Digital Commons Network^™

Risking The Wrist, Tyler Mosier, Evan White

Physician Assistant Capstones, 2020-current

Abstract:

Background: Carpal tunnel syndrome (CTS) is now one of the most common workplace injuries, with nearly 50% of patients eventually requiring CTS release surgery as a permanent solution. With a concern of a younger incidence of CTS developing in a technology dependent society, some patients may fear even a minimal loss of function. To our knowledge there has been no study comparing forearm grip strength before symptoms develop to grip strength after the procedure has been performed.

Objectives: The aim of this study was to determine if there was a significant change in strength of the flexor digitorum superficialis …

Plantar Fasciitis: Steroids Or Prp?, Alexandra Lepecha, Grant Rankins

Physician Assistant Capstones, 2020-current

Abstract

Objective: The aim of this review is to compare the therapeutic effects of corticosteroids injections and platelet rich plasma therapy in the treatment for chronic plantar fasciitis that is refractory to conventional treatment options, using the Foot Function Index (FFI) score as an indicator of improvement

Design: Meta Analysis

Methods: A search of PubMed and CINAHL was performed in 2021 using the terms “‘plantar fasciitis’, and ‘prp or platelet rich plasma’ and ‘corticosteroids’ and ‘foot function index.’” Three articles were chosen to be included in qualitative synthesis.

Results: Studies from Peerbooms et al, Ugurlar et al, and Tabrizi et …

Injuries In Manual And Mechanical Cpr, Macon Spruill, Malik Bangura

Physician Assistant Capstones, 2020-current

Objective: To compare the rate of injuries during cardiopulmonary resuscitation (CPR) using manual versus mechanical chest compressions with the Lund University Cardiopulmonary Assist System (LUCAS™).

Design: Systematic literature review

Methods: We investigated the use of 2 different CPR methods, manual and mechanical, in order to determine if one was more likely to cause injury in individuals during a cardiac arrest. PubMed searches were conducted using the terms “cardiopulmonary resuscitation,” “adverse effect,” “classification,” “method,” “mortality,” “statistical and numerical data,” “trends,” “complication,” “epidemiology,” and “etiology.” Studies were excluded if they took place before the year 2000, included individuals under 18 …

Effect Of Mesenchymal Stem Cells On Osteoarthritis Of The Knee, Brendan Avery, Jessica Gray

Physician Assistant Capstones, 2020-current

Osteoarthritis of the knee is one the most common sources of chronic pain due to altered joint function.¹ Current treatment modalities offer short term relief of symptoms but lack long term aid and regenerative properties.¹ Mesenchymal stem cells (MSC) offer regenerative and anti-inflammatory properties and can be collected from umbilical cord blood, adipose tissue, or bone marrow.⁴ The three studies included were all randomized controlled trials within the past 10 years that each utilized more than 30 participants who had a diagnosis of osteoarthritis and a mean age above 50 years old. MSCs were compared to corticosteroid …

Prophylactic Intravenous Prehydration With Sodium Bicarbonate Or Sodium Chloride In The Prevention Of Contrast Induced Acute Kidney Injury, Briana Lockett, Caroline Dong

Physician Assistant Capstones, 2020-current

Introduction: Iodinated contrast media is a crucial component in the diagnostic work up of many life-threatening illnesses. However, it has been reported to cause acute kidney injury after administration, especially in patients with pre-existing renal disease. Several prophylactic treatments have been studied in hopes of minimizing these adverse events. The current standard of care in this patient population is prophylactic intravenous volume administration with either sodium chloride or sodium bicarbonate. Objective: The goal of this literature review is to determine if prophylactic intravenous volume administration with either saline or sodium bicarbonate prior to contrast administration decreases the incidence of contrast …

The Effect Of A Wellness Curriculum On First Semester Jmu Pa Students, Abigail Larson, Jeanine Aberbook

Physician Assistant Capstones, 2020-current

Physician Assistant (PA) programs are rigorous graduate-level medical programs that achieve a Master’s degree but complete an equal number of credits as a Doctorate degree. They are notorious for triggering high levels of stress pre-matriculation as well as upon matriculation. While this is a well-known topic discussed between students and incoming students, it is an under-researched topic. As a result of the lack of research in physician assistant education regarding implementing a wellness curriculum and the desire to reduce stress, anxiety, and depression symptoms in first semester PA student, the faculty and students at James Madison University (JMU) implemented a …

The Use Of Autologous Prp Gel For The Treatment Of Diabetic Foot Ulcers, Erin Klein, Dominic E. Paoletti

