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Description
Startle-evoked-movement (SEM), the involuntary release of a planned movement via a startling stimulus, has gained significant attention recently for its ability to probe motor planning as well as enhance movement of the upper extremity following stroke. We recently showed that hand movements are susceptible to SEM. Interestingly, only coordinated movements of the hand (grasp) but not individuated movements of the finger (finger abduction) were susceptible. It was suggested that this resulted from different neural mechanisms involved in each task; however it is possible this was the result of task familiarity. The objective of this study was to evaluate a more familiar individuated finger movement, typing, to determine if this task was susceptible to SEM. We hypothesized that typing movements will be susceptible to SEM in all fingers. These results indicate that individuated movements of the fingers are susceptible to SEM when the task involves a more familiar task, since the electromyogram (EMG) latency is faster in SCM+ trials compared to SCM- trials. However, the middle finger does not show a difference in terms of the keystroke voltage signal, suggesting the middle finger is less susceptible to SEM. Given that SEM is thought to be mediated by the brainstem, specifically the reticulospinal tract, this suggest that the brainstem may play a role in movements of the distal limb when those movements are very familiar, and the independence of each finger might also have a significant on the effect of SEM. Further research includes understanding SEM in fingers in the stroke population. The implications of this research can impact the way upper extremity rehabilitation is delivered.
ContributorsQuezada Valladares, Maria Jose (Author) / Honeycutt, Claire (Thesis director) / Santello, Marco (Committee member) / Harrington Bioengineering Program (Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
Previous research has shown that a loud acoustic stimulus can trigger an individual's prepared movement plan. This movement response is referred to as a startle-evoked movement (SEM). SEM has been observed in the stroke survivor population where results have shown that SEM enhances single joint movements that are usually performed with difficulty. While the presence of SEM in the stroke survivor population advances scientific understanding of movement capabilities following a stroke, published studies using the SEM phenomenon only examined one joint. The ability of SEM to generate multi-jointed movements is understudied and consequently limits SEM as a potential therapy tool. In order to apply SEM as a therapy tool however, the biomechanics of the arm in multi-jointed movement planning and execution must be better understood. Thus, the objective of our study was to evaluate if SEM could elicit multi-joint reaching movements that were accurate in an unrestrained, two-dimensional workspace. Data was collected from ten subjects with no previous neck, arm, or brain injury. Each subject performed a reaching task to five Targets that were equally spaced in a semi-circle to create a two-dimensional workspace. The subject reached to each Target following a sequence of two non-startling acoustic stimuli cues: "Get Ready" and "Go". A loud acoustic stimuli was randomly substituted for the "Go" cue. We hypothesized that SEM is accessible and accurate for unrestricted multi-jointed reaching tasks in a functional workspace and is therefore independent of movement direction. Our results found that SEM is possible in all five Target directions. The probability of evoking SEM and the movement kinematics (i.e. total movement time, linear deviation, average velocity) to each Target are not statistically different. Thus, we conclude that SEM is possible in a functional workspace and is not dependent on where arm stability is maximized. Moreover, coordinated preparation and storage of a multi-jointed movement is indeed possible.
ContributorsOssanna, Meilin Ryan (Author) / Honeycutt, Claire (Thesis director) / Schaefer, Sydney (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
This document introduces the need for the Rest Egg system and defines an accessible method of smartphone integration. Excessive noise can prevent recovering patients and special needs persons from resting correctly. The Rest Egg was designed for these people- people who are in critical need of quality rest but are often unable to eliminate stressors themselves. This system ensures their environment is calm by alerting caretakers' smartphones if noise reaches abrasive levels. Smartphones were the preferred device due to the wide spread of such devices in today's market. After making open sourcing a goal, something ubiquitous and affordable \u2014 yet usable and dependable \u2014 was necessary for the alert system. These requirements lead to the election an online alert service: Pushover, a trademark and product of Superblock, LLC.
ContributorsJennings, Tyler Blake (Author) / Goryll, Michael (Thesis director) / Kozicki, Michael (Committee member) / Barrett, The Honors College (Contributor) / Electrical Engineering Program (Contributor)
Created2016-05
Description
The National Center for Missing & Exploited Children (2014) estimated that one in six runaways were likely to be victims of sex trafficking. Nearly 88% of trafficking survivors reported having some kind of contact with the health care system while they were trafficked (Lederer & Wetzel, 2014). In this study, the Office of Sex Trafficking Intervention Research at Arizona State University is attempting to determine the knowledge medical students and healthcare professionals have on identification of a sex trafficking victim and methods of reporting these situations within their organizations. To explore the knowledge providers and students have on sex trafficking victim identification as well as reporting protocols, our office sent out an online, anonymous survey to current medical students and healthcare professionals in the United States. The survey results will assist in the development of a training curriculum addressing the identification of sex trafficking victims within a medical setting and how to report within organizations. The anticipated outcome of this study was that medical students and healthcare professionals have not had training or continuing education on identifying a potential sex trafficking victim.
