Medicine and Health Sciences Commons^™

Analysis Of Intrauterine Device Implementation And Review Of Prevention Strategies To Reduce Adolescent Pregnancy In Nicaragua, Haley Johnson

Theses and Graduate Projects

Adolescent pregnancy is one of the main healthcare issues facing Nicaragua. Prevention strategies are needed to avoid the maternal and fetal outcomes associated with young pregnancies. Extensive literature analysis and face-to-face discussions in Nicaragua were conducted to determine the current incidence of adolescent pregnancy and contraception use, barriers to reproductive health for adolescents, maternal outcomes of adolescent pregnancy, and if intrauterine devices have the potential to be a culturally effective method of contraception. Specific barriers to reproductive health for adolescents were identified to be machismo, societal criticism, lack of reproductive education, fear of infection from IUDs, and underutilization of healthcare …

Drug Therapy Vs. Ablation Therapy For Patients With Atrial Fibrillation, Jessica Ansara

Theses and Graduate Projects

The prevalence of atrial fibrillation is 6.5 percent in the adult population in the United States, in an attempt to treat this patient population, there are numerous options and this study attempts to find the optimal treatment plan that has the least Atrial fibrillation(AF) reoccurrence, best quality of life and is the most effective. This is a Systematic Review comparing catheter ablation therapy vs. drug therapy in treating patients with atrial fibrillation. The search engines used in this analysis include PubMed, UpToDate, Google Scholar and Academic Search Premier. A total of 19 articles were analyzed and data was extracted, and …

The Future Of 5-Fluorouracil Treatment Of Colorectal Cancer: Translating A Better Understanding Into Improved Patient Care, Nathan Smits

Theses and Graduate Projects

5-fluorouracil (5-FU) is a pyrimidine analog that has been successfully employed in anticancer therapy for over forty years. Over the past several decades, researchers have characterized its cellular and clinical pharmacology and uncovered multiple mechanisms of action, which include the inhibition of thymidylate synthase (TS) and incorporation of its metabolites into DNA and RNA. The purpose of this quantitative systemic review was to summarize and evaluate what is known of these mechanisms to determine which are of most significance in the anticancer effects of 5-FU in metastatic colorectal cancer (mCRC) patients. A literature search of peer-reviewed articles dating back to …

Therapeutic Hypothermia For Neonatal Hypoxic Ischemic Encephalopathy: Effects On Neurodevelopmental Outcomes, Claire Rustad

Theses and Graduate Projects

Therapeutic hypothermia is a standardized protocol in the management of term- or near- term neonates who have suffered asphyxia in the perinatal period. Birth asphyxia, if sustained, may develop into a more serious condition known as hypoxic ischemic encephalopathy (HIE). Depending on severity, HIE is associated with adverse cognitive and neurodevelopmental outcomes, yet through various physiological mechanisms, hypothermia sustained for a 72-hour period has been shown to attenuate, or even prevent, permanent brain damage by decreasing cerebral energy demands. Unfortunately, cognitive and neurodevelopmental outcomes are difficult to prognosticate before or after completion of hypothermia protocol, but existing standards and technology …

The Effectiveness Of Video And Other Electronic Media On Dnr/Dni Decisions Within Advance Care Planning, Peter Seebarg

Theses and Graduate Projects

Advance Care Planning is used to ensure patients’ wishes and preferences for treatment are in line with their medical situation. Its use has increased over the past years, but it has been implemented in a piece wise and unorganized fashion. Changes in provider billing capabilities and a recent consensus definition and implementation strategies of Advance Care Planning have created an opportunity to research and explore best use practices. A key feature of Advance Care Planning is creating autonomy for patients’ decisions. Autonomy is especially important for the use of cardiopulmonary resuscitation (CPR) in the event of a medical crisis.

Research …

Are Children Of A Diabetic Mother In Comparison To Children Of A Nondiabetic Mother At An Increased Risk For Developing Obesity In The First 10 Years Of Life?, Chhorn Pho

Theses and Graduate Projects

Body weight, glucose, insulin, and leptin were studied in children of mothers with gestational diabetes, type 1 or type 2 diabetes. Breast milk of diabetic mothers was also analyzed to study its relationship to childhood obesity. In the first 2 years of life, infants of mothers with gestational diabetes have no significant difference in weight gain but by the age of 10, most of the children birthed by any diabetic mothers were either overweight or obese. Children of mothers diagnosed with diabetes mellitus type 2 have higher resistance to insulin than children of mothers with other diabetes types. Leptin was …

Acute Post-Operative Pain Management: Preventing Overuse Of Opioids, Alison Hirsch

Theses and Graduate Projects

Background: Surgical pain management with opioids is common. The use of multimodal analgesia has been proposed in order to provide opioid-sparing regimens and improve pain control post-operatively. Inadequate control of surgical pain can lead to development of chronic pain. Furthermore, studies have linked acute surgical opioid use to increased risk of long-term use. Long-term opioid use has undesirable, life-altering consequences, including physical dependence and addiction which may lead to overdose or death. Use of a variety of medications in the operative setting can lead to synergistic or additive effects on pain control, thus decreasing post-operative opioid consumption.