Physician Assistant Capstones, 2020-current

The purpose of this systematic literature review is to examine the efficacy of platelet rich-plasma (PRP) gel as a therapy for diabetic foot ulcers (DFUs). Infections in patients with diabetes, especially diabetic foot ulcers, are challenging to treat due to neurovascular compromise. Searches were done in PubMed utilizing the terms “diabetic foot ulcer”, “platelet rich plasma” and “autologous”. In PubMed, the following limits and terms were used: randomized control trial (RCTs), sample size greater than 30 participants, foot ulcers, and English. A meta-analysis revealed three studies meeting inclusion/exclusion criteria: Li et al, Gude et al, and Ahmed et al. The …

Use Of Long-Acting Injectable Cabotegravir And Rilpivirine In Hiv Maintenance Therapy, Andrea K. Ferrero, Nabil Naim

Physician Assistant Capstones, 2020-current

To determine if long-acting injectables cabotegravir and rilpivirine are non-inferior to oral antiretroviral therapy at maintaining viral load suppression below 50 copies per milliliter of serum. Design: Systematic literature review. Methods: A search was done in PubMed using the terms “HIV + cabotegravir” or “HIV + cabotegravir, rilpivirine drug combination.” Limitations included non-randomized control trials, comparison of injectable regimens directly or injectables to placebo, studies that evaluate compliance or side effects only, and studies with small sample sizes. Results: Meta-analysis revealed that continued use of injectables was sufficient in maintaining viral suppression at 93.6%, 92.5%, and 94% in each of …

The Use Of Kernig’S And Brudzinski’S Sign In Determining Meningitis: A Review, Crystal T. Duong, Ashton Hughes, Kerem Yilmaz

Physician Assistant Capstones, 2020-current

Objective: Assess the diagnostic value of Kernig’s and Brudzinski’s signs in determining meningitis among individuals aged 18 to 64. Design: Systematic literature review. Methods: Searches done in PubMed utilizing the terms Kernig and Brudzinski. In PubMed, studies were excluded if not in English, older than 2000 or done on animals, and meta-analyses. Results: Three studies were found including Nakao JH, et al, Thomas KE, et al, and Waghdhare S, et al. Conclusion: Kernig’s and Brudzinski’s signs have high specificity but yield a low sensitivity in determining meningitis. They are great tools to be utilized by medical providers, but only support …

Is A Lumbar Puncture Necessary? Identifying The Need For A Lp With A Negative Ct Scan When Diagnosing A Non-Traumatic Subarachnoid Hemorrhage, Carlee Raymond, Erin S. Lang

Physician Assistant Capstones, 2020-current

Objective: To assess the current standard for the detection of non-traumatic subarachnoid hemorrhage (SAH), and evaluate the need for a lumbar puncture with a negative head CT. Is a negative head CT thorough enough to definitively rule out a SAH?

Design: Systematic literature review

Methods: Our research began on the PubMed database using the search terms Subarachnoid Hemorrhage and Lumbar Puncture. We filtered our data with filters including; data in the last ten years, primary research, and full text articles.

Results: Retrospective studies include; Bianchi et al. (2021), Chee et al. (2020) and Tulla et al.(2018). All three studies showed …

Use Of Cardiomems Hf Sensor In Management Of Nyha Class Iii Heart Failure, Trevor Andrunik, Anne Eady

Physician Assistant Capstones, 2020-current

Objective: Assess the ability of continuous pulmonary artery pressure monitoring via implantable CardioMEMs HF device to reduce hospitalization in New York Heart Association (NYHA) Class III heart failure patients over the age of 18. Design: Systematic literature review. Methods: Searches were conducted via PubMed and ClinicalTrials.gov using the single search term “CardioMEMs.” Inclusion criteria narrowed results to studies performed in the last 10 years, randomized control trials, cohort studies, and utilizing heart failure related hospitalization as the primary endpoint. Results: The current data unanimously asserts that the CardioMEMs HF device is effective at reducing heart failure related hospitalizations, with secondary …

An Enhanced Enrollment Process To Impact Appointment Compliance In The Hf-Optimize Clinic, Carolyn Coons, Teri Diederich, Kyana Holder

