Medicine and Health Sciences Commons^™

Music, Dhikr, And Deep Breathing Technique To Decrease Depression Level In Older Adults: Evidence-Based Practice In Depok City, Indonesia, Bahtiar Bahtiar, Junaiti Sahar, Wdiyatuti Widyatuti

ASEAN Journal of Community Engagement

Depression is a mental health problem that affects the elderly. As meeting the spiritual needs of depressed older people is important, a spiritual approach nursing intervention must be applied to reduce the level of depression in this population. This study proposed an integrated spiritual nursing approach through music therapy, dhikr, and deep breathing to improve depression levels among the elderly living in Cisalak Pasar, Depok City, in 2019. The research method used was a case study of an evidence-based practice using the Geriatric Depression Scale. The study sample consisted of 106 elderly, who were recruited by purposive sampling. The average …

Use Of A Smartphone Ecg Monitor To Identify Electrocardiogram Abnormalities Due To Hyperkalemia From Urinary Obstruction In A Jacob’S Sheep, Joseph Smith

Faculty Publications and Other Works -- Large Animal Clinical Sciences

Smartphone-based ECGS present a diagnostic opportunity for large animal practice. A two year old Jacob’s sheep presented with severe hyperkalemia secondary to a urinary obstruction. Collection of an electrocardiogram from a smart-phone based device demonstrated altered waveforms typical of severe hyperkalemia. The patient was successfully managed with medical and surgical therapies. This case presents that the method of collecting a smartphone-based ECG as determined for other large animal species, may be applicable to sheep. Additionally, this report demonstrates that the smartphone-based device may be sensitive enough to detect the absence of a P wave as commonly encountered with cases of …

The Use Of Life-Like Robotic Animals In The Acute Care Setting To Assist In The Care Of Patients With Dementia, Abby Denby

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The purpose of this pilot project was to describe the effect of life-like robotic animals on the nurses’ ability to provide care, patients’ level of agitation, use of antipsychotic medications, restraint and sitter use for patients with dementia in an acute care setting. Nurses report challenges and feelings of helplessness while caring for patients with dementia. Dementia may cause depression, agitation, aggression (physical or verbal) and a decrease quality of life. Animal Assisted Therapy (ATT) is a growing therapy in many healthcare settings but there is a lack of literature specifically related to the use of AAT in the acute …

Transanastomotic Feeding Tube In Surgical Management Of Congenital Duodenal Obstruction: Case Series, Hardian Gunardi, Asri D. Rachmawati, Nanok E. Susilo, Riana P. Tamba

The New Ropanasuri Journal of Surgery

Introduction. Prolonged fasting is a major concern in the postoperative management of congenital duodenal obstruction. Massive dilatation of the proximal segment would lead to diameter discrepancy and lack of propulsion, thus delaying enteral feeding. A transanastomotic feeding tube is an option to deliver early enteral feeding after surgical correction. The study evaluates the effectiveness and safety of a transanastomotic feeding tubes in the surgical management of congenital duodenal obstruction.

Method. The transanastomotic feeding tube's effectiveness in cases of congenital duodenal obstruction of the newborn underwent surgical correction was evaluated. Those managed from January 2016 to December 2018 at …

Angiotensin Ii In The Treatment Of Distributive Shock, An Old Theory Revitalized, Jennifer D. Leach, Daniel P. Curran

Physician Assistant Capstones, 2020-current

Objective: To assess whether or not angiotensin II in combination with current treatment has a favorable outcome in the treatment of distributive shock in terms of decreasing duration of vasopressor usage, increasing mean arterial pressure (MAP) above 65 mmHg, and improving mortality.

Design: Systematic Literature Review

Methods:Searches were conducted in PubMed, Google Scholar, and the James Madison University Library Database for the key terms angiotensin II, shock, septic shock, vasodilatory shock, distributive shock, blood pressure, double-blind, humans, and vasoconstrictor agents. Search results were filtered by year, for animal trials, irrelevant therapies, meta-analysis, retrospective studies, and case studies. Only original …

Hips That Harm: When Medical Devices Fail Women, Sophie N. Putka

Capstones

Medical devices that save the lives of thousands of Americans each year advance at a rapid pace - but some of them consistently leave women behind. When it comes to joint replacements and even heart devices, women have worse health outcomes. Behind this preventable problem is a system that overlooks women from start to finish. Female bodies are different from male bodies, but women are often underrepresented in medical trials for device approval. Women’s participation in clinical testing for devices has increased, but there’s rarely a detailed analysis of performance by sex, and even less information on women by race …

Diagnostic Accuracy Of Mcmurry’S Test In The Diagnosis Of Meniscal Tears, Jessica Smyth, Hartwell Rainey

Physician Assistant Capstones, 2020-current

No abstract provided.

