Digital Commons Network^™

Music Therapy In Traumatic Brain Injury Rehabilitation, Avisha Patel

Academic Festival

Music therapy is, “the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional” (Magee, 2020). Therapeutic interventions are designed to ultimately accomplish clinical goals that aim to meet the patient’s individual health goals as well as to develop a holistic understanding of the patient.

Health Vs Economic Impacts Of Artificial Food Dyes, Sophia Racanelli

Academic Festival

In today’s market, foods containing artificial food dyes are extremely popular. Consumers have been purchasing products with added food dyes at an increasing rate because of how appealing it looks. They have become increasingly normalized as an additive in foods every year. They are extremely hard to avoid since they are found in tons of food items including juices, jellies, jams, condiments, puddings, candy, chewing gum, dairy baked goods and lots more. Because of the large demand for foods with artificial food dyes, companies are generating large amounts of profit from these products. Artificial food dyes are extremely common and …

Opt-Out Mental Health Support Groups: Confronting Ethical And Financial Concerns For Parents Facing Childhood Cancer, Abigail Cofsky

Academic Festival

No parent can ever be adequately prepared for the devastating diagnosis that their child has pediatric cancer. While it is clear this situation would be difficult for anyone, the true prevalence of mental health struggles among parents of this population has not been analyzed in the depth that it should be. Successful professional support groups for caregivers of children diagnosed with pediatric cancer have been shown to improve their quality of life. This essay will identify a needed change in the current advertisement of support groups with aiding information to address possible questions that may arise through various disciplines. All …

Rural Homelessness: The Effect On Children's Academic, Social, And Emotional Development In Schools, Hannah Viele

Academic Festival

There is an astonishing amount of data that highlights both the educational deficiencies, as well as behavioral problems, that are heightened with early elementary students who are experiencing homelessness. Children who experience rural homelessness perform substandardly in academic settings, and therefore need stronger academic, social, and emotional support in schools.

Social Determinants Effecting Health Outcomes Worldwide, Mollie Mcmanus

Academic Festival

Health disparities are problems affecting the health outcomes of populations all around the world. This problem is not unique to the United States, and it affects all nations including those in Latin America and Sub-Saharan Africa. Social determinants of health are health factors influencing an individual’s health outcomes and the health disparities that arise. Rural areas worldwide are significantly affected by varying health outcomes due to poverty levels, lack of transportation, and unique cultural factors. Like the United States rural locations around the world struggle to access health care for a variety of reasons, but this lack of access greatly …

Lack Of Access To Diabetes Technology And Its Effect On Sociological Groups, Allison Benish

Academic Festival

Evolving technologies to help Type 1 Diabetics learn how to live with their condition are out of reach for many due to the price point set on the products by large pharmaceutical organizations, otherwise known as Big Pharma. To explore this, I researched the sociological demographics of youth, low-income patients, and minorities. Through this, I confirmed that minority groups of Non-Hispanic Blacks and American Indians not only had the highest prevalence of Type 1 Diabetes, but they also had the lowest use rates for glucose monitors and insulin pumps. Similarly, the youth prevalence of Type 1 Diabetes is incredibly high …

Effect Of Covid-19 On Child Development, Sydney Colesworthy

Academic Festival

The COVID-19 pandemic has not only had major effects on the economy and society as a whole but also had a vast impact on children and their developmental processes.

Genetic Editing: Technology Ahead Of Its Time, Natalie Champagne

Academic Festival

For my capstone topic I will be writing a bioethics paper discussing the potential uses and social implications of genetic editing. Editing the human genome is a controversial topic spanning across many different circles from the science community to health professionals to the public and religious groups up to international legislation. I will begin by providing background on the process of CRISPER/cas9 which is the technology that makes genetic editing possible. Next it is important to discuss the current uses and potential uses of the technology as well as the legislative response. Currently the laws in place focus primarily on …

Reviewing Resilience - Studying The Link Between Resilience And Children With Speech And Language Disorders, Natalie Untener

Academic Festival

This paper reviews the positive relationship between building resilience and children with speech and language disorders. This paper discusses the importance of building resilience, especially in speech therapy sessions for these children.

The Impact Of Religion And Spirituality On Nursing Compassion Fatigue, Gabriella Catino

Academic Festival

Religion and spirituality have demonstrated connections to positive outcomes for nurses. Religion and spirituality are positively connected to resilience and a proven protective factor against compassion fatigue and nursing burnout. This information should be used to incorporate spirituality and religion into interventions to support nurses and decrease their emotional load.