Doctor of Nursing Practice Projects: College of Nursing

Background The HF-Optimize clinic showed improved utilization of guideline-directed medical therapy (GDMT) along with improved clinical outcomes from 2018 to 2020. Appointment compliance was poor with only 44% of patients completing all HF-Optimize visits. Missed appointments led to worse health outcomes, fragmented care, and provider inefficiencies. Interventions to improve appointment compliance are vital to improving heart failure outcomes. Objective The purpose of this quality improvement project is to evaluate the impact that an enhanced enrollment process has on appointment compliance in a culturally diverse, adult population referred to the HF-Optimize clinic at Nebraska Medicine. Methods This prospective quality improvement project …

Counselor Educator's Perspective On Clinical Supervision Interventions For International Counseling Students, Ah Ram Lee

Dissertations - ALL

The present study employed Q methodology to answer the research question of what the shared subjective understanding of counselor educators (CEs) is about what necessary clinical supervision interventions are for the professional development of international counseling students (ICSs). Based on the review of current clinical supervision literature, the researcher created a Q sort that addresses what ICSs believe as helpful or could have been helpful supervision interventions on improving their professional development. The 32 CEs who participated in the present study ranked the 38 items on the Q sort based on their subjective understanding of the most and least necessary …

Cost-Benefit Analysis Of A Pediatric Patient Blood Management Program, Karen D. Gibbs

Dissertations and Theses (Open Access)

Introduction

Red blood cell (RBC) transfusions can be a life-saving and important intervention used to replace blood loss or manage anemia, but they also come with risks from transfusion-associated adverse events (TAAEs). Patient blood management (PBM) involves a multidisciplinary approach to optimize care of patients who may need a transfusion, including blood conservation modalities, patient-centered decision making, among others. The impact of PBM in the pediatric setting is not well understood, particularly the impact on TAAEs and the economic impact of these programs.

The following specific aims were pursued: (1) To investigate the effect of a PBM program on transfusion …

Assessing The Mental Health Of Women At The Intersection Of Intimate Partner Violence And Animal Cruelty: Personal And Population Level Risk Factors For Co-Victimization, Alaina M. Beauchamp

Dissertations and Theses (Open Access)

One predictor of intimate partner violence (IPV) occurring in the home is pet abuse. The high prevalence of pet cruelty among IPV relationship can create a significant barrier to seeking help due to the inability to bring the pet or concern for the pet’s wellbeing. This human-animal bond is a more common source of emotional support among victims with experiences of pet abuse, as opposed to women whose pets had not been abused. This study 1) explored the relationship between victims of IPV and their pets, the dynamics and characteristics of situations of co-victimization (i.e., abuse of both a human …

An Essay On Ideology And Legal Education In Micro Jurisdictions: The Example Of Jersey, David Marrani

Journal of Civil Law Studies

This article explores the question of legal education in micro jurisdictions using the case of Jersey, a British Crown Dependency, positioned geographically, historically and culturally between two larger jurisdictions, France and the UK. It analyses how Jersey’s legal training is pulled towards those large “big neighbours,” rather than focusing on what makes its specificity and attraction. It questions how legal education in micro-jurisdiction is actually linked to ideology. The article starts with the following question: are we taking micro jurisdictions seriously? It then considers the routes to legal qualification in micro jurisdictions, before focusing specifically on the case of Jersey …

Conversations About Book Challenges And Bans: Civil Discourse Through Talking Frames And Sentence Stems, Alonna Lynn Liabenow

Masters Projects

Book challenges and bans are more prevalent than ever in the year 2022. The conversations surrounding the challenge of a book are often very stressful for the librarian, teacher, or administrator involved. This project seeks to ease some of that stress by giving the parties involved in conversation a talking frame. These talking frames are based on the norms of civil discourse and make use of sentence stems to guide potentially tense and awkward conversations.

Difficult Intravenous Access In Pediatrics: Improving First Attempt Success Rates, Daisy G. Portier

Master's Projects and Capstones

Abstract

Problem: This project aims to improve the success rate of peripheral intravenous catheter insertion on the first attempt from 50% to 60% with the implementation of the Difficult Intravenous Access (DIVA) clinical assessment and escalation tool, developed by the Queensland Children’s Hospital of Australia.

