Matching Items (25)
Description
In a world in which technologies proliferate at a rapid rate, it is no surprise that the medical device industry has grown in leaps and bounds. This surge in medical technology, especially implantable medical technology, has altered the modern operating room, transforming surgery from a technique-driven activity into a technology-driven profession. This reliance upon technologies has fostered close ties between physicians and the medical device industry and within this relationship, medical device representatives play an integral role. This paper will investigate the relationship that exists between physicians and the medical device industry along with the potential conflicts of interest that may result due to this relationship. I will focus in particular on orthopedic medical devices due to media attention as a result of a 2007 Department of Justice settlement involving the leading orthopedic companies. This case proved instrumental in highlighting previously unknown instances in which conflicts of interest were occurring in the medical device industry.
ContributorsLove, Kailey (Author) / Robert, Jason (Thesis director) / Marchant, Gary (Committee member) / Buchholtz, Stephanie (Committee member) / Barrett, The Honors College (Contributor) / School of International Letters and Cultures (Contributor) / School of Life Sciences (Contributor) / School for the Science of Health Care Delivery (Contributor)
Created2014-05
Description
Menopause is reproductive senescence characterized by a loss of ovarian estrogen and progesterone. Women can experience cognitive decline and other negative symptoms with the loss of ovarian hormones (Sherwin, 2006). While hormone therapies (HT) can treat symptoms of menopause and may have neuroprotective properties, such as the potential to decrease the risk of Alzheimer's Disease (Behl & Manthey, 2000), there are many effects of current HTs that are not ideal. Indeed, optimizing conventional HTs has proven complex, indicating a need for alternative therapies. Phytoestrogens are estrogenic compounds found naturally in plants such as soybeans, that could provide new treatment options. Dietary phytoestrogens can benefit memory in the rodent model (Luine, 2006), although the mechanism underlying these effects is unclear. Basal forebrain cholinergic projections have been shown to mediate the cognitive benefits of estrogen (Gibbs, 2010); we hypothesize that phytoestrogens act similarly, via the cholinergic system, to impact memory. We administered varying doses of phytoestrogen-containing diets to ovariectomized female rats, and used the place recognition task to evaluate spatial memory. Brains were then analyzed for choline acetyltransferase (ChAT), the synthesizing enzyme for acetylcholine, in the vertical-diagonal bands (VDB) and the medial septum (MS) of the basal forebrain. Results showed that ChAT cell counts in the VDB were marginally higher with dietary phytoestrogen treatment. Further, VDB ChAT cell counts positively correlated with place recognition performance, indicating that animals with more VDB ChAT neurons exhibited better spatial memory performance. These results suggest that phytoestrogens might act similarly to natural, endogenously circulating estrogens, and identify phytoestrogens as a direction for investigation as a HT.
ContributorsMousa, Abeer Abdul (Author) / Bimonte-Nelson, Heather (Thesis director) / Olive, Foster (Committee member) / Deviche, Pierre (Committee member) / Barrett, The Honors College (Contributor) / School of International Letters and Cultures (Contributor) / W. P. Carey School of Business (Contributor) / School of Life Sciences (Contributor) / School for the Science of Health Care Delivery (Contributor)
Created2014-05
Description
Patients face tremendous challenges when attempting to navigate the United States health care system. This difficulty to navigate the system creates a burden that is placed on the patient and caregiver, in turn affecting the health outcomes of the patient, resulting in higher health care costs, less than desirable outcomes, and a large strain on the patient and caregiver's daily lives. There are several ways that people have tried to create a comprehensive theoretical framework to understand the system from multiple perspectives. This work will expand existing theoretical frameworks that observes the relationship between the patient, their social networks, and health care services such as the Burden of Treatment Theory. Consisting of a comprehensive, multidisciplinary literature review, research was derived from the disciplines of medicine, informatics, management, and ethics. In this paper, I attempt to identify key contributing factors and then develop and categorize these stressors into a typology. Since there are many contributing factors that affect the burden of work at multiple levels, a nested typology will be used which will link micro- and macro-leveled pressures to a single system while also showcasing how each level interacts and is influenced by the others. For the categorization of the contributing factors, they will be sorted into individual actors, organizational level, and macro-level factors. The implications of this work suggest that a combination of historical shifts, structural design, and secondary effects of policy contribute to patients' burden of work.
