Digital Commons Network^™

The Effect Of Proton Pump Inhibitors On Normal Gastrointestinal Flora Leading To Weight Change, Emi L. Binstock

Physician Assistant Scholarly Project Papers

The goal of this literature review was to determine what effects proton pump inhibitors (PPIs) have on the normal gastrointestinal (GI) flora and how that may lead to weight loss or weight gain. A literature search was performed using the database PubMed. Only articles from the last ten years (2009-2019) were included in this review. Keywords used in the search are listed below. After exclusion criteria was applied, 30 articles were relevant and used in this review. Five themes were identified in the literature review. An investigation of normal GI flora associated with weight loss and weight gain identified a …

Comparing Romosozumab And Alendronate In The Treatment Of Osteoporosis In Postmenopausal Women, Taylor Johnshoy

Physician Assistant Scholarly Project Papers

The purpose of this literature review is to determine if there is a statistical difference in the safety and efficacy between romosozumab, the prototypical drug in the new drug class sclerostin inhibitors, versus alendronate, the prototypical bisphosphonate, in the treatment of postmenopausal osteoporosis. A comprehensive literature review was performed searching three databases, including PubMed, EMBASE, and Access Medicine from the last five years. Works chosen for review were limited to articles published in English, full-text articles, clinical trials, randomized control trials, systematic reviews, and meta-analyses. Items were excluded after reviewing abstracts due to material not directly comparing the treatment modalities. …

Comparison Of Anterior Cruciate Ligament Graft Materials And Risk Of Rupture/Reinjury In Young Athletes, Matthew Hockert

Physician Assistant Scholarly Project Papers

The anterior cruciate ligament tear is a standard surgical injury seen with young athletes competing at elite, amateur, and recreational capacities. The purpose of this literature review is to determine the rehabilitation guidelines and risks associated with anterior cruciate ligament reconstruction, as well as determining the role of rehabilitation in graft rupture. This literature review also serves to determine if graft choice for surgical repair plays a role in an increased risk of rupture or reinjury. This literature review used various online databases, including Dynamed, Cochran, and Pubmed, with the utilization of MeSH terms listed below in “keywords” in order …

Treatment Of Clostridioides Difficile With Fecal Microbiota Transplantation, Brenton Green

Physician Assistant Scholarly Project Papers

Research was performed to discuss the epidemiology and current guidelines of Clostridioides difficile infection (CDI), recurrent C. difficile infection (rCDI), the different modalities of fecal microbiota transplantation (FMT), the donor screening process, as well as the safety and efficacy of treatment. Utilizing Clinical Key, NCBI database, Dynamed Plus, Cochrane Review, and the websites for the CDC and FDA, a literature review was produced, encompassing recent research and human studies related to CDI. Recent studies were preferred, however since C. difficile has sparsely changed, older data was utilized with updates applied accordingly. Articles excluded were due to not meeting the themes …

Comparison Of Buprenorphine-Naloxone And Buprenorphine Monotherapy In Opioid Dependent Pregnant Women, Ellie Gillund

Physician Assistant Scholarly Project Papers

Opioid use disorder during pregnancy has continued to rise, and more primary care providers are being encouraged to prescribe opioid agonist pharmacotherapy. Such medications include methadone, buprenorphine, and naloxone. Many studies have been done to compare these medications’ role in medication assisted treatment (MAT) in pregnant women with opioid use disorder. The purpose of this literature review is to compare the use e of buprenorphine, with and without naloxone, as MAT for opioid dependent pregnant women. Specific outcomes compared in this study include maternal and neonatal safety, neonatal abstinence syndrome, and peripartum pain management. This review included three electronic search …

The Gut-Brain Axis: Treating Depression Through Microbiome Alterations, Alexandra Bachman-Williams

Physician Assistant Scholarly Project Papers

The purpose of this research and literature review is to explore the possible role that gut microbiome alterations have in the treatment of neurobehavioral diseases; specifically, anxiety and depression. This literature review searched PubMed, CINAHL, and Clinical Key. A variety of key terms were used during the search. Due to the field of research being relatively new and limited, studies from the last ten years and animal models were included in the study. Studies were excluded due to poor design or if the studies did not include anxiety or depression in the research. The research shows that there are the …

