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Contracture Management for Acute Burn Injury Patients
Get PDFBackground: The Occupational Therapists working within the burn unit at West Penn Hospital assess and treat patients utilizing the biomechanical approach FOR, as well as the support from MOHO and PEOP. The patients seen within the burn unit encompass a variety of injuries and occupational deficits that require an individualized and holistic approach to care.
Purpose: The purpose of the contracture management project is to provide an interdisciplinary approach to improve carryover and patient care within and out of the hospital.
Theoretical framework: The contracture management project is guided using the biomechanical frame of reference as well as supporting constructs derived from the Model of Human Occupation (MOHO) and Person-Environment- and Occupational Performance model (PEOP). The biomechanical approach the primary guide for this project due to the numerous barriers individuals face when injured. The biomechanical frame of reference emphasizes positioning, range of motion, strength, and occupational performance which are all areas of impact during a burn injury.
Methods: The Qualitative study included a pre and post-correlation survey, consisting of 15 questions. The survey was given before and after individualized group presentations of n=10 registered nurses and n=11 occupational therapists working at West Penn Hospital. The findings were reported using descriptive statistics.
Results: The results indicated that occupational therapy and nursing had an increase in knowledge from pre-survey to post-survey after an educational informational in-service was given and contracture management binders were developed.
Conclusions: The contracture management presentations and binders provided in-depth knowledge regarding splinting, positioning, and range of motion activities
Eating Concerns and Self-injury Among Collegiate Populations: A Comparison of Sexual Orientation Groups
Get PDFThis study examined the prevalence of eating concerns and nonsuicidal self-injurious behaviors (NSSIB) in college students seeking services at college and university counseling centers (UCCs), focusing on whether sexual minority students experience these issues at higher rates than their heterosexual peers. Eating concerns and NSSIB are understudied among sexual minority individuals. Previous research has demonstrated that through prejudice, stigma, and social stress, sexual minority individuals may be at a higher risk of developing mental health concerns and conditions than their heterosexual counterparts. The present study used a cross-sectional design to examine data from a sample of collegiate clients nationwide. Data was collected from clients upon intake at college and university counseling centers participating in Penn State University’s Center for Collegiate Mental Health (CCMH) during the 2020-2021 academic year. This study aimed to contribute to the existing literature on health disparities in marginalized populations by examining differences between sexual orientation groups on eating concerns and NSSIB. Control variables identified were race, age, gender identity, and relationship status. Findings from this study showed a significant relationship between eating concerns and non-heterosexual identities. Findings also revealed a significant relationship between NSSIB and non-heterosexual identities. The findings of this study contribute to a growing but still widely understudied area of literature. This study contributes to the increasing body of evidence underscoring the unique mental health needs of sexual minority college students
High-Pressure Ignition and Flame Propagation – An Experimental and Numerical Study
Get PDFThe next generation of advanced combustion devices is being developed to operate under ultra-high-pressure conditions, to improve combustion efficiency and reduce pollutant emissions. However, at such extreme conditions, flame tends to become unstable, and measurement of fundamental properties becomes challenging. The laminar burning speed ( ) is among those properties, as it is required for the validation of kinetic models and the modeling of turbulent combustion. One potential method to resolve this issue and achieve measurement at very high pressures (i.e., 20-50 atm), is focusing on ignition affected region. The flame kernel in this region is more resistant to perturbations and remains smooth due to the high stretch rates (i.e., small radii). Therefore, the principal aim of this work is to provide detailed time-resolved information for a deep understanding of the ignition process at high pressures. In addition, the measurement methodologies and developed computational models will have a broad and valuable impact on combustion and plasma communities by enabling predictive capabilities for designing and optimizing advanced combustion devices operating under high-pressure conditions.
