Matching Items (44)
Description
The goal of my study is to test the overarching hypothesis that art therapy is effective because it targets emotional dysregulation that often accompanies significant health stressors. By reducing the salience of illness-related stressors, art therapy may improve overall mood and recovery, particularly in patients with cancer. After consulting the primary literature and review papers to develop psychological and neural mechanisms at work in art therapy, I created a hypothetical experimental procedure to test these hypotheses to explain why art therapy is helpful to patients with chronic illness. Studies found that art therapy stimulates activity of multiple brain regions involved in memory retrieval and the arousal of emotions. I hypothesize that patients with chronic illness have a reduced capacity for emotion regulation, or difficulty recognizing, expressing or altering illness-related emotions (Gross & Barrett, 2011). Further I hypothesize that art therapy improves mood and therapeutic outcomes by acting on the emotion-processing regions of the limbic system, and thereby facilitating the healthy expression of emotion, emotional processing, and reappraisal. More mechanistically, I propose art therapy reduces the perception or salience of stressors by reducing amygdala activity leading to decreased activation of the hypothalamic-pituitary-adrenal (HPA) axis. The art therapy literature and my hypothesis about its mechanisms of action became the basis of my proposed study. To assess the effectiveness of art therapy in alleviating symptoms of chronic disease, I am specifically targeting patients with cancer who exhibit a lack of emotional regulation. Saliva is collected 3 times a week on the day of intervention: morning after waking, afternoon, and evening. Stress levels are tested using one-hour art therapy sessions over the course of 3 months. The Perceived Stress Scale (PSS) assesses an individual's perceived stress and feelings in past and present situations, for the control and intervention group. To measure improvement in overall mood, 10 one-hour art sessions are performed on patients over 10 weeks. A one-hour discussion analyzing the participants' artwork follows each art session. The Spielberger State-Trait Anxiety Inventory (STAI) assesses overall mood for the intervention and control groups. I created rationale and predictions based on the intended results of each experiment.
ContributorsAluri, Bineetha C. (Author) / Orchinik, Miles (Thesis director) / Davis, Mary (Committee member) / Essary, Alison (Committee member) / School of Life Sciences (Contributor) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
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
Individuals with Down syndrome (DS) display significantly earlier symptoms of Alzheimer's disease (AD) beginning around age 35. Because AD-like symptoms tend to be ever present in those with DS, it is difficult to accurately evaluate those with DS for earlier onset of AD. It has been suggested that physical activity and sleep are potential measures to monitor for manifestations of early AD-like symptoms in people with DS. Our lab has previously shown remarkable improvements in physical activity, cognition, and motor control while using Assisted Cycle Therapy (ACT) for adolescents with DS, Parkinson's disease (PD), and stroke populations. This novel exercise intervention is suggested to mediate improvements in cerebral activation through upregulated neurogenesis, angiogenesis, and neuro-plastic mechanisms. Despite prior research, there remains to be limited studies behind these concepts in adults with DS and sleep, which is suspected to be an accurate metric for AD-like manifestations. Fifteen older adult participants with DS were assigned to one of two cycling interventions: ACT or VC. All participants were provided Fitbit HR devices for sleep and physical activity tracking. Only five adults had viable continuous collection of data for both sleep and physical activity. While none of our results reached conventional levels of significance, there were trends towards significance in the VC group for total steps taken and in the ACT group for sleep-onset latency (SOL). Individual cases of improvement were noted but it globally can be supported that Fitbit devices are not optimistic for adults with DS due to poor long-term compliance. It comes to no surprise to those involved with these groups that cooperativity tends to be low with long term interventions in research design. In spite of this significant barrier, Fitbit devices offer to be a reliable and inexpensive record keeper of physical activity and sleep. Future research should lean to investigate the viability of Fitbit devices within younger populations, the role of heart rate variability on sleep efficiency and sleep onset latency in DS, and utilize more extensive compliance reinforcement to obtain volume of data collection needed to establish significant measurements of physical activity and sleep in populations with DS.
