Medicine and Health Sciences Commons^™

Shifting The Load: Improving Bioscience Performance In Undergraduate Nurses Through Student Focused Learning, Angela Owens, Tracey Moroney

Angela Owens

Applying Osteopathic Principles To Formulate Treatment For Patients With Chronic Pain, Michael Kuchera

Michael Kuchera

Osteopathic manipulative medicine (OMM) is a physician-directed approach to patient care that incorporates diagnostic and therapeutic strategies to address body unity issues, enhance homeostatic mechanisms, and maximize structure-function interrelationships. Osteopathic physicians integrate a thorough medical history with palpatory examination of a patient to ascertain distinctive characteristics and origins of the patient's pain, to evaluate how pain uniquely affects the patient, and to determine whether segmental, reflex, or triggered pain phenomena coexist in the patient. Osteopathic manipulative medicine expands differential diagnoses by allowing the physician to consider somatic dysfunction and implement treatment options via integration of specific aspects of complementary care …

Hysteresis As A Measure Of Ankle Dysfunction, Alissa Cohen, James Mertz, Peggy Stewart, Michael Warner, Michael Kuchera

Michael Kuchera

There is no abstract for this article.

A Comparative Study Of Cervical Hysteresis Characteristics After Various Osteopathic Manipulative Treatment (Omt) Modalities, Precious Barnes, Francisco Laboy, Lauren Noto-Bell, Veronica Ferencz, Jeffrey Nelson, Michael Kuchera

Michael Kuchera

BACKGROUND: Few objective measures have been used to document change in myofascial tissues after OMT.

HYPOTHESIS: Paraspinal tissues associated with cervical somatic dysfunction (SD) will demonstrate quantifiable change in myofascial hysteresis characteristics after a given OMT technique but not after a Sham intervention.

MATERIALS AND METHODS: 240 subjects were palpated for cervical articular SD. A randomly selected intervention (5 OMT techniques or a Sham) was applied to the cervical SD clinically considered to be most severe. A durometer (SA201(®); Sigma Instruments, Cranberry, PA, USA) objectively measured myofascial structures overlying each cervical spinal segment pre- and post- intervention. Using a …

Mortality, Mauling, And Maiming By Vicious Dogs, John Bini, Stephen Cohn, Shirley Acosta, Marilyn Mcfarland, Mark Muir, Joel Michalek

John K. Bini

Objective: Maiming and death due to dog bites are uncommon but preventable tragedies. We postulated that patients admitted to a level I trauma center with dog bites would have severe injuries and that the gravest injuries would be those caused by pit bulls. Design: We reviewed the medical records of patients admitted to our level I trauma center with dog bites during a 15-year period. We determined the demographic characteristics of the patients, their outcomes, and the breed and characteristics of the dogs that caused the injuries. Results: Our Trauma and Emergency Surgery Services treated 228 patients with dog bite …

Osteopathic Evaluation And Manipulative Treatment In Reducing The Morbidity Of Otitis Media: A Pilot Study, Brian Degenhardt, Michael Kuchera

Michael Kuchera

OBJECTIVE: To study the effects of osteopathic manipulative treatment in routine pediatric care for children with recurrent acute otitis media. STUDY DESIGN: Pilot cohort study with 1-year posttreatment follow-up. At follow-up, subjects' parents or legal guardians and their referring and/or family physicians were contacted to determine recurrence of otitis media since intervention. Subjects: A referred and volunteer sample of pediatric patients ranging in age from 7 months to 35 months with a history of recurrent otitis media (N=8). INTERVENTION: For 3 weeks, all subjects received weekly osteopathic structural examinations and osteopathic manipulative treatment. This intervention was performed concurrently with traditional …

Osteopathic Manipulative Medicine Considerations In Patients With Chronic Pain, Michael Kuchera

Michael Kuchera

Osteopathic manipulative medicine (OMM) incorporates diagnostic and therapeutic strategies that address body unity, homeostatic mechanisms, and structure-function interrelationships. In regard to pain, osteopathic physicians take thorough histories guided by palpatory examination to determine the quality, duration, and origin of this condition, how it uniquely affects the individual, and whether segmental, reflex, or triggered pain phenomena coexist. Osteopathic manipulative medicine expands differential diagnoses by considering somatic dysfunction and treatment options by integrating specific aspects of complementary care into state-of-the-art pain management practices. Prescriptions formulated through an OMM algorithm integrate each osteopathic tenet with biopsychosocial and patient education models and medication, rehabilitation, …

Whole-Body Vibration Improves Functional Mobility, Flexibility, And Relative Risk For Falling In The Assisted Living Elderly: A Case Series, Christina Garrity, Harold Merriman, C. Brahler

C. Jayne Brahler

Study design: A randomized double blind repeated measures, case series study of whole body vibration (WBV) in the assisted living elderly.

Background: A single exposure to WBV has been shown to have benefit with respect to muscle activity, strength, balance, and power in some studies while other studies have found no benefit. Its overall effectiveness is unknown due to the conflicting findings reported in the literature.