ContributorsMorris, Sierra Taylor (Author) / Roe-Sepowitz, Dominique (Thesis director) / Rendell, Dawn (Committee member) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Introduction. Evidence shows that the United States' healthcare system is inefficient and lacks the quality and cost-effectiveness of other systems. The Institute for Healthcare Improvement outlined the Triple Aim to improve the healthcare system through 1) improvement of population health for a defined population, 2) enhance the patient care experience, and 3) reduce per capita cost of care. The World Health Organization has identified interprofessional practice (IPP) and interprofessional education (IPE) as a possible approach to achieve the Triple Aim. The Student Health Outreach for Wellness (SHOW) initiative is an interprofessional free clinic and outreach initiative for individuals experiencing homelessness. The goal of the current study was to evaluate whether interprofessional care delivery through SHOW moved SHOW's practice towards the Triple Aim for SHOW's defined population. Methods and Results. Data assessing adherence to Triple Aim goals of population health and costs of care were collected from voluntary post-visit patient satisfaction surveys, while data assessing patient experience were collected from shift rosters of SHOW versus a similar non-interprofessional clinic. SHOW, on average, provided access to more disciplines than a similar non-interprofessional clinic. Access to care cost savings was assessed by surveying patients on where they would have sought care elsewhere SHOW had not been available ; of the 53 patients surveyed, 14 indicated they would have gone to the emergency department (ED); in all, SHOW diverted a little over $30,000 in patient ED visits. Improved health outcomes were measured by each patient's self-perception of his/her health. 91% of patients agreed or strongly agreed that their health had been improved by coming to the clinic. Conclusion. Preliminary data suggest that SHOW's IPP care delivery results in high patient satisfaction rates and positive self-perception of health outcomes, thus may improve the patient experience and minimize costs of care by deterring ED visits within the population. Further studies are needed to determine how specific aspects of interprofessional care can further move towards Triple Aim objectives.
ContributorsSingh, Sukhdeep (Co-author) / Paode, Pooja (Co-author) / Harrell, Liz (Thesis director) / Wermers, Rita (Committee member) / Department of Finance (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
The introductory section of my thesis will draw heavily from sources written by experts in the field of creative thinking. First, I will introduce the ideas proposed by Mihaly Csikszentmihalyi in his groundbreaking publications, Flow and Finding Flow. Here, I will discuss the "what" and "why" elements of my thesis, more specifically explaining why creativity is so important and how it could serve to improve the lives of those feeling emotionally or intellectually stifled by their stays in long-term healthcare facilities. Next I will use the steps outlined in Keith Sawyer's Zig Zag to explain the different elements that are involved in achieving creativity, "flow," and fulfillment. This will begin to touch on the issue of "how" from a theoretical perspective. For the latter half of my thesis, I draw from case studies, research papers, and design solutions from architects, designers, and manufacturers alike to begin imagining what designing a creatively conducive long-term care facility would entail, along with providing some examples of how these spaces might look, feel, and function. This portion is not meant to be a comprehensive design solution, but is simply meant to provide a framework and foundation for healthcare designers interested in incorporating creative spaces into their designs. The conclusion of this thesis is that creatively conducive spaces would be a beneficial contribution to the health care environment, particularly in settings that provide long-term care for individuals with limited capacity to leave the facility. These creative spaces will be guided by three key themes: (1) taking influence from children's health care facilities, which are more focused on the formative experiences of the user, (2) utilizing technology to provide opportunity for creative inspiration, expression, and collaboration, and (3) providing patients with the means to be creatively productive, including giving patients the power to control aspects of their environment.
ContributorsHumphrey, Amanda Rose (Author) / Bernardi, Jose (Thesis director) / Neaves, Jeff (Committee member) / Pickett, Christine (Committee member) / Herberger Institute for Design and the Arts (Contributor) / The Design School (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Short-term medical volunteer work via a nongovernmental organization is a popular tool for students in the health care field to gain experience, while further providing communities that normally lack health care options the opportunity to receive free care. One such organization, VIDA Volunteer Travel, has been successful in implementing this model in Central America. However, organizations of this form have not been evaluated for effectiveness or improvement. This exploratory study examines the effectiveness of VIDA based on six qualifying characteristics that make up a successful NGO. The researcher conducted in-depth, semi-structured interviews with 21 individuals, including VIDA staff members in Costa Rica and Nicaragua, health professionals working for VIDA, local community leaders, and volunteers participating in VIDA's programs. Summaries and quotes of these interviews were uploaded and analysed using Atlas.ti to identify common words and themes from the interviews. Informants frequently identified the organization as sustainable, both from a fiscal and ecological standpoint. The organization also successfully managed volunteers, although post-trip follow-up was lacking. Adherence to the mission statement and distribution of supplies allowed for improved organization and successful structure of the organization. Education and health promotion was also emphasized, although implementation of this education into the communities was lacking. Collaboration with the community and volunteers allowed for stringent, successful treatment to be given to patients, and ethical guidelines set up by the organization allowed for self-governance and improvement of the NGO. This study suggests future research opportunities for the organization, to evaluate its own impact and opportunities for improvement. Furthermore, suggestions are addressed that allow the organization to improve upon its well-implemented infrastructure, and allow for future organizations to use VIDA as a model for improvement.
