Medicine and Health Sciences Commons^™

Fall 2021

Scientia

A Decade of Progress and Success; Speech Language Pathology Program; COVID-19 Long-Hauler Study; Peer Mentors Initiative; Faculty Update; Expert Engagement: Three CSH initiatives further education and scholarship while supporting communities in need; Strategic Command: Business consultant and med tech expert Stephen Sichak helps others face pandemic challenges; Taking Care: A School of Nursing research team plumbs the pandemic experiences of nurses nationwide

Obat Ambeien Di Apotik - Paling Ampuh 3 Hari Sembuh, Musa Fatih

Jual Kurmaqu

Kumpulan Obat Antibiotik Untuk Sakit Saat Buang Air Kecil, Obat Kelamin Nyeri Obat Kelamin

obat kelamin nyeri

55-Word Stories: Insight Into Healthcare, Nancy E. Krusen

Translational Science in Occupation

Narrative medicine and health humanities focus on arts, ethics, and clinical practice. Many health education programs incorporate creative activities to facilitate learner self-awareness and insight. We include them to address programmatic themes of professional growth and translational science.

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Sex Differences In Allergic Asthma Responses Of Mice Prenatally Exposed To Wood Smoke, Adelynne Walley

Undergraduate Theses, Professional Papers, and Capstone Artifacts

No abstract provided.

Institutional Connectedness And Social Support Among College Students: Links To Campus Involvement, Carissa Strum

Honors Theses

Background. College is a pivotal period in the lives of students, and an important aspect of the experience is involvement within the campus. College student wellness is also a growing area of interest in higher education, with increased attention on ways to help students thrive. This study explores which aspects of campus involvement contribute to students’ feelings of connectedness and social support. This study aims to 1) assess the association between campus involvement and social support among college students, 2) assess the association between campus involvement and institutional connectedness among college students, and 3) examine whether the association between campus …

Implementation Of Guidelines For Preprocedural Ultrasound In Neuraxial Placement For Obstetric Patients With Scoliosis, Luther Nyirenda

Doctor of Nursing Practice Scholarly Projects

Neuraxial anesthesia including epidural, spinal, and combined spinal-epidural, is used with 65% of parturients in the United States for the management of pain and discomfort. Conventional landmark palpation has been the mainstay technique for neuraxial anesthesia, but unfamiliar spinal anatomy can lead to incomplete blockade or an increased incidence of complications. Scoliosis causes lateral curvature and rotation of the spine leading to arthritis and soft tissue changes that can present obscure anatomical landmarks, cause difficulty in needle passage, and result in inadequacy of local anesthetic efficacy. The literature illustrates that preprocedural ultrasound is recommended for needle placement in parturients with …

Final Scholarly Project: Evidence-Based Practice Guidelines For The Perioperative Management Of Blood Glucose Levels In The Cardiac Surgery Patient, Chelsey Benner

Doctor of Nursing Practice Scholarly Projects

Cardiovascular disease is the leading cause of mortality worldwide, necessitating a high demand for cardiac surgery. A unique stressor for cardiac surgery is an increased surgical stress response involving hyperglycemia. Perioperative hyperglycemia contributes to adverse postoperative outcomes following cardiac surgery. Current evidence examines blood glucose control and its effect on adverse postoperative outcomes, including sternal wound infections, acute kidney injury, prolonged mechanical ventilation, and an increased length of stay in the intensive care unit. Despite the link between hyperglycemia and poor postoperative outcomes, most facilities lack standardized guidelines for the perioperative management of blood glucose levels in cardiac surgery patients. …

Development Of Clinical Practice Guidelines For Incorporating Paravertebral Blockade For Thoracic Surgery Adult Patients, India Hutchison

Doctor of Nursing Practice Scholarly Projects

Thoracic surgery is considered one of the most painful surgical procedures due to its severity and the duration of the procedure. Pain is detrimental to the patient experience, and poor patient satisfaction results in revenue loss for hospitals. Maintaining adequate pain control after surgery is crucial in preventing pulmonary complications such as atelectasis and respiratory failure that prolong patient recovery. It is the responsibility of the anesthesia provider to ensure adequate pain control throughout the perioperative experience. Although current evidence-based data shows that regional anesthesia provides superior thoracic postoperative pain control, the current practice continues to be the utilization of …