ContributorsTomlinson, Rachel Laiku (Author) / Pine, Katie (Thesis director) / Trinh, Mai (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2017-05
Description
As a 21-year-old collegiate athlete, I was overcome with a sudden debilitating pain. Eight months of this pain and over a hundred doctors' appointments could not fix my problem. My issue was not uncommon, as it was due to chronic testicular pain. My experience was so terrible that I want to make sure what happened to me never happens to another person. It is unacceptable that fifty percent of chronic testicular pain cases are idiopathic. This is because conventional diagnostic and treatment protocols for men experiencing testicular pain are insufficient. Because the literature does not consider the body as a whole, testicular pain is diagnosed as idiopathic once trauma and torsion, tumors and cancer, infection, and sexually transmitted diseases are ruled out. This gap in the literature overlooks the links between biomechanical dysfunctions of the pelvic floor and testicular pain. Furthermore, recently proposed treatment algorithms do not consider the pelvic floor and are vague in their approach to treating and diagnosing testicular pain. If up to fifty percent of testicular pain cases are deemed to be idiopathic, then a more holistic approach must be utilized. This paper proposes a method to holistically evaluate patients with testicular pain and how to more efficiently diagnose the source of their pain. This paper will also coincide with my personal case study of idiopathic testicular pain.
ContributorsJackson, Cody John (Author) / Collins, Michael (Thesis director) / Fawcett, Lubayna (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Asian Americans have a unique relationship with food. From the moment they landed on American soil, their history and experiences have been tied to food, and not entirely by their own will. Now, the general American population enjoys foods from a multitude of ethnic groups, but in America’s early history, these foods were abhorred and used as justifications for legal discrimination, murders, massacres, and banishment. These struggles forced Asian Americans to work in the food industry (the only work they could do without as much backlash), further promoting the association of Asian Americans and food. While working in the food industry in order to find passage into America and to survive, many Asian dishes had to be assimilated to the palette of the general White American population and many dishes were made up and presented as authentically Asian. Some of these dishes have become iconic when thinking of classic American foods—chow mein, orange chicken, and more. For many non-Asian Americans, these popular dishes contribute to the pairing of Asian Americans with food and the food industry. But for Asian Americans, these dishes symbolize their struggles—leaving their homes and families behind, trying to live out the American dream, assimilating and changing their foods in just the right way in order to fit in, be accepted, and to survive. This project, in the form of a cookbook, examines the significance of food in the Chinese American, Japanese American, and Filipino American experiences in America while looking at the histories of those specific foods as well as histories of each group.
ContributorsTo, Lennie (Author) / Yoo, Hyung Chol (Thesis director) / Nakagawa, Kathryn (Committee member) / Department of Psychology (Contributor) / School of Life Sciences (Contributor) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
This paper describes Social Determinants of Health and the implementation of a screener. Social Determinants are structural drivers in an individual's life that affect their status of health. A screener's potential effectiveness at a student-run interdisciplinary clinic was also explored in the paper through the analysis of Student Health Outreach for Wellness (SHOW). SHOW's framework allows for a unique implementation of the screener because of the vulnerable population it serves, and the flexibility of the organization's structure. Its interdisciplinary nature allows for the SDOH screener to be integrated into its process more easily, especially with the presence of disciplines such as social work. A Social Determinants of Health questionnaire can be an important instrument to increase effectiveness in patient care by acknowledging each patient's situation more comprehensively, and moving forward with the most appropriate care plan. Among a vulnerable population such as those experiencing homelessness, an SDOH screener can identify key areas of focus that patients need addressed in order to improve their health status. A literature review was conducted to observe previous screener structures and questions. A model screener and best practices are provided as a guide for other clinics to use and adapt in their own settings. The domains of the sample screener questionnaire are tailored to serve populations with housing insecurity. The hope is to move forward with this screener after further modification of the questions, resources associated to each, and its prospective connection to the EHR system. The screener is planned to be executed at the SHOW clinic in Fall of 2018. In conclusion, a social determinants of health screener should be implemented in interdisciplinary clinics in a similar manner to SHOW's approach, to shift the focus of healthcare toward patient-centered care.