The result of this work is a novel framework/method to measure in the ignition-affected region using a spherically expanding flame (SEF) under ultra-high pressures. The complication with this region is that the kernel growth rate does not only depend on the chemical reaction but also on other terms such as energy discharge, as well as radiative and conductive energy losses. None of these terms has been adequately assessed, due to the generation of ionized gas (i.e., plasma). This research will fill this broad knowledge gap via combined experimental and modeling studies focused on two specific aims: (1) using a well-defined and well-controlled high-pressure experimental configuration and (2) developing a self-consistent theoretical framework to explain the influence of energy discharge on the plasma formation and initial flame propagation. On the experimental side, the project will utilize high-speed imaging of the plasma kernel propagation in conjunction with electronic ignition power. The plasma properties were calculated using statistical thermodynamics and a presently developed thermodynamic model.
Experiments presented in this work examine methane and air combustion up to 50 atm initial pressure. Flame propagation is observed via high-speed camera for radii up to 20 mm at 45kfps. Flame propagation is modeled for the purpose of laminar burning speed extraction utilizing ignition affected flame down to ~0.5 mm radius. Modeling work is supported by several measurements including plasma temperature, electrical power, and potential drop across plasma sheath formations. The electrical power was measured via the voltage and current across the electrode gap while the sheath formation was extracted via a modified zero length extrapolation. Plasma temperature was measured using optical emission spectroscopy.
The model interpretation of the ignition propagation was found to accurately account for symmetric, steady, normal glow, and arc discharge. Inaccuracies up to ~15% were found for the present ignition propagation because of the transit behavior. This behavior (because of the current waveform) results in a time varying sheath formation and bulk plasma temperature
Does it Sound like I\u27m Talking?
Get PDFJean-Baptiste Poquelin, better known by his stage name, Molière, was widely known as one of the greatest writers in France. His biting satirical thoughts on French hypocrisy, as well as the brilliance in his verse, will be investigated through one of his most popular plays, The Misanthrope. Throughout these pages, I will explore this by diving into the character of Philinte, the trusted best friend of Alceste, the misanthrope, and take a deeper look into the empathetic character who is desperately trying to walk the line of truth and bootlicking. I will accomplish this by researching Molière himself, his specific style of writing, and the French hypocrisy he pokes fun at within in his plays. Finally, I will look back on the process itself and the highs, lows, and struggles within the rehearsal room of West Virginia University’s recent production of Richard Wilbur’s adaptation of The Misanthrope as well as the creation of my own adaptation of the play, haters gonna hate, and how the writing of this piece helped further my understanding of this old French play that rhymes
The Perceived Effects of Peer-Assisted Learning in a Collegiate Instrumental Pedagogy Classroom
Get PDFPeer-assisted learning (PAL) is an approach that teachers can use in the classroom to increase students’ ownership of their learning. Besides increased autonomy, PAL can provide several other academic and social benefits, such as increased achievement and fostering a sense of community. This study aimed to examine the effects of PAL on college students’ performance on a secondary instrument. Five students in a collegiate instrumental pedagogy course experienced PAL activities in class while learning secondary instruments. After a statistical and content analysis of all the data, results showed that 1) all but one of the participants improved in their performance after participating in the PAL activities; 2) participants felt that PAL benefitted them by helping them learn, increasing their confidence, increasing a sense of community, and helping them learn to give constructive criticism; 3) participants felt that PAL did not benefit them through creativity or feeling empowered; and 4) participants agreed that the most helpful aspect of PAL was the ability to collaborate with peers who share similar struggles and solve problems together. The author will discuss recommendations for best practices in implementing PAL in a music classroom
Comparative cephalometric study between Class II patients treated with Herbst appliance and patients treated with MARA
Get PDFABSTRACT
Comparative cephalometric study between Class II patients treated with Herbst appliance and patients treated with MARA
Mona Meky, D.D.S.
Background and Objectives: Functional appliances have been used for over 100 years in orthodontics to correct Class II malocclusions. The Herbst and the MARA appliances have different designs that may enhance mandibular growth. Recent clinical evidence has questioned whether they really have a lasting influence on facial growth and that the effects of these appliances were mostly dentoalveolar rather than skeletal. The objective of this retrospective comparative study was to compare the dental and skeletal changes between Class II division 1 malocclusions treated with the Herbst and the MARA appliances.