Development Of Evidence-Based Practice Guidelines For Utilizing Erector Spinae Plane Blockade For Patients Undergoing Cardiac Surgery, Gabrielle Metoyer

Doctor of Nursing Practice Scholarly Projects

In the United States, the aging population and high rates of cardiovascular disease leads to increased cardiothoracic surgeries. Analgesia for cardiac surgeries often involves high-dose opioids. However, with an ever-increasing opioid epidemic and adverse effects on the postoperative healing process, recent literature seeks to decrease opioid consumption by utilizing alternative methods of analgesia. The American Association of Nurse Anesthetists recommends the use of regional anesthesia techniques to reduce the incidence of undertreated postoperative pain that can occur from opioid-sparing methods of analgesia. This project aims to create an evidence-based analgesia guideline for adult patients undergoing cardiac surgery. Interventions will include …

Final Scholarly Project: The Administration Of Transversus Abdominis Plane Blocks In Patients Undergoing Anesthesia For Open Ventral Hernia Repairs, Brennon Pinion

Doctor of Nursing Practice Scholarly Projects

Ventral hernia repairs are the only definitive treatment for umbilical or abdominal hernias. These procedures are prevalent and often lifesaving but also carry high risks of adverse effects. Some of the problems that follow include postoperative ileus, increased opioid use, and prolonged length of stay. Due to the rate of complications, there was a need to improve these outcomes. One way to improve outcomes is to implement superior anesthetic techniques. This Final Scholarly Project (FSP) followed the Plan-Do-Study-Act (PDSA) model to conduct evidence-based practice (EBP) and quality improvement (QI) sections. The plan phase included a thorough literature search and analysis …

Evidence-Based Practice Guidelines For Perioperative Use Of Dexmedetomidine In Pediatric Congenital Cardiac Surgery, Kayla Thomsen

Doctor of Nursing Practice Scholarly Projects

Tachyarrhythmias are common postoperatively in the congenital cardiac surgery population. About 1% of the population is born with congenital heart disease (CHD), with 50% of patients undergoing surgery for CHD experiencing arrhythmias. Complications can arise from postoperative arrhythmias, including hemodynamic instability and myocardial depression, having catastrophic health repercussions. Despite the high prevalence and complications, there is no standard practice for postoperative tachyarrhythmia prevention in the chosen population, and prevention is at the provider's discretion. However, literature exploring the effects of dexmedetomidine notes promising results for using the drug for postoperative tachyarrhythmia prevention. The project aims to address the lack of …

Final Scholarly Project: Enhanced Recovery After Surgery (Eras) Guidelines For Pancreaticoduodenectomies, Rebecca Wheeler

Doctor of Nursing Practice Scholarly Projects

A pancreaticoduodenectomy, or Whipple procedure, is the only curative option for pancreatic cancer. For those eligible for tumor resection, the Whipple procedure is a difficult surgery for both the patient and provider. Complications following pancreaticoduodenectomy are numerous and include infection, delayed gastric emptying, high hospital costs, and pancreatic fistulas. Enhanced Recovery After Surgery (ERAS) protocols exist to provide evidence supporting standardization of practices that lead to the improvement of these patient outcomes. An ERAS protocol for the pancreaticoduodenectomy, first established in 2012, is inconsistently implemented in healthcare facilities. Researchers collected data involving the use of the Whipple procedure ERAS guidelines …

Guidelines For Intraoperative Use Of Quantitative Neuromuscular Monitoring, Alex Thompson