Galcanezumab As A Treatment For The Prevention Of Migraines, Jacob Brown, Chelsea Weedon

Physician Assistant Capstones, 2020-current

Objective: To determine the effectiveness of subcutaneous galcanezumab as a preventative treatment for chronic migraines via a systematic review. Methods: JAMA and PubMed databases were searched using the terms galcanezumab and migraines in order to survey resulting patient clinical trials. Results: The 3 studies reviewed here all showed a statistically significant decrease in migraine headache days (MHDs) per month when using galcanezumab. Stauffer, et al. showed a mean decrease in MHDs of 4.7 and 4.6 for the 120mg and 240 mg doses of galcanezumab vs. 2.8 for placebo⁹ . Rosen, et al. showed a mean monthly 100% response rate …

Feasibility Of Continuous Fever Monitoring Using Wearable Devices, Benjamin L. Smarr, Kirstin Aschbacher, Sarah M. Fisher, Anoushka Chowdhary, Stephan Dilchert, Karena Puldon, Adam Rao, Frederick M. Hecht, Ashley E. Mason

Publications and Research

Elevated core temperature constitutes an important biomarker for COVID-19 infection; however, no standards currently exist to monitor fever using wearable peripheral temperature sensors. Evidence that sensors could be used to develop fever monitoring capabilities would enable large-scale health-monitoring research and provide high-temporal resolution data on fever responses across heterogeneous populations. We launched the TemPredict study in March of 2020 to capture continuous physiological data, including peripheral temperature, from a commercially available wearable device during the novel coronavirus pandemic. We coupled these data with symptom reports and COVID-19 diagnosis data. Here we report findings from the first 50 subjects who reported …

A Comparison Of 4-Year Total Medical Care Costs, Adverse Outcomes, And Opioid/Prescription Analgesic Use For 3 Knee Osteoarthritis Pain Treatments: Intra-Articular Hyaluronic Acid, Intra-Articular Corticosteroids, And Knee Arthroplasty., John Mackowiak, John T Jones, Vinod Dasa

School of Medicine Faculty Publications

To compare the medical costs associated with treatments for knee osteoarthritis (OA): intra-articular corticosteroids (ICS) and intra-articular hyaluronic acid (IHA) primarily, and ICS/IHA vs knee arthroplasty (TKA) secondarily. This was a retrospective analysis of an insurance claims database. Eligible members had diagnosed OA and no claims for ICS, IHA, or TKA during the 6–18-month look-back period. Cohorts of interest over the 4-year observation period were: patients who received ICS only, those who received IHA only, and those who received TKA only. Outcomes assessed included: (1) total allowed medical costs, (2) claims for pre-specified, treatment-related adverse outcomes and costs, and (3) …

Heart Failure 30-Day Readmission Frequency, Rates, And Hf Classification, Yolanda R. Brown, Twonia M. Goyer, Margaret C. Harvey

Doctor of Nursing Practice Projects

30 Day Hospital Readmission Rates, Frequencies, and Heart Failure Classification for Patients with Heart Failure

Background Congestive heart failure (CHF) is the leading cause of mortality, morbidity, and disability worldwide among patients. Both the incidence and the prevalence of heart failure are age dependent and are relatively common in individuals 40 years of age and older. CHF is one of the leading causes of inpatient hospitalization readmission in the United States, with readmission rates remaining above the 20% goal within 30 days. The Center for Medicare and Medicaid Services imposes a 3% reimbursement penalty for excessive readmissions including those who …

A Note From The Editor, Kristina Bross

Ideas: Exhibit Catalog for the Honors College Visiting Scholars Series

This letter introduces issue five of volume one, Ideas magazine, featuring the work of Dr. Lindsay Bottoms, fencer and sports physiologist.