Follow The Money- Investigating The Influence Of Pharmaceutical Companies On Continuing Medical Education, Jayden Tabor

Academic Festival

Continuing medical education (CME) is an essential component of ongoing professional development for healthcare providers. However, the pharmaceutical industry’s influence on CME has raised concerns about potential conflicts of interest and biased education. Big Pharma’s funding, sponsorship, and marketing practices have significant implications for the content and direction of CME, potentially leading to healthcare providers receiving biased information and prescribing drugs based on commercial interests rather than patient needs. This paper will examine the ways in which the pharmaceutical industry influences CME and the potential consequences of this influence, as well as the measures that medical associations, universities, and healthcare …

The Ethical Implications And Benefits Of Supervised Injection Facilities, Brianna Boone

Academic Festival

Supervised Injection Facilities (SIFs) are a place where individuals who use drugs can go to safely inject drugs. SIFs seek to reduce harm and negative consequences to drug users. They are ethical and provide individuals with autonomy that is lost. Worldwide there are 177 supervised injection facilities. The United States currently has minimal SIFs due to legal constraints.

The Relationship Between Nutrition And The Success Of Learning In American Elementary-Aged Students, Christina Molinelli

Academic Festival

Nutrition is widely understood as an important factor in many health outcomes. However, the impact that nutrition has on learning outcomes is often not considered. Studies have found an identifiable relationship between nutrition and academic achievement in elementary-aged children in American schools. Just as poor nutrition leads to poor health outcomes, poor nutrition also leads to poor academic achievement in ways such that mental development is hindered, cognitive functions are not optimal, test scores are low, and rates of absenteeism are high. With the influence that nutrition has on learning outcomes, studies have also found the importance that eating breakfast …

New, New, New: Uab’S New Repository On A New Platform With A New Librarian, Amy Reese

Southern Miss Institutional Repository Conference

The University of Alabama at Birmingham is launching a new open access repository using the Digital Commons platform. I was hired to make this happen. Starting with nothing, my first question was, so now what? I will discuss the challenges faced with having zero institutional knowledge and having a skill set grown under a very different focus. More generally, I will discuss why repositories are important, especially in an age where everyone Googles first. I would like to explore the lie of ubiquitous information, and the role libraries should be playing in promoting unique local content.

The Impact Of Socioeconomic Factors And Familial Structure On Pediatric Health: An Analysis Of Child Physical And Mental Health Outcomes, Hannah Hunter

Academic Festival

The minds and bodies of children are some of the most impressionable, open to influence from the environment and the actions and ideas of those around them. The ways which children think about themselves and those they may come into contact with can be strongly influenced by the way they are raised, in a rich or poor family, in a small or large one. Both the socioeconomic status and structure of a child's family throughout their upbringing impacts the physical and mental health outcomes of the child. Children of lower socioeconomic statuses, particularly those from low-income backgrounds, minority racial and …

Medical Marijuana Efficacy: Cannabis In Treating Chronic Pain And Inflammation, Erin Keenan

Academic Festival

The ingredients in medical marijuana can act on different receptors to decrease sensitivity to pain and reduce inflammation. However, it's been shown to have negative consequences on the lungs, developing brain, and possible tolerance. There should be certain conditions/ requirements in which medical marijuana can be used.

The Relationship Between Takosubo Cardiomyopathy And Covid-19, Jenna Lee

Academic Festival

Cardiomyopathy is a cardiac disease in which the heart experiences severe swelling of its cardiac muscle. While experiencing a wide range of symptoms, the heart itself has a very difficult time pumping blood into the rest the of the body. There are variants of cardiomyopathy, such as hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic cardiomyopathy, etc. However, the variant of cardiomyopathy being discussed in this paper will be Takosubo Cardiomyopathy (TCM), otherwise known as Stress Induced Cardiomyopathy and or Broken Heart Syndrome. What makes Takosubo cardiomyopathy different is how when a patient is experiencing an episode, it is due to a severe …

Locked Within, Ambrosia Washington

HCA Healthcare Journal of Medicine

In this work, Locked Within, I examine my relationship with Western and alternative medicines, exploring how both areas can provide holistic treatment when used together. Seen here through the medium of photography, my illness relates to common experiences in Western medical care. Through images that consider themes of time, choice, faith, the effects of illness, the medical gaze, and health as a commodity, this series provides commentary on medical experiences and the influence of the American healthcare system.

