Digital Commons Network^™

Crystalloids Or Colloids… What’S In Your Iv? Determining Fluid Type For Septic Shock Resuscitation, Eleanor L. Jordan, Amy K. Lansing

Physician Assistant Capstones, 2016 to 2019

Objective: To compare the efficacy of crystalloid versus colloid solutions, specifically normal saline versus albumin, in decreasing mortality among patients with septic shock requiring resuscitation fluids in the intensive care unit (ICU) setting. Design: Systematic literature review. Methods: Research was conducted in PubMed and UpToDate, utilizing the search terms sepsis, septic shock, fluid resuscitation, colloids and crystalloids. Specifically, in PubMed, the following limits and terms were used: randomized control trial, human subjects, English, and within the last 7 years. Results: The Annane et al study found no significant difference in colloid fluid resuscitation versus crystalloid fluid resuscitation in the decreasing …

Subanesthetic Iv Ketamine Reduces Acute Suicidal Ideation In Patients With Mood Disorders, Kimberly Jenko, Jack Anzilotti

Physician Assistant Capstones, 2016 to 2019

Background. Depression and suicide are common in the United States and present a significant problem in the healthcare landscape. Currently, there are few options that can rapidly reduce suicidal ideation in patients with depression. Ketamine, a glutamate N-methyl-D-aspartate (NMDA) receptor antagonist, has been shown to reduce acute suicidality in patients with depression. Previous studies have a reduction of suicidal ideation compared to saline placebo, but few studies have shown a significant effect compared to a similar psychoactive drug such as midazolam.

Method. A search of PubMed and PsychNET was performed in September 2018 using the terms “ketamine,” “suicide,” …

Exclusive Enteral Nutrition And Corticosteroids: Two Effective Methods Of Induction Treatment In Crohn’S Disease, Sarah E H Hutchison, Rachel L. Stottlar

Physician Assistant Capstones, 2016 to 2019

Objective: To compare the effectiveness of corticosteroids (CS) versus exclusive enteral nutrition (EEN), as induction therapy of Crohn’s disease to induce remission. Design: Systematic literature review. Methods: Searches were done in PubMed utilizing the terms: enteral nutrition therapy, exclusive enteral nutrition, inflammatory bowel disease, Crohn’s disease, corticosteroids, pediatric, nutrition, and steroids. Articles were excluded with patients > 18 years of age, confounding variables, inclusion of other treatment options, or physician discretion bias in selecting a treatment option. Results: Ultimately, three articles were included in our review. Two of three studies examined showed a statistically significant improvement in remission rates in …

The Effect Of Yoga On Fatigue In Breast Cancer Patients Undergoing Radiotherapy, Magdalene Bredehoeft, Karli Ribsam

Physician Assistant Capstones, 2016 to 2019

Objective: Assess the effect of yoga on levels of fatigue among women with breast cancer currently undergoing radiotherapy. Design: Systematic literature review. Methods: Searches were done on PubMed, utilizing the terms “yoga,” “fatigue,” “breast cancer,” and “radiotherapy.” Limits that led to inclusion of studies included: published after 2008, studies researching breast cancer, and studies that were randomized controlled trials. Results: Randomized controlled trials studied were by Chandwani et al. (2010), Chandwani et al. (2014), and Vadiraga et al. (2009). Conclusion: Yoga can improve quality of life among women with breast cancer undergoing radiotherapy, specifically by decreasing levels of fatigue. We …

Mapping Spatial Variations Of Structure And Function Parameters For Forest Condition Assessment Of The Changbai Mountain National Nature Reserve, Lin Chen, Chunying Ren, Bai Zhang, Zongming Wang, Yeqiao Wang

Natural Resources Science Faculty Publications

Forest condition is the baseline information for ecological evaluation and management. The National Forest Inventory of China contains structural parameters, such as canopy closure, stand density and forest age, and functional parameters, such as stand volume and soil fertility. Conventionally forest conditions are assessed through parameters collected from field observations, which could be costly and spatially limited. It is crucial to develop modeling approaches in mapping forest assessment parameters from satellite remote sensing. This study mapped structure and function parameters for forest condition assessment in the Changbai Mountain National Nature Reserve (CMNNR). The mapping algorithms, including statistical regression, random forests, …

