Digital Commons Network^™

Direct Factor Xa Inhibitors Versus Warfarin In Non-Valvular Atrial Fibrillation: Efficacy, Safety, Cost, And Reversibility, Cory D. Jacobs

Physician Assistant Scholarly Project Posters

Atrial fibrillation is a common cause for stroke. Vitamin K antagonists such as warfarin are an effective prophylactic medication to prevent stroke in patients with atrial fibrillation. Warfarin, however, has a narrow therapeutic index, reacts with certain foods, increases bleeding risks, and requires frequent monitoring. New medications have been developed to prevent clot formation while avoiding the negative effects of warfarin. The purpose of this study was to compare direct factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban) versus warfarin in stroke prevention, safety, and cost.

The review of literature analyzed studies comparing warfarin and direct factor Xa inhibitors in patients …

Pcsk9 Inhibitors: A Review Of The Efficacy, Safety And Current Literature Recommendations, Lacey L. Jandrin

Physician Assistant Scholarly Project Posters

Atherosclerotic cardiovascular disease is the leading cause of morbidity and mortality in developed counties. It is estimated that 60 million Americans have LDL-C levels > 160 mg/dl. Only about 1/3 of these patients meet treated LDL cholesterol goals of < 70 mg/dl indicating a need for greater control. High dose statins have been the mainstay in treatment of dyslipidemia, however, up to 20% of patients are statin intolerant indicating a need for secondary treatment strategies. This lead to the development of monoclonal antibodies to proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. PCSK9 inhibitors result in decreased destruction of the low-density lipoprotein receptor (LDL-R) which leads to an increase in the transport of LDL-C to its destruction effectively reducing LDL-C levels in the blood. The purpose of this study is to analyze the literature available on the efficacy and safety of new PCSK9 inhibitors. The results of this literature review indicated that PCSK9 inhibitors effectively lowered LDL-C by an average of approximately 50%. The evidence reviewed by this analysis indicate that 70% of patients treated with PCSK9 inhibitors met LDL-C goals. The findings also indicate that the side effects associated with this new class of medications are comparable to current side effects seen with traditional cholesterol lowering agents. The largest side effect seen in up to 10% of patients were injection site reactions and did not require discontinuation of the medication. The results of this analysis indicate that PCSK9 inhibitors may be of benefit in patients who are statin intolerant, do not meet LDL-C goals on traditional statin therapy or have familial hypercholesterolemia. Education in use of injectables, cost and insurance coverage and dosing schedule are likely to be areas of continued research and may affect use of this new class of cholesterol lowering agents.

Does Adherence To A Plant-Based Diet Cause A Statistically Significant Decrease In The Risk Of Cardiovascular Events?, Amber H. Johnson

Physician Assistant Scholarly Project Posters

• One of the current problems in many affluent societies is the straightforward access to convenience and fast foods. Although these selections have suitability for today’s fast-paced world, overall nutritional value becomes the martyr of such practices. It is a logical thought that there could be a correlation between this nutritional pattern and the ever-increasing presence of obesity, cardiovascular disease, type 2 diabetes mellitus, hypertension, dyslipidemia, cancer, and other conditions carrying a proverbial death sentence.

• The intent of this review of the literature was to determine the effect a plant-based diet versus an omnivorous diet would have on adults, …

Whole Body Cryotherapy Vs. Cold Water Immersion, Brett M. Johnson

Physician Assistant Scholarly Project Posters

In this country a significant percentage of the population present to clinics with generalized musculoskeletal disorders related to pain. More than one-quarter of Americans (26%) age 20 years and over, or an estimated 76.5 million Americans report a problem with general musculoskeletal disorders related to pain that persisted for more than 24 hours in duration. The treatment for various musculoskeletal disorders related to pain are anti-inflammatory agents or opioid analgesics. Another form of anti-inflammatory /analgesia for such ailments is cold therapy.

