Medicine and Health Sciences Commons^™

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

Bowel Clean Out Prior To Intrathecal Baclofen Pump Implantation: Effects On Acute Post-Operative Gastrointestinal Complications, Amanda Lindenberg, Sathya Vadivelu, Brittni Walton, Matthew J. Mclaughlin

Research Days

Background: Intrathecal baclofen (ITB) pumps have been used for management of spasticity and dystonia There is limited data on immediate post-operative complications such as GI adverse events after surgery for ITB pump related procedures. This study aimed to compare patients who underwent a pre-operative bowel cleanout to those who did not and the relationship with post-operative nausea, vomiting and constipation requiring an escalation of their bowel regimen.

Design: Retrospective cohort study.

Setting: Pediatric acute care hospital.

Participants: All patients who underwent new ITB pump and/or catheter placement from January 2015-December 2022.

Interventions: Preoperative bowel clean out. Main

Outcome Measure: Quantity …

Emotional Intelligence And Stress Coping Strategies In Health Care Workers., Roxana Traverso Zumaeta, July Patricia Aguirre Mollehuanca, Jesús Enrique Talavera, Juan Carlos Palomino Baldeon

Revista de la Facultad de Medicina Humana

Objective: To determine the relationship between emotional intelligence and stress coping strategies in health care workers of a Third Level of Care Hospital during 2021. Methods: An analytical cross-sectional study was carried out. Two surveys were used: the COPE test which measures how to cope with stress and the Bar-On Emotional Coefficient Inventory which measures the level of emotional intelligence. The main variable was coping with stress. The independent variable was emotional intelligence. Results: A total of 290 health care workers were worked. Emotional intelligence was significantly positively correlated (Pearson = 0.6003) with stress coping. The stress coping strategies with …

A Literature Review Of Current Treatments For The Hypermobility Subtype Of Ehlers-Danlos Syndrome, John Gericke, Mary Zsolway, Chelsea Reyes, Pooja Patel, Saad Ahmed, Julia Hwang, Venkateswar Venkataraman

Rowan-Virtua Research Day

Purpose: The purpose of this study is to compare pharmacologic intervention, neurocognitive therapy, physical therapy, and orthotics in treating the hypermobility subtype of Ehlers-Danlos Syndrome (hEDS) and determine which has the most positive effect on symptoms.

Introduction: Ehlers-Danlos Syndrome is an inheritable connective tissue disorder which results from a genetic mutation that alters the body’s ability to produce collagen. The most common subtype of Ehlers-Danlos Syndrome is hEDS, which leads to hypermobility and hyperextensibility and can cause frequent joint dislocations.

Methods: A review of literature was performed to compare each treatment based on reported results. The types of studies reviewed …

Examining The Differences In Functional Outcomes For Patients With Traumatic Brain Injury After Acute Rehabilitation And Subacute Rehabilitation: A Review Of The Literature, Michael Rangel, Dr. Ashley Kakkanatt

Rowan-Virtua Research Day

BACKGROUND/PURPOSE

Traumatic brain injury (TBI) is one of the major causes of morbidity in the US [1-4]. Studies suggest TBI patients’ enrollment in a rehabilitation program strongly predicts social reintegration. The structure and outcomes of inpatient rehabilitation programs, including acute and subacute rehabilitation, are not well-delineated [5-7].

DESIGN

A structured review of current literature was conducted. Articles were screened using the search string: (post-traumatic brain injury OR post-TBI OR traumatic brain injury OR TBI) AND (acute rehabilitation OR subacute rehabilitation) AND (outcomes OR functional outcomes) NOT (outpatient OR outpatient populations) NOT (pediatric OR pediatric populations). Articles were limited to 1990 …

Brief Review: Regional Anesthesia For Vaso-Occlusive Pain Crises, Oluwatomi Alade

