Digital Commons Network^™

Celebrating Alutiiq Cultural Revitalization: Pathways To Holistic Individual Health And Community Wellness, Margaret Susan Mete

Indigenous Studies

It is well understood that disease is a consequence of varied causation. Despite the fact that many health care providers acknowledge the importance of treating patients in a comprehensive manner in order to successfully cure sickness or alleviate symptoms, the contemporary medical system dispenses care in a fragmented and frequently incomplete manner. The essential differences between Indigenous epistemologies and the predominant Western worldview has had a more devastating impact on well-being and infirmity than is often recognized. The intention of this research is to explore the importance of promoting balanced holistic health care at a deeper and more essential level …

Bridging The Cultural Divide: Creating Culturally Diverse Therapeutic Foster Homes In Rural Alaska, Erica A. Dillard

Justice

The disproportionate number of American Indian and Alaska Native children being removed from their homes and communities by Child Protective Services is statistically alarming. Despite the current resources available, many families are unable to take advantage of these resources due to issues caused by their rural environments. This paper reviews the causes leading up to the removal of American Indian and Alaska Native children from their homes and communities, examines the importance of cultural identity, and discusses the resources that are needed to prevent these removals from occurring.

Hatred And Harm: The Influence Of Digital Pimps And The Miseducation Of The Hyper-Masculine Man, Justin Lantier-Novelli

Justice

The purpose of this research project is to measure the effects of a correlation between exposure to violent, hardcore sexually-explicit Internet materials, or SEIM (also known as pornography), and behaviors and attitudes that demean, degrade, subjugate, and abuse women and girls resulting in systemic gender inequality. Research is based on peer-reviewed journal articles, subject-matter publications, crime statistics, personal interviews with experts, and meta-analyses of previous research on related topics. The research has demonstrated a very strong correlation between exposure to SEIM and hyper-masculine attitudes and behaviors of gender-inequality toward women, beginning at one end of the spectrum with verbal micro-aggressions …

A Literature Review Of Wetland Treatment Systems Used To Treat Runoff Mixtures Containing Antibiotics And Pesticides From Urban And Agricultural Landscapes, Emily R. Nottingham, Tiffany L. Messer

Biosystems and Agricultural Engineering Faculty Publications

Wetland treatment systems are used extensively across the world to mitigate surface runoff. While wetland treatment for nitrogen mitigation has been comprehensively reviewed, the implications of common-use pesticides and antibiotics on nitrogen reduction remain relatively unreviewed. Therefore, this review seeks to comprehensively assess the removal of commonly used pesticides and antibiotics and their implications for nitrogen removal in wetland treatment systems receiving non-point source runoff from urban and agricultural landscapes. A total of 181 primary studies were identified spanning 37 countries. Most of the reviewed publications studied pesticides (n = 153) entering wetlands systems, while antibiotics (n = 29) had …

Two Students Awarded Independent Pharmacy Grant, Patrick Smith

University of Mississippi News

Hayden Wooldridge and Lindsey Simmerman plan for future in community pharmacy

Decreasing Maternal Breastfeeding Dissatisfaction During The Night Shift Related To Lactation Support, Robyn Caston

Master's Projects and Capstones

Abstract

Problem

This paper will discuss the Clinical Nurse Leader (CNL) project's specific aim: to decrease maternal dissatisfaction during the night shift related to lactation support in a high-risk maternal department.

Context

Research has shown that adding lactation support improves the decision to exclusively breastfeed and increases the duration. Breastfeeding for all infants starting at birth and continuing until at least 6 months of age has been recommended by the World Health Organization, UNICEF, and the American Academy of Pediatrics. Many studies about lactation support have demonstrated the health benefits to mothers and their infants.

Interventions

A baseline survey will …

Employee Engagement And Increasing Patient Satisfaction In The Pediatric Outpatient Setting, Carol Liang

Master's Projects and Capstones

Problem: An ambulatory pediatric surgical center in the San Francisco Bay Area has an organizational goal of reaching the 85th percentile in NRC patient satisfaction scores. The annual compliance report states the current score is at 80.7 as of September 2021. These NRC findings indicate several areas for improvement including: (1) trust providers with care, (2) care providers listened, (3) was told when could leave, (4) got help as soon as wanted, (5) care provider explain things, (6) NPS: facility would recommend, and (7) procedure began on time.