Experimental Design and Methods: This is a retrospective study comparing twenty-eight patients treated with the Herbst appliance and twenty-eight patients treated with the MARA appliances. Orthodontic records were obtained in Dr. Neal Kravitz’s private practice in Northern VA. The stage of dental development varied from late mixed dentition to early permanent dentition. The skeletal maturation of the patient samples was matched as close as possible using the CVM method. Patients with a CVM between stages 3 and 4 were included in the sample. Lateral cephalogram was taken before treatment , immediately following the removal of the appliance, and following completion of fixed appliance therapy for the Herbst sample (T1, T2, T3) and the MARA sample (t1, t2, t3). Dental and skeletal changes were recorded using the Dolphin digital software. Data were analyzed using a two sample t test for the craniofacial morphology, a matched pair t test Wilcoxon signed rank test for the skeletal and dental changes across three time periods. Significant differences between the two treatment groups in changes across the three treatment time periods were analyzed by a two sample t tests. Intra-rater reliability for treatment changes were analyzed using the Intra-class correlation coefficients (ICCs). A two-sided p-value of less than 0.05 was considered statistically significant.
Results: The average total treatment time in the functional appliance was 11.3 +1.1 for Herbst and 11.2 +1.2 months for MARA. Significant differences were found in the reduction of overjet, change in molar relationship and overbite with the Herbst and the MARA appliances. The change in overjet and molar relationships were attributed to restriction in the forward movement of the maxilla, more forward movement of the mandible, backward movement of the maxillary molars, and forward movement of the mandibular molars. Greater reduction in the overjet was seen with the Herbst compared to the MARA appliance. There was also more skeletal contribution to the reduction in overjet and change in molar relationship seen with the Herbst sample. After comprehensive therapy, both groups maintained a reduction in overjet and overbite as well as a Class I molar relationship. The change in overbite was similar between the Herbst (1.9mm) and the MARA (2.0mm) groups. There was greater eruption of the maxillary incisors seen with the MARA (0.58mm vs. 0.06mm). Greater proclination of the lower incisors was seen in the MARA group (4.72° vs. 4.46°).
Conclusion: Both the Herbst and MARA appliances were effective in the reduction of overjet and correcting the molar relationships into a Class I molar relationship with treatment for 9-12 months. A large part of the correction is due to the fact that the patients were in their peak growth spurt. The treatment changes were greater with the Herbst appliance due to the headgear effect on the maxilla. There was more proclination of the lower incisors seen with the MARA group
A Legacy of Labor: Maternity Narratives in 1960s and 1970s North American Life Writing
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A Legacy of Labor: Maternity Narratives in 1960s and 1970s North American Life Writing
Katelynn Ann Vogelpohl
The phenomenon of maternity has been repeatedly described as an event that shakes the very foundations of social and physical identity. As the flesh of the pregnant person literally divides to produce new life, one subject becomes enclosed within another, dramatically affecting the pregnant person’s sense of self and causing a confluence of intense, and often conflicting, feelings. In North America, there are two dominant, and seemingly opposing, discourses on pregnancy and childbirth: the institutional medical discourse and the natural childbirth discourse. These two discourses have perpetuated the myth of a homogenous, monolithic maternity experience and generally ignore the myriad of intersectional diversities that affect maternity and mothering. This dissertation explores North American maternity life writing from the 1960s and 1970s—a time period heavily influenced by the second women’s movement, Black Power movement, women’s health movement, and natural childbirth movement. These narratives destabilize the concepts of a universal maternity or mothering experience and create discursive room to address the cultural taboos that permeate the realities of pregnancy and birth.