Rowan-Virtua Research Day

Vaso-occlusive pain crisis occurs with obstruction of blood vessels from sickled red blood cells. This results in ischemic injury causing in pain. Acute vasoocclusive pain crisis is one of the most common reasons for patients with sickle cell disease to present to the hospital for medical attention. Acute treatment involves IV opioid therapy, non-opioid therapy, and IV hydration. There is a known lack of trust between a patient in acute pain and a provider in the emergency department (ED) and hospital secondary to stereotypes regarding pain seeking behavior. Here we discuss a case of vasoocclusive pain crisis refractory to opioid …

Standing Posterior Trunk Rotation With Adaptive Proprioceptive Toss, Jennifer Elvir

Electronic Theses and Dissertations

Parkinson’s disease (PD) is a remarkably individualized disease. Nearly every person’s trajectory is unique. One person may experience tremor at an early stage of the disease, while another may experience tremor at a later stage or even not at all. For all PD patients, for certain can expect increasing difficulty as the disease progresses. Parkinson’s disease is responsible for the loss of dopamine which displays itself most notably through motor and cognitive symptom disruption. Although Parkinson’s is a chronic and progressive condition that is irremediable, significant strides have been facilitated to help control and manage the trajectory of the disease. …

New & Current Non-Invasive Occupational Therapy Interventions In Post Stroke Rehabilitation, Cynthia Carr Drot, Ms, Otr/L, Genevieve Marion Ots, Jaclyn Robbins Ots, Gema Solis Ots

Research Days

Occupational therapy practitioners use neuro-rehabilitative interventions to treat patients, post-stroke, across a continuum of care in the United States. New and current evidence-based interventions are being used in a variety of settings to treat patients. The objective of this study was to identify which new and current neuro-rehabilitative interventions approaches were being utilized by occupational therapy practitioners throughout the U.S., in their practice for patients who have experienced stroke. To achieve this a nationwide, anonymous online survey conducted by occupational therapy graduate students was delivered to members of the Illinois Occupational Therapy Association and the American Occupational Therapy Association through …

An Occupational Therapy Approach To Improving Adl/Iadl Performance In Diabetic Adults With Stroke And Upper Extremity Pathologies, Halle Thomas, Cassandra Nelson

Spring 2024 Virtual OTD Capstone Symposium

This capstone presentation depicts the impact of diabetic management with an occupational therapy approach on upper extremity motor function for the adult stroke population. This program utilizes dietary management, a home exercise program, and task modification strategies to improve ADL and IADL performance.

The Impact Of Physique On Strategy And Performance In The 400 M Hurdles Race Among Elite Male Athletes, Janusz Iskra, Subir Gupta, Krzysztof Przednowek, René V. Best, Arkadiusz Stanula

Baltic Journal of Health and Physical Activity

Introduction: the objective of this study was to assess the impact of physique on the stride pattern and performance of elite male 400-m hurdles runners. Materials and Methods: this study is based on the analysis of the performance of 297 male 400-m hurdlers in 13 Olympic games, 16 world championships, and 15 European championships. The hurdlers were divided into 4 groups, based on their height and body mass index (BMI) – taller and heavier (TH), taller and lighter (TL), shorter and heavier (SH), and shorter and lighter (SL). Times taken to complete various phases of the 400-m hurdles race – …

Posteriormedial Ankle Impingement In A Male Division I Ice Hockey Player: A Case Report, Bethany Thompson

UNO Student Research and Creative Activity Fair

The purpose of this case report is to present the case of a 21 year old male Division I collegiate hockey player’s injury during their season, resulting in posteriormedial ankle impingement of the deep posterior tibiotalar ligament, osteochondral lesion of the talus, and tenosynovitis of the tibialis posterior. The patient’s injury did not require surgery; however, they did complete a rehabilitation plan with a physical therapist and receive a cortisone injection. The patient had a positive outcome due to the athletic trainer sending the patient for immediate diagnostic imaging after initial consultation. The patient was able to continue participation in …

Acute Simultaneous Medial And Lateral Ankle Sprain In A Collegiate Football Player: A Case Report, Ian Matlack