Context: Priorities include implementing strategies to increase employee engagement and patient satisfaction. …

Peer Support Wellness Groups In Physician Assistant School, Allison Pingston, Alexa Wagoner

Physician Assistant Capstones, 2020-current

Objective: To investigate the effect of peer support wellness groups on the perceived stress, anxiety, and depressive symptoms encountered in Physician Assistant (PA) school in order to implement a wellness program for James Madison University (JMU) PA students. Design: Systematic literature review. Methods: Searches were done in PubMed and Google Scholar using the search terms: “wellness,” “peer support,” “small group(s),” “medical school,” and “PA school.” The limits used were: randomized controlled trials, meta-analysis, and completed in the past 10 years. Results: Search results revealed three articles that met inclusion and exclusion criteria. Conclusion: No articles showed statistical significance. However, all …

Paracetamol Compared To Nsaids As Treatment For Patent Ductus Arteriosus In Neonates, Toné Boykins, Carly Anne C. Wilson

Physician Assistant Capstones, 2020-current

Objective: To evaluate the use of paracetamol in the treatment of closure of patent ductus arteriosus (PDA), as well as to investigate the amount of adverse side effects. Design: Systematic literature review. Methods: Searches were done in PubMed and Google scholar, using the search terms Paracetamol for patent ductus arteriosus and alternative treatment patent ductus arteriosus. In PubMed the following limits and terms were used: randomized control trial, English, and secondary endpoints. Results: Randomized control trial studies by Dash et al., El-Mashad et al., and El-Farrash et al. were included based on inclusion/exclusion criteria of the meta-analysis and with secondary …

The Effect Of Hydroxychloroquine On Mortality In Hospitalized Covid-19 Patients, Misha Suresh, Jeff Abraham

Physician Assistant Capstones, 2020-current

As of October 2020, there are no commonly accepted or proven effective treatments for coronavirus disease 2019 (COVID-19). Hydroxychloroquine (HCQ) is an established anti-malarial drug with demonstrated action against SARS-CoV-2 (the virus that causes COVID-19) in-vitro and early observational studies and anecdotal evidence supported its use in treatment of COVID-19. In this review, three of largest and most statistically powerful studies to date (two cohort studies and one randomized controlled trial [RCT]) are synthesized for the purpose of determining whether HCQ is effective in reducing mortality in patients hospitalized with COVID-19. All three studies found no statistically significant difference in …

Are Polypills A Viable Option To Improve Health Outcomes In Those With Cardiovascular Disease?, Alexander Voytovich, Cara Mckee

Physician Assistant Capstones, 2020-current

Objective: Does the use of polypill therapy improve systolic blood pressure and low-density lipoprotein cholesterol (LDL-C) levels more than usual care in adults with established cardiovascular disease (CVD) or with 10-year atherosclerotic cardiovascular disease risk >10%. Design: Systematic literature review. Methods: Searches were performed in PubMed and UpToDate using the following search terms polypill and cardiovascular. Other limits included: randomized control trials, adults, published in the last 10 years, LDL-C and systolic blood pressure. Results: Analysis of articles to ensure similar design, intervention and fit with the other inclusion/exclusion criteria yielded three studies: Labefer et al, Muñoz et al, and …

The Necessity Of Implementing A Wellness Curriculum Into Physician Assistant Programs, Jessica K. Erim, Darryl Bines Jr.

Physician Assistant Capstones, 2020-current

Purpose: In response to the decline of mental health and wellness of students within medical school programs, recent research has been exploring the effects of implementation of wellness curriculums. The purpose of this review is to highlight the research that has been conducted in the medical school environment and to establish the need for further research. This review will specifically discuss the implementation of a student-led wellness curriculum at James Madison University’s Physician Assistant Program and its impact on students. Methods: A thorough search was conducted using Google Scholar using specific inclusion and exclusion criteria (see Table 1). …

Effectiveness Of Tpa At Reducing Amputations In Patients With Severe Frostbite, Kylie Gravatt, Meredith Mahen

Physician Assistant Capstones, 2020-current

Objective: To determine the efficacy of tissue plasminogen activator (tPA) therapy in reducing the number of limb and digit amputations in patients with severe frostbite.

