MEDICA@MUSC (Medical University of South Carolina)
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Safe & Steady: A Toolkit for Injury Prevention in Pickleball for Older Adults with Parkinson’s Disease
No full textAbstract
Title: Safe & Steady: A Toolkit for Injury Prevention in Pickleball for Older Adults with Parkinson’s Disease
Background: Parkinson’s Disease (PD) is a movement disorder that affects balance, walking, posture, coordination, cognition, and more that can increase the risk of falling. Around 60% of people with Parkinson’s Disease (PwPD) fall every year for a variety of reasons (Parkinson’s Foundation, 2025). Studies have shown that physical activity not only has a positive impact on symptoms, but exercise has an integral impact on overall wellbeing and quality of life for PwPD (Bispo, et. al, 2024). There are many types of physical activity and exercise that PwPD can participate in including the booming sport of pickleball.
Purpose: This project aimed to empower PwPD to participate in the sport of pickleball safely and enhance overall wellbeing by 1) evaluating needs for safety and fall/injury prevention for individuals with PD interested in playing pickleball recreationally and 2) developing an evidenced-based written guide tailored toward older adults with PD.
Methods: Considered a Quality Improvement (QI) project by MUSC IRB, this doctoral capstone involved participation in the MUSC Wellness Center’s 8-week instructional pickleball program for individuals with Parkinson’s called “Pick It Up,” followed by creation and implementation of a toolkit called “Safe & Steady.” Data was collected via pre/post surveys and informal interviews, including qualitative and quantitative measures.
Results: Analysis yielded heightened confidence, satisfaction, effectiveness, and awareness among individuals with Parkinson’s on the benefits of the “Safe & Steady” toolkit for future sessions. Data was analyzed using descriptive statistics and thematic analysis.
Conclusion: This doctoral capstone enhanced the awareness and need for safety resources for PwPD in the sport of pickleball. Future projects could prioritize ongoing advocacy and education through structured classes focused on safe falling techniques and strategies for getting up after a fall.
References:
Bispo, D. P. C. F., Lins, C. C. S. A., Hawkes, K. L., Tripp, S., & Khoo, T. K. (2024). The Positive Effects of Physical Activity on Quality of Life in Parkinson\u27s Disease: A Systematic Review. Geriatrics (Basel, Switzerland), 9(4), 94. https://doi.org/10.3390/geriatrics9040094.
Parkinson’s Foundation. (2025) What is Parkinson’s? Parkinson’s Foundation. https://www.parkinson.org/understanding-parkinsons/what-is-parkinson
Occupational Therapy Guided Interactive Workbook for College Students with Autism Spectrum Disorder for Transition into the Workplace
No full textThe number of students with autism spectrum disorder entering college has been steadily increasing. When these graduates enter the workforce, the support and accommodations available throughout their education may not necessarily be readily available in their new workplace. This quality improvement project aimed to increase the resources of a college program whose purpose is to support autistic and neurodivergent students throughout their college career. The project aims were to create an interactive job readiness and independent living workbook to assist and provide resources for students during their transition into the workforce. The senior cohort completed seventeen fillable workbook pages with various topics to help prepare and equip them for job searching, interviewing, and living independently. After completion of the workbook, all eight seniors completed a post-survey regarding effectiveness of the workbook. On a scale of 1 to 5, all seniors reported a 4 or higher in terms of helpfulness of the workbook. 7 out of 8 seniors reported that they would likely reference the workbook during their transition out of college. Topics that seniors found most help included budgeting, cost of living, and interview preparation. Outcomes indicate that this senior cohort now have an increased awareness of job readiness and facets of living
The Mauna Model: A Trail Guide for Developing Competencies in Occupational Therapy Professionals
No full textImportance: Occupational Therapists (OTs) require a conceptual model that guides their individual and holistic professional development in a way that aligns with the fundamental values of our profession.
Objective: A needs assessment gathered insights from stakeholders regarding current professional development and mentorship practices and areas of need to aid in developing a conceptual model, the Mauna Model. Following the development of the Mauna Model, the usability of the model and its benefit to the occupational therapy profession were measured.
