Digital Commons Network^™

Occupational Radiation Exposure Health Risks And Radiation Safety Practices Relative To Interventional Cardiology Providers, Brandon Young

Theses and Graduate Projects

Background: Occupational radiation exposure is a health risk for many healthcare professionals working in interventional cardiology. As technology has progressed, interventional procedures have become more complex and subsequently longer in radiation exposure duration, resulting in a need for radiation safety practices to meet the ever growing demands of the interventional team and ideally outpace these demands.

Methods: A comprehensive systematic literature review was conducted using PubMed. Articles on the health risks of occupational radiation exposure were selected to demonstrate the breadth of potential adverse effects of radiation exposure with less focus on the depth of these effects. Articles covering occupational …

Ethically Addressing Vaccine Hesitancy In Pediatric Populations, Tommie L. James Iii

Theses and Graduate Projects

Vaccines are highly regarded in the scientific and medical community for their efficacy in the prevention of disease; yet the prevalence of misinformation and mistrust surrounding vaccines is growing in communities around the world. Specifically observed in the United States (US) as an increase in vaccination exemption rates, this trend of vaccine hesitancy is leading to an increasing number of parents and caregivers to either refuse or delay vaccinations from the recommended schedule. As a result, an increasing number of outbreaks of diseases such as measles and pertussis, thought to be on the verge of elimination, have spiked. While health …

A Literature Review: An Analysis Of The Widespread Effects Of Solitary Confinement/Social Isolation On Mental Illness And Mortality, Taneasha Muonio

Theses and Graduate Projects

Solitary confinement or isolation is widespread globally and has been used as a form of punishment, reform, reflection, and cleansing throughout time. The devastating impacts of not having social interactions for extended periods of time have been documented and noted.1 These impacts include severe mental health disorders such as schizophrenia, bipolar disorder, anxiety, depression, post-traumatic stress disorder (PTSD), suicide, motor disturbances, biological changes, and increased mortality.1-3 The analysis of how the United States became the country with the largest prison system and mentally ill population is addressed in this thesis including understanding how the prison-industrial complex was built. Understanding how …

New Treatment Options For Concussions Using Hyperbaric Oxygen Therapy, Crystal Amundson

Theses and Graduate Projects

Background: Millions of Americans experience concussions every year. With new attention from the media looking into the long-term sequela of concussions, more research and studies are initiated to find an effective treatment. Concussions happen after an impact to the head or body that causes a pathologic disruption in normal brain function. Symptoms most commonly associated with the trauma are headaches, emotional distress, vestibular disturbances and sensitivity to light. Historically, treatment has been physical and cognitive rest.

Methods: A systematic search of PubMed was performed to identify articles pertaining to the use of hyperbaric oxygen therapy in concussions and traumatic brain …

The Great Flood: An Exploration Of Fluid Resuscitation In Sepsis, Adam Olsson

Theses and Graduate Projects

Sepsis and septic shock continue to be major causes of in-hospital mortality. The World Health Organization (WHO) declared sepsis as a global health top priority as of 2017. To combat sepsis mortality, the Surviving Sepsis Campaign (SSC) released the first set of guidelines in 2004 and continues to publish treatment guidelines, updating the guidelines every four years based on emerging evidence. The 2018 update to the 2016 guidelines contains an Hour-1 Bundle released by the SSC, which includes a rapid infusion of a 30 ml/kg fluid bolus as a strong recommendation with low quality evidence. Recently, studies have challenged this …

The Presence And Prognosis Of Acute Kidney Injury And Renal Abnormalities In Hospitalized Sars-Cov-2 Patients, Mara Waaraniemi

Theses and Graduate Projects

SARS-CoV-2, a novel coronavirus reached pandemic status by the World Health Organization in the spring of 2020. As a novel virus, analysis of the early literature on the clinical manifestations of SARS-CoV-2 is imperative to help guide clinical practice and inform future research. Early studies about the clinical manifestation of the virus showed a proportion of hospitalized patients developing renal abnormalities and AKI. This paper analyzed literature through searching the PubMed database to assess whether renal abnormalities and AKI were present in hospitalized SARS-CoV-2 patients, how the renal abnormalities manifested themselves in patients, and the associated treatment and prognosis of …

Does An Acl Autograft, Allograft Or Synthetic Graft Lead To Improved Long Term Knee Stability?, Parker Lanoue

Theses and Graduate Projects

Current literature surrounding anterior cruciate ligament (ACL) reconstruction outlines four primary classes of grafts used to replace the existing ACL. These classes include bone-patellar tendon-bone (BPTB) autografts, hamstring tendon (HT) autographs, allografts and synthetic grafts. Research has been conducted on each of these primary ACL reconstruction strategies and through this research we are looking to answer the question on which of these classes of ACL grafts in turn leads to the most improved long-term knee stability. In addition to analyzing these classes of grafts we will also inspect options along the non-surgical route to ACL repair, a more conservative approach, …