Introduction: Current treatment regimens for frostbite consist mainly of rapid rewarming measures and wound care. This regimen is unfortunately many times not sufficient in cases of severe frostbite and frequently leads to delayed amputations.

Methods: A search was conducted in Pubmed using the terms "Frostbite"[Mesh]) AND "Tissue Plasminogen Activator"[Mesh]. Articles were chosen based on relevancy to the research question and having a publication date after 2005. Case reports were excluded.

Results: All three studies reported …

Baseline Bmi, Gender, & Age As Predictive Factors For Intragastric Balloon Weight Loss Outcomes, Nirali Shah, Miranda A. Myers-Burton

Physician Assistant Capstones, 2020-current

Objective: To determine whether obese and morbidly obese patients aged 18-75 with a lower baseline BMI (BMI 30-39.9 kg/m2) who received an intragastric balloon (IGB), have a higher percentage of total body weight loss (%TBWL) and percentage of excess weight loss (%EWL) compared to those with a higher baseline BMI (BMI > 40 kg/m2). Secondary objective was to ascertain whether gender and age are also predictors of weight loss outcomes following an IGB procedure.

Design: Systematic literature review

Methods: Literature searches of PubMed and SpringerLink were conducted using the search terms: “intragastric balloon, weight loss, and “BMI” and then limited to …

Sglt2 Inhibitors In The Management Of Heart Failure With Reduced Ejection Fraction, Susannah Jackson, Meghan Mathis

Physician Assistant Capstones, 2020-current

Objective: to assess whether SGLT2 inhibitors significantly reduce the risk of hospitalization for heart failure (HAHF) and cardiovascular death in patients with heart failure with reduced ejection fraction (HFrEF). Design: systematic literature review. Methods: searches were conducted in PubMed with the terms "SGLT2 Inhibitors,” “heart failure with reduced ejection fraction (HFrEF),” and "hospitalization” and the following limits: publication within the last 5 years, clinical trials, meta-analyses, randomized control trials, humans, and English. These criteria determined the selected literature: randomized control trial (RCT), use of an SGLT2i compared to placebo, and outcomes including HAHF and/or cardiovascular related death. Results: DAPA-HF: 27% …

Breakthroughs In Hormonal Male Contraception, Alexander Patton, Seth Vann

Physician Assistant Capstones, 2020-current

Objective: Assess the efficacy of a nestorone plus testosterone gel at suppressing progestin levels and spermatogenesis.

Design: Systematic literature review.

Methods: Searches were done in PubMed and Dartmouth library using the terms nestorone, randomized control trial, human, and male. Limits used while searching included published in the last 10 years, randomized control trials, and English.

Results: Using the search criteria the following three studies were found that met the inclusion/exclusion criteria of this study: Ilani et al, Zitzmann et al, and Anawalt et al. All three studies were found on PubMed and reference the Ilani et al study.

Conclusion: Nestorone …

Unscrambling Egg Allergies: Examining The Impact Of Introduction Timing Of Egg Protein On The Development Of Food Allergies, Emily Sherald, Mark Peterson

Physician Assistant Capstones, 2020-current

Objective: To assess the efficacy of early egg protein introduction in the reduction of later childhood egg allergy development. Design: Systematic literature review. Methods: Searches were done using PubMed and cross referenced with articles on UpToDate, using the search strings ‘egg‘, ‘allergy‘, ‘randomized controlled trial‘, ‘early‘, and ‘introduction‘. Our inclusion criteria included: published in the last 5 years, human trial, randomized controlled trials only. Results: Our selection process yielded 3 quality studies: the “Beating Egg Allergy Trial” (BEAT)¹, “Start time of egg protein to prevent egg allergy” (STEP)², and “Two-step Egg Introduction for Prevention of Egg …