ContributorsThomas, Christy Maria (Author) / Reddy, Swapna (Thesis director) / Essary, Alison (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Project C.U.R.E. is a nonprofit organization that delivers donated medical supplies and services to developing nations across the world. Currently, the Phoenix location has three full time employees, so a majority of the manual work is completed by episodic and long-term volunteers as well as semesterly interns. Volunteers are the backbone of the organization's daily productivity. Productivity among the Project C.U.R.E. warehouses varies greatly by location and is not directly related to the size of the warehouse. Productivity if hereby defined as as a warehouse's capability to meet the organization's goal of one container per week. Productivity can be increased or decreased based on the number of volunteers, funding, and catalogued inventory. Across all warehouses there is generally an overflow of donated equipment and consumable products, and therefore this is not usually a factor in productivity. In order to better understand why the Phoenix warehouse is the second most productive despite being the smallest, we researched how the motivations of volunteers. A survey was conducted to assess the motives of Project C.U.R.E.'s volunteers by quantifying their responses according to the Volunteerism Functional Inventory (VFI). The survey also produced information regarding volunteer demographics (ie. including gender, age, and occupation), as well as statistics about how often they volunteer at Project C.U.R.E. and their overall satisfaction with the organization. The data was then analyzed to determine the most relevant VFI characteristic. Upon analyzing the data, it was observed that the majority of participants were male (58.95%) and were between the ages of 18 and 25 (82.11%). The results also showed that Project C.U.R.E. utilizes a large number of episodic volunteers from Arizona State University (due to its close proximity to the Phoenix warehouse) was supported in that the data showed 72.63% of participants were undergraduate students and that 48.42% had just volunteered for their first time. After combining survey questions that corresponded to the same characteristic of volunteerism as outlined by Clary et al. (values, social, career, understanding, protective, and enhancement) the average of the responses was taken and used to determine the most relevant motives for our volunteer population. Based on the data, values (average score of 5.0) and understanding (average score of 5.0) were the two most relevant characteristics and protective (average score of 1.0) was the least relevant to volunteers. Additionally, 41.1% of survey respondents reported food would incentivize them to return to Project C.U.R.E. Additionally, 35.6% of survey respondents reported receiving Project C.U.R.E. merchandise would incentivize them to return in the future. Moving forward, it is recommended that the Project CURE Phoenix location begin providing their volunteers with merchandise and other forms of recognition based on the number of hours they committed to the organization.
ContributorsPrimiano, Sarah (Co-author) / Maglajac, Benjamin (Co-author) / Wang, Lili (Thesis director) / Kizer, Elizabeth (Committee member) / Watts College of Public Service & Community Solut (Contributor) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
Executive function is a crucial part of daily living and activities for individuals with Down Syndrome (DS). The aim of this study was to examine if Assisted Cycle Therapy (ACT) would improve cognitive planning as measured by the Tower of London (TOL), set switching as measured by the modified Wisconsin Card Sorting Test, and spatial memory as measured by the Corsi Block Test in older adults with DS. Twenty-six participants were randomly assigned to one of three interventions over eight weeks. 1) Thirteen older adults with DS completed the ACT intervention, which is stationary cycling with the assistance of a motor to maintain a cadence at least 35% greater than voluntary cycling. 2) Eleven older adults with DS completed voluntary cycling (VC) and 3) Two older adults with DS were in our no cycling intervention. There were tests administered a week prior to the invention (or no intervention) and one week after their completed intervention (or no intervention). The pre- and post-tests were used to assess different measures, which could have been influenced from the eight-week intervention. The measures analyzed from our study were as followed; Tower of London, Card Sorting Test, and the Corsi Block Test. Our results showed that cognitive planning improved after ACT and VC, but not NC. Cognitive planning was assessed through the TOL task and showed improvements after the eight-week intervention (due to its sensitive nature in analyzing smaller changes pre- and post-intervention). Our results are discussed with respect to upregulation of neurotrophic factors that increase functioning in the prefrontal cortex that accompanies exercise.