Carbon Dots As Artificial Peroxidases For Analytical Applications, Shih-Chun Wei, Yang-Wei Lin, Huan-Tsung Chang

Journal of Food and Drug Analysis

Nanozymes have become attractive in analytical and biomedical fields, mainly because of their low cost, long shelf life, and less environmental sensitivity. Particularly, nanozymes formed from nanomaterials having high surface area and rich active sites are interesting since their activities can be tuned through carefully controlling their size, morphology, and surface properties. This review article focuses on preparation of carbon dots (C dots) possessing peroxidase-like activity and their analytical applications. We highlight the important roles of the oxidation states and surface residues of C dots and their nanocomposites with metal, metal oxides, or metal sulfides playing on determining their specificity …

Using Preliminary Data And Prospective Power Analyses For Mid-Stream Revision Of Projected Group And Subgroup Sizes In Pragmatic Patient-Centered Outcomes Research, Elizabeth A. Tolley Md, Satya Surbhi Md, James E. Bailey Md

Faculty Publications and Presentations

Pragmatic clinical trials are commonly used in patient-centered outcomes research to assess heterogeneity of treatment effects. Patient-Centered Outcomes Research Institute (PCORI) methodology standards for assessing heterogeneity of treatment effects are extremely rigorous, but their implementation in real-world settings can be difficult. Predicting recruitment effectiveness and subgroup characteristics is often challenging and may require mid-stream revision of projected group and subgroup sizes. Yet, little real-world data are available to demonstrate methodologically valid approaches to address situations where such revisions are necessary. These data were used for mid-stream revision of group and subgroup sizes in the Management of Diabetes in Everyday Life …

Differential Diagnosis Of Exercise-Induced Laryngeal Obstruction And Exercise-Induced Asthma, Allison Lyman, Allison Lyman

Honors College Theses

Sensations of shortness of breath and difficulty breathing are not uncommon, especially among athletes and those who regularly engage in aerobic activities. Often, athletes will seek treatment for their respiratory symptoms and may be diagnosed with exercise-induced asthma. Doctors prescribe inhalers to these individuals to help alleviate their symptoms; however, there are occasions in which inhalers fail to lessen the severity of breathing difficulties. This is because asthma is not the only condition that can cause shortness of breath, also known as dyspnea. There exists another condition which affects the vocal folds but not the lungs and bronchioles as is …

Early Diagnosis Of Alzheimer’S Disease In The Primary Care Setting, Raymond R. Romano

Theses and Dissertations (ETD)

The burden of Alzheimer’s disease (AD) affects not just the individual but also families, providers, and society. Early recognition and diagnosis of AD may reduce cost by reducing interaction with the health care system, earlier initiation of treatment, and prolonging time to long- term care. Primary care providers, the first contact for diagnosis of patients with AD, are not fulfilling the potential of early diagnosis for a variety of reasons. Biomarkers of AD emerge on average 15 to 20 years before clinical diagnosis, yet currently established biomarkers are not easily available in the primary care setting. A growing body of …

Cardiac Electrophysiology: Exploring Racial And Gender Outcomes Of Treatment Of Paroxysmal And Persistent Atrial Fibrillation Using Sotalol And Dofetilide, Nicole Lanette Bradford-Love

Dissertations

Purpose

The purpose of this study is to explore the association between gender and racial lines in the conversion and sustainment of normal sinus rhythm (NSR) from paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation using the anti-arrhythmic drugs (AADs) sotalol and dofetilide.

Methods

A secondary data analysis was performed to assess the relationships of the independent and dependent variables listed above. Using SPSS v. 24 descriptive statistics were obtained and initially evaluated for accuracy with histograms. A cross-tabulation frequency table was produced to determine the number of variables that fell into each dependent category. Following this, the frequencies were …

Using Collaborative Objective Simulation Clinical Evaluation With Undergraduate Nursing Students And Nurse Anesthesia Students Labor Epidural Placement In An Active Labor Patient, Chaka K. Jackson, Aisha Pierre

Doctoral Projects

Developing interdisciplinary teamwork and patient communication skills are essential for the student registered nurse anesthetist (SRNA) to provide quality patient care when administering epidural anesthesia. The synthesis of the evidence revealed limited available information on simulation use for SRNA epidural administration and collaboration. This doctoral project examined the effectiveness of learning through traditional simulation to enhance communication and collaboration between the Bachelor of Science in Nursing (BSN) and the Nurse Anesthesia Program (NAP) students. The BSN and NAP students were provided with a simulation environment to care for a laboring patient while improving patient safety and quality outcomes. The project …

Evaluation Of An Intervention To Maintain Therapeutic Pressure Of The Endotracheal Tube Cuff During Intraoperative Surgery, Jamare Reed