Medical Treatment Of Diabetes Compared To Bariatric Surgery, Daniel Thornley

Theses and Graduate Projects

In this retrospective review, metabolic factors present in diabetic patients who underwent bariatric surgery were compared against those who were treated with medical therapy alone. These factors include: diabetes remission, glycosylated hemoglobin levels, medication use, changes in beta cells function, insulin sensitivity, incretin levels, weight loss, lipid profiles and blood pressures. Following bariatric surgery, patients observed superior changes in diabetes remission rates, glycosylated hemoglobin levels, medication use, beta cell function, insulin sensitivity, incretin levels, and weight loss when compared to those who were treated with medical therapy alone. Blood pressure changes were not significantly different among the two treatment groups. …

Does Administration Of Antipsychotic Medications Reduce The Incidence And Duration Of Delirium In Critically Ill Adult Patients?, Ellen Brateng

Theses and Graduate Projects

Background: Acute delirium is a common complication among critically ill patients. Besides the manifestation of distressing symptoms, delirium can result in negative patient outcomes. Several studies show that antipsychotics such as haloperidol are one of the most commonly used interventions for delirium despite large variability and lower quality of evidence available to advocate for their use.

Methods: A literature review was conducted to investigate current evidence on the use of antipsychotic agents for preventing and treating delirium in the intensive care unit.

Discussion: There is conflicting data concerning the prophylaxis and treatment of delirium in critically ill patients. For prophylaxis …

Does The Use Of Extracorporeal Cardiopulmonary Resuscitation Improve Neurologically Favorable Survival In Patients With Refractory Out-Of-Hospital Cardiac Arrest?, Timothy Lund

Theses and Graduate Projects

In this retrospective review, the use of extracorporeal cardiopulmonary resuscitation (ECPR) using extracorporeal membrane oxygenation (ECMO) was assessed in the management of refractory ventricular fibrillation (VF) and ventricular tachycardia (VT) out-of-hospital cardiac arrest (OHCA). Multiple factors were evaluated such as the duration of manual or mechanical cardiopulmonary resuscitation (CPR), ECPR protocols and the rate of favorable neurologic outcomes for these OHCA patients. Survival with a favorable neurologic outcome is defined as cerebral performance categories (CPC) 1 or 2. Although CPR remains and will continue to be a critical component in the management of cardiac arrest, the persistently high mortality rate …

Factors That Impact Glycemic Control In Adolescents With Type 1 Diabetes, Kelsey Mcfarling

Theses and Graduate Projects

The incidence of Type 1 Diabetes (T1D) is increasing worldwide and is diagnosed disproportionately in adolescent populations. Additionally, studies show that adolescents with T1D experience worse glycemic control during this developmental period. Maintaining glycemic control in patients with T1D decreases the risk of developing future diabetic-related complications. Factors such as race, ethnicity, gender identity, sexual orientation, socioeconomic status, and medical comorbidities influence disparities in maintaining glycemic control in adolescents. The recognition of these factors on the management of T1D through an integrative team approach leads to increased glycemic control and decreased diabetic- related complications. This paper explores the effects of …

The Role Of Temperature Management In Neurologic Outcomes Of Adult Cardiac Arrests:, Trenton Christensen

Theses and Graduate Projects

Background: Targeted Temperature control for post cardiac arrest patients has a long history dating back to the ancient Greeks. In the last twenty years there has been a push to define and implement a protocol for targeted temperature control for post cardiac arrest patients, specifically those with ventricular fibrillation arrests, to improve neurological outcomes and post-arrest quality of life. In this review, literature from the last twenty years and beyond was examined to attempt to determine whether populations treated with therapeutic hypothermia experienced improved neurological results.

Methods: Literature searches were preformed using the PubMed database as well as Google Scholar. …

Idiopathic Gastroparesis: Lifestyle Modifications Versus Pharmacotherapy, Rebecca K. Schieffer

Theses and Graduate Projects

Idiopathic gastroparesis is a chronic symptomatic motility disorder of the stomach of unknown cause characterized by delayed gastric emptying in the absence of mechanical obstruction, with the majority of gastroparesis cases being classified as idiopathic. Idiopathic gastroparesis continues to be a challenging diagnosis to manage and difficulty remains in treating associated symptoms that result in decreased quality of life. Current non-invasive recommendations for the treatment of idiopathic gastroparesis are lifestyle modifications, including dietary adjustments to follow a gastroparesis diet, and pharmacotherapy prescribed for symptomatic relief. Metoclopramide is currently the only medication approved by the Food and Drug Administration (FDA) in …

Colloids Compared To Crystalloids In Emergent Stabilization Of Critically Ill Adults, Jerry Johnson

Theses and Graduate Projects

Background: With the advent of newer and 􏰖safer􏰗 fluids there have been numerous trials and studies conducted to test the safety and validity of colloids. Are colloids more effective then crystalloid for emergent resuscitation? The purpose of this systematic literature review is to assess the claims on treatment success and explore safety to gain clarity on which fluid is the best treatment for the patient.