In Chapter 1, I explore how the dominant discourses of the mid-twentieth century create and utilize metaphorical language to describe the physical processes and sensations of pregnancy and childbirth. This chapter introduces the public language and ideologies associated with maternity in the 1960s and 1970s that the authors in my subsequent chapters negotiate. In Chapter 2, I discuss three pieces that center splitting or multiplying maternal subjectivities and feelings of maternal ambivalence: Margaret Atwood’s “Giving Birth,” Doris Betts’s “Still Life with Fruit,” and Maxine Chernoff’s “A Birth.” In this chapter, I purposefully focus on writing from white, married, heterosexual, middle-class, cisgender female authors to explore the diversity of maternity experiences within a relatively homogenized and culturally idealized group. In Chapter 3, I turn to Black revolutionary Assata Shakur’s memoir, Assata, to discuss the tenets of Black maternal theory and mythology that view Black motherhood as a source of strength, resistance, and cultural revolution. Finally, in Chapter 4, I extend the understanding of maternity life writing to include stories of reproductive loss and abortion. Looking to Sylvia Plath’s “Three Women: A Poem for Three Voices” and Ntozake Shange’s for colored girls who have considered suicide / when the rainbow is enuf, I discuss the value of polyphony as a writing technique to further foreground the complexities and diversities of maternity experiences. This chapter highlights an overarching theme of the dissertation: the value of storytelling as a source of connection for individuals whose experiences have been essentially erased from public discourse
Parental Socialization of General and Domain-Specific Self-Control in Adolescents
Get PDFAdolescent self-control appears to be an important competency to develop. It has pervasive links with various outcomes (e.g., educational, financial, and interpersonal) both during adolescence and into adulthood (Allemand et al., 2019, Moffitt et al., 2011). Adolescents often report lower self-control compared to adults, although individual levels of self-control vary widely between adolescents (Allemand et al., 2019, Romer et al., 2010). Despite its importance, very little is known about how self-control develops. Thus, the current study aims to examine the relationship between parents’ self-control and that of their teen children. To further understand how adolescents\u27 self-control may be socialized by parents, parental behaviors that may be evidence of self-control (e.g., exercise, social media addiction, etc.) and adolescent self-control were examined. Additionally, because a domain-specific model of self-control has been shown to better fit individuals’ patterns of self-control than a domain-general model (Tsukayama et al., 2012), the current study employs both a domain-general and domain-specific approach.
As part of a larger study conducted in the Appalachian region of the United States, 226 adolescents (Mage = 15.09, 51.8% female) and at least one of their parents (N = 207 mother-figures; N = 72 father-figures) reported on their domain-general and domain-specific self-control. The current study utilized data from 2 waves of collection which occurred roughly six months apart. Parents reported on their general self-control, SES, difficulty paying bills, BMI, eating, exercise, drug use, social media addiction, attachment in relationships, education, and relationship satisfaction at Wave 1, and their self-control in the domains of health, leisure, money, relationships, and work at Wave 2. Teens reported their general self-control and domain-specific self-control at Wave 2.
Regression models were used to predict teens’ self-control from their parents’ self-control, and separately, from their parents’ self-controlled behaviors. Several associations between parental behaviors and teen self-control were found (e.g., fathers’ drug use was negatively associated with teens’ leisure self-control, mothers’ difficulty paying bills was positively associated with teens’ money self-control). After accounting for multiple comparisons using the False Discovery Rate (Benjamini & Hochberg, 1995), only two associations remained significant: higher maternal relationship satisfaction with their teen significantly predicted greater general self-control in their teens (b = .27, SE = .07), and greater maternal health self-control significantly predicted greater health self-control in their teens (b = .26, SE = .07).
The current study provides important preliminary information on the utility of a domain-specific model of self-control, as well as the role of socialization in intergenerational transmission of self-control between parents and their adolescent teens. Furthermore, the study highlights a need for additional research on the factors that contribute to the development of self-control in teens
The function of protein glutamylation in vision
Get PDFPosttranslational glutamylation of protein has emerged as a novel candidate for cellular integrity. In a dynamic process, Tubulin Tyrosine Ligase Like proteins (TTLLs) introduce glutamate groups to their substrates, while Cytosolic Carboxypeptidases members (CCP1-CCP6) remove these glutamate groups. The outcome of this interplay is a wide range of substrates; each is glutamylated to a level crucial for its function.