Context:[LB1] Inserting a peripheral intravenous catheter is the most common invasive procedure during hospitalization. Obtaining vascular access in children may require multiple attempts due to their anatomical variations, smaller caliber veins, and the child's level of anxiety. Up to 69% of first-attempt insertions fail, leading to delays in medical treatment and extended hospitalizations. Early …

The Link Between Fat Soluble Vitamin Deficiencies, Decreased Microbiota Diversity And Severity In Children With Sickle Cell Disease Followed In A Clinic In Omaha Nebraska, Chinenye R. Dike

Theses & Dissertations

Fat soluble vitamin (FSV) deficiencies are associated with worse pain in individuals with sickle cell disease (SCD). Data on the dietary and pancreatic function influence on fat soluble vitamin levels are limited. Additionally, individuals with SCD have gut dysbiosis but there are gaps in knowledge on the impact of this on severity. This thesis attempted to evaluate FSV prevalence and gut microbial profile in our cohort of children with SCD and compare this with matched healthy children and to ascertain if diet or pancreatic function affects these levels and see if these affects sickle cell severity.

The Association Between Physical Pain, Depression, Anxiety, And Nervios Among Latinx Agricultural Workers, Iveth Cuellar Celallos

Doctoral Dissertations

The purpose of this study was to examine the association between physical pain, chronic pain, socio-cultural factors and mental health outcomes such as depression, anxiety, and nervios among Latinx agricultural workers. Survey data were collected in Northern California (N = 104). The sample of Latinx agricultural workers consisted of 47 (45.2%) female and 57 (54.8%) male respondents. The average age of participants was 43.13 years (SD = 14.37). Over half of participants were married (60.6%). The majority of participants (95.2%) reported Mexico as their country of origin. Most (85.6%) participants reported currently working in agriculture. Two hierarchical multiple linear regressions …

African American Female Identified Therapists' Experiences Working Culturally Similar And Dissimilar Populations, Kimiko J. May

Doctoral Dissertations

African-American female-identified individuals continue to be one of the smallest subgroups of licensed therapists. However, this group continues to grow steadily and offer services to a broad array of clientele. While the aims of literature have grown to include populations that have been historically marginalized, the research surrounding African-American female-identified therapists is scarce. Deep understanding of their lived experiences while navigating the multifaceted nature of clinical work has been grossly overlooked. This study aimed to qualitatively analyze the lived experiences of African-American female-identified therapists who work with diverse populations using interpretative phenomenological analysis. Since the nature of clinical work is …

Developing Queer Faith: Exploring Experiences Of Cognitive Dissonance And Identity Integration For Lgbq Catholics Individuals, Kendal M. Vaarwerk

Doctoral Dissertations

While religion may be meeting existential needs, it may, at the same time, be asking the LGBQ youth to be someone different than who they are (Longo et al., 2018). LGBQ individuals experience severe cognitive and emotional consequences because of oppressive religious doctrine, including guilt, shame, self-loathing, and suicidal ideation (Schuck & Liddle, 2001). When LGBQ individuals are involved with religious belief systems that cast rejecting or disapproving messages about LGBQ individuals, these individuals often experience more internalized negative self-messages, as well as more significant challenges in developing and accepting one’s sexual identity (Page et al., 2013). Therefore, this very …

Detection Of Biomarkers For Filoviral Infection With A Silicon Photonic Resonator Platform, Krista Meserve, Abraham J Qavi, M Javad Aman, Hong Vu, Larry Zeitlin, John M Dye, Jeffrey W Froude, Daisy W Leung, Lan Yang, Frederick W Holtsberg, Gaya K Amarasinghe, Ryan C Bailey

2020-Current year OA Pubs

This protocol describes the use of silicon photonic microring resonator sensors for detection of Ebola virus (EBOV) and Sudan virus (SUDV) soluble glycoprotein (sGP). This protocol encompasses biosensor functionalization of silicon microring resonator chips, detection of protein biomarkers in sera, preparing calibration standards for analytical validation, and quantification of the results from these experiments. This protocol is readily adaptable toward other analytes, including cytokines, chemokines, nucleic acids, and viruses. For complete details on the use and execution of this protocol, please refer to Qavi et al. (2022).

Mouse Kidney Nuclear Isolation And Library Preparation For Single-Cell Combinatorial Indexing Rna Sequencing, Haikuo Li, Benjamin D. Humphreys

2020-Current year OA Pubs

Single-cell combinatorial indexing RNA sequencing (sci-RNA-seq3) enables high-throughput single-nucleus transcriptomic profiling of multiple samples in one experiment. Here, we describe an optimized protocol of mouse kidney nuclei isolation and sci-RNA-seq3 library preparation. The use of a dounce tissue homogenizer enables nuclei extraction with high yield. Fixed nuclei are processed for sci-RNA-seq3, and self-loaded transposome Tn5 is used for tagmentation in library generation. The step-by-step protocol allows researchers to generate scalable single-cell transcriptomic data with common laboratory supplies at low cost. For complete details on the use and execution of this protocol, please refer to Li et al. (2022).