ContributorsDietz, Matthew David (Author) / Ringenbach, Shannon (Thesis director) / Holzapfel, Simon (Committee member) / School of Nutrition and Health Promotion (Contributor) / School of Molecular Sciences (Contributor) / Dean, W.P. Carey School of Business (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
Individuals with Down Syndrome (DS) are subject to a spectrum of behavioral, cognitive and physical impairments. This population is more predisposed to comorbidity and typically has an increased risk of inactivity resulting in a lower level of fitness. Previous studies on physical activity have shown that routine exercise has similar health benefits for those with DS as those individuals without a disability and in turn progresses their balance ability. Due to limited exercise program opportunities and studies that intentionally investigate the benefits of specific modes of exercise on the DS population, a community-based Exercise Program for Adults with DS (ExDS) was created with the goal of improving their physical and mental health and measuring changes in their balance capabilities throughout the program. ExDS partnered with Arizona State University (ASU) students to create biweekly customized workouts, that followed exercise prescription guidelines, consisting of an aerobic warm-up, main aerobic exercise bout, resistance training, balance training, and stretching for each participant with DS. Participant dynamic and static balance ability was measured using the Berg Balance Scale (BBS) during program pre- and post-assessments. The BBS composite score did not change and no significant improvement was seen in the p-values for each line item of the BBS from pre- to post-testing. For follow-up analyses, the participants with low treatment fidelity were removed. Follow-up analyses showed significant increases in BBS composite score and line item 13 from pre- to post-testing. Treatment fidelity was a limitation in this study and future studies should aim to increase fidelity and consistency of tester for pre- and post-testing. In conclusion, holistic exercise programming for adults with DS appears to benefit balance as long as treatment fidelity is high. It is unclear which mode of exercise had the greatest impact on changes in balance.
ContributorsShikles, Ann Kelly (Author) / Holzapfel, Simon (Thesis director) / Ringenbach, Shannon (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
Background and Purpose— There is limited conclusive data on both pharmacological and holistic treatment options to improve cognition in adults after stroke. In particular, there is lacking evidence for cognitive rehabilitation in the subacute and chronic phases when cognitive impairment may be more perceptible. In this meta-analytic review, our primary objective was to determine the cognitive effects of aerobic exercise on post-stroke adults in the post-acute phases. Secondary objectives were to investigate the differential effects of aerobic exercise on sub-domains of cognitive function.
Methods— Data were extracted and filtered from electronic databases PubMed (MEDLINE), CINAHL, Embase, PsycINFO, and Scopus. Intervention effects were represented by Hedges’ g and combined into pooled effect sizes using random effects models. Heterogeneity was evaluated using the Chi-squared (Q) and I-squared statistics.
Results— Five studies met inclusion criteria, representing data from 182 participants. The primary analysis produced a positive overall effect of aerobic exercise on cognitive performance (Hedges’ g [95% confidence interval]= 0.42 [0.007–0.77]). Effects were significantly different from zero for aerobic interventions combined with other physical activity interventions (Hedges’ g [CI] =0.59 [0.26 to 0.92]), but not for aerobic interventions alone (P= 0.40). In specific subdomains, positive moderate effects were found for global cognitive function (Hedges’ g [CI] =0.79 [0.31 to 1.26]) but not for attention and processing speed (P=0.08), executive function (P= 0.84), and working memory (P=0.92).
Conclusions— We determined that aerobic exercise combined with other modes of training produced a significant positive effect on cognition in adults after stroke in the subacute and chronic phases. Our analysis supports the use of combined training as a treatment option to enhance long-term cognitive function in adults after stroke. Further research is needed to determine the efficacy of aerobic training alone.
Methods— Data were extracted and filtered from electronic databases PubMed (MEDLINE), CINAHL, Embase, PsycINFO, and Scopus. Intervention effects were represented by Hedges’ g and combined into pooled effect sizes using random effects models. Heterogeneity was evaluated using the Chi-squared (Q) and I-squared statistics.
Results— Five studies met inclusion criteria, representing data from 182 participants. The primary analysis produced a positive overall effect of aerobic exercise on cognitive performance (Hedges’ g [95% confidence interval]= 0.42 [0.007–0.77]). Effects were significantly different from zero for aerobic interventions combined with other physical activity interventions (Hedges’ g [CI] =0.59 [0.26 to 0.92]), but not for aerobic interventions alone (P= 0.40). In specific subdomains, positive moderate effects were found for global cognitive function (Hedges’ g [CI] =0.79 [0.31 to 1.26]) but not for attention and processing speed (P=0.08), executive function (P= 0.84), and working memory (P=0.92).
Conclusions— We determined that aerobic exercise combined with other modes of training produced a significant positive effect on cognition in adults after stroke in the subacute and chronic phases. Our analysis supports the use of combined training as a treatment option to enhance long-term cognitive function in adults after stroke. Further research is needed to determine the efficacy of aerobic training alone.
ContributorsMitchell, Michaela (Author) / Holzapfel, Simon (Thesis director) / Bosch, Pamela (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05