Protein glutamylation is particularly abundant in neurons and in the axoneme of cilia and flagella. This distribution, along with the correlation between imbalanced glutamylation levels and compromised cellular functions, underscores the significance of protein glutamylation in maintaining cellular viability. However, the precise molecular function of protein glutamylation is not fully understood.
In vision, mutations in both TTLL5 (the enzyme responsible for the addition of a glutamate group) and CCP5 (an enzyme that removes glutamates) are linked to blindness in humans, indicating the vital role of protein glutamylation-deglutamylation in photoreceptor health.
Our study reveals tubulin as a retinal substrate of CCP5. We demonstrate the necessity of tubulin glutamylation in maintaining the integrity of the photoreceptor outer segment, and we establish a link between the structural defect in the outer segment and shortening the photoreceptor axoneme.
Understanding the molecular mechanisms that underlie the role of protein glutamylation in preserving outer segment integrity and axoneme length, as well as its potential impact on photoreceptor protein trafficking, mitochondrial dynamics, and light response pathways, presents challenging questions for future investigation. Answering these questions is essential to comprehend the function of protein glutamylation in visual health and diseases and to explore the potential utilization of the glutamylation code in treating related disease
Self-Efficacy and Parental Miscarried Helping in Adherence and Transition Readiness Among Adolescents and Young Adults with Epilepsy
Get PDFBackground: Given the complex regimen associated with epilepsy, ensuring that adolescents and young adults (AYAs) adhere to their medications, and are ready to transition from pediatric to adult care, is crucial to optimizing their health outcomes. Several social and ecological factors such as self-efficacy and parental miscarried helping can strengthen or weaken an adolescent’s medication adherence and readiness to shift from pediatric to adult care. Intending to contribute to informing and improving clinical care, this study sought to understand the relationships between self-efficacy, parental miscarried helping, medication adherence, and transition readiness. Methods: Using a cross-sectional observational design, 46 AYAs with epilepsy and their caregivers completed measures of self-efficacy (Epilepsy Self-Efficacy Scale- ESES), parental miscarried helping (Helping for Health Inventory- HHI), medication adherence (parent and adolescent versions of the Pediatric Epilepsy Medication Self-Management Questionnaire- PEMSQ/AEMSQ), and transition readiness (Epilepsy Transition Readiness Assessment Questionnaire- EpiTRAQ). Young adults and caregivers of teens also completed a Family Information Form to assess for demographics (e.g., race, sex, income) while research staff performed a medical chart review to gather information on various medical variables (e.g., seizure type, three-month seizure history). PROCESS Macro was then used to (a) determine the association between parental miscarried helping and medication adherence/transition readiness as mediated by self-efficacy; and (b) investigate the relation between self-efficacy and medication adherence/transition readiness as moderated by parental miscarried helping. Results: Mediation analyses between parental miscarried helping, self-efficacy, and medication adherence/transition readiness were not significant. Moderation analyses between self-efficacy, medication adherence/transition readiness, and parental miscarried helping were also not significant. However, parental miscarried helping remained a predictor of medication adherence even with self-efficacy included in the model (B = -0.1215, t (32) = -2.7194, p = 0.0105). Self-efficacy and patient age were significant predictors of transition readiness, while self-efficacy and seizure severity were significant predictors of medication adherence. Discussion: While the mediation and moderation analyses did not yield statistically significant results, as hypothesized, the novel finding of an association between parental miscarried helping and medication adherence fills a gap in the literature and serves as a foundation for future studies. It is also imperative to interpret the findings of this study cautiously, recognizing the limitations posed by the study\u27s underpowered nature, thereby emphasizing the need for further research with a larger sample size to enhance the robustness of conclusions drawn from this investigation