The Safety And Efficacy Of Antidepressant Use In The Adolescent Population, Jason Marcello

Physician Assistant Scholarly Project Papers

This literature review was conducted to determine the safety and efficacy of antidepressants in the adolescent population based on the currently available research. Specifically, are antidepressants safe and efficacious in treating depression in adolescents and is their use associated with increased risk of suicide. Data was collected by searching medical databases including: Clinical Key, CINAHL Complete, PsycINFO, PubMed, DynaMed Plus, and Cochrane Review. The review of the literature included systematic reviews, meta-analysis, cross-sectional, longitudinal, randomized control trials, and survey methods. All literature works selected were published within the past 14 years. A focused search was performed to gather information on …

Implementation Of Mental Health Resources To Decrease Depression And Suicide In Healthcare Professional Students, Matthew Knealing

Physician Assistant Scholarly Project Papers

The intent of this review of literature is to determine if implementing mental health resources in graduate healthcare programs decreases the rate of depression and suicidal ideations. In this review of literature, five databases were searched. Databases included: PubMed, PsycInfo, CINAHL Complete, Clinical Key, and the Cochrane Library from September 15 to January 3, 2020. Due to the topic being dynamic and receiving more acknowledgment in recent years, articles reviewed were restricted to the last six years within the United States. Works chosen were peer-reviewed, which included meta-analysis, cross-sectional, systemic reviews, longitudinal and, survey method studies. Sources excluded included opinion-based …

Review Of Anticoagulation Therapy In Unprovoked Pulmonary Embolism To Prevent Recurrence, Christopher Klucas

Physician Assistant Scholarly Project Papers

The purpose of this research was to identify the best course of action in response to a diagnosis of unprovoked pulmonary embolism. This meta-review was compiled through a systematic query of four databases: Pubmed, Embase, CINAHL Complete, and Cochrane Review. The search was limited to peer-reviewed systematic reviews published between October 1, 2014, and October 1, 2019. 17 reviews were included in this research which evaluated relevant trials of FDA-approved anticoagulation therapies. Key search terms that were used included anticoagulation, unprovoked, and duration. MeSH terms applied on PubMed included anticoagulation, therapy, and duration. The evidence demonstrates non-inferiority status of new …

Comparison In The Effectiveness Of Mat In Patients With Oxycodone Vs Heroin Opioid Use Disorders, Casey Myklebust

Physician Assistant Scholarly Project Papers

The purpose of this research and systematic literature review is to determine if there is a measurable difference of effectiveness in medication assisted treatment (MAT) in patients with oxycodone and heroin use disorders, retention in treatment, and sustained sobriety. In this review, the databases searched included CINAHL, Clinical Key, and Embase. A variety of key terms and MeSH terms were used to define a set of literature discussing the topic. The works chosen for review were published between 2015 and 2019 were peer reviewed, and included randomized control trials, pilot studies, and systematic reviews. Sources that were excluded, included those …

Catheter Ablation Of The Accessory Pathway In The Asymptomatic Patient With Wolff-Parkinson-White, Erin Breann Mondry

Physician Assistant Scholarly Project Papers

Wolff-Parkinson-White (WPW) is a condition in which an accessory conduction pathway exists within the heart. This accessory pathway may or may not cause symptoms, in fact, the first manifestation of the condition may be sudden cardiac death. The management of this condition in asymptomatic individuals is controversial. The purpose of this research and literature review is to analyze the safety and efficacy associated with invasive catheter ablation of the accessory pathway, in comparison to risk of sudden cardiac death and malignant arrythmias in non-ablated, asymptomatic individuals with WPW. In this review, five databases were searched including CINAHL, Clinical Key, PubMed, …

The Safety, Accuracy, And Cost-Effectiveness Of Confirmatory Penicillin Allergy Testing In The Outpatient Setting As A Means Of Reducing Patient Morbidity And Mortality, Mitchell Mimbach