Doctor of Nursing Practice Scholarly Projects

Chemical paralysis with neuromuscular blocking agents is common practice in anesthesia. Adequate reversal of these medications is essential for postoperative recovery and return to physiologic baseline. Inadequate reversal may lead to residual paralysis and respiratory complications such as hypoxemia, upper airway obstruction, atelectasis, and pneumonia. Quantitative neuromuscular monitoring was introduced as an objective measure of adequate recovery from neuromuscular blockade. The American Society of Anesthesiologists recommends utilizing quantitative neuromuscular monitoring before tracheal extubation in their 2023 practice guidelines, as the research involving quantitative neuromuscular monitoring shows a reduction in postoperative residual paralysis rates and adverse respiratory complications postoperatively. In this …

Analysis Of Clinical Outcomes And Cost Effectiveness Of Neuromuscular Blocking Drug Reversal In Patients Classified As Obese, Trevor Mack

Doctor of Nursing Practice Scholarly Projects

Obesity predisposes patients to heightened risks of adverse outcomes following surgery, including residual neuromuscular blockade and postoperative complications. The administration of non-depolarizing neuromuscular agents (NMBAs) is fundamental for muscle relaxation and optimal surgical conditions. However, the subsequent reversal of these blockers with agents like sugammadex or neostigmine is crucial to mitigate these risks. While sugammadex is recognized as a clinically superior choice due to its rapid and more complete reversal, its extensive use is often limited by cost, presenting challenges in obese patients who already face increased susceptibility to complications. This project evaluates the cost-effectiveness of sugammadex versus neostigmine in …

Development Of Evidence-Based Clinical Practice Guidelines For Pediatric Preoperative Anxiety, Whitney R. Stant

Doctor of Nursing Practice Scholarly Projects

Preoperative anxiety is a problem that occurs frequently in pediatric patients. Preoperative anxiety creates physical and psychological changes that impact a child’s surgical experience. Pediatric patients who experience preoperative anxiety may also experience prolonged postoperative care, long-term psychological complications, and increased postoperative pain. Sedating medications are often administered to prevent and treat preoperative anxiety. Commonly, midazolam is administered intranasally to prevent preoperative anxiety. Midazolam increases the risk of cognitive impairment and respiratory depression. Dexmedetomidine is an effective alternative to midazolam. Dexmedetomidine is a highly selective alpha-2 agonist and provides arousable sedation without respiratory depression. Dexmedetomidine is safe and effective at …

Using The Bispectral Index Monitor To Decrease The Incidence Of Unintended Intraoperative Awareness In The High-Risk Population, Bridget Hayes

Doctor of Nursing Practice Scholarly Projects

Unintended intraoperative awareness is a traumatizing complication of general anesthesia. This negative outcome affects 0.1-0.2% of all patients undergoing general anesthesia. Patients at higher risk for this experience include those undergoing emergency surgery, traumas, cesarian sections, those on cardiopulmonary bypass, those with substance use disorder, and those undergoing total-intravenous anesthesia (TIVA). This high-risk population is affected by unintended intraoperative awareness 1% of the time. The bispectral index (BIS) monitor has been proposed as a tool to decrease the incidence of unintended intraoperative awareness. There are several large, randomized controlled trials that demonstrate that using a BIS monitor decreases the incidence …

Clinical Guidelines For The Perioperative Management Of Patients With Aortic Stenosis Undergoing Noncardiac Surgery, Owen Diehl

Doctor of Nursing Practice Scholarly Projects

Aortic stenosis (AS) is a common valvular disorder that causes left ventricular (LV) outflow obstruction. The prevalence of AS may increase with the aging population and the widespread availability of diagnostic capabilities like echocardiography. With the increasing patient population diagnosed with AS, the chance of encountering these patients during noncardiac surgery (NCS) increases. Performance of anesthesia is challenging in patients with AS due to the pathophysiological consequences of AS and the hemodynamic changes associated with anesthesia. The patient with AS presenting for NCS is at an increased risk of perioperative major adverse cardiac events (MACEs). This project aimed to determine …

Implementation Guidelines For Total Hip And Total Knee Arthroplasty To Reduce The Incidence Of Deep Vein Thrombosis And Subsequent Pulmonary Embolism, Mitchell Mccorkle