Improving Chronic Hepatitis B Virus Screening At A Safety-Net Primary Care Clinic, Uwaezu J. Umeh

Doctor of Nursing Practice (DNP) Projects

Hepatitis B Virus (HBV) is a type of virus that affects the liver. Chronic hepatitis B is usually asymptomatic and many HBV carriers remain unaware of their viral status, thereby may unknowingly transmit the disease. If left untreated or undetected, it could lead to cirrhosis, hepatocellular carcinoma or mortality. Although this virus is endemic in some parts of the world such as Asia and Africa, it is important to note that HBV has become a global problem. The Centers for Disease Control and Prevention (CDC) in conjunction with the United States Preventive Services Task Force (USPSTF) estimates that about 700,000 …

Cuba Journals Volume I - Transcription, Laura Swarner

Undergraduate Theses

The document is a transcribed version of volume I of the digital copy of the Cuba Journals which can be found online at the New York Public Library Archives. The Cuba Journals were written by Sophia Peabody Hawthorne during her time abroad in Cuba recovering from illness.

Effect Of Postpartum Protocols On Maternal Outcomes, Kelsey Grimm, Emily Harnish

Physician Assistant Capstones, 2016 to 2019

Objective: To determine whether postpartum hemorrhage (PPH) protocols lead to decreases in maternal morbidity and mortality.

Design: Systemic literature review.

Methods: The clinical question investigated is whether the implementation of PPH protocols has measurable impact on maternal morbidity and mortality. Searches were done through PubMed using the keywords: “maternal hemorrhage postpartum protocol.” Studies were eliminated if they were more than 10 years old, conducted outside the United States, published in a non-English language, used other animal subjects besides humans, used non-female subjects, if they did not answer the clinical question, or were review articles. Eventually, three cohort …

Chlorhexidine Gluconate Vs Povidone-Iodine In The Prevention Of Clean-Contaminated Surgical Site Infections, Erin Layne, Abigail Stone

Physician Assistant Capstones, 2016 to 2019

Abstract

Background:

A patient’s skin is the major source of pathogens that can cause post-operative complications such as surgical site infections (SSIs). Optimization of pre-operative skin antisepsis is obtained with chlorhexidine gluconate (CG) and povidone-iodine (PI). These two solutions are the most widely used antiseptics for pre-operative purposes.

Objective:

Among surgical patients greater than 18 years of age undergoing clean-contaminated surgery, which antiseptic, iodophors or chlorhexidine gluconate, is more effective at reducing postoperative surgical site infections?

Methods:

A search was done in PubMed utilizing the terms chlorhexidine, infection control, iodophors, and surgical site infection. The limits applied included randomized …

Effects Of Prehospital Vs. In Hospital Therapeutic Hypothermia On Neurological Status After Cardiac Arrest, Cassandra Johnson, Ingrid Brown

Physician Assistant Capstones, 2016 to 2019

Objective: To conduct an analysis of literature that examines whether the use of prehospital therapeutic hypothermia (TH) results in significant changes in neurologic outcomes that are in adults that experienced out of hospital cardiac arrest (OHCA). Methods: Systematic searches were conducted through PubMed at the James Madison University Library. The inclusion criteria included human adults who experienced out of hospital cardiac arrest and were treated by Emergency Medical Services (EMS) with and/or without prehospital TH by means of intravenous cold fluids and surface cooling. Results: Three studies involving 2180 cases were included. This review indicated that prehospital TH after …

Comparing Effectiveness Of Colonoscopy Versus Fecal Immunochemical Testing In Screening For Colorectal Cancer, Hannah Vanrooyen, Lindsay Burns