UNO Student Research and Creative Activity Fair

The purpose of this case report is to present a twenty-year-old African American male with a complex ankle injury. During a collegiate football game, the athlete injured his left ankle, damaging his deltoid ligament complex, and lateral ankle complex, causing several bone bruises and tearing his peroneal retinaculum. With surgery being declined, standard rehabilitation protocols of POLICE for initial management of inflammation, strengthening, and ROM exercises were conducted. Manual therapies consisting of milking massage, scraping, and joint mobilizations were added to aid in pain and edema control. Comparative case studies suggest that the athlete may have experienced a subluxation of …

Management Of Sepsis With The Quick Sequential Organ Failure Assessment, Jeanna Adams

Providence Nursing Research Conference 2023 – Present

Abstract

Background:

Sepsis can be a source of morbidity and mortality particularly when there are delays in treatment. Early identification may improve time to antimicrobial administration. The quick Sequential Organ Failure Assessment (qSOFA) is an evidence-based practice screening tool that, when in used in conjunction with the Systemic Inflammatory Response Syndrome (SIRS) criteria can enhance recognition and treatment of sepsis. On a suburban Southern California hospital Neurological/Telemetry Unit the qSOFA is automatically calculated in the electronic medical record (EMR) but the bedside nurses were unaware of its availability and value. In addition, sepsis was not being identified in a timely …

Measures Of Function In Physical Therapy Assessment Of Children With Cerebral Palsy: A Clinical Audit, Marvin D. Zotomayor

Philippine Journal of Physical Therapy

Introduction: The assessment of outcomes in children with cerebral palsy (CP) is important for monitoring their progress, evaluating interventions, and guiding health policies. This study aimed to (1) identify the most common outcome measures used in the clinics to assess function in children with CP, and (2) determine whether the outcome measures used in the clinics meet the current standards of assessment for the purpose of improving patient care decisions, research, and quality assurance.

Methodology: A retrospective record audit study design was used to determine if the current practice in the clinics on the assessment of function in children with …

Understanding Decision Making As It Influences Treatment In Thoracolumbar Burst Fractures Without Neurological Deficit: Conceptual Framework And Methodology, Charlotte Dandurand, Cumhur F. Öner, Olesja Hazenbiller, Richard J. Bransford, Klaus Schnake, Alexander R. Vaccaro, Lorin M. Benneker, Emiliano Vialle, Gregory D. Schroeder, Shanmuganathan Rajasekaran, Mohammad El-Skarkawi, Rishi M. Kanna, Mohamed Aly, Martin Holas, Jose A. Canseco, Sander Muijs, Eugen Cezar Popescu, Jin Wee Tee, Gaston Camino-Willhuber, Andrei Fernandes Joaquim, Ory Keynan, Harvinder Singh Chhabra, Sebastian Bigdon, Ulrich Spiegel, Marcel F. Dvorak

Rothman Institute Faculty Papers

STUDY DESIGN: This paper presents a description of a conceptual framework and methodology that is applicable to the manuscripts that comprise this focus issue.

OBJECTIVES: Our goal is to present a conceptual framework which is relied upon to better understand the processes through which surgeons make therapeutic decisions around how to treat thoracolumbar burst fractures (TL) fractures.

METHODS: We will describe the methodology used in the AO Spine TL A3/4 Study prospective observational study and how the radiographs collected for this study were utilized to study the relationships between various variables that factor into surgeon decision making.

RESULTS: With 22 …

Using Of Fragment Specific Plate 2.5 Millimetre In Cases Of Distal Radius Fracture, Ibrahim Ahmed Hussien, Amro Ahmed Fouaad, Ahmed Samy Al-Noamany

Al-Azhar International Medical Journal

Background: Fractures of the distal radius inside the joint are a common injury. Whether caused by high-energy trauma or, more commonly among the elderly and those with osteoporosis, low-energy trauma, these fractures tend to be unstable and require immediate medical attention. The use of external fixators for intra-articular distal radius fractures has been supplanted by the use of internal fixators. Aim and objectives: to examine the radiological and clinical results of treating distal radius fractures that occurred on the dorsum of the individual's right and left arms (dorsal or dorso-radial) using a fragment-specific plate (2.5 mm). Subjects and methods: Hospitals …

Influences Of Athletic Trainers' Return-To-Activity Assessments For Patients With An Ankle Sprain, Ryan S. Mccann, Cailee E. Welch Bacon, Ashley M. B. Suttmiller, Phillip A. Gribble, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context: Athletic trainers (ATs) inconsistently apply rehabilitation-oriented assessments (ROASTs) when deciding return-to-activity readiness for patients with an ankle sprain. Facilitators and barriers that are most influential to ATs' assessment selection remain unknown.