The purpose of this literature review is to compare Whole Body Cryotherapy (WBCt) to Cold Water Immersion (CWI) in …

Exercise As The Best Treatment Option For Nafld, Amber Kirtley-Perez

Physician Assistant Scholarly Project Posters

Nonalcoholic fatty liver disease (NAFLD) is an advancing disease in children and adults that has the potential to be reversed. This disease is emerging in the population due to an increase in processed foods in the diet, increase in glucose intake in diet or liquid form, and lack of exercise. It is a growing epidemic in children that may progress into adulthood. The purpose of the literature review is to determine if the addition of daily exercise will decrease the amount of NAFLD and reverse the disease. The review of literature explored studies that are related to increasing exercise into …

Artificial Disc Replacement As An Alternative To Lumbar Spinal Function In The Treatment Of Chronic Low Back Pain, Jennifer Polniak

Physician Assistant Scholarly Project Posters

Chronic low back pain leads to activity limitations for the patient and widespread burdens on health care systems. Lumbar fusion has been the “gold standard” surgery for severe chronic low back pain non-responsive to conservative treatment, however it has been associated with continued limitations in spinal mobility. This study was executed in order to compare an alternative surgical intervention, artificial disc replacement, with lumbar spinal fusion in the treatment of chronic low back pain in terms of long term spinal function. Literature searches of trials, guidelines and systematic reviews within the past 5 years were completed exploring surgical procedures, associated …

Efficacy In Screening Patients For Lynch Syndrome, Adria Ridl

Physician Assistant Scholarly Project Posters

Lynch syndrome is an autosomal dominant syndrome caused by an inherited germline mutation of the MMR proteins. A mutation of any of the MMR proteins, MLH1, MSH2, MSH6, PMS2 and EPCAM increases the risk of developing cancer, specifically colorectal and endometrial cancer. Approximately 3% of colorectal cancers are associated with Lynch Syndrome (LS). Early identification of a patient’s hereditary cancer risk offers the best outcome. To aid clinicians in the identification of a carrier of LS clinical guidelines and risk prediction models are used. In this analysis the Amsterdam II criteria and Revised Bethesda guidelines are compared to the more …

Impact Of Increasing Glp-1 On Markers Of Inflammation, Glucose Control And Cardiovascular Risk Factors In Patients With Type 2 Diabetes, Kristina Sandstedt

Physician Assistant Scholarly Project Posters

There is a strong established relationship between diabetes and cardiovascular disease. Much of the latest research studies have identified a link between the inflammatory processes and the pathogenesis of both cardiovascular disease and diabetes. Specific inflammatory markers include: Interleukins 1,6,18; C-reactive protein, Fibrinogen, Tumor Necrosis Factor-α, PAI-I and cell adhesion molecules. As a result, there has been an emphasis on identifying therapeutic approaches that would improve both markers of inflammation and glucose control. The endocrine hormones known as incretins, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropicpolypeptide (GIP), are produced in the gastrointestinal tract following ingestion of a meal. In individuals with …

Comparing Short Versus Long Term Antibiotics For Reducing Persistent Lyme Symptoms, Joe Webster

Physician Assistant Scholarly Project Posters

• Lyme disease is the most common tick borne illness in the United States with over 300,000 cases annually.

• Two main organizations called the Infectious Disease Society of America and the International Lyme and Associated Diseases Society differ on their opinions in the treatment duration of Lyme disease.

• A review of the literature explored studies that compared the effectiveness of short term versus long term antibiotics in the treatment of Lyme. Determining the most effective treatment method duration for reducing the long term risk of persistent symptoms of Lyme will be important for the improvement of the delivery …

Occupational Therapy Feeding And Eating Interventions For Autism Spectrum Disorders And Pervasive Developmental Disorders: A Systematic Review, Jordan T. Adolf, Hana M. Mattern

Occupational Therapy Capstones

Due to the limited evidence and lack of methodological rigor regarding feeding and issues in children with Autism Spectrum Disorders (ASD) and Pervasive Developmental Disorders (PDD), clinicians who treat children with these diagnoses rely on the limited amount of information and many are not aware of evidence-based interventions (Ahearn, Castine, Nault, & Green, 2001; Marshall, Hill, & Dodrill, 2013). The purpose of this scholarly project is to gather, critique, and determine efficacy of occupational therapy feeding and eating interventions for children with ASD and PDD.