Physician Assistant Capstones, 2016 to 2019

Introduction: Colorectal cancer (CRC) is deadly neoplasm that takes many lives in the United States and is a leading cause of cancer worldwide. If CRC is detected early through screening, there is a higher chance of remission which makes screening an important tool in CRC prevention. Currently, colonoscopy is the gold standard, but due to the undesirable preparation needed for a colonoscopy, patient compliance is low. Giving patients a screening option that requires less preparation may help to increase the compliance for CRC screening. Fecal Immunological testing has been shown to have higher compliance rates among patients as compared to …

The Use Of Probiotics To Prevent Ventilator-Associated Pneumonia In Adults, Michael Roper, Paige Douthett

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the efficacy and safety of preventing the acquisition of ventilator- associated pneumonia with the use of probiotic supplementation, as compared to a placebo, among hospitalized adult men and women receiving more than 24 hours of mechanical ventilation. Design: Systematic Literature Review. Methods: Systematic searches were conducted through PubMed and Scopus using the search terms “ventilator”, “probiotics”, and “prevention”. Records were excluded from the analysis if they were published before 2015, full text was not available, studies other than randomized control trial or cohort studies, and if the study population was less than 18 years old. Results: Of …

Increasing Nursing Policy And Advocacy Engagement, Marketa Houskova

Doctor of Nursing Practice (DNP) Projects

At present, professional nursing does not benefit from strong policy development and advocacy influence in the United States. This project focused on CA nursing policy development and advocacy influence deficit among new members of a statewide professional nursing association. There are nearly 457,000 licensed registered nurses (RNs) in CA (BRN, 2019) and around 3.8 million RNs in the United States (AACN, 2019) making CA RNs twelve percent of the national nursing workforce. Yet only five percent of RNs serve on hospital boards, and legislative efforts to advance important nursing issues such as full practice authority for advanced practice RNs in …

The Impact Of Tourism On The Population Growth In Orlando, Florida, Timothy Mccann

MBA Student Scholarship

Orlando, Florida is currently experiencing one of the fastest population booms in the country. The purpose of this research is to explore possible factors that have acted as a catalyst for this population boom. With tourism, hospitality and events being such an important part of the economy, a qualitative field study will be used to determine whether tourism or hospitality can make an impact on how people are moving. Walt Disney World is one of the largest employers in central Florida and has a strong relationship with the City of Orlando and its residents. The participants in this qualitative field …

Green And Animal Manure Use In Organic Field Crop Systems, Patrick M. Carr, Michel A. Cavigelli, Heather Darby, Kathleen Delate, Jed O. Eberly, Heather K. Fryer, Greta G. Gramig, Joseph R. Heckman, Ellen B. Mallory, Jennifer R. Reeve, Erin M. Silva, David H. Suchoff, Alex L. Woodley

Plants, Soils, and Climate Faculty Publications

Dual‐use cover/green manure (CGM) crops and animal manure are used to supply nitrogen (N) and phosphorus (P) to organically grown field crops. A comprehensive review of previous research was conducted to identify how CGM crops and animal manure have been used to meet N and P needs of organic field crops, and to identify knowledge gaps to direct future research efforts. Results indicate that: (a) CGM crops are used to provide N to subsequent cash crops in rotations; (b) CGM‐supplied N generally can meet field crop needs in warm, humid regions but is insufficient for organic grain crops grown in …

Perceived Helicopter Parenting And Self-Determination Theory In Emerging Adulthood, Emily Hivick

Senior Honors Projects, 2010-2019

Self-determination theory encompasses three different elements, competence, autonomy and social belongingness (Deci & Ryan, 2000). Helicopter parenting is defined as extreme involvement in a child’s life to the point of making decisions for them while also being associated with high levels of parental support and high feelings of parental-child closeness (Padilla-Walker & Nelson, 2012). Research has shown that helicopter parenting has been associated with psychological and behavioral problems in young adults, (Odenweller, Booth-Butterfield, & Weber, 2014). The current study investigated the association between perceived helicopter parenting and self-determination theory components along with intrinsic motivation and academic and extracurricular engagement in …

