R1 university located in an urban area in the Mid-Atlantic region of the United States. The significance and need for this study were based on three main objectives: 1) evaluate the effects that these Context-Based POGIL curricula have on student performance; 2) to promote the implementation of evidence-based pedagogies fostering chemistry and climate change education content; and 3) to provide practical recommendations for instructors to engage students in chemistry content by instruction using socioscientific issues that are pressing to society like climate change in context. The participants in this study (N=78) were undergraduate students enrolled in a second-term of three introductory chemistry courses designed for chemistry majors over a period of three years (AY 2017-2020). All students learned topics through three instructional methods [Non-POGIL (Lecture), Traditional POGIL and Context-Based POGIL]. Inferential statistics indicated a significant difference on individual students' average exam performance based on questions that were learned using both the Traditional POGIL and Context-Based POGIL methods and no statistically significant differences based on gender. Similarly, the results found that there were statistically significant differences on percentages of students achieving course content proficiency based on instructional method. Based on the findings, pedagogical practices for enhancing student performance, content proficiency and potential lowering attrition levels in science courses were discussed. Additionally, recommendations for future research on Context-Based POGIL activities were offered.
A Journal Article Acknowledging Native Americans' Experiences in the Healthcare System
Authors:   , Williams Amanda Lea , Devereaux Christina
Published: July 2021

This culminating project acknowledges the history and resilience of Native people in America. It provides a brief overview of historical contexts, invisibility of accurate Native representation in literature and media, and indigenous ways of knowing. This broad look at factors influencing the patient/provider relationship for Native Americans seeking health care is done so to provide a generalized foundation which trusting relationships can potentially be established on. The article portion of this project offers suggestions that could be implemented moving forward to aid in establishing trust through the patient/provider relationship. It does so by displaying the patient/provider relationship as a kaleidoscope, reflective and multifaceted. The kaleidoscope uses Relational-Cultural theory as an approach, using reciprocal recognition, while simultaneously incorporating the systems impacting the individual and the collective.
The Creation of a Music Therapy Grief Support Group for Young Adults
Authors:   , Brockway Regina Allison , Horowitz Scott A
Published: July 2021

This paper details the development and implementation of a music therapy-focused grief support group for young adults at a Hospice Bereavement Department in a major city on the East Coast. There is a gap in research on the use of music therapy with bereaved young adults, and this project aimed to explore the use of this modality to support grieving individuals in this life stage. This project was guided by a community music therapy model and a framework of cultural humility, and the steps to its implementation included an introductory workshop, a community brainstorming meeting, and the creation of ongoing programming. During the time period of this project, the COVID-19 pandemic occurred and the program had to be adapted to a virtual format. The group used music therapy interventions to help individuals connect to one another, as well as their creativity, as a means of supporting their grief processes. Both the in-person workshop and the virtual bi-weekly group seemed to provide young adults with connection, support, and creative release in their bereavement, leading to my recommendation of future support groups of this nature being offered in both virtual and in-person formats. Moreover, the music therapy interventions allowed participants to oscillate between the loss and restoration oriented coping styles of the dual process model in a safe and contained way, thereby illuminating that more research is needed on the application of this model in music therapy contexts.
Reducing Readmissions in Programs of All-Inclusive Care for the Elderly Through Transition of Care Interventions
Authors:   , Banks Yvette Rene , Wilson Linda
Published: July 2021

Twenty percent of older adults age 65 years and older discharged from the hospital are readmitted within 30 days of discharge (Jencks, Williams & Coleman 2009). The readmission rate among the same population is roughly 23% (Segelman et al., 2014). Each year, the estimated cost of avoidable hospital readmissions is roughly $12 billion (Hudali, Robinson and Bhattari 2017). The purpose of this pilot quality improvement project was to evaluate the effectiveness of a transition of care interventions when applied to individuals enrolled in Programs of All-Inclusive Care for the Elderly (PACE). Transition of care interventions are evidence base practice which creates a standard of care with the goal of avoiding and reducing hospital readmissions (Dusek, Harripaul, & Lloyd, 2014). The Promoting Action on Research Implementation in Health Services (PARiHS) was the conceptual model which provided the foundational constructs of the project while the Model for Evidence Base Practice Change guided the implementation of this pilot quality improvement project (Rosswurm and Larrabee, 1999). PACE enrollee's hospital admission data was collected, measured and analyzed to evaluate the effectiveness of the transitional care interventions which are designed to prevent hospital readmissions. In a study of a comparable population, hospital readmissions decreased by 43% when transition of care interventions were applied (Lipani, Holster and Bussey, 2015). Key Words: Programs of all-inclusive care for the elderly, hospital readmissions, transitions of care
Integrating Music Therapy and Internal Family Systems Methods to Address Complex Trauma
Authors:   , Cephas Anna S. , Ierardi Florence M
Published: July 2021