We systematically reviewed literature for higher-level evidence, as defined by Level III evidence or above, …

The Relationship Between Athletes' Perceptions Of Coaching Efficacy And Collective Efficacy In Collegiate Soccer, Frazer Atkinson

Theses and Dissertations

This study examined the relationship between athletes’ perceptions of their coaches’ confidence and team confidence in a sample of 272 collegiate soccer players (M = 19.84 years; SD = 1.42) from the NCAA and NAIA. Athletes’ perceptions of their coaches’ confidence were assessed using a modified version of the Coaching Efficacy Scale (CES) (Feltz, Chase, Moritz & Sullivan, 1999), and a single item measure asked participants to rate their perceptions of their coaches’ confidence. Team confidence was assessed using the Collective Efficacy Questionnaire for Sport (CEQS) (Short, Sullivan & Feltz, 2005). Athletes also reported the results of their team’s previous …

Negotiating Higher Education In The Us: Voices Of Ghanaian Graduate Students At A Midwestern University, Mildred Emefa Biaku

Theses and Dissertations

In this case study, there was an examination to gain a deeper understanding of the

effects of social interactions experienced by Ghanaian Students with various actors in

curricular and co-curricular departments and perceptions of the support during these

social interactions. Recommendations were made for ways to enhance social interactions.

Data for this qualitative study was collected using three methods; non-participant

observation, interviews, and focus group discussions. Participants for the study were six

Ghanaian international students and five service providers selected from departments

across the campus of a university in the Midwest. It was found that there were systemic

issues that …

Shelterbelt Density Dynamics And Their Driving Forces In Grand Forks County, North Dakota, 1962 To 2014, Morgen Walter Victor Burke

Theses and Dissertations

Grand Forks County, ND, has one of the highest concentrations of shelterbelts in the World (Knutson 2011). As these trees aged and reached their expected lifespans, the quality of the shelterbelts has decreased and many have been removed. The rate of tree removal is thought to be increasing, with few shelterbelts being replanted. This raises concerns over possible increases in soil erosion caused by wind, such as was experienced in the 1930s. Using remotely sensed imagery and GIS, historic and recent shelterbelt densities can be measured and changes over time can be recorded. Geographic object-based image analysis (GEOBIA) can be …

Risky Sexual Behaviors Among College Student Drinkers As A Function Of Drinking Motivation And Alcohol Use, Tess Mone't Kilwein

Theses and Dissertations

Risky sexual behaviors (e.g., sex without protection against pregnancy, sex with multiple partners) are common among college students. In order to decrease these behaviors, it is necessary to understand factors associated with their occurrence, such as alcohol use. Drinking motives are a known predictor of both alcohol use and alcohol-related consequences, which may theoretically include risky sex. However, no research has directly examined drinking motives as a predictor of engaging in a wide range of risky sexual behaviors. Thus, the current study examined whether drinking motives interact with alcohol use to predict risky sex among college students. One-hundred and eight …

Vitamin D Awareness, Prevalence Of Supplementation And Estimated Total Vitamin D Intake In College Athletes, Bennett Leitch

Theses and Dissertations

This study aimed to investigate the awareness of vitamin D among collegiate athletes and evaluate the association between vitamin D awareness and total dietary intake of vitamin D. Eighty-one athletes completed the vitamin D awareness and dietary intake questionnaire. The results showed that males and females had very little concern over their vitamin D levels. Men reported 20.7% while females 25% for “likely” or “very likely”. Furthermore, overall male and female belief for being at risk for vitamin D deficiency was low. Males reported 24.1% for either “likely” or “very likely” to be at risk for deficiency and females 30.7% …

Schedule Flexibility And The Impact On Work-To-Family Conflict Among Low Earners And High Earners, Brittany Love

Theses and Dissertations

Today many Americans struggle to balance work and family life, and schedule flexibility is one mechanism that can be used to reduce conflict between work and family. Since social class is understudied in work-family scholarship, this study will compare the experiences of high and low earners, with a focus on examining the relationship between schedule flexibility and work-to-family conflict. Using secondary data from the 2008 National Study of Changing Workforce (NSCW), this study explores whether schedule flexibility impacts work-to-family conflict differently among low and high earners (N = 1,665). Results indicated that both low and high earners experienced less work-to-family …

Racial Microaggressions, College Self-Efficacy, And The Persistence Of Students Of Color In Predominantly White, 4 Year Institutions Of Higher Education, John Mccullagh

Theses and Dissertations

College students of Color face unique challenges and barriers in college settings (Allen, 1992; Harper & Hurtado, 2007) and many of these students are not able to effectively integrate into the academic and social realms of college life. This leads many students of Color to ultimately drop out of college (Fischer, 2007).The present study utilized a sample of 228 Freshman college students of Color to examine the influence of college self-efficacy and experiences of racial micro-aggressions on factors related to the persistence in college of racial and ethnic minority students. Structural equation modeling was utilized to test the direct and …