Do Faces Facilitate Or Distract Children From Attending To Threats?, Sarah A. Skidmore

Senior Honors Projects, 2010-2019

Threatening stimuli may produce an attentional bias in humans, capturing and holding attention to a greater extent than other types of stimuli. Humans rely on others to alert their attention to threats in their environment, and social stimuli, such as faces, have privileged processing compared to nonsocial stimuli. We wanted to explore whether task-irrelevant fearful or neutral faces facilitate, distract, or have no effect on the detection of threatening or neutral images (spiders and frogs, respectively). Three- to-five-year-old children (N=37) completed a visual search task in which they searched for threatening or neutral animals. Consistent with previous literature, we found …

Implementation Of A Simulation-Based Interprofessional Patient Safety Program, Mariko Nowicki

Doctor of Nursing Practice (DNP) Projects

Problem: Despite mandatory biannual patient-safety training at hospitals in Japan, medical adverse events continue to increase. However, many such events are preventable through adherence to standard practices of safe patient care.

Context: A lecture-based educational approach is inadequate to develop patient-safety competency in clinical educators or clinicians. Participation in simulation-based interprofessional patient-safety training programs can enhance knowledge, skills, and attitudes to promote patient safety culture and enhance patient outcomes.

Interventions: An evidence-based train-the trainer-patient safety program was conducted using simulation for interprofessional healthcare educators to serve as safety champions.

Measures: Three outcome and three process measures geared toward self-evaluation and …

Lvhn Weekly-Hazleton, Lehigh Valley Health Network

LVHN Weekly-Hazleton

No abstract provided.

Lvhn Weekly, Lehigh Valley Health Network

LVHN Weekly

No abstract provided.

Rachel Jones V. Pennsylvania State Police

2019 Decisions

USDC for the Eastern District of Pennsylvania

Effects Of Ketamine Versus Morphine In The Treatment Of Acute Pain In The Emergency Department, Dakoda Farrington, Amber Knowlton

Physician Assistant Capstones, 2016 to 2019

No abstract provided.

Effect Of Metformin On Adolescent Obesity, Mackenzie Mcnamee, Victoriya Eggen

Physician Assistant Capstones, 2016 to 2019

Objectives: Metformin is the first line treatment for type 2 diabetes mellitus (T2DM) in both adults and children and has been shown to result in weight loss. Pediatric obesity is a major risk factor for the development of T2DM as well as several other diseases. Recently, physicians have reported using Metformin off-label to treat obesity in adolescent patients. The purpose of this study is to investigate whether Metformin is effective in reducing BMI in obese adolescents.

Methods: Studies were found using PubMed, MeSH, Medline, and CINAHL. The search terms used were: “obesity,” Metformin,” “adolescents,” “children,” “metformin and weight,” …

A Case Study On The Effects Of Functional Exercises In Improving Quality Of Life (Qol) In A Patient Diagnosed With Glioblastoma Multiforme (Gbm), Kathy Nguyen, Savonna Reed, Sepehr Rezaei, Vanessa Rindge-Silvas, Brianne Bozzella

San Marcos, Fall 2019

Background and Purpose: The estimated prevalence of primary brain tumors in the US population is 14 per 100,000. GBM accounts for 50% of primary central nerve tumors in people older than 15 years old. Approximately 12,820 deaths each year are due to primary and nervous system tumors. There is limited research on the optimal interventions and effects of physical therapy on individuals diagnosed with GBM.¹ The purpose of this case report was to determine which aspects of the International Classification of Functioning, Disability, and Health model are the most important to consider during physical rehabilitation and possible interventions that …

Occupational Therapy's Role In Maternal Mental Health Within Transition From Nicu To Home, Victoria Briltz, Becki Cohill, Susan Macdermott