Physician Assistant Scholarly Project Papers

The purpose of this review is to investigate the prevalence of documented penicillin (PCN) allergies in health care and any negative outcomes associated with being labeled as such. Additional topics researched included the safety and accuracy of PCN allergy testing, the cost-effectiveness of PCN allergy testing versus using non-PCN related antibiotics, and barriers to confirmatory PCN allergy testing implementation. A complete review of the aforementioned topics included meta-analysis’, systematic reviews, cohorts, clinical trials, and cross-sectional studies from the last five years. Databases utilized for this research included PubMed, Cochrane Review, Embase, Dynamed Plus, and ClinicalKey. Sources that were excluded from …

An Analysis Of The Incidence And Severity Of Drug-Drug Interactions Between Prescribed Pharmaceuticals And Cannabinoids, Jennifer Lee Mcrae

Physician Assistant Scholarly Project Papers

The purpose of this research and systematic literature review is to identify the incidence and severity of drug-drug interactions between commonly prescribed medications and cannabinoids. In this review, four databases were searched including PubMed, CINAHL, and Embase from October 1 to January 5, 2019. A variety of key terms were used when searching. Works chosen for review were published after the year 2014, were peer reviewed, and included randomized control trials (RCTs), systematic literature reviews, and meta-analyses. For this review, 9 resources were selected. Much of the research presented shows evidence that medications that are substrates for CYP2C19, CYP2C9 and …

Early Intervention: Addressing Opioid Use Disorder With Emergency Department Initiated Buprenorphine Therapy, Dustin Peter Voss

Physician Assistant Scholarly Project Papers

The subsequent review evaluates opioid use disorder (OUD) as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria, including the use of buprenorphine in the process of induction, its efficacy for the management of OUD, and barriers to its initiation. The outcomes of the initiation of office-based buprenorphine treatment are compared to emergency department-initiated buprenorphine treatment for the management of OUD. This project is a review of current meta-analysis, systematic reviews, cross-sectional, longitudinal, and survey methodologies were analyzed. The medical research databases PubMed, Embase, Cochrane Review, CINAHL Complete, and PsychINFO, have been utilized in obtaining peer-reviewed …

Evaluation Of Hyperbaric Oxygen Therapy In The Treatment Of Traumatic Brain Injuries, Jordan Wiedmann

Physician Assistant Scholarly Project Papers

Traumatic brain injuries (TBIs) affect approximately 2.5 million people each year (Brain, 2014). The most current treatment options for TBIs include extensive long-term rehabilitation and therapy services, in which many only gain little improvement of their overall health (Traumatic, 2019). New trends in treating TBIs with hyperbaric oxygen therapy (HBOT) are emerging due to increased accessibility to hyperbaric oxygen chambers. The purpose of this research and systematic literature review is to evaluate the safety and efficacy of using HBOT to improve the treatment outcomes of TBIs. This review included the search of four databases including PubMed, Cochrane Review, Clinical Key, …

Treatment Option Decision Making For Low-Grade Prostate Cancer, Janene Caldwell Witherite

Physician Assistant Scholarly Project Papers

Prostate cancer (PCa) is the second most common cancer, behind skin cancer, among men, in the United States (Centers for Disease Control and Prevention [CDC], 2019.). PCa is defined as low-grade or low risk if the neoplasm grows slowly or not at all. According to the Institute for Quality and Efficiency in Health Care, (2020), to make the conclusion that a PCa is low-grade, several tests are performed including a prostate specific antigen (PSA) level, a Gleason score, and a TNM score, which refers to tumor size, lymph node involvement, and metastasis outside the prostate. Low-grade PCa is further defined …

Analysis Of Tech-Based And Telemental Health Approaches Within The Adolescent And Young Adult Populations Of Rural America, Audrey Smeenk

Physician Assistant Scholarly Project Papers

Background: The incidences of depression and anxiety among adolescent and young adult populations are intensifying, and resources remain limited for the management of these diseases within rural America. Objective: The purpose of this literature review is to evaluate evidence-based practices regarding telemedicine and tech-based mental health interventions. Evaluation of different interventions will demonstrate the ability of access, efficacy, and patient adherence with the hope of decreasing the incidence of disease and increase the availability of resources to rural areas. Methods: A comprehensive literature review was completed by assessing journal articles and scientific databases from the last fifteen years using a …

