Medicine and Health Sciences Commons^™

What Alternative Models Are Effective In Improving Health Outcomes In Children With Obesity In The United States?, Kelsey Reineke

Theses and Graduate Projects

Background: Obesity in children has increased at an alarming rate in the past three decades and has been associated with multiple comorbidities. This literature review has been focused on pediatric obesity management research utilizing Family-Based Therapy, community-centered interventions, behavioral modifications, and implementations for management within the Primary Care setting.

Purpose: There has not been an established standard of care for children suffering from obesity. This investigation was focused on the question; What alternative models are effective in improving health outcomes in children with obesity in the United States?

Methods: A comprehensive literature review was conducted using Pub …

Stroke Prevention In Patients With Non-Valvular Atrial Fibrillation: The Watchman Device Versus Warfarin, Emma Delaney

Theses and Graduate Projects

Atrial fibrillation is a common heart arrhythmia that leads to an increased risk of stroke. Warfarin was the original anticoagulant that would be used as the treatment for atrial fibrillation. However, there are people who have contraindications to anticoagulation or are a high fall risk and shouldn’t be on Warfarin. The Watchman Device was originally designed in 2005 as a way to close the left atrial appendage where clots are usually present with atrial fibrillation. The watchman may be a superior way to help reduce the risk of stroke compared to the traditional use of Warfarin. Purpose: Literature review …

Effective Pharmacological And Non-Pharmacological Treatments For Sleep Disturbances And Fatigue In Patients Who Have Experienced A Mild To Severe Traumatic Brain Injury, Mika Muras

Theses and Graduate Projects

Background: In the United States alone, an estimated 1.5 million people sustain a head injury every year.1 With improved recognition of traumatic brain injuries by healthcare providers, the number of patients diagnosed with a traumatic brain injury (TBI) is only increasing. Unfortunately, many patients who sustain a TBI, regardless of the severity, experience sleep disturbances, insomnia, fatigue, and daytime sleepiness.

Purpose: For the purposes of this systematic review, the focus will be primarily on the comparison of nonpharmacological treatments of sleep disturbances or fatigue secondary to a TBI. In addition, the focus will include recent studies on pharmacological …

A Review Of Monoclonal Antibody Regimens In Small Cell Lung Cancer Compared To Chemotherapy Standard Of Care, Rachael St. Clair

Theses and Graduate Projects

Background: Small cell lung cancer (SCLC) is an aggressive neuroendocrine tumor closely linked to tobacco use. Chemotherapy with platinum-etoposide is the current standard of care, with positive initial response rates and subsequently high rates of recurrence and death. Monoclonal antibodies are a therapeutic drug class attempting to block suppression of T cell activation, enabling a stronger immune response.

Purpose: The current predicament in SCLC treatment is determining if monoclonal antibodies have any effect on overall survival. Chemotherapy briefly suppresses SCLC, but given its rapid progression and recurrence, it is necessary to investigate alternative treatments. The following literature review …

Can Exercise Be An Alternative Treatment Option For Depression, Walker Rogers

Theses and Graduate Projects

As most people know, exercise has always been beneficial for our overall health. No matter which exercise program it is, they all provide some sort of benefit. A growing problem has been depression as more and more people are being diagnosed. Since normally, most people would be prescribed SSRIs, I wanted to find out if there were alternative options. I sought to determine if exercise can be an alternative treatment option for depression. A comprehensive literature review was conducted using the websites PubMed, NCBI, Science Direct, & Academic Search Premier and using the search terms depression, anxiety, exercise, yoga, resistance …

Investigating The Relationship Between Mental Health And Co- Morbidity Management During The Covid-19 Pandemic: A Literature Review, Alejandra Soto

Theses and Graduate Projects

Background: The COVID-19 pandemic caused many disruptions to millions of lives, especially with the enforcement of government shutdowns, isolations, and social distancing. These measures lead to increased anxiety and depression in the general population. With many high- risk patient populations having chronic comorbidities, accessing routine medical care and supplies became difficult during the pandemic.

Purpose: How has mental health affected the management of pre-existing comorbidities during the COVID-19 pandemic?

Methods: A comprehensive literature review was conducted using the research engine PubMed using the search terms: “pandemic”, “COVID-19”, “comorbidities”, “mental health”, “morbidity”, and “mortality”. Inclusion criteria were studies …

Thermal Ablation As An Alternative To Standard Breast Conserving Surgery In The Treatment Of Invasive Ductal Carcinoma Of The Elderly, Dani Ducharme

Theses and Graduate Projects

An aging population means an inevitable increase in cancer diagnoses, and thus, a novel solution is needed to address this looming problem. Within the field of breast cancer, thermal ablation has emerged as a promising alternative to surgical excision. As a minimally invasive treatment, it significantly reduces the morbidity and mortality for geriatric patients, as well as healthcare costs overall.