Design: Mixed-Method.
Participants: Licensed OT professionals (OT/OTA) with various experience levels and roles; OT/OTA students.
Outcomes and Measures: The finalized structure, metaphor, visual representations, and application tools of the Mauna Model were evaluated using a mixed-methods survey. This survey incorporated questions from the User Experience Questionnaire, Short Version (UEQ-S) and questions designed to measure individual aspects of the Mauna Model. It aimed to gather quantitative and qualitative feedback on the usability of the Mauna Model.
Results: A needs assessment surveyed 404 total participants, with data saturation reaching 92% regarding the structure, including the components and subcomponents, of the Mauna Model. Following the development of the structure, metaphor, visual representations, and applications of the Mauna Model using quantitative and qualitative data from the needs assessment survey, the usability of the model was measured using a new survey to assess the usability of the model. A total of 101 respondents then completed the usability survey and rated the Mauna Model high in hedonic quality (M=2.043; SD=0.833), pragmatic quality (mean=2.212; SD=0.853), and overall quality (mean=2.127; SD=0.791). Additionally, the usability of the individual aspects of the Mauna Model was rated above 6.0 on a 7-point Likert scale, indicating a perception of high usability overall for each item measured when considering all stakeholder groups combined.
Conclusions and Relevance: The findings indicate that OT professionals and students resonated with the metaphor and visuals of the Mauna Model and found the structure and application tools helpful for professional development. Additionally, they indicated that they were likely to implement the model into practice and found it beneficial to the profession of occupational therapy. The Mauna Model can be used to develop more confident and competent OT professionals, strengthening our profession and our position as an integral part of the interdisciplinary healthcare team.
Plain-Language Summary: The Mauna Model provides our profession with an accessible, conceptual model that guides the individual, holistic development of the OT professional by helping them identify, develop, and reflect on core professional competencies
Addressing Interoperability Issues in Employment for Youth with Autism Spectrum Disorder: Teaching Self-Determination Skills in Conjunction with Early Exposure to Work Experiences
Get PDFYouth with autism spectrum disorder (ASD) who graduate from high school face higher rates of unemployment, lower wages than their neurotypical peers, and lower levels of self-determination, which is crucial for autonomy and positive adult outcomes. Early exposure to work experiences, whether paid or voluntary, has been identified as a key predictor of post-school success. However, there is a significant gap in services when students graduate from high school, and parents often lack the preparation to navigate transition-related resources related to their child’s employment, transportation and independent living.
To address these challenges, this project provided early exposure to work experiences, implemented a self-determination curriculum, created a transition resource guide for parents of students aged 14-16, and conducted a scoping review. Following the completion of the curriculum outcomes were completed in three domains: self-determination, early exposure to work experiences, and success of providing transition related resources. Self-determination skills outcomes were measured by improvements in writing SMART goals, knowledge change, and tracking goals. Early exposure to work outcomes included improvements in three subscales of the VocFit assessment, and two subscales of the Arc’s Self-Determination Scale. The transition resource guide was found to be helpful and beneficial for parents. The scoping review details whether improvements in self-determination increased employment outcomes for young adults on the autism spectrum
The Self-Sustainability of Federally Qualified Health Centers
Get PDFThis exploratory data analysis examines the self-sustainability of Federally Qualified Health Centers (FQHCs) using the 2023 Uniform Data Systems (UDS) dataset, focusing on health centers\u27 reliance on government grants as a revenue source. FQHCs provide high-quality healthcare services to medically underserved populations; today, nearly 1 out of every 11 Americans receives some form of care at an FQHC. There is widespread variability in the delivery of care amongst FQHCs. Additionally, funding and reimbursement methodologies vary across states and geographic regions. FQHCs face challenges maintaining operational efficiency amid federal funding shortfalls, shifting reimbursement methodologies, and the lingering impact of the COVID-19 pandemic. This study is the first to focus solely on using publicly available UDS data to assess the self-sustainability of FQHCs. Limitations include the self-reported nature of UDS data, and the limited information made publicly available by the Bureau of Primary Health within the UDS. Future research should focus on conducting multiyear analyses, utilizing the full uncensored UDS data, and aim to establish benchmarks for health centers by determining drivers of technical and operational efficiencies. Further, more research is needed to determine the full impact of adopting alternative payment models and their effect on staffing and care delivery