Complex trauma with early life onset is shown to have severe disruptions in emotional and inter-personal development, with effects lasting well into adulthood. Defined as cumulative stressful events beginning in early life within the context of attachment relationships, complex trauma introduces levels of stress that children are developmentally unable to regulate, leading to pervasive difficulties with cognitive, emotional, and behavioral functioning. Music therapy methods have been shown to be effective in facilitating emotional expression, creating reparative attachment experiences, and reconstructing personal narratives, while Internal Family Systems (IFS) offers a unique conceptualization of attachment injuries that teaches clients to regulate physio-logical responses by developing self-understanding and compassion. This author explored how these techniques may be combined to support the needs of adults with complex trauma. The intentional utilization of improvisational and songwriting methods using an IFS framework was helpful in re-framing past experiences, illuminating internal resources, and increasing self-compassion. Exploratory improvisations and songwriting processes were guided by IFS steps of identifying activated parts within the self, bearing witness to the experience of parts, and communicating compassion and acceptance. Reflections on this process warrant further exploration of how future methods may be developed using these techniques and frameworks.
Encouraging Full Bodied Movement in Art Therapy
Authors:   , Dobbins Lauren Noel , Rattigan Michele D
Published: July 2021

A culminating project investigating trauma work in art therapy. Utilizing trauma research, multiple theoretical perspectives, and professional disciplines, this paper suggests a body-based art therapy method for adults with trauma.
Evaluating the Local Release, Systemic Transport, and Biological Significance of Cobalt Chromium Debris in Total Knee Replacement
Authors:   , Arnholt Christina Marie , Kurtz Steven M. , Brandt-Rauf Paul
Published: July 2021

Total knee arthroplasty (TKA) is one of the most commonly performed orthopedic surgeries during which a tibial tray, either titanium (Ti) or cobalt-chromium (CoCr) alloys, a polyethylene insert, and a cobalt-chromium alloy femoral component are implanted. Sensitivity to metal debris re-emerged as a concern in arthroplasty, with relatively little research focused on metal release in TKA. The overall focus of this work was to describe the potential biological burden of metallic debris from TKA. This dissertation investigated TKA devices, and tissues collected from routine revision and post-mortem TKA retrievals.
Investigating the Electrophysiological Response of Neonatal Brachial Plexus Nerves Brachial Plexus Nerves When Subjected to Stretch
Authors:   , Gangakhedkar Radhika Rahul , Balasubramanian Sriram , Singh Anita
Published: July 2021

Neonatal brachial plexus palsy (NBPP) has been a prominent challenge in obstetrics with reported incidence of 1 to 4 per 1000 childbirths in the United States. NBPP occurs due to over stretching of brachial plexus (BP) during complicated birthing scenarios resulting in functional disability of the upper limb. No data exists on functional responses of BP nerves acutely post-stretch. The goal of this study is to investigate the electrophysiological responses of BP nerves (musculocutaneous, radial, median and ulnar) when subjected to varying degrees of strain ranges from 5-10%, 15-20% or 25-30% at displacement rate of 500 mm/min. Neonatal piglets (3-5 days old, N=10) were anesthetized and intubated to perform surgical exposure of bilateral BP. All the animal procedures were approved by the Institutional Animal Care and Use Committee. Baseline nerve conduction data were collected prior to subjecting varying degrees of pre-determined BP strains. Immediately post stretch, electrophysiological recordings were performed to investigate the effects of strain on BP function. Data analysis included calculating the latency, amplitude, and conduction velocity (CV) before stretch and after stretch and calculating percentage change in these parameters in response to subjected strain. Increasing strains resulted in an increase in latency and reduction in amplitude and CV in the stretched nerves. Strain range of 15-20% exhibited a greater functional deficit while strain range of 5-10% exhibited lower functional deficit. Furthermore, strains higher than 20% reported a conduction block (CB) in all four BP nerves. In bifurcating nerves from the common cord, the unstretched nerves exhibited no change in latency and CV but a decrease in amplitude with respect to the stretched nerves at strain ranges of 5-10% and 15-20%. These study findings will help in better understanding the functional responses associated with NBPP in human neonates and can aid in better prognosis and treatment options.
The Design of an Apparatus for Creating a Model Drug-Eluting Stent
Authors:   , Kitchmire Rebecca Lynn , Kurtz Steven M.
Published: July 2021

