Promoting Engagement of Male Individuals with Alzheimer’s in a Memory Day Care

Alzheimer’s and related dementias impact an individual\u27s cognitive, psychological, social, and physical functions resulting in impairments within the engagement of activities. Activities offer many therapeutic benefits including improvements in mood, alertness, communication, socialization, sleep, cognitive function, and quality of life. The focus of this quality improvement capstone project was to address the decreased level of engagement in male members within a memory day care center setting through engaging them in male-tailored activities. The project included the development of a website that provided tailored male-oriented activities and educational resources that were shared with the staff to revise their day care activity program, as well as with caregivers to increase activity engagement at home. The outcomes of the project revealed male participation increased, with observable signs of increased energy level, affect, attention, engagement, and communication. Additionally, all of the staff and the majority of caregivers reported satisfaction with activities provided, and increased comfort and confidence in initiating the implementation of activities in the future. Therefore, successful implementation of male-tailored activity program within the day care and successful distribution of resources to caregivers and staff that promote the engagement of male members in activities occurred

The Role of Midline Thalamic Nuclei in Mediating Alcohol Consumption and Cognitive Performance in Alcohol Dependent Mice

Midline thalamic nuclei are a cluster of brain regions known for their involvement in higher-order cognitive functions. In particular, the medio-dorsal thalamus (MDT) is known for utilizing short term memory in order to perform tasks and the paraventricular thalamus (PVT) is known for using feedback for behavior regulation. Both regions are highly interconnected with the infralimbic cortex (IL) and involved in behavioral flexibility and decision making. Alcohol Use Disorder (AUD) has previously been shown to alter decision making, but the underlying mechanism has yet to be determined. While there is some evidence that alcohol influences MDT and PVT function, these effects are not well characterized. Current literature shows that while the pathway between these midline thalamic structures and IL is reciprocal, directionality determines the function. Projections from the MDT to the IL were involved in supporting working memory maintenance while projections from the IL to MDT supported subsequent choice for a task. Likewise, the projections from the PVT to IL consolidate emotionally important memories and the projections from the IL to PVT are involved with behavioral responses. Given the role of these midline thalamic nuclei in mediating aspects of cognitive functions impacted by chronic alcohol exposure, I hypothesized that these brain areas would be activated by alcohol consumption after dependence and inhibition of these regions would reduce alcohol drinking and improve cognitive performance. The Chronic Intermittent Ethanol Exposure (CIE) model of alcohol consumption was used to model alcohol dependence in FosTRAP::Ai14 and DREADD-expressing (designer receptors exclusively activated by designer drugs) C57BL/6J mice to assess the effects of dependence on neural activation and inhibition, respectively. While we see a trend towards increased c-Fos activation in the anterior PVT during alcohol drinking after dependence, the MDT shows significantly more activation compared to water drinking. Despite a slight increase in activation of the PVT, we did not see a significant effect of chemogenetic inhibition of the PVT on alcohol consumption after CIE. Taken together, these results indicate that while the PVT might be engaged by alcohol consumption following induction of dependence, functional inhibition of this region during dependence-induced drinking does not alter consumption

Developing Educational Resources for Clinicians and Caregivers to Increase Use of Aquatic-Based Therapy in Occupational Therapy