ContributorsLopez, Corinna Lolita (Author) / Ringenbach, Shannon (Thesis director) / Holzapfel, Simon (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
Description
Glioblastomas (GBMs) are the most aggressive type of brain tumor. GBMs are known for their aggressive and invasive nature because of their ability to easily grow and spread into the surrounding areas of the brain. The annual incidence rate of GBM is 2 to 3 people per 100,000 people in the United States and Europe, and the median survival for patients with an aggressive GBM is 14.6 months. The standard of care for GBMs follows a protocol of surgery, radiation concurrent with the chemotherapeutic drug, temozolomide (TMZ), followed by the administration of up to 6 cycles of TMZ in an adjuvant setting. The objective of this retrospective study was to compare the clinical responses in a patient cohort from varying amount of adjuvant TMZ cycles. Using patient overall survival, the responses to TMZ cycles were tested within different groupings, and the patient covariates were analyzed. The results from the different analyses indicated that survival success of GBM patients is not solely dependent on the number of TMZ cycles, but that other covariates can also affect survival outcomes.
ContributorsSuri, Yash (Author) / Swanson, Kristin (Thesis director) / Massey, Susan (Committee member) / School of Geographical Sciences and Urban Planning (Contributor) / School for the Science of Health Care Delivery (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Hispanic children have the highest prevalence of obesity versus other ethnic groups. This leaves this population susceptible to many adverse health risks, including hypertension, cardiovascular disease, and high blood pressure. Unfortunately, little research has been done investigating the contributing cause to this issue, specifically common sedentary behaviors in children that limit physical activity and it’s purpose in expending energy. Amongst these behaviors, amount of time spent on electronic devices has proven to have increased drastically in recent years. The relationship between screen time and electronic device use, specifically with television, video games, and computer usage, and physical activity levels, and how those affect cardiometabolic disease risk factors, were explored in this study. Participants of this study were elementary school-aged children from Maricopa County, AZ. Electronic device usage, physical activity amounts, and presence of the specific devices in the child’s were collected from the participants’ parents through self-reported survey questions. Anthropometric and biochemical markers of cardiometabolic disease risk were directly measured. The average time spent engaged in physical activity per day by these participants was 20.02 ± 21.1 minutes and the average total screen time per day was 655 ± 605 minutes. Findings showed strong significance between total screen time and computer and video game use (r=0.482; p=0.01 and r=0.784; p=0.01, respectively). Video game time in the group of children with a video game in their room (350.66 ± 445.96 min/day) was significantly higher than the sample of kids without one in their room (107.19 ± 210.0 min/day ; p=0.000). Total screen time was also significantly greater with children who had a video game system in their room (927.56 ± 928.7 min/day) versus children who did not (543.14 ± 355.11 min/day; p=0.006). Additionally, significance was found showing children with a computer in the bedroom spent more time using the computer per day (450.95 ± 377.95 min/day), compared to those children who did not have a computer in their room (333.5 ± 395.6 min/day; p=0.048). No significant association was found between metabolic markers and screen time. However, HDL-cholesterol, triglycerides, and insulin proved to be dependent on BMI percentile (r=-0.582; p=0.01, r=0.476; p=0.01, r=0.704; p=0.01 respectively). Our data suggest further research needs to be done investigating other potential sources that limit physical activity so that strategies can focus on reducing obesity incidence and the associated health risks. Future studies should use larger sample sizes to be more representative of this population, and develop more direct observations instead of self-reported values to limit bias.
ContributorsGaines, Michael Anthony (Author) / Vega-Lopez, Sonia (Thesis director) / Crespo, Noe (Committee member) / School for the Science of Health Care Delivery (Contributor) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05