Objective: To examine facilitators of and barriers to ATs' selection of outcome assessments when determining return-to-activity readiness for patients with an ankle sprain.

Design: Cross-sectional study.

Setting: Online survey.

Patients or other participants: We sent an online survey to 10 000 clinically practicing ATs. The survey was accessed by 676 individuals, of whom 574 submitted responses (85% completion rate), and 541 respondents met the inclusion criteria.

Main outcome …

Endoscopic Assisted Management Of Benign Osteolytic Bone Lesions, Ahmed Mohamed Shawky, Mahmoud Seddik Hassan, Amro Ahmed Fouaad Attia, Ahmed Ismail Hammouda

Al-Azhar International Medical Journal

Background: Benign lytic bone lesions have various clinical and histopathological forms, the most frequent lytic lesions are unicameral bone cyst, giant cell tumor, aneurysmal bone cyst, fibrous dysplasia, osteoblastoma and enchondroma, and they are rarely to be symptomatic and usually diagnosed accidentally on imaging. Treatment has wide range from conservative treatment with regular follow up to many surgical interventions without significant established consensus to support any of them. Aim of the work: this study evaluates the outcome of endoscopic assisted management of benign osteolytic bone lesions for 2 year of follow up. Patients and methods: In this prospective, 20 patients …

The Impact Of Telestroke Services On Diagnosis, Patient Outcomes, And Treatment, Dustin Baum

Theses, Dissertations and Capstones

Introduction: In 2011, an estimated 20% of U.S. residents lacked timely access to stroke care. As of 2019, that number plummeted to 4% of patients. A reason for this improved access was the implementation of telestroke services. Telestroke services have utilized remote stroke specialists to help guide local emergency department physicians in reviewing imaging, diagnosing, treating, or transferring patients appropriately.

Purpose: The purpose of this research was to analyze the impact of telestroke implementation in the hospital setting. The study hypothesized the implementation of telestroke services in the hospital setting maintained an accurate stroke diagnosis, decreased inappropriate hospital transfers, reduced …

Utilizing Ai Integrated Neuroimaging Technology To Expand Upon Machine Learning In Positron Emission Tomography Technology With The Aim Of Detecting Amyloid Beta Biomarkers Early In The Onset Of Alzheimer's., Ethan S. Terman

Undergraduate Research Posters

Early intervention in Alzheimer's is vital for treatment. The earlier a professional can detect symptoms and make a diagnosis the earlier a prognosis can be implemented. With the prevalence of data in our day-to-day world combined with Artificial intelligence (AI), utilizing both for machine learning can pave the way for more accurate and efficient detection of Alzheimer's and other neurodegenerative diseases. AI combined with Machine learning (ML) increases diagnostic efficiency and reduces human errors, making it a valuable resource for physicians and clinicians alike. With the increasing amount of data processing and image interpretation required, the ability to use AI …

Feasibility And Safety Of Early Post-Covid-19 High-Intensity Gait Training: A Pilot Study, Joakim Halvorsen, Christopher Henderson, Wendy Romney, Magnus Hågå, Tonje Barkenæs Eggen, Jan Egil Nordvik, Ingvild Rosseland, Jennifer Moore

Physical Therapy Faculty Publications

Background: The feasibility and safety of rehabilitation interventions for individuals recovering from COVID-19 after the acute stage is not well understood. This pilot study aims to provide a preliminary investigation of the feasibility and safety of providing high-intensity gait training (HIT) with a targeted cardiovascular intensity of 70–85% of the age-predicted maximum heart rate (HRmax) for individuals undergoing rehabilitation post-COVID-19. Methods: Consecutive patients who were medically cleared for HIT were invited to participate in the study. Participants practiced walking in varied contexts (treadmill, overground, and stairs), aiming to spend as much time as possible within their target cardiovascular intensity zone …