Dm Ii Bugging You? Probiotics May Help Reach Your Glycemic Goals, Robert Kime, Kayla Siford

Physician Assistant Capstones, 2020-current

Objective: To determine the effects of probiotics on glycated hemoglobin (HbA1c) and fasting blood glucose (FBG) in patients with Type II Diabetes (T2DM) controlled with oral medications. Design: Systematic Literature Review. Methods: Searches were conducted on PubMed using the terms: prebiotic, probiotic, type 2 diabetes, non-insulin dependent, and microbiota. Searches refined with parameters for Randomized Control Trials, written in English, and available texts. Results: Firouzi et al. did not show a significant change in the FBG between groups and a decrease in the HbA1c in the intervention group. Ejtahed et al. showed a significant decrease in …

The Effect Of Platelet Rich Plasma On The Treatment Of Androgenetic Alopecia Compared To Placebo, Mackenzie D. Comstock, Hannah E. Stephenson

Physician Assistant Capstones, 2020-current

Objective: To assess the efficacy of plasma rich proteins (PRP) compared to placebo in the treatment of androgenetic alopecia (AGA).

Design: Systematic literature review

Methods: Searches were done in PubMed utilizing the terms PRP, plasma rich protein, autologous activated PRP, autologous activated plasma rich protein, androgenetic alopecia, placebo, hair count, hair density, hair follicles, hair loss, therapeutic effect, growth factors, dermatology, and regenerative medicine. Articles were excluded if they were published before 2013, involved animal studies, compared minoxidil only in their research, included only female participants, non-English articles, studies with no quantifiable data, review research articles, and injections besides the …

Ketamine As A Treatment Modality For Treatment-Resistant Depression, Tracy Wulff, Shen Cao

Physician Assistant Capstones, 2020-current

Many recent studies have demonstrated the ability of ketamine, an NMDA receptor antagonist, to produce antidepressant effects that may be effective in helping reduce treatment-resistant major depression. In particular, three double-blinded randomized control trials have been conducted to assess the viability and effectiveness of this medication for treatment. This systematic literature review will analyze these studies and determine if the overall research indicates that ketamine is useful in improving depression as measured by the Montgomery–Asberg Depression Rating Scale (MADRS)¹.

Objective: Assess the effectiveness of IV Ketamine in reducing treatment-resistant major depressive disorder as measured by the Montgomery–Asberg …

Effects Of Cannabidiol As Adjunct Therapy For Management Of Treatment-Resistant Epilepsy, Harry Gray, Molly Anadale

Physician Assistant Capstones, 2020-current

Background. Lennox-Gastaut Syndrome (LGS) and Dravet Syndrome(DS) are two types of childhood epilepsy syndromes that are often resistant to traditional anti-epileptic drug (AED) regimens. With the development of a pharmaceutical grade purified cannabidiol (CBD), there has been increasing interest in its utility for treatment of epilepsy. We conducted a systematic review to explore the efficacy of CBD in reducing seizure frequency when added to traditional AED regimens in those who are considered to have treatment resistant epilepsy (TRE).

Method. A search of PubMed was performed in September 2020 using the terms “cannabidiol”, “Lennox-Gastaut Syndrome”, “Dravet Syndrome”, and “epilepsy” with …

Influencing A Culture Of Quality And Safety Through Huddling, Tysa Ferguson, Natalia Mccain

Doctor of Nursing Practice Projects: College of Nursing

Not available

The Relationship Between Discoid Meniscus And Articular Cartilage Thickness: A Quantitative Observational Study With Mri, Joseph Brutico, Margaret Wright, Sarah Kamel, Adam C Zoga, Kirsten Poehling-Monaghan, Sommer Hammoud

Rothman Institute Papers

Background: Several cadaveric imaging studies have demonstrated that the articular cartilage thickness on the tibial plateau varies depending on coverage by native meniscal tissue. These differences are thought to partially contribute to the rates of cartilage degeneration and development of osteoarthritis after meniscectomy. Because there is greater tibial plateau coverage with meniscal tissue in the setting of a discoid meniscus, these findings may also have implications for the long-term health of the knee after saucerization of a torn discoid meniscus.