Coronary artery disease (CAD) is the most common form of cardiovascular disease in the United States. Drug eluting stents (DESs) are a commonly used medical device in the treatment of CAD. However, the polymer coatings that are applied to these stents for drug release over an extended period can cause an inflammatory response at the implantation site. To counteract this, many researchers are seeking new polymer coatings by fabricating DESs at a laboratory level. These fabrication processes are inconsistent across research facilities and could benefit from a well-defined processing procedure for DES fabrication. This study aimed to create an apparatus and processing procedure for applying a polymer coating to a bare metal stent. The design incorporated a combination of hardware and software components to develop a polymer spray-coating apparatus. The final apparatus design consisted of both a stent mount component and a polymer spray component. The stent mount component was capable of 360 degrees of rotary motion. The polymer spray component was capable of more than 20 mm of linear motion and also released a polymer spray of polylactic-co-glycolic acid (PLGA) dissolved in ethyl acetate. Both components of the design incorporated custom designed and 3D printed elements. A processing procedure was then developed to allow the device to apply a polymer coating of uniform morphology and thickness to stainless-steel foils. Information from experiments involving the mass flow rate and spraying efficiency of the polymer spray component were utilized to create this processing procedure. When this procedure was used to apply a polymer coating to stainless-steel foils, a uniform coating morphology and thickness were observed. However, when this processing procedure was translated to stainless-steel stents, large variations in coating morphology and thickness were observed. Future work will be useful to further refine the processing procedure and create DES samples with uniform coating morphologies and thicknesses.
eNOS O-GlcNAcylation in Endothelial Cell Dysfunction
Authors:   , Meldrum Danika Emily , Clyne Alisa Morss
Published: July 2021

Pulmonary arterial hypertension (PAH) increases pulmonary vascular resistance and right ventricular afterload, which eventually results in right heart failure. In PAH, endothelial cells (EC) are dysfunctional through both decreased nitric oxide (NO) production and increased glucose metabolism. However, neither the cause for PAH-related EC dysfunction nor effective treatments are known. We hypothesized that increased EC glucose metabolism would increase endothelial nitric oxide synthase (eNOS) O-GlcNAcylation, which has been shown to decrease eNOS phosphorylation at Ser1177 and consequently decrease NO bioavailability. We further hypothesized that statins, which are known for decreasing lipids but also decreased EC glucose metabolism, would decrease eNOS O-GlcNAcylation and restore eNOS phosphorylation and NO bioavailability. To explore these hypotheses, I measured eNOS O-GlcNAcylation and phosphorylation after fluvastatin treatment in human umbilical vein endothelial cells (HUVEC) and pulmonary artery endothelial cells (PAEC) from healthy and PAH patients. Fluvastatin decreased HUVEC eNOS O-GlcNAcylation and increased eNOS in a dose and time dependent manner. Fluvastatin also increased eNOS phosphorylation compared to untreated groups. In addition, PAEC from PAH patients (n=2) showed increased eNOS O-GlcNAcylation compared to PAEC from healthy patients (n=2). PAEC from female patients (n=2) also had increased eNOS compared to PAEC from male patients (n=2). Finally, I designed a chamber to enable long term hyperoxia treatment so that we could simulate hyperoxia-induced PAH animal models. Existing in vitro hyperoxia chambers do not allow for cell feeding without disrupting the desired oxygen environment. I designed, built, and tested a system to pump old media out of and new media into up to 12 cell culture dishes without opening the hyperoxia chamber. The system successfully changed cell culture media in under 1 minute, maintained the internal chamber environment, and kept the samples sterile for 96 hours. 96-hour hyperoxia treatment decreased EC viability but did not change eNOS O-GlcNAcylation. The results presented here suggest that eNOS O-GlcNAcylation may be involved in EC dysfunction in PAH. The results further support that fluvastatin may restore EC function by increasing eNOS and decreasing eNOS O-GlcNAcylation. Finally, the new in vitro media changing system could extend controlled hyperoxia treatment to times not previously possible. Additional experiments should be conducted to determine if fluvastatin restores PAEC function and NO bioavailability through a decrease in eNOS O-GlcNAcylation.
Absolution and Defiance
Authors:   , Tant Lara Elizabeth , Morningstar Dawn
Published: July 2021