The purpose of this analysis is to understand the utility of thermal ablation for the treatment of invasive ductal carcinoma. Specifically in the context of elderly patients, it is determined if this treatment modality is superior to traditional breast conserving …

Immunotherapy Versus Chemotherapy: Which Treatment Offers Better Survival To Adults With Advanced Melanoma?, Nadeline Abro

Theses and Graduate Projects

Background: Melanoma is the most serious type of skin cancer that can lead to metastasis. The main treatment for melanoma is surgical removal — a wide excision. Patients with advanced melanoma require further treatment such as chemotherapy or immunotherapy due to the concern of continuous spread.

Purpose: Literature review of studies to examine if patients with advanced melanoma, treated with immunotherapy, enjoy better overall survival rates than patients treated with chemotherapy?

Methods: A comprehensive literature review was conducted using using the search terms <(advanced melanoma) AND (immunotherapy)) AND (chemotherapy)) AND (skin cancer)>. Inclusion criteria were studies that were related to immunotherapy and chemotherapy among advanced melanoma patients. Exclusion …

Does Probiotic Supplementation Improve Depression/Anxiety Outcome Measures?, Kathryn M. Decleene

Theses and Graduate Projects

Background: Depression and anxiety continue to be a healthcare burden worldwide. Current depression and anxiety treatments include medications and psychotherapy; however, for many patients this is not enough. Literature has recently come out detailing the gut-brain axis and its potential impact on mental health.

Purpose: This literature review sought to answer the question if probiotics could play a role in the treatment of depression and anxiety. Specifically, does supplementation with a probiotic improve clinical outcome measures of depression, anxiety, or both? Methods: A comprehensive literature review was conducted using PubMed and Google Scholar using the search terms probiotics, …

A Role For Cox Inhibition In The Prevention Of Progression Of Barrett’S Esophagus To Esophageal Adenocarcinoma, John Speakman

Theses and Graduate Projects

Background: Barrett’s esophagus is the most significant predictor of the development of esophageal adenocarcinoma. The current treatment recommendation is a proton pump inhibitor to control acid reflux, yet there remains a significant number of individuals who progress to cancer. More can be done to prevent this progression.

Purpose: To this end, this paper seeks to answer the following PICO question: P: Patients with Barrett’s esophagus not yet esophageal adenocarcinoma; I: Standard PPI treatment with the addition of Aspirin; C: Standard PPI treatment only; O: Prevention of progression of Barrett’s esophagus to esophageal adenocarcinoma.

Methods: A comprehensive literature …

Lower Extremity Risk Assessment In Athletes Following A Traumatic Brain Injury, Carlos D. Villalpando

Theses and Graduate Projects

Background: According to the Centers for Disease Control and Prevention, Concussions are a major health disorder. Continued research regarding the impact of concussions on athletes has led to an increased risk for lower extremity injury across a variety of populations following head trauma. Guidelines from the CDC use a self-reported symptom and cognitive examination for return to play.

Purpose: Current recommended guidelines increase the risk of lower extremity injury due to failure of identifying neurological deficits that persist following a concussion. This literature review aims to identify if athletes diagnosed with a concussion are at an increased risk …

Socioeconomic Determinants Of Antibiotic Resistance, Kausar Jama

Theses and Graduate Projects

Background: Antibiotics were first developed to treat wounded soldiers and cases of pneumonia in World War II. By the 1940s, antibiotics became widely used to treat several infectious processes. It was not long after antibiotics were being used frequently by clinicians that resistant strains began to emerge. Today, antibiotic resistance is a growing global health concern seen in many parts of the world. There are many factors that contribute to the prevalence of antibiotic resistance.

Purpose: This paper aims to demonstrate how socioeconomic factors play a role in the development and spread of antibiotic resistance. The literature review …

Lowering Depression Symptoms In Adults: Exploring Nonpharmacologic/Non-Talk Therapy Based Approaches, Alyssa A. Raiolo

Theses and Graduate Projects

Background: Depression has a high prevalence, affecting more than 300 million people worldwide.1 Antidepressants and talk therapy are the current mainstays for treatment. Given the high prevalence of depression, there is value in the research regarding further treatment options.

Purpose: A literature review of studies exploring additional treatment modalities to lower depression symptoms in adults.