A Whole-Genome Sequencing Study Implicates Gramd1b In Multiple Sclerosis Susceptibility, Federica Esposito, Bryan Bollman, Laura Piccio, Et Al.

2020-Current year OA Pubs

While the role of common genetic variants in multiple sclerosis (MS) has been elucidated in large genome-wide association studies, the contribution of rare variants to the disease remains unclear. Herein, a whole-genome sequencing study in four affected and four healthy relatives of a consanguineous Italian family identified a novel missense c.1801T > C (p.S601P) variant in the

De Novo Non-Alcoholic Fatty Liver Disease After Pancreatectomy: A Systematic Review, Parth Shah, Vanisha Patel, Motaz Ashkar

2020-Current year OA Pubs

BACKGROUND: As operative techniques and mortality rates of pancreatectomy have improved, there has been a shift in focus to maintaining and improving the nutritional status of these patients as we continue to learn more about post-operative complications. Although pancreatic endocrine and exocrine insufficiencies are known complications of pancreatectomy, increased longevity of these patients has also led to a higher incidence of

AIM: To identify and summarize patterns and risk factors of post-pancreatectomy

METHODS: We performed a database search on PubMed selecting papers published between 2001 and 2022 in the English language. PubMed was last accessed 1 June 2022.

RESULTS: Various …

The State Of Oral Health In People With Disabilities And The Impact Of Family-Centered Care On The Oral Health Of Children With Special Health Care Needs, Bedant Chakraborty

Theses & Dissertations

Oral diseases are one of the most prevalent non-communicable, chronic diseases of the 21st century. Yet, dental diseases are generally neglected and are a top concern for policymakers globally. The burden of oral diseases disrupts routine activities that affect the overall quality of life, especially for those with special healthcare needs. Dental diseases have also been marked as the “silent epidemic” and are the leading secondary health condition that affects individuals with disabilities. Disabled people are less likely to receive timely and adequate dental care, which could be tied to poor oral health outcomes among them. This group of studies …

Understanding The Perceived Risk And Biopsychosocial Impact Of The Covid-19 Pandemic On People Living With Hiv And Pre-Exposure Prophylaxis Users In Nebraska: A Mixed Methods Approach, Titilola O. Labisi

Theses & Dissertations

The COVID-19 pandemic disrupted HIV care and prevention services. COVID-19 guidelines required physical and social distancing, resulting in movement restrictions and limited healthcare services. People living with HIV (PLWH) may be more vulnerable to the pandemic’s impact due to immune suppression and socioeconomic status than people without HIV. Consistent use of pre-exposure prophylaxis (PrEP), condoms, and regular sexually transmitted infection tests are critical strategies for HIV prevention. The pandemic’s impact on PLWH have not been thoroughly studied, and whether PLWH may be more impacted than PrEP users is inconclusive.

This research aimed to use an explanatory sequential mixed methods design …

Hepatocyte-Hepatic Stellate Cell Axis In Potentiation Of Alcohol And Hiv-Induced Liver Injury, Moses O. New-Aaron

Theses & Dissertations

Human Immunodeficiency Virus (HIV) remains a global threat, with approximately 38.4 million active infections and 33 million HIV-related deaths since the first case. While many may be tempted to think of HIV as a relic of the past, emerging data suggests otherwise. By the end of 2021, approximately 1.5 million HIV incidences and 650 000 mortalities were reported globally. The etiologies of HIV-related mortality are numerous. Liver disease is one of the leading etiologies of HIV-related mortality, especially in recent times of antiretroviral therapy (ART)-induced longevity among people living with HIV (PLWH). While co-infections with hepatotropic viruses notoriously contribute to …

Mental Health Promotion, Early Identification & Treatment Services And Supports In Public K-12 School Districts: Three Case Studies To Explore Available Resources, Interventions, And Community Partnerships, Keenan Krick

Theses & Dissertations

Objective: This study: 1) identifies the multi-tiered efforts public K-12 school districts in a large Midwestern metropolitan area use to support mental health promotion activities and comprehensive mental health services, and 2) compares district efforts to domains defined by the National Center for School Mental Health (NCSMH). Participants: A sample of public K-12 school districts (n=12) in a large Midwestern metropolitan area participated in this study from August 2021 to October 2022. Methods: Using the Multi-Tiered Systems of Support (MTSS) intervention framework, a series of three case studies identify the resources public K-12 school districts utilize to support mental health …