The purpose of this performance-based culminating project was to promote social justice and advocacy through giving a voice to the lived experiences of the victims and survivors of human trafficking. This domestic population has been underrepresented in literature and underserved in practice. Dance/movement therapy (DMT) as a component of post-trafficking services created a safe space to use self-expression to improvise new narratives on the pathway to healing. The use of DMT provided the means to express and investigate deeply imprinted body trauma. The impact and efficacy of DMT witnessed in clinical practice was widespread across this population, not dependent upon the survivors' readiness to exit "the life," but instead supporting those still enmeshed with their traffickers as well as those working towards reintegration post-trafficking. However, this project focused on one survivor and describes how performance used witness as a method to help her reclaim her body when emerging from sexual slavery. By examining the method of dance performance as a tool in DMT for self- empowerment in the healing of sexual trauma, this project served to help one survivor find her voice and observe her effect on others, promoting her self-efficacy.
The identification of barriers to care for health risks of poor function due to sleep impairment with an assessment and intervention in the primary care setting
Authors:   , Bomalaski Patricia Marie , Rundio Al
Published: July 2021

Barriers to care for the identification of poor function related to sleep impairment were identified in clinical practice and confirmed in the literature. This information was applied clinically in a symptoms review among patients seen in primary care clinic in an urban setting, using a nursing theoretical framework. The PROMIS assessment tool for sleep impairment was used to assess sleep impairment with an intervention pre and post assessment to improve sleep by an educational intervention for sleep hygiene. The comparison was made and measured by a T-test, per the PROMIS Assessment tool to identify if knowledge and self-care lifestyle changes could promote improved sleep and improved health. Key words: sleep impairment, daytime sleepiness, primary care sleep and function, PROMIS tool, memory loss, insomnia, sleep and health outcomes
Welcoming Pause
Authors:   , Kinsley Caroline Anne , Morningstar Dawn
Published: July 2021

This Culminating Project paper is a synthesis of an exploration with Mindfulness-Based Dance/Movement Therapy (MB-DMT) in a high school setting with adolescents managing anxiety. From experience, I created context and population guidelines for future application. I explored ways in which nonjudgement, present focused, and compassion are integrated into the DMT therapeutic setting. This paper includes a review of the current literature to support, guidelines for application, a clinical example, and future considerations. As a result of exploration, I found the connection between the use of Pause in MB-DMT (Schweitzer, 2019) and the DMT theory of exertion and recuperation (Bartenieff, 2002). Finding that each emphasizing the need to acknowledge the body's natural rhythm for action and rest. Supporting a student's ability to develop coping skills to manage anxiety applicable across contexts. I consider social and cultural factors that influence the process in need of future development. I discuss future potential, implications, and additional considerations needed.
Navigating Music Therapy Relationships in the Neonatal Intensive Care Unit
Authors:   , Laventure John W. , Ierardi Florence M
Published: July 2021