ContributorsPearson, Presley Kyle (Author) / Yoshioka, Carlton (Thesis director) / Wang, Lili (Committee member) / Larsen, Dale (Committee member) / Barrett, The Honors College (Contributor) / School of International Letters and Cultures (Contributor)
Created2013-05
Description
G3Box's 2013 Marketing Plan outlines a strategic plan and short term operational strategies for the company. The document includes a discussion of the company's decision to enter the market for healthcare facilities in developing counties, and a situation assessment of the market conditions. G3Box is targeting small and large NGOs that currently provide healthcare facilities in developing countries. The market size for healthcare aid in developing countries is estimated to be $1.7 billion. The plan also analyses the customer's value chain and buying cycle by using voice of the customer data. The strategic position analysis profiles G3Box's competition and discusses the company's differential advantage versus other options for healthcare facilities in developing countries. Next the document discusses G3Box's market strategy and implementation, along with outlining a value proposition for the company. G3Box has two objectives for 2013: 1) Increase sales revenue to $1.3 million and 2) increase market presence to 25%. In order to reach these objectives, G3Box has developed a primary and secondary strategic focus for each objective. The primary strategies are relationship selling and online marketing. The secondary strategies are developing additional value-added activities and public relations.
ContributorsWalters, John (Author) / Denning, Michael (Thesis director) / Ostrom, Lonnie (Committee member) / Carroll, James (Committee member) / Barrett, The Honors College (Contributor) / Ira A. Fulton School of Engineering (Contributor)
Created2012-12
Description
The Community Action Research Experiences (CARE) Program collaborated with the WellCare Foundation (WCF) to assess the referral sources of the clinic in order to more effectively reach additional potential patients. Archival data were analyzed from a 19-month period from the medical records of patients. Also, data were collected from interviews with the case manager of agencies that were a known referral source of WCF. These case manager interviews were completed over a one-month period. For the archival data part of the project, data were collected from 117 patients. Four representatives from community agencies participated in phone interviews. The results indicated that the most common referral sources were word of mouth, followed by community agency referrals. The results also indicated that WCF appears to have served a unique niche that is not served by other non-profit health clinics. These results led to implications for action and direction for future applied research.
ContributorsEbbing, Brittany Gabrielle (Author) / Spinrad, Tracy (Thesis director) / Dumka, Larry (Committee member) / Brougham, Jennifer (Committee member) / Barrett, The Honors College (Contributor) / T. Denny Sanford School of Social and Family Dynamics (Contributor) / School of Life Sciences (Contributor)
Created2013-05
Description
Incorporating sustainability education in primary healthcare practice is an important step toward promoting sustainability in the US healthcare system. This health strategy is also consistent with a renewed focus of the US healthcare system, mainly prompted by the Affordable Healthcare Act of 2010, toward preventive care and patient wellness. The major challenge, however, is an effective implementation of sustainability education in the healthcare industry. This honors thesis project developed a sustainability education model, in which primary healthcare providers or the physicians educated the patients about sustainability and its connection to public health issues. The main purpose of this thesis project is to analyze the effectiveness of this sustainability education model and to evaluate its impact on the individuals and households in terms of sustainable attitudes and practices. The study was conducted with 26 parents of newborn babies at Estrella Pediatrics PC using a classic randomized control-group pretest-posttest design. The Pre- and Post-Surveys were completed to evaluate change in their knowledge and attitudes toward sustainability practices covered in the sustainability education model. In the research, the relationships between sustainability-related issues and their negative impacts on the health of human beings were established in the sustainability education pamphlet provided to the physicians, which they shared with the patients during the wellness visits. This pamphlet focused on waste management, air pollution, and locally grown food. Moreover, samples of environmentally-friendly diapers were given to the study respondents to complement this education. The study demonstrated positive trends with the intervention protocol, though the level of statistical significance was marginal. More specifically, it was observed that the respondents placed the highest significance on the education provided by the pediatricians. Interestingly, the receipt of the diaper samples by itself did not generate any significant effect. However, the education provided by the physician and the pamphlet coupled with the diaper gave very positive results. In conclusion, physician led sustainability education has significant potential in promoting sustainability in primary healthcare practice, and further inquiry should be pursued.
ContributorsQuintero Cervantes, Laura Beatriz (Author) / Shrestha, Milan (Thesis director) / Boone, Christopher (Committee member) / Thunderbird School of Global Management (Contributor) / W. P. Carey School of Business (Contributor) / School of Sustainability (Contributor) / Barrett, The Honors College (Contributor)
Created2015-12