The Effectiveness Of Resistance Exercises Performed On Stable And Unstable Surfaces In Relation To Torso Activation, Radim Jebavy, Dusan Blazek, Helena Vomackova, Jan Vavra, Jan Busta, Anna Pisz, Petr Stastny

Baltic Journal of Health and Physical Activity

Introduction: Deep stabilization system (DSS) strength and endurance are crucial for injury prevention and athletic performance. Training surfaces can influence training outcomes; therefore, this study aimed to compare the impact of performing strength trunk exercises on unstable and stable surfaces with conventional trunk exercises. Materials and Methods: DSS and trunk stability were assessed before and after 10 weeks of three different training interventions among twenty elite futsal players. Each intervention included 25 strength training sessions. Pre- and post-tests encompassed various measurements, including diaphragm, trunk flexion, trunk back extension, hip flexion, intraabdominal pressure, side plank, pronation, and supination tests. Results: Conventional …

The Importance Of Multidisciplinary Approach In Management Of Pressure Injury In Elderly With Multiple Comorbidities, Dina Kusumawardhani, Shannaz Nadia Yusharyahya, Lili Legiawati, Rinadewi Astriningrum, Kara Adistri

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Pressure injury (PI) can occur as a result of prolonged bed rest in immobilized patients. The healing process is often slow if the wounds are not managed comprehensively, particularly in elderly patients or patients with neurological disorder, diabetes mellitus, and malnutrition. Proper treatment can improve the healing process.

Case illustration: A 66-year-old female with multiple comorbidities presented with PI on the left lower back, as well as the sacral and right gluteal regions. She was diagnosed with grade 3 and unstageable PI, and was treated using a multidisciplinary approach. Her wounds were treated with a combination of …

Decreasing Surgical Complications In Diabetic Patients, Bandana Mahato

DNP Qualifying Manuscripts

Executive Summary

Objective: This manuscript aims to determine if controlling diabetes prior to undergoing low back surgery could decrease complications and disability.

Contexts: Despite the overwhelming information on the complications of uncontrolled diabetes, patients continue to have elevated HgA1C before having surgery. Furthermore, there is a plethora of data showing uncontrolled diabetic patients will have higher complications after surgery, yet patients continue to have elective surgery despite having unchecked diabetes. There are no clear guidelines for primary care providers or surgeons on when they should allow patients to have elective surgery. Therefore, it is vital that HgA1c needs to be …

"My Gut Feeling Is…": An Ethnographic Study Exploring Interprofessional Communication About Children And Adolescents With Chronic Musculoskeletal Pain In Paediatric Rheumatology., Rebecca R. Lee, Janet E. Mcdonagh, Tim Rapley, Albert Farre, Mark Connelly, Tonya M. Palermo, Karine Toupin-April, Emily Wakefield, Sarah Peters, Lis Cordingley

Manuscripts, Articles, Book Chapters and Other Papers

Interprofessional communication about inflammatory and non-inflammatory musculoskeletal conditions is an important component of assessment and management in paediatric rheumatology. Chronic pain is a feature of some of these conditions which likely influences the extent and type of communication about pain. Research investigating interprofessional communication about paediatric pain is limited but has found that communication is inclusive of the biopsychosocial context of children/adolescents as well as their families. The aim of this ethnographic study was to explore interprofessional communication about children and adolescents with chronic musculoskeletal pain in paediatric rheumatology. We observed forty-five healthcare professionals recruited from 3 UK paediatric rheumatology …

Human Parechovirus Central Nervous System Infection In A Young Infant Cohort, Aspasia Katragkou, Avni Sheth, Christina Gagliardo, Jessica Aquino, Niva Shah, Eberechi Nwaobasi-Iwuh, Christina Melchionne, Paige Black, Stephanie Chiu, Cecilia Di Pentima

Department of Pediatrics Faculty Papers

In 2022, a surge in cases of pediatric human parechovirus (HPeV) central nervous system infections in young infants was seen at our institution. Despite the dramatic increase in the number of cases seen that year, the clinical features of the illness were similar to prior years. The recent pediatric HPeV surge highlights the need to evaluate treatment options and standardize follow-up to better understand the long-term prognosis of infants with HPeV infection.