Doctor of Nursing Practice Scholarly Projects

With patients living longer, the orthopedic sector has given rise to joint prostheses as a treatment for those experiencing osteoarthritis (OA). With the increase of these procedures, there is also an increased risk of deep vein thrombosis (DVT) and subsequent pulmonary embolus (PE) following these surgical procedures. The orthopedic medical community and anesthesia providers aim to decrease DVT and PE risk through multiple modalities. The anesthesia focuses on reducing DVT, and PE involves a multimodal approach to each anesthetic. Modalities used for the multimodal approach involve peripheral nerve blocks (PNB), neuraxial spinal anesthesia, early mobilization, postoperative nausea and vomiting (PONV) …

How Music Is Used To Facilitate Communication In Speech-Language And Music Therapy For Children With A Diagnosis Of Autism Spectrum Disorder, Anna Mcgreevy

Honors College Theses

The goal of this research was to determine how music is being used in speech and music therapy sessions for children with a diagnosis of autism spectrum disorder, to discover the most common targets of these therapy sessions, and to examine the anatomical and physiological constructs that support the inclusion of music. This study was a review of literature, and included research from a variety of articles, several written in the past 25 years. Overall, results showed that music-based speech interventions such as Melodic Based Communication Therapy and Developmental Speech and Language Training, as well as music therapy interventions, are …

Functional Analysis Of Chromatin Remodeler Csb In Parp1/2- Mediated Oxidative Dna Lesion Repair, Rabeya Bilkis

Biomedical Sciences ETDs

The ATP-dependent chromatin remodeler Cockayne syndrome protein B (CSB) is essential for maintaining genome integrity. Mutations in CSB are the primary cause of Cockayne syndrome (CS), a premature aging disorder with severe sun sensitivity and neurodevelopmental symptoms. However, the precise mechanisms underlying the disease etiology remain poorly understood. Given the critical roles of oxidative stress in aging and neurodegenerative disorders, this research sought to determine the mechanisms of CSB’s functions in oxidative DNA damage repair.

In the first aim, we investigated how CSB participates in PARP1/2-mediated oxidative DNA repair. We showed that PARP1 and PARP2 recruit CSB to oxidized chromatin …

Use Cases For Art Therapy Intervention In Clinical Psychedelic Praxis, Kaitlin Maud

Expressive Therapiehttps://digitalcommons.lesley.edu/cgi/myaccount.cgis Capstone Theses

Psychedelic medicine has existed for thousands of years as a traditional, sacred practice and is now in varying stages of legalization for clinical application in the United States. Psychedelic-Assisted Therapy uses specific psychoactive substances to facilitate altered states of consciousness in which clients have access to unconscious material and there is a greater cognitive openness to new perspectives and possibilities. Art Therapy is a modality of psychotherapy with decades of data to support its clinical efficacy in treating mental illness and other chronic conditions. A review of the literature shows a range of use cases for art in the context …

Forgiveness Of Self And Others: A Group Approach To The Treatment Of Ptsd And Other Trauma Related Experiences, Jarrod A. Mask

Psychology Doctoral Specialization Projects

Forgiveness is often misinterpreted as the act of forgetting what happened or offering one’s offender the ability to redeem themselves for their wrongdoings. This is simply not the case. Rather, forgiveness is the process of the individual making the unprovoked choice to release their resentment in their own voyage towards living a free and happy life without being imprisoned from the emotions un-forgiveness produces. Forgiveness, as it may be a necessary process for the individual is to attain a sense of peaceful acceptance and liberation from their pain, is not an easy process. Providing a peer-based support system in the …

Saponin Tql1055 Adjuvant-Containing Vaccine Confers Protection Upon Mycobacterium Tuberculosis Challenge In Mice, Mushtaq Ahmed, Eric Farris, Rosemary V Swanson, Shibali Das, Yan Yang, Tyler Martin, Shabaana A Khader

2020-Current year OA Pubs

Tuberculosis (TB), caused by the intracellular pathogen

The Association Of Caregiver Attitudes, Information Sources, And Trust With Hpv Vaccine Initiation Among Adolescents, Akila Anandarajah, Thembekile Shato, Sarah Humble, Alan R Barnette, Heather M Brandt, Lisa M Klesges, Vetta L Sanders Thompson, Michelle I Silver