With a nod toward scientific documentation, this photographic study documents my journey toward health. The element of typology in my work forms …

Adherence Versus Compliance, Tasaduq H. Mir

HCA Healthcare Journal of Medicine

Adherence and compliance are 2 words that are used interchangeably by medical professionals. When we come across a patient who is not taking their medication as advised, we say the patient is non-compliant when the truth is that the patient is non-adherent. Although the terms are used as if they mean the same thing, the 2 words are different in so many ways. In order to understand the difference, it is important to understand the true meaning of these words. According to the literature, “adherence is an active choice of patients to follow through with the prescribed treatment while taking …

Metformin-Associated Lactic Acidosis: A Case Report, Joshua Santoli, Jamie Lee Aldakkour, Hossein Tohidi, Yizhi Lin

HCA Healthcare Journal of Medicine

Introduction

Metformin is considered a first-line therapy for patients with diabetes secondary to its cost efficiency, minimal side effects, and marked improvement in one’s hemoglobin A1c; however, metformin is avoided in patients with renal insufficiency out of concern for drug accumulation and lactic acidosis. In fact, there is a black box warning for metformin, identifying lactic acidosis as the inciting trigger for fatal arrhythmias and death.

Case Presentation

A 62-year-old male presented with multiple episodes of nausea, vomiting, abdominal pain, and decreased urine output for 3 days after working on a roof, all day in the summer heat. He did …

Complete Clearance Of Pustular Psoriasis After A Single Dose Of Risankizumab, Ashleigh E. Hermann, Stephen E. Weis

HCA Healthcare Journal of Medicine

Introduction

Psoriasis is a chronic, multifactorial, inflammatory skin disease with several subtypes, including pustular psoriasis. Pustular psoriasis is characterized by pustules forming lakes of pus on the skin. Pro-inflammatory pathways, such as the interleukin (IL)-17/IL-23 axis, have been shown to play a significant role in the pathogenesis of psoriasis. Biologic therapies directed towards these pro-inflammatory pathways have effectively treated plaque psoriasis, but fewer treatments have shown similar efficacy for pustular psoriasis.

Case Presentation

We present a 45-year-old Black female who presented to the dermatology clinic with generalized pustular psoriasis affecting approximately 70% of her body surface area. She also noted …

Accidental Extravasation Of Mitomycin C Into The Subcutaneous Tissue, Johnathon Chung, Brooke Walterscheid, Jose Lopez-Vera, Hytham Rashid, Mike K. Liang

HCA Healthcare Journal of Medicine

Introduction

Mitomycin C (MMC) is a common chemotherapeutic agent used to treat a variety of solid tumors. Cutaneous adverse events are rare, but MMC is a known vesicant reported to cause tissue necrosis and sloughing, erythema, and ulceration if incorrectly infused into the subcutaneous tissue. Definitive treatment of extravasation injuries due to MMC depends on the severity of the cutaneous manifestation, which includes stopping the infusion, removing the catheter, or possible debridement.

Case Presentation

We present the case of a 70-year-old female with extensive soft-tissue injury secondary to extravasation of MMC that required hospital admission and surgical intervention to remove …

Rapid Hepatomegaly From Ruxolitinib Discontinuation Syndrome, Ryan Jansen Van Rensburg, Shayna Hale, Anna Calara, Kulveer Dabb, Uday Dandamudi, Parth Desai

HCA Healthcare Journal of Medicine

Introduction

Ruxolitinib (RUX) is a Food and Drug Administration-approved Janus Kinase (JAK) inhibitor shown to be effective in improving hypercatabolic symptoms and splenomegaly in patients with myelofibrosis (MF). RUX therapy provides symptomatic benefits for MF patients but is often discontinued for various reasons including worsening cytopenias. Ruxolitinib Discontinuation Syndrome (RDS) involves an acute cytokine-storm rebound phenomenon that can manifest as an acute relapse of symptoms, worsening splenomegaly, respiratory distress, systemic inflammatory response syndrome, or disseminated intravascular coagulopathy.

Case Presentation

We present the case of a patient with JAK2-positive post-polycythemia vera MF, whose RUX therapy was discontinued due to an active …

Death Due To Drug Reaction With Eosinophilia And Systemic Symptoms (Dress) Syndrome: A Case Report, Samantha P. Sternad, Jane Pangburn, Chad Johnston, David Rowe

HCA Healthcare Journal of Medicine

Background

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a life-threatening, multi-organ adverse drug reaction with an incidence of 1 in 1000 to 1 in 10 000 highrisk drug exposures.

Case Presentation

An elderly female presented to the hospital with progressive weakness and a diffuse erythematous macular rash covering most of her body that started 3 days prior. Over the next 3 days, the patient quickly deteriorated, developing disorientation with acute onset left-sided weakness, leukocytosis, thrombocytopenia, eosinophilia, liver and kidney failure, and hypoxia. Clinical and histological changes supported the diagnosis of DRESS syndrome caused by intravenous (IV) ampicillin …

Demonstration Of The Managing For Daily Improvement Quality Improvement Methodology In An Alcohol Withdrawal Protocol Audit, Alex Stephens, Diana Hoot, Amy Cain

HCA Healthcare Journal of Medicine

Background

The Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) is an assessment tool designed to standardize care and minimize the risk of complications in patients experiencing alcohol withdrawal. After discovering an increase in medication errors and late assessments under this protocol, pharmacists at a 218-bed community hospital performed an audit of protocol compliance using a performance improvement methodology known as Managing for Daily Improvement (MDI).