Physical Activity, Anthropometric Measurements, Quality Of Life And Menopausal Symptoms Among South-Indian Women, Lavanya N, Sathyaprabha B

Journal Articles

INTRODUCTION: Menopause is the period when the reproductive capacity ceases in women's life. A wide range of symptoms occur as a consequence of estrogen decrease during menopause. Evidence suggests that physically active women have a better quality of life (QoL) and fewer menopausal symptoms. The aim of the study was to analyze the relationship between physical activity (PA), anthropometric measurements, QoL and menopausal symptoms.

MATERIAL AND METHOD: A cross-sectional study was conducted online through WhatsApp and Facebook and via email among menopausal women (April 2021 - June 2021). In total 168 responses were received; 153 responses were included in the …

Barriers To The Diagnosis, Care, And Management Of Pediatric Patients With Ehlers-Danlos Syndrome In The United States: A Qualitative Analysis., William R. Black, Lora L. Black, Jordan T. Jones

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: Ehlers-Danlos Syndromes (EDS) are a family of heritable connective tissue diseases. Primary practitioners are capable of diagnosing and managing EDS; however, few are knowledgeable and comfortable enough to see patients with EDS, resulting in delays in diagnosis and care. This study explores the barriers physicians experience with diagnosing, managing, and caring for patients with EDS, and potential resolutions to those barriers. Methods: As part of a larger online study, providers (n = 107) in the United States were asked to specify "What information would improve (their) comfort" in diagnosing, caring for, and managing EDS via open-ended questions. Results …

Evaluating The Efficacy Of Chatgpt In Navigating The Spanish Medical Residency Entrance Examination (Mir): Promising Horizons For Ai In Clinical Medicine., Francisco Guillen-Grima, Sara Guillen-Aguinaga, Laura Guillen-Aguinaga, Rosa Alas-Brun, Luc Onambele, Wilfrido Ortega, Rocio Montejo, Enrique Aguinaga-Ontoso, Paul Barach, Ines Aguinaga-Ontoso

Department of Medicine Faculty Papers

UNLABELLED: The rapid progress in artificial intelligence, machine learning, and natural language processing has led to increasingly sophisticated large language models (LLMs) for use in healthcare. This study assesses the performance of two LLMs, the GPT-3.5 and GPT-4 models, in passing the MIR medical examination for access to medical specialist training in Spain. Our objectives included gauging the model's overall performance, analyzing discrepancies across different medical specialties, discerning between theoretical and practical questions, estimating error proportions, and assessing the hypothetical severity of errors committed by a physician.

MATERIAL AND METHODS: We studied the 2022 Spanish MIR examination results after excluding …

Acute Hepatic Porphyrias: Recommendations For Diagnosis And Management With Real-World Examples, Akshata Moghe, Amy Dickey, Angelika Erwin, Rebecca K. Leaf, Alan O'Brien, John G. Quigley, Manish Thapar, Karl E. Anderson

Division of Gastroenterology and Hepatology Faculty Papers

Acute hepatic porphyria (AHP) is a group of four rare inherited diseases, each resulting from a deficiency in a distinct enzyme in the heme biosynthetic pathway. Characterized by acute neurovisceral symptoms that may mimic other medical and psychiatric conditions, lack of recognition of the disease often leads to a delay in diagnosis and initiation of effective treatment. Biochemical testing for pathway intermediates that accumulate when the disease is active forms the basis for screening and establishing a diagnosis. Subsequent genetic analysis identifies the pathogenic variant, supporting screening of family members and genetic counseling. Management of AHP involves avoidance of known …