2020-Current year OA Pubs

This study described caregiver attitudes and the information sources they access about HPV vaccination for adolescents and determined their influence on human papillomavirus (HPV) vaccination initiation. An online survey was administered to 1,016 adults in July 2021. Participants were eligible if they were the caregiver of a child aged 9-17 residing in Mississippi, Arkansas, Tennessee, Missouri, and select counties in Southern Illinois. Multivariate logistic regression was used to estimate the association of caregiver attitudes and information sources with HPV vaccination. Information from doctors or healthcare providers (87.4%) and internet sources other than social media (31.0%) were the most used sources …

Assessing Knowledge, Confidence, And Attitude Toward Virtual Care And Telehealth Among Graduate Nursing Students, Natasha Asante

Doctor of Nursing Practice Scholarly Projects

In response to the COVID-19 pandemic, telehealth and virtual healthcare modalities have become primary care delivery methods. The American Academy of Ambulatory Care Nursing (AACN) and the American Association of Nurse Practitioners (AANP) support using virtual care and telehealth technology in health care services. Although most healthcare institutions utilize telehealth to provide care, emerging research highlights the lack of telehealth training in Advanced Practice Nurse (APRN) education. However, no standard curriculum requirements mandate graduate nursing programs to train APRN students in telehealth or virtual health modalities. Due to the lack of training for APRNs, it can be very challenging for …

The Effects Of Music Therapy On Pediatric Patients With Congenital Heart Defects In The Pre And Postoperative Setting, Janelle Marie Choy

Nursing | Student Research Posters

Congenital heart defects is a prominent medical occurrence especially in pediatrics. These defects often require surgeries and extensive treatment plans. These treatment plans often include invasive surgeries and extensive treatment plans which can require long recovery times along with potential surgical complications. This study aims to evaluate the effectiveness of music therapy on pediatric patients with congenital heart defects in the pre and postoperative setting and how music therapy can be implemented in treatment plans to yield effective recovery results for these patients. This research is significant as elevated vital signs and preoperative anxiety are associated with an increased need …

Asthma Prevalence Among United States Population Insights From Nhanes Data Analysis, Sarya Swed, Bisher Sawaf, Feras Al-Obeidat, Wael Hafez, Amine Rakab, Hidar Alibrahim, Mohamad Nour Nasif, Baraa Alghalyini, Abdul Rehman Zia Zaidi, Lamees Alshareef, Fadel Alqatati, Fathima Zamrath Zahir, Ashraf I. Ahmed, Mulham Alom, Anas Sultan, Abdullah Almahmoud, Agyad Bakkour, Ivan Cherrez-Ojeda

All Works

Asthma is a prevalent respiratory condition that poses a substantial burden on public health in the United States. Understanding its prevalence and associated risk factors is vital for informed policymaking and public health interventions. This study aims to examine asthma prevalence and identify major risk factors in the U.S. population. Our study utilized NHANES data between 1999 and 2020 to investigate asthma prevalence and associated risk factors within the U.S. population. We analyzed a dataset of 64,222 participants, excluding those under 20 years old. We performed binary regression analysis to examine the relationship of demographic and health related covariates with …

Exploring Treatment Burden In People With Type 2 Diabetes Mellitus: A Thematic Analysis In China's Primary Care Settings, Kai Lin, Mi Yao, Lesley Andrew, Rouyan Li, Yilin Chen, Jacques Oosthuizen, Moira Sim, Yongsong Chen

Research outputs 2022 to 2026

Background: Understanding treatment burden is a critical element to the effective management of Type 2 Diabetes Mellitus (T2DM). The current study aims to address the knowledge gap surrounding treatment burden of T2DM from the patient’s perspective in China’s primary care settings. Methods: A narrative review informed the creation of an a priori coding structure to identify aspects of T2DM treatment burden. Focus groups were conducted, employing a maximum variation sampling strategy to select participants from diverse sociodemographic backgrounds across urban, suburban, rural, and remote areas in China. Participants included adults with T2DM care in primary care settings for over a …