San Marcos, Fall 2019

The purpose of this capstone project is to identify OT’s role in maternal mental health following the transition home from a NICU setting. This capstone project focused on mothers’ roles, routines, and environment during the transition from the NICU to home. Mothers may feel unprepared for the discharge home when their babies are ready to leave the NICU (Boykova, 2016). Occupational therapists address occupational performance through skilled interventions for women during the perinatal period; however, there is a lack of evidence guiding occupational therapy for providing services for maternal wellness (Slootjes, 2016). This capstone project will help share information, ideas, …

Anatomy Of An Exhibit: The Academic Library As Place Of Self-Instruction, Matthew Chase

San Marcos, Fall 2019

This exhibition project addresses the central question: How can we creatively transform academic library spaces to support and engage students in critical information literacy? The project used physical library space to install a series of exhibitions at the San Marcos Campus Library of the University of St. Augustine for Health Sciences. Guided by the theoretical frameworks of Foucauldian perspective on knowledge and discourse, Falk and Dierking’s Contextual Model of Learning, and critical librarianship, the exhibit series engages students in a self-guided journey to discover and evaluate how knowledge is constructed, produced, and disseminated. Particular focus is directed to the Fall …

The Role Of Occupational Therapy For Survivors Of Human Trafficking, Margaux Mariano, Becki Cohill, Susan Macdermott

San Marcos, Fall 2019

Human trafficking involves sex trafficking, labor trafficking, and trafficking of children. The needs of survivors of human trafficking are widespread due to the traumatic experiences they face. Concerns that may arise include decreased participation in meaningful activities in an individual's life, possibly due to anxiety, depression, suicidal ideation, memory loss, posttraumatic stress disorder, and social isolation. Individuals who have been subjected to human trafficking often experience occupational deprivation and occupational therapy has yet to establish its role in the recovery process for survivors. This poster presents a capstone project consisting of the process towards the development of an occupation-based, trauma-informed, …

The Effect Of Aquatic Interventions In Combination With Early Start Physical Therapy Services On Gross Motor Development In A Male Child With Down Syndrome, Roxanne Mueller

San Marcos, Fall 2019

Introduction: Aquatic therapy has been used in various patient populations as a modality to facilitate motor control and manage tonicity.^1-3 Despite the variety of literature addressing individuals with Down syndrome (DS) and aquatic therapy, there has been little described about the effects of aquatic therapy on early gross motor development in children with DS.

Purpose: The purpose of this case study is to examine whether aquatic physical therapy interventions combined with early start physical therapy influence gross motor developmental delay in a child with DS.

Case Description: The patient is a 31-month-old boy with diagnosis of …

Case Study: Efficacy Of Physical Therapy On A Patient With Cva In Normalizing Gait And Shoulder Mechanics, Jane Mongkolvipakul, Amanda Orr, Queenie Lim, Rajbir Basati, Faris Alshammari

San Marcos, Fall 2019

Background & Purpose: Cerebrovascular Accident (CVA) is known as Stroke. It is a damage to the brain due to an interruption of blood supply. Two main types of stroke are ischemic stroke and hemorrhagic stroke. Ischemic stroke, the most common type of stroke, is due to a blocked artery and a hemorrhagic stroke is due to a leak or burst of a blood vessel. Signs and symptoms of stroke are presented contralaterally. The purpose of this case report is to demonstrate the use of PT interventions to improve shoulder function and gait mechanics in a post CVA patient.

Case …

Weight-Bearing Interventions To Decrease Spasticity And Improve Gait In Stroke Patients: A Case Report, Melin Nguyen, Shelby Peterson, Jessika Sun, Irene Taing, Faris Alshammari

San Marcos, Fall 2019

The purpose of this case report was to determine the success of weight-bearing interventions on spasticity reduction and improved gait patterns in a 61 year-old-male patient recovering from a chronic left hemorrhagic CVA. The patient’s primary impairments included right upper and lower extremity spasticity, circumduction gait, weakness and decreased range of motion of right extremities.

The interventions included in this patient’s treatment program included standing calf stretches, toe raises, ankle range of motion and gait training for 1 hour once a week for 4 weeks. This case report supports the application of weight-bearing through the paretic limb, which has been …