Case description: Six subjects (5 female, 1 male; mean age = 85.4) in an assisted living community volunteered to participate. Subjects were exposed to a single bout of WBV at 0, 2, 20, and …

Metastatic Brain Tumors: Current Therapeutic Options And Historical Perspective, Mark Rivkin, Richard Kanoff

Mark Rivkin

Metastatic brain tumors affect more than 150,000 patients annually in the United States. The therapeutic paradigms for these tumors have evolved over the years and currently encompass numerous modalities implemented by treating physicians across several medical disciplines. The armamentarium of brain tumor treatment involves neurosurgical intervention, whole-brain and focused radiation modalities, chemotherapy, and immunotherapy. Patient selection, however, remains critical to achieve maximal therapeutic benefit and depends on functional status, number and location of lesions, and tissue histologic findings. Best outcomes can be expected with a multidisciplinary approach to patient care where state-of-the-art treatment options are readily available.

Perioperative Nonopioid Agents For Pain Control In Spinal Surgery., Anna Rivkin, Mark Rivkin

Mark Rivkin

PURPOSE: Commonly used nonopioid analgesic agents that are incorporated into multimodal perioperative pain management protocols in spinal surgery are reviewed. SUMMARY: Spinal procedures constitute perhaps some of most painful surgical interventions, as they often encompass extensive muscle dissection, tissue retraction, and surgical implants, as well as prolonged operative duration. Perioperative nonopioid analgesics frequently used in multimodal protocols include gabapentin, pregabalin, acetaminophen, dexamethasone, ketamine, and nonsteroidal antiinflammatory drugs (NSAIDs). There is evidence to suggest that gabapentin is safe and effective in reducing opioid consumption and pain scores at optimal doses of 600-900 mg orally administered preoperatively. Pregabalin 150-300 mg orally perioperatively …

Middle-Aged Man With Penetrating Trauma To The Pancreaticoduodenal Complex, Thomas Bening, John Bini, Brian Perry, Melanie Richards

John K. Bini

No abstract provided.

Informal Care Vs. Formal Services: Changes In Patterns Of Care Over Time, S Tennstedt, B Harrow, Sybil L. Crawford

Sybil L. Crawford

Longitudinal data from a representative sample of community-residing older persons were used to document changes in patterns and costs of care, both informal and formal. It was found that use of formal services was usually in conjunction with, and secondary to, informal care. Limited availability of informal care as well as increased disability raised the odds of using services. Substitution of formal services for informal care was limited and usually temporary. Total costs of community care, including living expenses, were generally less than the cost of nursing home care.

Injuries And Footwear (Part 1): Athletic Shoe History And Injuries In Relation To Foot Arch Height And Training In Boots, Jospeh Knapik, Rodney Pope, Rob Orr, Tyson Grier

Rodney P Pope

This article traces the history of the athletic shoe, examines whether selecting running shoes based on foot arch height influences injuries, and examines historical data on injury rates when physical training (PT) is performed in boots versus running shoes. In the 1980s and into the 2000s, running shoe companies were advertising specialized shoes with “motion control,” “stability,” and “cushioning,” designed for individuals with low, normal, and high arches, respectively. Despite marketing claims that these shoes would reduce injury rates, coordinated studies in Army, Air Force, and Marine Corps basic training showed that assigning or selecting shoes on this basis had …

Professional Ethics: What You Should Know, Ann Obergfell

Ann M. Obergfell

No abstract provided.

Medical Law, Ann Obergfell

Ann M. Obergfell

No abstract provided.

Promoting Access To Care, Patient–Provider Communication, And Adherence In Underserved Populations, Tammy Toscos, B Doebbeling, P Dechant

Tammy R Toscos

No abstract provided.

Redesigning Healthcare Systems For Improved Access To Care For Underserved Patients, Tammy Toscos, A Turkcan, E Dogar, B Doebbeling

Tammy R Toscos

No abstract provided.

Best Intentions: Health Monitoring Technology And Children, Tammy Toscos, K Connelly, Y Rogers

Tammy R Toscos

No abstract provided.

Patient-Centered Appointment Scheduling Using Agent-Based Simulation, Tammy Toscos, Ayten Turkcan, Brad Doebbeling

Tammy R Toscos

Enhanced access and continuity are key components of patient-centered care. Existing studies show that several interventions such as providing same day appointments, walk-in services, after-hours care, and group appointments, have been used to redesign the healthcare systems for improved access to primary care. However, an intervention focusing on a single component of care delivery (i.e. improving access to acute care) might have a negative impact other components of the system (i.e. reduced continuity of care for chronic patients). Therefore, primary care clinics should consider implementing multiple interventions tailored for their patient population needs. We collected rapid ethnography and observations to …

Incorporating The Proposed New Qsen Competencies Into A Graduate Informatics Course: A Collaborative Experience, Tammy Toscos, B Vottero

Tammy R Toscos

Advance practice nurses are knowledge workers, capable of synthesizing data from health information systems and translating it into knowledge and actions that lead to the provision of safe and high quality patient care. The interdependent relationship between technology and quality issues that exists in the modern healthcare environment has challenged nursing faculty to design curricula that will produce graduates who are not simply competent users of technology, but more importantly, are empowered to become members of interdisciplinary teams responsible for the effective design and implementation health information systems. The Quality and Safety Education in Nursing (QSEN) initiative is addressing the …

Cervical Screening: Assessing Patient Anxiety, Janette Jones

Janette S. Jones

Severe stress reactions in female patients presenting for annual pelvic examination may occur for a variety of reasons, including previous sexual assault, post-traumatic stress disorder, and /or intimate partner violence. The clinician's approach to care delivery is critical for establishing trusting relationships with female patients exhibiting these types of reactions. A case study is used to describe assessment and communication techniques to improve care delivery.