Purpose: To evaluate the relationship between lateral compartment articular cartilage thickness and the presence or absence of a discoid meniscus. …

Contracting Out Liability For Negligent Pre-Contractual Misrepresentation, Daniele Bertolini

Dalhousie Law Journal

This article examines the extent to which entire agreement clauses (EACs) and non-reliance clauses (NRCs) are enforceable to preclude actions for negligent pre-contractual misrepresentations. It is argued that courts could improve legal certainty and contractual fairness by adopting two distinct legal rules to be applied, respectively, to contracts between sophisticated parties and in adhesion contracts. First, it is suggested that in contracts between sophisticated parties only specific contractual barriers to actions should provide a complete defence against negligent misrepresentation claims. Under this rule, the exclusionary effect of EACs and NRCs would be achieved only if an express term of the …

Masthead & Table Of Contents

Dalhousie Law Journal

No abstract provided.

The Role Of Micrornas In The Pathophysiology Of Neonatal Hypoxic-Ischemic Brain Injury, Eric S. Peeples

Theses & Dissertations

Neonatal hypoxic-ischemic brain injury (HIBI) is a devastating injury resulting from impaired blood flow and oxygen delivery to the brain at or around the time of birth. The subsequent metabolic failure and cellular injury in the brain can be partially attenuated by rapid initiation of therapeutic hypothermia, but even with prompt induction of hypothermia, more than one in four survivors suffer from major developmental disabilities – an indication of the critical need for more effective therapies. MicroRNAs (miRNA) may be able to act as therapeutic targets in neonatal HIBI; however, very little is known about the endogenous expression of miRNAs …

Intention To Breastfeed: Breastfeeding Attitudes, Norms, Self-Efficacy, Social Support Network And Community Resources Of African American, Low-Income, Emerging Adult Women, Pregnant For The First Time, Sara E. Brown

Theses & Dissertations

African American (AA) women continue to have the lowest rates of breastfeeding. This continues to create a health disparity even though breastfeeding is extensively recognized in the scientific and health care communities as the optimal feeding choice for infants. This study examined the relationship between the external variables (social support network and community resources) and the explanatory variables (attitudes, norms, and perceived self-efficacy) and intention to breastfeed, for the AA, first time, low-income, emerging adult pregnant woman. The Integrated Behavior Model (IBM) was used as the theoretical framework to guide this study in better understanding the variables influencing breastfeeding intention. …

Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji

Theses & Dissertations

Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In …

The Effect Of Orthodontic Treatment With Extraction On The Upper Airway Dimensions And Three-Dimensional Morphology: A Retrospective Study Using Cone-Beam Computed Tomography Technique, Ehsan Mostaghni

Theses & Dissertations

The purpose of this study was to evaluate the effect of orthodontic treatment with and without extractions of teeth on the upper airway dimension and morphology. Records of 40 consecutively treated patients who received orthodontic treatment with or without dental extractions were evaluated. Pre-and post-treatment volumes, minimum cross-sectional areas, and linear dimensions of oropharyngeal airways were quantified using InVivo Dental 6.0 (Anatomage, San Jose, CA). Additionally, pre and post CBCT images of the upper airways were superimposed on each other using voxel-based registration and fixed coordinate system using 3D Slicer 4.1.1 (www.Slicer.org) and ITK-SNAP (http://www.itksnap.org). While the …

Design And Synthesis Of Small Molecular Probes For Cns And Kidney Disorders, Swagat H. Sharma

Theses & Dissertations

The G protein regulated inwardly rectifying potassium channels (GIRK) are a family of inwardly rectifying potassium channels and are key effectors in signaling pathways. GIRK 1/2 channel subunit, predominantly found in the brain, is involved pathophysiology of various neurological disorders including, but not limited to, epilepsy, anxiety, Parkinson's, pain, reward, and addiction. Previously, our laboratory had identified a series of urea containing molecules as GIRK1/2 preferring activators. Unfortunately, the urea series suffers from significant PK liabilities (solubility, brain penetration and high clearance). The chapter 1 of the dissertation describes our efforts in developing three new series of activators with improved …