Methods: A literature …

Among Patients With Endometriosis, Does The Use Of Serum Biomarkers, Versus Laparoscopic Surgery For Diagnosis And Staging Of The Disease Decrease The Incidence Of Disease Related Negative Outcomes, Ellyn C. Hexum

Theses and Graduate Projects

Objective: To determine the ability and efficacy of non-invasive serum biomarker testing as a replacement for laparoscopic surgery in the diagnosis and staging of endometriosis to decrease the incidence of negative disease outcomes, leading to improvement in the accuracy of diagnoses and patient tailored treatment protocols.

Background: Endometriosis is a debilitating inflammatory disease of the reproductive tract. Currently, the gold standard for the diagnosis and staging of endometriosis is exploratory laparoscopic surgery. The use of surgery as the source of achieving a definitive diagnosis holds the potential to increase the incidence of negative disease outcomes. Because of this, the use …

Are Platelet Rich Plasma Injections A Better Choice Compared To Glucocorticoid Injections For The Treatment Of Rotator Cuff Tendinopathy In Adult Patients?, Sawyer Lange

Theses and Graduate Projects

An estimated 16 to 34 percent of the general population will experience shoulder pain at some point in their life. Rotator cuff tendinopathy makes up a large portion of that percentage. Platelet rich plasma (PRP) is an autologous blood product that has supraphsyiologic levels of growth factors and cytokines that have the potential to expedite the tendon healing process. This literature review will look at the current science surrounding PRP and look at studies comparing its efficacy to the commonly used corticosteroid injection.

Does Music Therapy Decrease Agitation In Patients With Dementia?, Clinton Billhorn

Theses and Graduate Projects

Dementia is an encompassing word that includes specific symptoms which alter a patient’s problem-solving ability, decision making capacity, and personality.1 Personality changes, otherwise known as Behavioral and Psychotic Symptoms of Dementia (BPSD) can have negative impacts on caregivers and families. BPSD can include agitation, depression, elation, and hallucinations. Music therapy has been proposed as a non-pharmacologic treatment for BPSD in patients with dementia. This research is intended to identify whether or not music therapy decreases agitation in patients with dementia. Although evidence for efficacy varies, there are no side effects in the literature. Widespread use may provide an increase in …

Do Non-Steroidal Anti-Inflammatory Drugs Increase The Risk For Non- Or Mal-Union Following Acute Fracture? A Literature Review, Bryan Moritz

Theses and Graduate Projects

NSAID medications are among the most commonly used analgesic medications world wide, and it was estimated in 2010 (updated 2015 data is expected to be published next year) that about 29 million adults in the United States regularly used NSAID medications at least three times per week for more than three months. Fracture healing has been shown to be dependent on the inflammatory cascade. NSAID medication use appears to have a mechanistic in-vivo and in-vitro animal risk for the development of non- and mal-union following fracture. However, human data is lacking to support total avoidance of this analgesic option for …

The Impact Of Breastfeeding Interventions On Breastfeeding Behavior, Ryan D. Steele

Theses and Graduate Projects

Breast milk is the natural first food for all infants, and breastfeeding provides multiple benefits for both the mother and child. However, breastfeeding rates in the United States are far from optimal, despite these benefits. There are multiple complex and interrelated reasons for the suboptimal breastfeeding rates, and multiple interventions have been completed with the goal of obtaining optimal breastfeeding rates. This literature review examines the efficacy of these breastfeeding interventions, specifically examining whether antenatal breastfeeding education was associated with increased breastfeeding initiation and duration relative to individualized support. Results of the literature review suggest that a combination of antenatal …

Access And Attitudes Regarding Emergency Contraception And Reproductive Health In Nicaragua, Nadia Commers

Theses and Graduate Projects

Unintended pregnancy affects millions of women across the globe and often leads to an increased risk of health complications and socio-economic stress. In Nicaragua, approximately 1 in 6 births are unplanned, a relatively low number in comparison to the United States. However, the rate of unintended pregnancy is particularly problematic within the adolescent age group of Nicaragua, where 50% of women give birth before age 20 and 45% of those births are unplanned. The annual fertility rate of Nicaragua’s adolescents (109 births per 1,000 15-19- year-olds) is the highest in all of North, Central and South America, where the average …

Analysis Of The Effects Of Music Therapy On Pain And Anxiety Levels In Pediatric Burn Patients, Maria Cook

Theses and Graduate Projects

Burn injuries resulting in tissue damage are considered one of the most severe traumas that can be experienced. Pain and anxiety continue to be major problems for patients with burn injuries during all stages of the treatment. Proper pain management is essential during recovery because it reduces the chance of developing malnutrition and promotes a stronger immune system. A number of studies have explored the effects of music on pain levels before, during, and after medical procedures for burn patients. Few studies have examined the effects of music therapy in the population of pediatric burn patients. Many studies have shown …

In Developing Countries, Does The Implementation Of Basic Cardio-Pulmonary Resuscitation Education In The Community Improve Patient Outcomes?, Ashley Gross

Theses and Graduate Projects

Circulatory shock and cardiovascular diseases contribute to significant mortality globally, with an increased burden in developing countries. The compilation of these studies and anecdotal support gathered while in Nicaragua supports the impact education on high-quality CPR among the community can have on out-of- hospital cardiac arrest patient outcomes. Even though some studies showed guideline-compliant CPR does not improve all patient outcomes, we cannot estimate the time it will take a patient to achieve ROSC. Therefore, educating the public and refining the skills of health care professionals can have a significant positive impact on out-of-hospital cardiac arrest patient outcomes if there …