Methods: A comprehensive literature review was conducted using with the search terms <(adults) AND (depression, low mood, mental health) AND (pharmacologic, SSRI, SNRI) OR ( physical activity, fitness, exercise), OR (time outdoors, UV exposure, phototherapy) OR (non-talk therapy)>. Inclusion criteria were studies that were published from 2015 to the present. Exclusion criteria were studies not in English.

Conclusions: Aside from the currently recommended approaches to treating …

Sound And Silence For Patients With Dementia, Jess Porteous

Theses and Graduate Projects

Dementia, a condition that causes cognitive and physical impairments in the aging population, is becoming a global health issue as life expectancy continues to rise. Ineffective and inhumane interventions, such as physical and chemical restraints, are often used in acute hospitalizations due to safety concerns stemming from behavioral and psychological symptoms of dementia. Nurses often feel overwhelmed by the complex needs of patients with dementia and may suffer from moral injury while trying to care for them with limited interventions. Fortunately, integrative therapies such as mindfulness meditation, energy therapies, and sound healing, show promising results for patients with dementia. Resonant …

Dual Antiplatelet Therapy With Ticagrelor Vs Clopidogrel In Patients With Acute Coronary Syndrome, Binh Vu

Theses and Graduate Projects

Background: Dual antiplatelet therapy (DAPT) is an effective secondary prevention and an essential component of treatment after patients suffering from acute coronary syndrome (ACS). Recently, clinicians rapidly switched to DAPT with ticagrelor as the preferred treatment option after it was introduced in 2011. Compared to clopidogrel, ticagrelor is not a prodrug and does not require metabolic activation to inhibit the platelet P2Y12 receptor. It is the first reversible oral P2Y12 receptor antagonist; and its effect on platelet inhibition is more pronounced compared to clopidogrel.

Purpose: The purpose of this comprehensive review was to evaluate the efficacy and safety …

Comparing Efficacy Of Denosumab To Bisphosphonates In Fragility Fractures, Ronald Toledo Cardoso

Theses and Graduate Projects

Background: Osteoporosis is a disease of the bones with decreased bone mineral density and bone mass, leading to poor bone quality/structure, increasing the risk of fragility fractures. Pharmacological treatment is recommended to decrease risk of fractures. Current first line treatment is with bisphosphonates; however, alternative treatment includes denosumab. Both bisphosphonates and denosumab are antiresorptive drugs but differ in mechanism of action. Bisphosphonates remain as first line treatment.

Purpose: The purpose of this literature review is aimed at the PICO question in adults with osteoporosis, what is the efficacy of denosumab compared to bisphosphonates in decreasing the risk of …

3d And Bio-Printing As An Efficient And Safe Alternative To Traditional Methods And Materials In Cardiovascular Diseases, Angela Asare-Ose

Theses and Graduate Projects

Background: Cardiovascular diseases are the leading cause of death globally. Therefore, there is the need for more resources to be poured into the research of more treatment options, diagnostic methods and preventative steps for patients. Though several technological advancements are being made in the world of medicine, it is not a bad idea to look at other avenues that have great potential to improve patient outcomes in cardiovascular diseases. 3D and bioprinting, though a relatively new technology in the world of medicine, is showing a promising future. It is already being applied in the field of orthopedic surgery and …

Impact Of Provider Cultural Competency On Latino/Hispanic Patients During End-Of-Life And Hospice Care, Nicholle Nacionales

Theses and Graduate Projects

Background: Cultural competency in healthcare means delivering high quality care to patients with diverse beliefs, attitudes, values, and behaviors. Latinos/Hispanics are one of the fastest growing ethnic group and with an aging population, there is an increased need for providers to deliver culturally sensitive end-of-life and hospice care. Latino/Hispanic patients face many disparities that affect their quality of care which cultural competency aims to address. Purpose: The purpose of this literature review is to identify factors that affect Latino/Hispanic patient’s end-of-life and hospice care and how cultural competency of providers can influence management of their pain and quality of …

Intermittent Fasting And Reduction Of Cardiovascular Disease Risk, Ethan Dekam

Theses and Graduate Projects

Background: Cardiovascular disease remains one of the leading causes of death worldwide. Intermittent fasting is a unique intervention that is beginning to be studied more extensively for weight loss, positive alterations in serum lipid profile, and improvement of insulin resistance which are all modifiable risk factors for the development of cardiovascular disease.

Purpose: The research question at the center of this literature review is: does the addition of intermittent fasting reduce the risk of developing cardiovascular disease? The reduction of cardiovascular disease was studied through alterations in weight, cholesterol, and diabetic labs.

Methods: A comprehensive literature review …