How Substance Abuse Impacts Pain Management In Acute Care, Dawn Dunn, Janette Neuman

Janette S. Jones

Article includes a review of evidence-based interventions useful for assessing and managing pain in patients with histories of substance abuse.

Screening For High-Risk Alcohol Use On Campus - A Translational Research Project, Janette Neuman

Janette S. Jones

High-risk alcohol use occurs on college campuses across the United States. A 2008 Core Alcohol and Drug Survey performed on the campus of Indiana University-Purdue University Fort Wayne (IPFW) in northeast Indiana, found an annual prevalence rate of alcohol consumption by students of 82.3%. A commitment to reduce high-risk alcohol use by IPFW students is supported by IPFW leadership in congruence with Healthy Campus objectives. A translational research project using the Alcohol Use Disorders Identification Test (AUDIT) was implemented at IPFW’s nurse-managed health and wellness clinic in order to increase student awareness of high-risk drinking behaviors, administer risk-reducing interventions, and …

Annual Examination And The Overly Anxious Patient, Janette Jones

Janette S. Jones

Varying degrees of nervousness may be found in patients presenting for gynecologic examination. It is the clinician's role to distinguish typical (expected) anxiety from that which is considered excessive. Extreme stress reactions may occur from a variety of reasons including prior sexual assault, post-traumatic stress disorder, and/or intimate partner violence. Approach to care delivery is critical for establishing a trusting relationship. Case study format will be used to discuss stress-reducing techniques during annual examinations.

Health Care Access For Hoosiers, Janette Neuman

Janette S. Jones

A variety of barriers contribute to delays in accessing health care in Indiana. Medically underserved areas and health professional shortage areas further potentiate barriers creating additional delays. Reduction in barriers to access is critical for promoting optimal health for Hoosiers. Advanced practice nurses may be the answer for reducing access dilemmas by developing nurse-managed health centers and by maintaining active employment in Indiana's Community Health Centers.

Trunk Mobility In The Sagittal And Horizontal Planes: Clinical Methods To Quantify Movement In An Elite Male Surfing Population, James Furness, Mike Climstein, Jeremy Sheppard, Allan Abbott, Wayne Hing

Wayne Hing

Background High numbers of acute shoulder and chronic lumbar injuries have been identified in a surfing population. A simple screening tool could be used to determine whether thoracic spine dysfunction is a possible contributor to shoulder or lumbar injuries. Importantly, thoracic mobility in the sagittal and horizontal planes are key requirements in the sport of surfing; however to date the normal values of these movements have not yet been quantified in a surfing population. Objectives To develop a reliable method to quantify thoracic mobility in the sagittal plane; to assess the reliability of a thoracic rotation method, and quantify thoracic …

Using Surveymonkey® To Teach Safe Social Media Strategies To Medical Students In, Katrina Bramstedt, Ben Ierna, Victoria Woodcroft-Brown

Katrina A. Bramstedt

Social media is a valuable tool in the practice of medicine, but it can also be an area of ‘treacherous waters’ for medical students. Those in their upper years of study are off-site and scattered broadly, undertaking clinical rotations; thus, in-house (university lecture) sessions are impractical. Nonetheless, during these clinical years students are generally high users of social media technology, putting them at risk of harm if they lack appropriate ethical awareness. We created a compulsory session in social media ethics (Doctoring and Social Media) offered in two online modes (narrated PowerPoint file or YouTube video) to fourth- and fifth-year …

Load Carriage: An Integrated Risk Management Approach, Rob Orr, Rodney Pope

Rodney P Pope

Military load carriage (LC) gives rise to substantial risks to soldier health, tactical performance, and mission success. The aim of this article was to extract and synthesize the key findings of a series of LC research reports previously published by the authors. Five reviews and 6 studies were included, with key findings extracted and synthesized in tabulated and critical narrative form. The weight of a soldier's load is a source of risk for soldier's injuries and tactical task performance. The resulting level of risk is influenced by risk modifiers (like speed of march, terrain grade, and task type and duration) …

Optimizing The Physical Training Of Mililtary Trainees, Rob Orr, Rodney Pope

Rodney P Pope

Initial military training is designed to prepare new trainees for the requirements of military service.

The Role Of Parent Partners In Health Education (Pphe) To Enhance Family Medicine Residents' Awareness Of Medical And Social Issues Affecting Children With Developmental Disabilities, Sanjeev Vasishtha

Sanjeev Vasishtha MD

No abstract provided.