This case study describes an adult patient whose brachial plexus injury was treated with various modalities and exercise. The participant of this study was a 76 year old female who sustained a brachial plexus injury during an elective reverse total shoulder arthroplasty. The initial evaluation reported only passive range of motion with 90 degrees shoulder flexion, 85 degrees abduction, and 30 degrees external rotation. Muscle testing yielded significantly limited wrist and digit extension strength. Testing of sensation found diminished protective sensation along the median nerve distribution, including the thumb, index finger, and middle finger. Occupational therapy was initiated for postoperative treatment of the shoulder as well as treatment of the brachial plexus palsy. Therapy consisted of static splinting for healing structures and sensory reeducation through massage, finding objects with the eyes occluded, and fluidotherapy. Additionally, various exercises and modalities for improving motion and strength were initiated, including proprioceptive neuromuscular reeducation, passive/active assist/active exercises, dynamic splinting, muscle stimulation, kinesio tape, functional activities, and tendon glides. After five months, active range of motion in the shoulder, elbow, and wrist was finally achieved and median nerve sensation had improved. After nine months, elbow motion was within normal limits and wrist motion had significantly improved. Upon muscle testing, the elbow, forearm, wrist, and hand had made significant gains in strength. However, shoulder strength and motion was still limited. Overall, treatment made a significant improvement in the patient’s functionality.

Within the pediatric hospitalization experience, fear and anxiety are two emotions commonly felt by children of all ages. Hospitalized children can greatly benefit from interventions designed to help them cope with these emotions throughout their medical experiences. This study draws on each of our clinical experiences as volunteers at Phoenix Children’s Hospital, and uses a qualitative analysis of three semi-structured interviews with currently employed Child Life Specialists to understand and analyze the use of medical play, a form of play intervention with a medical theme or medical equipment. We explore the goals and benefits of medical play for hospitalized pediatric patients, the process of using medical play as an intervention, including the activity design process, the assessments and adjustments made throughout the child’s hospitalization, and the considerations and limitations to implementing medical play activities. Ultimately, we found that the element of fun that defines play can be channeled into medical play activities implemented by skilled Child Life Specialists, who are experts in their field, in clinical settings to promote several different and beneficial goals, including pediatric patient coping.

Veterans are approximately 30% more likely than non-veterans to suffer from severe hearing impairment. Tinnitus, or ringing in the ears, which is increasingly common among military service men and women, has been linked to significant cognitive and psychological impairment and can be worsened by the same sounds that trigger post-traumatic stress disorder (PTSD). In fact, tinnitus and PTSD often present as comorbidities, and recent studies suggest these two disorders may share a common neurological pathway. Additional studies are required to better understand the connection between hearing loss and impaired cognitive function such as that observed in with PTSD. Here, we use the fruit fly, Drosophila melanogaster, to explore the relationship between hearing loss and cognitive function. Negative geotaxis climbing assays and courtship behavior analysis were used to examine neurobehavioral changes induced by prolonged, intense auditory stimulation. Preliminary results suggest that exposure to loud noise for an extended period of time significantly affected Drosophila behavior, with males being more sensitive than females. Based on our results, there appears to be a potential connection between noise exposure and behavior, further suggesting that Drosophila could be an effective model to study the link between hearing loss and PTSD.

Background: The purpose of this study was to assess the efficacy of a lifestyle intervention on cardiorespiratory fitness in Latino youth with obesity and prediabetes. <br/>Methods: Participants (n=50) in this study were taken from a larger randomized controlled trial (n=180, BMI ≥ 95th percentile). Youth participated in a 6-month lifestyle intervention that included physical activity (60 minutes, 3x/week) and nutrition and wellness classes (60 minutes, 1x/week) delivered to families at the Lincoln Family YMCA in Downtown Phoenix. The primary outcome was cardiorespiratory fitness measured at baseline and post-intervention.<br/>Results: The mean BMI for the sample was 33.17 ± 4.54 kg/m2, which put the participants in the 98.4th percentile. At baseline, the mean VO2max was 2737.02 ± 488.89 mL/min. The mean relative VO2max was 30.65 ± 3.87 mL/kg/min. VO2max values significantly increased from baseline to post-intervention (2737.022 ± 483.977 mL/min vs 2932.654 ± 96.062 mL/min, p<0.001). <br/>Conclusion: Culturally-grounded, family-focused lifestyle interventions are a promising approach for improving cardiorespiratory fitness in high-risk youth at risk for diabetes.