Policy and Practice: Analyzing Abortion Laws and Their Relationship to Competent Women’s Health Services in Ohio
Get PDFThis study examines the relationship between abortion policy changes and women’s health services, focusing specifically on the state of Ohio’s evolving abortion laws and their implications. Using a qualitative approach, the research explores competency\u27s role in addressing mental health disparities among diverse populations and marginalized communities. Through analyzing state policies and interviews with healthcare advance practice providers, this study completed a thematic analysis that identified opportunities such as shaping access and quality of care. The findings aim to inform strategies that reduce health disparities and improve competent care in women’s health services
Risk Management Practices in the Healthcare Supply Chain: A Cross-Sectional Survey of Professionals in Saudi Arabia
No full textHealthcare supply chain disruptions threaten the quality of patient care, and can increase costs, particularly in systems reliant on global suppliers. This study examined the risk management practices of healthcare supply chain professionals in Saudi Arabia. A cross-sectional survey of 72 professionals from hospitals, regulatory agencies, and other healthcare organizations revealed that 72.2% experienced supply shortages in the past year, most often involving general medical supplies, specialty medicines, and essential medicines. The most frequently reported risks were supplier shortages, reliance on single-source suppliers, and logistics disruptions, while cybersecurity threats were rarely cited. Although 76.4% of organizations reported having formal risk management frameworks—most commonly business continuity planning, supplier risk assessments, and inventory buffers—persistent shortages indicate a disconnect between these frameworks and their practical effectiveness. These findings underscore the need for standardized, context-specific frameworks and greater supplier diversification to enhance healthcare supply chain resilience
An Investigation into Filopodia-mediated Cellular Entry and Diversification of Payload Capacity of a Cell-penetrating Peptide System for Expanded Gene Therapy Capabilities
No full textThe development of efficient, stable nucleic acid delivery vehicles remains a critical challenge in gene therapy, as many systems fail to achieve targeted uptake, protect cargo from degradation, or release it effectively inside cells. This dissertation addresses these limitations by investigating RD3AD, a novel peptide carrier designed to enhance nucleic acid delivery through natural cellular entry pathways. We demonstrate that RD3AD significantly improves siRNA uptake, stability, and gene silencing by exploiting filopodia-mediated transport. RD3AD-siRNA complexes displayed highly ordered binding along filopodia, facilitating efficient transport into cells. In 2D and 3D models of HPV+ oropharyngeal squamous cell carcinoma, RD3AD delivery of siRNAs targeting the oncogenic E6 and E7 genes achieved robust silencing, p53 restoration, and disruption of tumor spheroid architecture, addressing the need for less toxic, targeted treatments for HPV-driven cancers.
Beyond siRNA, RD3AD was evaluated for delivering miRNA, mRNA, plasmid DNA (pDNA), and mitochondrial DNA (mtDNA) to meet the demand for versatile nucleic acid carriers. While it effectively bound and protected small nucleic acids, release of mRNA and pDNA remained suboptimal, underscoring the need for further peptide optimization. In mitochondrial therapeutics, where no clinically viable method exists to restore the full mtDNA molecule, RD3AD enabled intracellular delivery of intact, functional mtDNA, restoring mitochondrial gene expression and protein synthesis. This addresses a critical gap in the treatment of mtDNA-associated diseases. Collectively, this work establishes RD3AD as a non-toxic, stable, and adaptable nucleic acid carrier with broad therapeutic potential. Future studies will optimize trafficking, cargo release, and in vivo validation to advance RD3AD toward clinical translation
Bioelectrically Guided Cancer Therapy: Advancing Toward Clinical Translation
No full textBioelectricity, the regulation of membrane potential through ion channels and transporters, is essential for cellular processes such as proliferation, signaling, and survival. Despite its central role, bioelectric signaling remains an underexplored area in cancer research.