Methods: A systematic database search was conducted from 2006 to the present. The search utilized such sources as PubMed, UpToDate and ScienceDirect. This search included more than 70 journal articles, where 24 articles were selected …

Vitamin C As An Adjunct Therapy In Sepsis Management, Nicholas Becker

Theses and Graduate Projects

In the United States, sepsis afflicts nearly one in three ICU patients, is associated with monumental healthcare costs, and is among the leading causes of death. The burden of sepsis is felt globally, and efforts are underway to discover an effective adjunctive therapy. Vitamin C is a novel treatment showing promising early evidence. Additionally, vitamin C's use in combination therapy with hydrocortisone and thiamine has been postulated. These components are thought to work congruently to attenuate the pathophysiologic process of sepsis.

To answer whether vitamin C improves septic patient outcomes, a variety of methods were used to obtain information. Primarily, …

Misuse Of Prescription Stimulants And Their Effect On Cognition, Zachary Friederichs

Theses and Graduate Projects

Prescription stimulants like Adderall and Ritalin are increasingly being diverted and misused by college students who fail to recognize the potential health risks in an effort to improve academic performance. The main aim of this literature review is to address the prevalence of their misuse, the effects they have on cognition, and adverse side effects that are typically associated with their use. Despite being frequently referred to as "cognitive enhancers" or "smart pills," results from studies on these m􏰗edications remain mixed/unclear as to whether cognitive domains such as memory, executive function, and processing speed are actually enhanced. However, not surprisingly, …

In Adults With Difficult Intubations, What Is A Gold Standard Method For Success?, Nathaniel Kitzmann

Theses and Graduate Projects

The objective of this thesis is to analyze existing literature and guidelines for difficult intubations and provide clinical recommendations. This paper is a retrospective analysis of human trials focusing on preparation, medication, and tools in the field of emergency airway management. Techniques will be described and discussed. A large portion of intubations are described as difficult and have the potential to fail. Articles retrieved from databases PubMed, Medline, and PLOS ONE and the search engine Google Scholar were reviewed. Websites for the institutions of the American Society of Anesthesiologists and Difficult Airway Society were used in guidance. Currently, many guidelines …

Comparison Of Non-Nsaid Pain Management In The Treatment Of Patients With Symptomatic Knee Osteoarthritis, Nicholas Schmitz

Theses and Graduate Projects

Objective To compare the efficacy of other modalities and interventions versus standard first-line therapy of nonsteroidal anti-inflammatory drugs for pain management in patients with symptomatic knee osteoarthritis

Methods Perform literature reviews outlining patients suffering from Grade II or higher KOA using the Kellgren-Lawrence classification system and currently experiencing symptoms of pain, stiffness, and impaired physical functioning. Use data and results from various studies to compare improvement of symptoms from these modalities versus improvement of NSAIDs alone.

Results Weight loss and physical activity should remain the mainstay of early osteoarthritis treatment to help slow disease progression and symptoms of KOA. Duloxetine …

Comparison Of Non-Nsaid Pain Management In The Treatment Of Patients With Symptomatic Knee Osteoarthritis, Nicholas Schmitz

Theses and Graduate Projects

Objective: To compare the efficacy of other modalities and interventions versus standard first-line therapy of nonsteroidal anti-inflammatory drugs for pain management in patients with symptomatic knee osteoarthritis

Methods: Perform literature reviews outlining patients suffering from Grade II or higher KOA using the Kellgren-Lawrence classification system and currently experiencing symptoms of pain, stiffness, and impaired physical functioning. Use data and results from various studies to compare improvement of symptoms from these modalities versus improvement of NSAIDs alone.

Results: Weight loss and physical activity should remain the mainstay of early osteoarthritis treatment to help slow disease progression and symptoms of KOA. Duloxetine …

Mild Traumatic Brain Injury: Parental Education For An Active Child, Elizabeth W. Roth

Theses and Graduate Projects

Mild traumatic brain injuries in the pediatric population are prevalent and pervasive. Identification and recognition of concussion symptoms is complicated by variable symptom manifestation and duration. The purpose of this evidence-based DNP project was to implement a concussion education intervention to increase parental recognition and knowledge regarding pediatric concussions. Individualized, in-person education, evidence-based injury prevention, symptom recognition, and collaboration encouraged lifestyle modification to reduce childhood injuries. Evaluation of parental concerns concluded a desire for future health promotion education resulting in bimonthly meetings to further improve personal, familial, and professional health.