Methods

A daily audit of CIWA-Ar protocol compliance was performed across all hospital units, followed by discussions with frontline nurses regarding barriers to compliance. The daily audit included assessments of appropriate monitoring frequency, medication …

Impact Of Inhaled Epoprostenol In Patients On Covid-19 Acute Respiratory Distress Syndrome (Ards), Stacey Nguyen, Stephen Chromi, Mark Decerbo, Surajit Dey, Joseph Mccoy, Jeffrey Murawsky

HCA Healthcare Journal of Medicine

Background

Coronavirus disease 2019 (COVID-19), a novel respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can progress to critical illness and the development of acute respiratory distress syndrome (ARDS). Variability in clinical presentation has led to 2 distinct theoretical classifications of COVID-19 ARDS based on different phenotypical presentations. The first of which follows closely to traditional ARDS presenting as severe hypoxemia with markedly reduced lung compliance, whereas the second presents as severe hypoxemia with preserved to high lung compliance. With uncertainty surrounding the specific pathological and mechanistic nature of COVID-19, we designed this study to elucidate the …

Operationalizing A Medication Safety Gap Assessment For A Large Health System, Carley Warren, Joan Kramer, L Hayley Burgess

HCA Healthcare Journal of Medicine

Background

Medication errors continue to be a leading cause of medical errors. In the United States alone, 7000 to 9000 people die annually due to a medication error, and many more are harmed. Since 2014, the Institute for Safe Medication Practices (ISMP) has advocated for several best practices in acute care facilities derived from reports of patient harm.

Methods

The medication safety best practices chosen for this assessment were based on the 2020 ISMP Targeted Medication Safety Best Practices (TMSBP) and health system-identified opportunities. Each month, for 9 months, select best practices were covered with associated tools to assess the …

Implementing Auc Monitoring In A Pharmacist-Managed Vancomycin Dosing Protocol: A Retrospective Cohort Study, Brandon L S Robinson, Blake Bennie, Mahmoud Nasiri, Kieu Nguyen, Reba Forbess, Mallory Gessner-Wharton, Cassie Robertson

HCA Healthcare Journal of Medicine

Background

Consensus guidelines on the therapeutic drug monitoring of vancomycin published in 2020 recognize that using the calculated area-under-the-curve (AUC) to guide dosing maximizes clinical efficacy and minimizes risk when compared to traditional trough-based dosing. The purpose of this study was to determine whether AUC monitoring results in reduced acute kidney injury (AKI) rates in adult patients receiving vancomycin for all indications.

Methods

In this study, patients 18 years or older who received pharmacist-managed vancomycin therapy were selected using pharmacy surveillance software from 2 timeframes. Patients were excluded if they received less than 48 hours of therapy or had unstable …

Scheduled Opioid Administration In Hospice Patients Before And After Targeted Caregiver Education, Katherine G. Hood, Eve B. Woodum, Rebeccah J. Collins

HCA Healthcare Journal of Medicine

Background

Hospice and palliative care have been shown to increase patient satisfaction and improve symptom control at the end of life. Opioid analgesics are typically given around the clock at the end of life to maintain symptom control and prevent the need for larger doses later. Many hospice patients have some degree of cognitive impairment, putting them at risk of being undertreated for pain.

Methods

This was a retrospective, quasi-experimental study at a 766-bed community hospital with hospice and palliative care services. Adult patients admitted to inpatient hospice care with active orders for scheduled opioids for at least 12 hours …

A Retrospective Comparison Of The Effectiveness Of Buprenorphine Versus Baclofen For Acute Opioid Withdrawal, Matthew Hermenau, Benton Stamper, Kitty Leung, Raymond Pomm, Christina Guerrier, Joseph Cammilleri, Brittany Johnson

HCA Healthcare Journal of Medicine

Background

A significant impediment to opioid cessation or dose reduction is mitigating withdrawal severity that has been shown to affect the course of opioid dependence. Current guidelines recommend the use of buprenorphine and methadone over alpha-2 adrenergic agonists. Baclofen, a GABA-B agonist, has promising results as an adjunct agent for opioid withdrawal but has not been compared to buprenorphine. This study compared the ability of buprenorphine and baclofen to mitigate acute opioid withdrawal.

Methods

This was a single-center, retrospective chart review of 63 patients with diagnosed opioid use disorder that received scheduled buprenorphine or baclofen for 3 days, in addition …