Our work has shown that high expression of specific ion channels—including the surface potassium channel Kv11.1, mitochondrial KCa3.1, and calcium channel TRPA1—is associated with improved prognosis in cancers of various histologies. We hypothesized that pharmacological activation of these channels would produce anticancer effects. Using selective activators, including FDA-approved drugs, we demonstrated that activation of each channel disrupts multiple cancer hallmarks, such as uncontrolled proliferation and metabolic reprogramming, without inducing significant toxicity.
Mechanistically, activation of KCa3.1 in breast cancer and Kv11.1 in lung cancer promotes tumor arrest by inducing a senescent-like phenotype and promoting degradation of key oncogenes like c-Myc and estrogen receptor alpha. In colon cancer, TRPA1 activation leads to cell death via oxidative stress and inhibition of EGFR signaling. Furthermore, ion channel activation enhances responsiveness to existing therapies and helps overcome drug resistance.
Notably, Kv11.1 activation also triggers a lethal immune response against senescent cancer cells. This response is driven by the senescence-associated secretory phenotype (SASP), which includes cytokines and chemokines that recruit immune effector cells. This leads to immune-mediated tumor clearance via TNFα signaling.
To improve delivery and reduce systemic toxicity, we developed a Smart Injectable Hydrogel (SIHD) loaded with NS1643 (SIHD-Ka), a Kv11.1 activator. SIHD enables sustained, localized drug release over three weeks under physiological conditions. In preclinical triple-negative breast cancer (TNBC) models, SIHD-Ka significantly inhibited tumor growth without notable adverse effects.
Given its efficacy, safety, and mechanistic clarity, our strategy is ready for clinical translation. We are preparing a Phase II clinical trial to test KCa3.1 activation using the FDA-approved molecule chlorzoxazone in ER-positive breast cancer patients unresponsive to standard therapies. This work pioneers a new class of bioelectrically targeted cancer treatments with strong translational potential
At Home Camp Programming to Improve the Quality of Life in Children with Disabilities and Medical Illnesses
Get PDFIn the state of South Carolina, more than 58,000 children living with a disability or serious medical illness are not being served with the opportunity to participate in a summer camp (Denton, 2023). Summer camps encourage children to interact with their peers, experience play, and engage in enjoyable activities. These are all skills that children with disabilities and medical illnesses tend to struggle with (Makaroff et al., 2013). Lack of these skills can contribute to a lower overall quality of life for these individuals.
A quality improvement capstone project was completed in collaboration with a nonprofit organization that creates overnight summer camps, hospital camps, family fun days, and day camps for children with disabilities and severe medical illnesses. This project was designed to increase participation in play, social interaction, and build life skills in children with disabilities and serious medical illnesses through an at-home summer camp program. The project had two main goals: (1) to obtain in-depth knowledge of the benefits of camp programming and their therapeutic activities for individuals with disabilities and serious medical illnesses and (2) to create and organize a comprehensive at-home instructional manual that enables CRA’s campers to engage in meaningful, adaptable, and activity-based interventions.
Data was collected through descriptive statistics (survey utilizing single-answer multiple choice, Likert scale, and text box questions) and thematic analysis (informal interviews and open-ended discussion) to gain feedback on the project and determine sustainability. This revealed high satisfaction with the provided resource, the therapeutic benefit that the activities within the resource provide, and the likelihood that the caregivers would use the resource with their child.
Denton, B. (2023, March 24). About. Camp Rise Above.
https://campriseabove.org/about/
Makaroff, K. S., Scobie, R., Williams, C., & Kidd, J. (2013, January 29). Let\u27s go to camp! An innovative pediatric practice placement. National Library of Medicine.
https://pubmed.ncbi.nlm.nih.gov/23369795