This capstone project is focused on preterm infants who have been admitted to the Neonatal Intensive Care Unit (NICU). The author conceptualized the best approach to building relationships in the Neonatal Intensive Care Unit - Music Therapy (NICU-MT) between the therapist-neonate, therapist-caregiver(s), and therapist-NICU personnel. Neonates are fragile and require critical care. Preterm infants born before 32 to 34 weeks' gestation may face challenges feeding and require the use of gavage feeding, oral-gastric or nasogastric tube. Literature shows that music therapy is effective in aiding preterm infants in neurological development thus allowing them to survive independently. However, the infant's survivability outcome is higher the longer that the fetus is able to develop in-utero. Each trimester consists of developmental milestones necessary for the infant's survival. When an infant is born prematurely, some of these milestones may not be achieved and can have long-term effects on the infant and family/caregivers. Within NICU-MT, there are a number of evidence-based interventions that have proven effective with the challenges related to prematurity. NICU-MT helps facilitate development in neonates and in promoting an atmosphere conducive to building relationships, between all parties within the NICU setting - NICU staff, parents/caregivers, and neonates. In this project, the author describes experiences in the context of a music therapy internship. Keywords: Music therapy, Neonatal Intensive Care Unit, relationships, Staff, Parents
Dance/Movement Therapy for Men who are Homeless and in Recovery
Authors:   , Sadler Emma Christine , Devereaux Christina
Published: July 2021

The purpose of this culminating project was to design a program proposal to develop a dance/movement therapy program at Miracles in Progress, a residential program for men who are homeless and in recovery. Miracles in Progress is located in the Behavioral Wellness Center at Girard, in Philadelphia, Pennsylvania, where homelessness and addiction affect and exasperate each other. The project examined existing treatments for addiction, systemic factors of homelessness, cultural aspects and gaps in the literature, and how dance/movement therapy could fill the gaps within current treatment. A program proposal was written to address how dance/movement therapy can expand current treatment at Miracles in Progress through its unique, nonverbal quality. The aim of this author was to understand an expanded view of how dance/movement therapy can be applied with this population. This culminating project also serves as a way to gain knowledge of the grant and the program writing processes, as it can be considered an essential skill in a field where funding is a consistent concern.
Mindful Art for Healthcare Professionals
Authors:   , Wexler Emily Celia , Rattigan Michele D
Published: July 2021

This culminating project demonstrated that it is possible to combine a mindfulness practice with artmaking that is accessible and applicable to support the wellbeing of healthcare professionals. A global pandemic was not going to interfere. Instead, changing the platform to an online event opened the experience to a wider audience. Thirty-nine participants from all over the United States participated.
Processing of Epitaxial Oxyfluoride Films and Characterization of Their Physical Properties
Authors:   , Wang Jiayi , May Steven J.
Published: July 2021

Controlling the carrier concentration in electronic materials via doping is of fundamental importance in engineering physical properties for applications in electronic devices. In ABO₃ perovskites, altering the electron count on the B-site cation is typically achieved through A-site cation substitution. In contrast, there has been less exploration of anion substitution. For example, F⁻ substitution for O²⁻ provides an alternative means to tailor the nominal B-site valence, the ionicity of the B-O bond, and the lattice volume. In the study of anion substitution, while bulk oxyfluorides have received interest over the last two decades, epitaxial perovskite oxyfluorides have only been reported in recent years. The goal of this project is to develop a mechanistic understanding of topotactic fluorination reactions in epitaxial perovskite films and the resultant effects on physical properties of the incorporated F content. In this work, I demonstrate a highly controllable fluorination process using as-grown SrMnO_[2.5] epitaxial thin films as a model system with polytetrafluoroethylene (PTFE) as F source. The F content is systemically controlled by the fluorination time. The F is found to incorporate by substituting for the in-site O, which provides a means of electron doping the transition metal perovskites. Upon fluorination, a c-axis expansion, resistivity increase, and blue-shift of the optical absorption features are observed. In addition, the F/O site occupancy in the SrMnO_[2.5-[delta]]F_[gamma] epitaxial thin film is successfully engineered using substrate-induced biaxial strain. The F is found to have an apical site preference under compressive strain while it has an equatorial site preference under tensile strain. This is the first report of the strain-induced anion arrangement in oxyfluoride thin films. The B-cation alloyed SrFe_xMn_[1-x](O,F)_[3-[delta]] system with different Fe substitution level is also investigated to reveal the B-cation and anion composition influence on structural, electronic, and optical properties. Keywords: fluorination, mixed-anion, oxyfluoride, perovskite, topotactic chemistry