Background: Aquatic therapy (AT) is a specialized intervention using the medium of water with therapeutic intent toward rehabilitation of specific physical and functional goals (Güeita-Rodríguez et al., 2019). AT benefits include increased joint mobility and muscle flexibility, improved head and neck control, increased attention and eye contact, improved tolerance of physical contact, and sensorimotor integration in the pediatric population (Kucher et al., 2015; Vonder Hulls et al., 2006). Physical therapists and occupational therapists (PT, OT) integrate AT into treatment plans supplemental to traditional practice. Occupational therapists facilitate performance patterns and directly influence children’s occupations of play, leisure, and social participation through integration of meaningful activities in an aquatic environment to ultimately promote functional outcomes. An occupational therapy (OT) doctoral capstone needs assessment identified gaps in knowledge of AT and opportunities for the development of evidenced-based educational resources. The International Classification of Functioning, Disability, and Health (ICF) framework guided the creation of these educational resources to promote client participation in AT programs as a supplement to traditional OT services at an outpatient pediatric therapy clinic. Aim: The purpose of this OT doctoral capstone project was to create educational resources to increase attention, awareness and accessibility of AT among clinicians and caregivers. Methods: Participants of a 10-week aquatic therapy program included 8 pediatric clinicians and 25 clients. Two anonymous REDCap surveys were administered to investigate perceptions, experiences, and knowledge about AT following implementation of project deliverables. Six clinicians and six caregivers completed responses to their respective survey. Results: Clinicians reported primary benefits of AT include sensory processing (100%, n=6), physical/motor development (100%, n=6), and water safety (100%, n=6) skills while caregivers reported benefits in sensory processing (100%, n=6), water safety (100%, n=6), and functional independence/life skills (100%, n=6). All clinicians and caregivers strongly agreed or agreed the resources provided increased their knowledge and understanding of AT. Clinicians strongly agreed or agreed (100%, n=6) they are comfortable explaining the benefits of AT to patient caregivers as a result of this project. Clinicians also reported these educational resources will be helpful to give to caregivers upon referral to AT in the future (100%, n=6). All caregivers strongly agreed (100%, n=6) AT benefits their child in addition to traditional therapy and reported interest in additional AT programs for their child. Conclusion: Evidence-based AT resources were a beneficial addition to the AT clinician training and clinic resource library. Clinicians feel confident referring patients for supplemental AT and have increased knowledge on AT benefits, hydrodynamic properties of water, aquatic sensory integration, equipment use, and treatment ideas. Educational handouts shared with caregivers facilitated understanding of the unique benefits AT provides to children with diverse needs in addition to land-based pediatric therapy. References Güeita-Rodríguez, J., Florencio, L. L., Arias-Buría, J. L., Lambeck, J., Fernández-de-Las-Peñas, C., & Palacios-Ceña, D. (2019). Content comparison of aquatic therapy outcome measures for children with neuromuscular and neurodevelopmental disorders using the international classification of functioning, disability, and health. International Journal of Environmental Research and Public Health, 16(21), 4263. https://doi.org/10.3390/ijerph16214263 Kucher, G., Moore, K., Rodia, R., & Szczech Moser, C. (2015). Aquatic therapy for children: Edited by christy szczech moser, PhD, OTR, FAOTA. Journal of Occupational Therapy, Schools & Early Intervention, 8(4), 277-291. https://doi.org/10.1080/19411243.2015.1113104 Vonder Hulls, D. S., Walker, L. K., & Powell, J. M. (2006). Clinicians\u27 perceptions of the benefits of aquatic therapy for young children with autism: A preliminary study. Physical & Occupational Therapy in Pediatrics, 26(1-2), 13-22. https://doi.org/10.1080/J006v26n01_0

Increasing Social Inclusion and Engagement of Exercise for Individuals with Spinal Cord Injuries: A Universal Resource Development for Wellness Facilities

Individuals with spinal cord injuries (SCIs) are 1.5 times more likely to disengage in exercise one-year post-injury despite 80% of these individuals agreeing that exercise is critical to their overall health and quality of life (Baehr. Et al., 2022). A needs assessment was conducted on why the lack of engagement in exercise exists for individuals with SCIs within fitness facilities to identify barriers preventing participation. A quality improvement program called the Spinal Cord Injury Wellness Toolkit was created based off these findings and implemented at the MUSC Wellness Center. 14 individuals with SCIs participated at wellness center; REDCap surveys were given before and after their visitation. It was found that participant’s overall confidence in the wellness facility, gym equipment, exercise knowledge, and staff awareness of SCI precautions showed a significant increase. Thematic analyses from post-implementation surveys showed that participants agreed the toolkit provided security & safety, showed adaptability, provided various kinds of equipment, versatile, easily understood, catered to a wide variety of injury levels, and increased confidence & quality of life. Feedback was taken into consideration to create a final copy, which was then copyrighted. The wellness program was disseminated to the MUSC Wellness Center and other fitness facilities, hospital-based therapy facilities, MUSC research affiliates, and SCI support groups within SC. This toolkit will further be distributed across the US to increase overall social inclusion and exercise engagement for individuals with SCIs

The Development of Intervention Toolkits for Non-Specialized Personnel and Families of Children with Autism Spectrum Disorder in La Paz, Bolivia