Doctoral Projects

The current practice of intraoperatively assessing the cuff pressure of the endotracheal tube (ETT) is arbitrary and potentially leads to negative impacts on patients. This best practice project aimed to review and synthesize the existing evidence-based literature on measuring ETT cuff pressure and to establish a policy guideline for anesthesia providers to measure ETT cuff pressure in the intraoperative environment. Based on the star model of the knowledge transformation framework model provided by the Academic Center for Evidence-Based Practice (ACE), the creation of evidence-based policy on ETT cuff measurement is expected to potentially prevent poor patient outcomes, patient expenses, and …

The Effect Of Hydroxychloroquine On In-Hospital Mortality In Covid-19, Samar Aboulenain, Nakeya Dewaswala, Fergie Ramos, Pedro Torres, Ahmed Abdallah, Mohamed Abdul Qader, Baher Al-Abbasi, Charles R. Bornmann, Karolina N. Dziadkowiec, Kai Chen, Jesus E. Pino, Robert Chait, Kleper De Almeida

HCA Healthcare Journal of Medicine

Background: Hydroxychloroquine (HCQ) is an antimalarial medication that has been tested against various viral illnesses. The available evidence regarding the role of HCQ in the coronavirus disease 2019 (COVID-19) remains controversial.

Methods: This is a comparative retrospective cohort study that aims to evaluate the efficacy and safety of HCQ in hospitalized patients with COVID-19. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included ICU admission rate, mechanical ventilation, prolonged length of stay (LOS), QTc prolongation and cardiac arrest.

Results: A cohort of 175 hospitalized patients with COVID-19 were included with a median (interquartile range [IQR]) age of 66 [48–79] …

Diagnostic Accuracy Of Resistive Index Of Capsular And Intratesticular Branches Of Testicular Arteries In Infertile Men With Oligoasthenospermia: A Case-Control Study, Mehdi Zolfaghar-Khani, Hadi Majidi Dr, Behzad Feizzadeh, Mojtaba Sabaghi

BioMedicine

Introduction: Male infertility accounts for nearly 50% of couples' infertility. Only a few studies evaluate the diagnostic accuracy of resistive index (RI) of testicular arteries using color Doppler imaging to identify male infertility. The aim of this study was to investigate the diagnostic accuracy of RI of the capsular and intratesticular branches of testicular arteries in infertile men with oligoasthenospermia and its comparison with normal men.

Material and Methods: In a case-control study, 30 patients with oligoasthenospermia (case group) and 30 healthy controls who meet the inclusion criteria, were selected. For all patients, RI was measured using color …

Extra Axial Chordoma Of The Distal Femoral Metaphysis: A Case Report, Long Nguyen, Irene Vasko Do, Gord G. Zhu Do, Veniamin Barshay Md, Ms, Phd

Cooper Rowan Medical Journal

Background

Chordomas are malignant bone tumors that are derived from remnant embryonic tissue of the notochord and are typically found in the axial midline. When they are found outside of the axial skeleton, the diagnosis can be challenging and elusive. Often, they are overlooked on initial presentation in lieu of other more common lesions, including cartilage tumors (eg, enchondroma, chondrosarcoma, osteochondromatosis) due to their overlapping features.

Case Report

A 30-year-old female with a four-year history of intermittent left knee pain presented for initial evaluation. Physical exam of the knee was unremarkable except for moderate tenderness on palpation. Radiographs showed a …

Mental Health And Its Wicked Factors, Michael Schuler

English Department: Research for Change - Wicked Problems in Our World

Mental health has long since been an issue in not just our society, but worldwide. While it is difficult to determine exactly what factors affect mental health, there has been significant research done within the past 30 years to show that major factors that affect mental health can be mitigated. Things such as poverty, physical health, and community outreach can all be linked to mental health issues. There are some solutions that will mitigate these factors that can be explored. These solutions can include things like raising awareness for mental illnesses in order to reduce stigma, getting more mental health …

Audiovisual Integration During Novel Word Learning Among School-Aged Children With Cochlear Implants, Kristen Elizabeth Thompson Thornton

Theses and Dissertations (ETD)

Objective. It is well established that being able to see someone’s mouth move as they speak boosts speech perception for children with cochlear implants (CIs). Thus, children with CIs are often instructed to orient themselves toward the person they are listening to, to gain access to visual speech cues. Children with CIs who are better “audiovisual integrators,” or those who experience an auditory-visual (AV) enhancement effect (higher performance for AV information than auditory-alone (AO) or visual-alone (VO)), are more likely to have better speech and language outcomes after receiving their CI than children with poorer AV integration skills. While AV …

The Importance Of The Freeway Space In Orofacial Myofunctional Therapy, Robert M. Mason, Honor Franklin, Patricia Grant, Ellen B. Role

International Journal of Orofacial Myology and Myofunctional Therapy

The purpose of this article is to explain the importance of evaluating and documenting the freeway space (interdental rest position), in initial examinations and at the completion of therapy in patients exhibiting an open mandibular resting position. The freeway space measurements obtained can be shared with parents, patients, and referral sources. To this end, the muscular, neural, and sensory components related to the freeway space are discussed, as well as airway, dental eruption patterns, tactile feedback, and orthodontic relapse considerations. An extraoral method for evaluating the dimensions of the anterior freeway space is proposed.