Low-Dose Naltrexone For Treatment In Crohn’S Disease And Fibromyalgia, Hannah Rachel Tkach

Physician Assistant Scholarly Project Papers

The United States has experienced a dramatic increase in opioid abuse and overdoses, leading to a national epidemic. Contributing to this epidemic is the use of opioid therapy for complex chronic inflammatory and neuropathic conditions that remain difficult to treat. Many traditional treatments are ineffective or have intolerable side effects, forcing providers to utilize opioid therapy as a last resort. Recently, there is increased interest in the use of partial opioid antagonist naltrexone to treat Crohn’s disease and fibromyalgia. Previous research suggests the potential for naltrexone to provide analgesic effects when administered in low doses via its unique interaction with …

Resting Heart Rate And Its Effect On Cardiovascular Disease, Peter Tronset

Physician Assistant Scholarly Project Papers

The purpose of the presented research and systematic review is to determine the associated impact resting heart rate has on development of cardiovascular disease. A literature review was conducted through electronic databases: PubMed, Clinical Key and Dynamed Plus. No limitation of timeframe was used when researching as few studies are available correlating resting heart rate and its associated development of cardiovascular disease. Research points to limitations of lowering resting heart rate due to adverse effects on blood pressure. Additionally, tachycardia is addressed through several methods including lifestyle modification and pharmacologic therapy. Comorbidities such as obesity, low body mass index (BMI), …

Efficacy Of Antibiotic Therapy In Those Diagnosed With Chronic Lower Back Pain, Alexander Marcel Lee

Physician Assistant Scholarly Project Papers

Chronic back pain affects approximately eight percent of the American population, yet no treatment has been agreed upon universally. Recent studies suggest that between 20-30 percent of lower back pain cases are caused by a low-virulence bacterial infection of the intervertebral disks in those who suffered disc herniation. This scholarly project is to investigate: In patients with chronic lower back pain and Modic changes after disc herniation, what is the effect of antibiotic therapy on reducing pain symptoms compared to placebo. This literature review used the following electronic databases: ClinicalKey, Cochrane Library, Embase, and PubMed. Keywords and mesh terms refined …

Hpv Vaccine In Adolescents: How To Increase Uptake, Natasha Richesin

Physician Assistant Scholarly Project Papers

The human papillomavirus (HPV) is a sexually transmitted virus that affects both males and females of all ages. An HPV vaccine was developed to help protect against harmful infections caused by the virus. This literature review focuses on the relationship between the HPV vaccine and its low uptake from untoward events, misinformation surrounding the vaccine, and different education methods. PubMed, Clinical Key, and Cochrane electronic databases are used for the literature review. A comprehensive literature review was conducted, and articles utilized were based on the age of the population being 11 to 29 years old, the HPV vaccine’s involvement in …

May 7, 2020: Agenda, University Of North Dakota

University Senate Meeting Minutes

Agenda for the May 7, 2020, meeting of the University Senate. 106 pages

A Murine Model Of Lyme Disease Demonstrates That Borrelia Burgdorferi Colonizes The Dura Mater And Induces Inflammation In The Central Nervous System, Timothy Casselli, Ali Divan, Yvonne Tourand, Heidi L. Pecoraro, Catherine A. Brissette

Biomedical Sciences Faculty Publications

Lyme disease, which is caused by infection with Borrelia burgdorferi and related species, can lead to inflammatory pathologies affecting the joints, heart, and nervous systems including the central nervous system (CNS). Inbred laboratory mice are effective models for characterizing B. burgdorferi infection kinetics and host immune responses in joints and heart tissues; however, similar studies are lacking in the CNS of these animals. Here we characterize the kinetics of B. burgdorferi colonization and associated immune responses in the CNS of infected C3H mice during early and subacute infection. B. burgdorferi colonized the dura mater following needle or tick challenge, and …