Academic Procrastination And Stimulating Substance Use Among College Undergraduates, Katlyn Moes

Theses and Dissertations

Today’s college students have a larger workload than past generations and are expected to work at a faster pace, all while adjusting to a new environment. Some students are able to successfully navigate these demands, while others become overwhelmed and engage in behaviors that allow them a diversion from academics and school life, such as avoidance and procrastination. When students procrastinate, they may find themselves with a lot to do in a short period of time. Past work indicates that stimulating substance use is on the rise among college students, particularly when they need to have focused periods of concentration. …

Perspectives Of Male American Indian Students In A Predominantly White Higher Education Institution, Patricia Ann Queen Jordheim

Theses and Dissertations

The purpose of this phenomenological study was to explore the perceptions of male American Indian students and their strategies for staying enrolled in school and to determine what issues they were facing while attending a predominantly-White institution (PWI) of higher education in the Northern Plains. Participants consisted of seven male American Indian students attending school during the 2014-2015 academic school year. Resistance theory provided a framework for this research on male American Indian students and their perceptions of cultural dominance and their responses concerning assimilation and the campus cultural climate. The Hypothesis of Transculturation is a bridge to how male …

Identity, Wellness, And Academics: A Move Toward A Freshmen Seminar For All Students, Matthew Torgerson

Theses and Dissertations

Using the Dana (2014) inquiry model, research was conducted to discover what traditional first-year students need to be successful in their academic careers. The research consists extensively of literature review along with casual conversations with faculty, staff, and students at a small, rural college in the Midwest. Through this research, identity development, wellness, and academics were found to be the most prevalent needs for freshmen success. This paper discusses each of these areas in depth as well as gives discussion and recommendations on how identity, wellness, and academics can be implemented into a first-year seminar curriculum.

Measuring The Effect Of Vocabulary Instruction On Reading Comprehension: A Comparison Of Academic And Tier Ii Words, Eiley C. Berg

Theses and Dissertations

The purpose of this study was (a) to determine if 4th grade students could learn academic vocabulary words or tier II general words using a vocabulary intervention program referred to as the lexicon enhancement program (LeEP), and b) to determine if the category of vocabulary words (tier II general vs. academic) impacts the number of vocabulary words learned, general vocabulary abilities, and reading comprehension. A total of 111 fourth graders participated in this study. Six classrooms were randomly assigned as either the academic group, tier II group, or control group. Pre- and posttest scores of the Zero-One-Two (ZOT; Robinson, 2013) …

Measuring The Effect Of Vocabulary Instruction On Reading Comprehension: Comparing Students Of Lower And Higher Socioeconomic Status, Michelle Burns Burns

Theses and Dissertations

This study examined the effect of a lexicon enhancement program on students categorized as lower SES, determined by whether or not they qualified for the federal free or reduced lunch program. Specifically, the performance of lower SES students on measures of vocabulary learning and reading ability were compared to classmates who did not qualify for the federal program (higher SES). Forty-six 4th grade students from the Grand Forks Public School district participated in the study. Students from the lower SES and higher SES group were randomly assigned by classroom to be either in the intervention or the control group, with …

Lumbar Radiculopathy Post Lumbar Discectomy: A Case Study, Amy Harmon

Physical Therapy Scholarly Projects

Background and Purpose: Low back pain (LBP) is one of the most common and costly musculoskeletal diagnosis in America. Approximately 50% of individuals with LBP have recurrent episodes by 1 year, 60% by 2 years, and 70% by 5 years. Micro-lumbar discectomies are often performed to relieve the radiculopathy and pain associated with nerve root entrapment. The purpose of this case study was to describe the clinical decision process implemented for the post-operative assessment and intervention of a patient with a L4-5, L5-S1 discectomy and to outline the associated outcomes.

Case Description: The patient, a 26 year-old male, …

Stepping On: Gait Velocity And Fall Risk Assessment, Brittney Herbst

Physical Therapy Scholarly Projects

Purpose: To identify fall risk and determine if the Stepping On program is effective at reducing the risk of falls in participants by increasing gait speed to greater than or equal to 1 m/s. Step and stride length were also compared to age related norms to determine if they correlated to fall risk. Gait speed of less than I m/s has been shown to increase the risk for falls in elderly.