Socioeconomic differences have driven society and laid the foundation for the types of opportunities and resources one is eligible to receive. Higher socioeconomic status provides individuals the chance of obtaining an overall better education, occupation, and income. We see this with particular clarity when we examine healthcare. The World Health Organization has regarded healthcare as a fundamental human right, except socioeconomically disadvantaged individuals not only do not have equal access to healthcare, but they also often receive a lower quality of care. These socioeconomic differences are often paired with racial differences, resulting in one group, or set of groups, having social advantage over the others. Although this problem has been discussed throughout the past century, it has not been properly addressed materially and practically. Unequal access to quality healthcare is especially highlighted throughout the COVID-19 pandemic, where there has been evidence that minorities, in particular Black communities, have received inadequate care. Quality healthcare has become unaffordable and a luxury that only certain groups get the privilege of receiving. Not only that, but the ongoing inequalities in the healthcare system have gone so far that they have instilled hostility and mistrust towards the healthcare system.

The following paper explores the various effects of stress on the endocrine system. Many understand that being stressed can jeopardize maintaining adequate health, but what specifically happens when humans are stressed? Why does stress affect human health? This paper delves into background information, previous research, and the depths to which stress negatively affects the body. The effects stress has on the endocrine system, specifically on the hypothalamic-pituitary-thyroid axis (HPT) and hypothalamic-pituitary-adrenal axis (HPA), is discussed, and additionally, at home de-stressing methods are researched. The study included a set of participants at Arizona State University. The method took place over the course of 2 weeks: one normal week, and the other with the implementation of a de-stressing method. The normal week involved the participants living their daily lives with the addition of a stress-measuring survey, while the second week involved implementing a de-stressing method and stress-measuring survey. The purpose of this study was to discover if there was a correlation between performing these relaxation activities and decreasing stress levels in ASU students. The results found that students reported they felt more relaxed and calm after the activities. Overall, this thesis provides information and first hand research on the effects of stress and stress-reducing activities and discusses the importance of maintaining lower stress levels throughout everyday life.

The purpose of this Barrett Thesis Project is to review the existing literature on ACL injuries specifically regarding their risk factors, prevention, and recovery options. The content of the review has been placed into four sections: physiological factors, biomechanical factors, surgery and recovery factors, as well as training factors. Physiological factors look at static structures and their impact on ACL injuries, more specifically, the role that variations on physical structure values can have on injury incidence. Biomechanical factors focus on the ways that movement can contribute to injury and the ways that incorrect movement or unanticipated movement can have on the structures of the knee. Surgery and recovery factors look at surgical techniques that have been used to correct ACL injuries and the details of their function as well as certain surgical techniques that have differing rates of success and how they can impact re-injury and rehabilitation rates. Finally, training factors analyze techniques that can be used in both pre-injury or post-injury situations therefore, this section looks at the ways that training can minimize re-injury as well as work towards preventing the initial injury. Overall, this research review looks at how these factors come together to contribute to an ACL injury and the ways that injury incidence can be minimized. Risk factors come together in order to create an undesirable situation in which the ACL ligament ruptures. These risk factors are either physiological or biomechanical in nature. As a result of injury, certain surgical techniques can be used that impact the success of a patient. Evidence for the benefit of training factors can then be applied in order to reduce injury risk or prevent future injuries.

In an effort to address the lack of literature in on-campus active travel, this study aims to investigate the following primary questions:<br/>• What are the modes that students use to travel on campus?<br/>• What are the motivations that underlie the mode choice of students on campus?<br/>My first stage of research involved a series of qualitative investigations. I held one-on-one virtual interviews with students in which I asked them questions about the mode they use and why they feel that their chosen mode works best for them. These interviews served two functions. First, they provided me with insight into the various motivations underlying student mode choice. Second, they provided me with an indication of what explanatory variables should be included in a model of mode choice on campus.<br/>The first half of the research project informed a quantitative survey that was released via the Honors Digest to attract student respondents. Data was gathered on travel behavior as well as relevant explanatory variables.<br/>My analysis involved developing a logit model to predict student mode choice on campus and presenting the model estimation in conjunction with a discussion of student travel motivations based on the qualitative interviews. I use this information to make a recommendation on how campus infrastructure could be modified to better support the needs of the student population.

Collective human attitudes influenced by macro-forces that impact environmental issues are partially correlated to our behaviors for the good and the harm of the planet. In this thesis, I will explore how collective human attitudes contribute to pro-environmental behaviors, common and pre-existing frames of mind on major conservation dilemmas, and finally suggest future directions on how humans could be inclined to take on more environmental responsibility through an increase in human-environmental connectivity. It is found that humans are largely driven by institution structures, education, and social influence. In conclusion, more efforts should be placed to further analyze these structural incentives for pro-environmental behaviors and use them to make environmental stewardship more accessible for all people and diverse circumstances. This can be done by evaluating the human dimensions of what influences human attitudes and behaviors, how to use these forces to systematically influence pro-environmental choices, applying these structural forces to main conservation issues, and further incorporating moral discourse into the environmental research in order to appeal correctly to all aspects and perspectives. Only when human connectivity is understood in relation to the natural sciences will we be able to make positive change in the direction of a healthier Earth.