State Transition Modeling Of Complex Monitored Health Data, Jörn Schulz, Jan Terje Kvaløy, Kjersti Engan, Trygve Eftestol, Samwel Jatosh, Hussein Kidanto, Hege Ersdal

Faculty of Health Sciences, East Africa

This article considers the analysis of complex monitored health data, where often one or several signals are reflecting the current health status that can be represented by a finite number of states, in addition to a set of covariates. In particular, we consider a novel application of a non-parametric state intensity regression method in order to study time-dependent effects of covariates on the state transition intensities. The method can handle baseline, time varying as well as dynamic covariates. Because of the non-parametric nature, the method can handle different data types and challenges under minimal assumptions. If the signal that is …

Assessing Disease Severity Of Diabetic Retinopathy Using Novel Graphical Interpretation Of Flicker Electroretinogram, Anjalee Choudhury, Jonas Moses, Victor Gonzalez

MEDI 9331 Scholarly Activities Clinical Years

Purpose: To assess the clinical value of reporting full-field electroretinogram (eg, flicker ERG) findings graphically to determine the severity of diabetic retinopathy (DR) within an office-based setting.

Methods: Patients with type 2 diabetes mellitus were included and classified into varying degrees of DR based on presence and severity. Flicker ERG responses were recorded and compared between groups.

Results: Between the varying disease stages, significant differences in the mean magnitude and phase values were found. There was also a significant difference between the proportions of the magnitude and phase color-coded frequencies between groups of severity and threat to …

The Effect Of An Anti-Slip Surface On Objective Measures Of Tongue Strength In Healthy Adults, Nancy Pearl Solomon, Heather M. Clark

International Journal of Orofacial Myology and Myofunctional Therapy

Purpose: Instrumental assessments of tongue strength have provided clinicians with the ability to obtain quantitative measures to document lingual weakness. A technical challenge with a common instrument is that the surface of the of the bulb-shaped sensor is smooth and can be slippery when contacted by the tongue. This study evaluated whether adding a textured layer to the bulb leads to enhanced strength measures in neurologically normal adults. Methods: Maximum-effort maneuvers for anterior and posterior tongue elevation, right and left tongue lateralization, and tongue protrusion were available from 62 healthy adults using the Iowa Oral Performance Instrument (IOPI). The IOPI …

Factores Asociados A Retinopatía En Diabetes Mellitus, Angie Nicole Peñuela Suárez, Fabio Andrés Manrique, Paula Daniel Pérez Espinel, Diana Valeria Rey Rodríguez, María Camila Sotomonte Flórez

Ciencia y Tecnología para la Salud Visual y Ocular

El propósito de esta investigación fue identificar, a través de la búsqueda de la literatura, factores asociados que afectan a la población que padece retinopatía diabética (RD). Para esto, se realizó una búsqueda electrónica de artículos científicos en las bases de datos Medline (PubMed) y LILACS, utilizando descriptores DeCS, donde de incluyeron palabras claves como factores de riesgo, diabetes y retinopatía. Como resultado, se identificaron 9 estudios, en donde los factores asociados a RD en la población con diabetes mellitus fue dislipidemia, control glucémico, área rural, hipertensión arterial, duración de la diabetes, tabaquismo, obesidad, índice de masa corporal (IMC), hemoglobina …

Developing A Computer-Controlled Treat Dispenser For Canine Operant Conditioning, Walker Arce, Jeffrey R. Stevens

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

When performing canine operant conditioning studies, the delivery of the reward can be a limiting factor of the study. While there are a few commercially available options for automatically delivering rewards, they generally require manual input, such as using a remote control, in accordance with the experiment script. This means that human reaction times and transmission distances can cause interruptions to the flow of the experiment. The potential for development of non-supervised conditioning studies is limited by this same factor. To remedy this, we retrofitted an off-the-shelf treat dispenser with new electronics that allow it to be remotely controllable as …