INTRODUCTION: There has been an increase in the understanding of autism-spectrum disorder (ASD) and corresponding occupational therapy (OT) interventions; however, much of this has yet to be implemented in several resource-limited countries, including Bolivia. Parent-mediated interventions (PMIs) are being heralded as a promising approach to address this gap. Through the creation of toolkits for non-specialized personnel (e.g., parents, teachers), the purpose of this quality improvement (QI) project is to enhance the occupational engagement and quality of life for children with ASD and their families in La Paz, Bolivia. METHODS: Pre-surveys were administered to parents of children with ASD at the sites to determine beneficial topics for the toolkits. Post-toolkit development, a self-report questionnaire was administered to healthcare professionals who reviewed and will distribute the toolkits to nonspecialized personnel. These surveys consisted of a variety of question types to acquire data, which was analyzed using both quantitative and qualitative methods. RESULTS: The findings indicate that the toolkits were found to be helpful, and the healthcare providers plan to share them with other non-specialized personnel. Qualitatively, there were reports of the toolkits being useful and easy to replicate; however, concerns were presented for ease of mass dissemination and comprehensibility for parents. CONCLUSION: This toolkit intervention for non-specialized personnel is viewed as a helpful and effective option among healthcare providers in Bolivia for reducing the gaps surrounding access to clinic-based services. The QI project supports the targeted goal for this population, and the sustainability allows for the continuation of this project

Role of Centrosomal P4.1 Associated Protein (CPAP) in Tumor Suppression

In eukaryotic cells, centrosomes are membrane-less organelles that function as the primary microtubules organizing center with a crucial role in cell division. For accurate bipolar spindle assembly and genetic transmission between generations, fidelity in centriolar duplication is critical. Disruption in this process can cause genomic instability, which could then lead to conditions like aneuploidy, a common feature of various cancers. Among the numerous proteins associated with mammalian centrioles, the centrosomal P4.1 associated protein (CPAP) stands out for its essential role in regulating centriole duplication. Dysfunctions in CPAP have been linked to abnormalities in centriole length that can contribute to conditions ranging from ciliopathies, immune dysfunction, and cancer. Recent discoveries in our lab have shed light on CPAP\u27s involvement in endocytic vesicular transport and are investigating its implications in cancer control. Specifically, defective CPAP function in oral cancer cell lines has been associated with constitutive signaling through the epidermal growth factor receptor, heightened epithelial-mesenchymal transition (EMT), and enhanced spontaneous tumorigenic properties, suggesting a potential role for CPAP as a tumor suppressor protein. Building on these findings, my research aimed to investigate the impact of CPAP dysfunction on tumorigenesis, by utilizing a hypomorphic mouse model. We evaluated the EMT features of both, primary and immortalized, lung as well as tongue-derived fibroblasts from these mice. In addition, we have also assessed the CPAP-deficient mice for their susceptibility towards spontaneous and induced tumors. Through my investigation, we seek to deepen our understanding of CPAP\u27s role as a tumor suppressor and its broader implications for cellular health

An N-glycan Tissue Atlas of Multiple Tissue Types and a Focus on DCIS

N-glycosylation is an abundant post-translational modification of most cell-surface proteins and is critical to many cellular functions. Each organ has its own distinct N-glycome which often becomes altered in disease states, especially cancer, and serve as some of the best clinical biomarkers. However, N-glycan atlasing is far from complete, both in general tissues and specific diseases, such as ductal carcinoma in situ (DCIS). DCIS is a pre-invasive, highly prevalent breast cancer with very low chances of progressing to invasive ductal carcinoma (IDC) yet is treated aggressively with no current method to predict progression. To address these issues, I used N-glycan-targeted MALDI mass spectrometry imaging for two specific aims: 1) generating a reference database of N-glycans for matched normal and tumor tissue types and 2) identifying the N-glycome of DCIS and determining differences between pure DCIS and DCIS that has progressed into IDC as well as between primary DCIS lesions with known outcomes. In Aim 1, N-glycomes of fifteen tissue types and their respective cancers were profiled. It was found that oligomannose N-glycans and core fucosylated multiantennary N-glycans were more abundant in most cancers, and exceptions to these patterns were identified. Individual N-glycans of various kinds were significantly altered in cancer for each tissue type. Overall patterns demonstrated reduction of tissue-specific N-glycosylation patterns in corresponding cancers. Sialylation and core fucosylation were also profiled in depth. For Aim 2, the profiling methods of Aim 1 were applied to DCIS to examine differences between un-progressed and progressed DCIS as well as primary lesions with known outcomes. N-glycans colocalizing to DCIS were identified and oligomannose structures were prominent among these. Several N-glycans were determined to be significant between pure DCIS and DCIS in IDC and between DCIS that did and did not eventually progress into IDC. Gene expression of N-glycosylation-related genes was also analyzed, indicating increased branching and decreased glycoprotein quality control in DCIS that would later progress. These findings offer valuable wide-scale information for normal and cancerous tissues and DCIS, indicating potential biomarker candidates for DCIS progression and serving as a reference for future studies and potential diagnostic applications of MALDI-MSI