Spring 2020, University Of North Dakota Alumni Association

ALL: UND Alumni Review Master List

Summer 2020 issue of "The University of North Dakota Alumni Magazine." 52 pages

Volume 103, Number 2

Mocca College: An Assessment Of Inferential Narrative And Expository Comprehension, Mark L. Davison, Ben Seipel, Virginia Clinton-Lisell, Sarah E. Carlson, Patrick C. Kennedy

Education, Health & Behavior Studies Faculty Publications

MOCCA-C is an assessment of adult reading ability designed for early diagnosis of reading problems, for formative assessment in reading intervention planning, for assessment of reading improvement over time, and for assessment of reading intervention outcomes. It uses both narrative and expository reading passages and it currently has four forms. Two goals of this research were to compare narrative and expository passages on (a) their difficulty and (b) their ability to discriminate between good and poor readers. An additional goal was to assess whether narrative and expository passages measure the same or different comprehension dimensions. A final goal was to …

Addressing Transportation Barriers To Improve Appointment Attendance In Outpatient Mental Health Services, Tehut T. Tefera

Nursing Capstones

This quality improvement project aimed to reduce missed appointment rates in five outpatient mental health services through appointment reminder calls along with mitigation of transportation barriers. Studies have established the wide-ranging health and financial implications of missed appointments affecting patients and healthcare systems. During a one-month project intervention period, pre- and post-intervention missed appointment rates were compared, and providers’ sentiments were measured utilizing Likert scale questionnaires. A reduction in missed appointments by 1.1% was achieved collectively across all sites through the project duration. Additionally, provider satisfaction regarding missed appointment rates increased by 4.46%. Project cost analysis revealed that this intervention …

Not A Magic Pill: An Educational Model On Antibiotic Prescribing, Christina Rose Leonard

Nursing Capstones

Background: Inappropriate antibiotic prescribing is common in outpatient settings across the United States. The Centers for Disease Control and Prevention has found in studies that nearly 1 in 3 antibiotics prescribed at outpatient facilities is unnecessary. The misuse and overuse of antibiotics is accelerating the process of antibiotic resistance, as well as causing an increase in adverse events, including death. The literature indicates that knowledge plays a major factor in overprescribing, as well as provider attitude and patient expectations.

Objective: Present clinical practice guidelines to providers within a rural family practice clinic setting aimed at improving antibiotic prescribing. Gather information …

A Drug Diversion Resource For Crna Supervisors, Steven D. Ydstie

Nursing Capstones

Substance abuse disorder among Certified Registered Nurse Anesthetists (CRNAs) poses risks to both the provider and the patients they care for. Associated with this disorder is the problem of drug diversion. The specialty of anesthesia is recognized as having an elevated risk for the development of substance abuse. Although there are multiple studies addressing substance abuse amongst anesthesiologists, there are few similar studies specific to CRNAs. The purpose of this DNP project was to ascertain the level of Self-Efficacy CRNA supervisors have when intervening with one of their direct reports found to have been diverting scheduled narcotics. Knowledge level regarding …

Improvement In Heart Failure Management Through Implementation Of An Interdisciplinary Algorithm To Reduce 30 Day Hospital Re-Admission, Lindsey Whiting

Nursing Capstones

Heart failure (HF) is a progressive disease in which the heart is unable to pump enough blood to support the body’s vital functions. Recent projections estimate that by the year 2030 the number of HF patients will increase by 46%, resulting in an increased financial strain on the health care system. In response to increasing health care costs the Hospital Re-Admission Reduction Program (HRRP) was implemented. The goal of the HRRP is to improve the quality of patient care by linking defined parameters of quality of patient care to the payment/reimbursement of health care providers and hospitals. A rural northern …

Effect Of Provider Education On Urinary Incontinence Knowledge And Assessment, Kendra L. Roloff

Nursing Capstones

Nearly 50% of women in the United States will experience urinary incontinence at some point during their lives. Urinary incontinence impacts multiple aspects of a woman’s life, yet remains underdiagnosed by primary care providers. The purpose of this project is to implement education and reminders for primary care providers, in order to improve urinary incontinence knowledge and assessment of women 18 years of age or older. The project was carried out in a primary care clinic with primary care providers serving as the participants.

A quasi-experimental one-group pretest-posttest design was utilized. Data from a five question pre- and posttest were …