Methods: Fourteen female participants over the age of 65 (mean age of 87) were recruited from a local Stepping On class conducted at an assisted living facility …

Physical Therapy Rehabilitation Following Arthroscopic Rotator Cuff Repair, Brittany E. Wirth

Physical Therapy Scholarly Projects

Background and Purpose: According to the American Academy of Orthopaedic Surgeons, previous studies have found the prevalence of rotator cuff tears may exceed 50% in individuals older than age 65. Since this age group is the fastest growing of the U.S. population, rotator cuff pathology is sure to become a more significant problem in the future. With this information, it is important to continue research on rotator cuff rehabilitation following arthroscopic surgery.

Case Description: This case report describes the physical therapy interventions and functional outcomes of a 58-year-old patient who underwent arthroscopic surgery to repair a partial tear …

Critical Illness Polyneuropathy, Complications, Erica E. Hjelmstad

Physical Therapy Scholarly Projects

Background and Purpose: Critical Illness Polyneuropathy/Myopathy results from the presence of sepsis, multi-organ or respiratory failure, septic inflammatory response syndrome, or difficulty weaning from the ventilator. Decreased amplitudes of compound muscle and sensory action potentials, and widespread denervation potentials in muscle are the primary cause for the resultant muscle weakness. The purpose of this paper is to report on the rehabilitation progress in a woman who developed CIP following surgical complications.

Case Description: A 63-year-old woman suffered from critical illness polyneuropathy following a complicated recovery following a sigmoidectomy secondary to diverticular disease. Multiple surgeries, inability to wean from …

Accessibility And Perceived Value Of Pre-Admission Clinical Contact Hours: A Physical Therapy Student Perspective, Katie Anderson, Megan Volden

Physical Therapy Scholarly Projects

Background and Purpose: The purposes of this study were to determine whether professional physical therapy students experience challenges obtaining pre-admission contact hours and if they found them to be beneficial. The results of the survey will be utilized to allow physical therapy programs to make informed decisions about admission requirements in regard to pre-admission contact hours.

Methods: This study was performed utilizing an electronic survey sent in an e-mail to program chairpersons or Directors of Clinical Education, asking them to distribute the survey to their respective current students. All accredited physical therapy programs in the United States were …

Shoulder Impingement, Jennifer Ramsay

Physical Therapy Scholarly Projects

Background. Women who undergo mastectomy are almost 6 times more likely to experience shoulder restriction and impairment than patients who undergo breast-conserving surgery. Many women in the U.S. will develop invasive breast cancer over the course of their lives. The purpose of this case study is to review the rehabilitation plan for a patient with shoulder dysfunction and a history of surgical intervention for breast cancer.

Case Description. The patient was referred to physical therapy with complaints of pain in the right shoulder and anterior chest which increased with overhead movement. The patient's medical history included a skin …

Emg Activity Of Accessory Muscles Of Breathing During Recovery Positions, Joel Kramer, Kelsey Meyer, Eric Nefstead, Daniel Vilaubi

Physical Therapy Scholarly Projects

Chronic obstructive pulmonary disease (COPD) is predicted to become the third leading cause of death worldwide between 2020 and 2030. Signs and symptoms of this disease can be debilitating, however techniques can be taught to decrease impairments. Suggested techniques for pulmonary recovery consist of supporting the upper extremities, supporting the head and leaning forward. The purpose of the current study was to examine the effects of recovery positions on the EMG activation of accessory muscles of respiration to decipher which recovery position is the most ideal for COPD patients. Fourteen healthy adults over the age of eighteen were recruited for …

Developmental Dysplasia Of The Hip: A Case Study, Joseph D. Taylor

Physical Therapy Scholarly Projects

PURPOSE: The primary purpose of this case study was to describe the implementation of a conservative treatment protocol for dysplasia of the hip in a young girl in an attempt to prevent surgical intervention. A secondary objective of reducing femoral acetabular impingement was subsequently undertaken in the course of the case study.

BACKGROUND: The patient was a 16 year old female with a diagnosis of bilateral developmental dysplasia of the hip (DOH), bilateral femoral acetabular impingement (FAI), anterior superior labral tear to left (L) hip, elevated antinuclear antibody (ANA) screening and a history of depression.

PLAN OF CARE …