Medicine and Health Sciences Commons^™

Aspirin In The Primary Prevention Of Cardiovascular Disease, Briana Stephanie Murar

Doctor of Medical Science (DMSc)

For decades, people have prophylactically used aspirin (ASA), or acetylsalicylic acid, to mitigate their risk for cardiovascular disease (CVD). The role of ASA as a means of secondary prevention for CVD is well established, however there are conflicting schools of thought as to whether or not it should be used as primary prophylaxis. While this indication has been studied for more than 30-years, questions remain pertaining to the risk of bleeding that is associated with ASA usage, which ranges from mild epistaxis to life threatening hemorrhage.1 Lifestyle and behavioral factors play a large role in a person’s CVD risk, however …

Special Topics In Neuroendocrinology Allopregnanolone: Pathophysiology, Effects On Mood, Emerging Treatments, Sarah Jane Lance

Doctor of Medical Science (DMSc)

KEY POINTS

● Allopregnanolone is a neurosteroid and metabolite of progesterone that has been shown to play a role in mood regulation.

● Low levels and rapid declines in this neurosteroid are associated with mood disorders such as those within the menstrual cycle, postpartum depression, chronic stress, anxiety, post-traumatic stress disorder, and major depression. Studies have also linked it to moodrelated aspects of addiction.

● Medications that increase allopregnanolone, such as serotonin reuptake inhibitors and Brexanolone, are correlated with improved symptoms. These medications represent established and newly developed drugs that increase its level and are currently used for treatments of …

Fertility Considerations In Prescribing Hormonal Contraceptives In Individuals With Polycystic Ovary Syndrome, Andrea M. Reichle

Doctor of Medical Science (DMSc)

Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine disorder and the most common cause of infertility among females of reproductive age.1 While the name “polycystic ovary syndrome” implies people diagnosed with PCOS have numerous cysts on their ovaries, this is not always the case. Clinicians currently use the Rotterdam criteria to diagnose PCOS.2 These criteria include: irregular periods/anovulatory cycles, clinical or biochemical signs of androgen excess (acne, hirsutism, androgenic alopecia, etc.), and numerous ovarian cysts seen on imaging.2 A diagnosis of PCOS can be made when at least two of three criteria are met.2 As this has become a …

Regional Anesthesia Techniques For Total Knee Arthroplasty: Reducing Post-Operative Complications And Improving Rehabilitation And Recovery, Miguel Castaneda

Doctor of Medical Science (DMSc)

Purpose

Total knee arthroplasty (TKA) is one of the most commonly performed procedures in the developed world, with several hundred thousand performed yearly in the United States alone.1 Majority of the patients will experience severe post-operation pain following TKA, limiting early mobilization and slowing the rehabilitation process. 2 Femoral nerve blocks (FNB) are often used for TKA analgesia, but cause a decrease in quadricep strength, increasing the risk of postoperative falls as well as limiting early post-operative mobilization.2 Other nerve blocks, such as femoral triangle block and adductor canal block are thought to preserve quadricep strength aiding in quicker recovery …

Evaluating The Effects Of Cannabis Use On Fertility And Artificial Reproductive Technology, Iridiana Hermenegildo

Doctor of Medical Science (DMSc)

Background: Cannabis is widely used among males and females of reproductive age. A growing body of research suggests the endocannabinoid system is negatively impacted by the use of cannabis affecting many factors required for fertility. Objective: This article aims to evaluate existing literature on trends seen in patients undergoing artificial reproductive therapy (ART) and the effects cannabis has on fertility outcomes, including conception. Methods: This is a systematic review searching PubMed, MEDLINE, and Academic Search Premier databases through August 2022 using keywords derived from three defined concepts. Articles were then evaluated for relevance and included if meeting criteria. Results: …

Evaluating The Role Of The Mediterranean Diet In The Progression Of Heart Failure, Valerie C. Miller

Doctor of Medical Science (DMSc)

INTRODUCTION

The prevalence of heart failure (HF) in the United States has been increasing for years. Many individuals, especially our older population, are ending up hospitalized, causing financial burden and worsened quality of life for our patients. HF is one of the leading causes of hospitalization and death in older adults in the United States.¹ Nearly one million patients are hospitalized due to HF every year and of those, many will be readmitted within a month of discharge.⁵ The American College of Cardiology Foundation/American Heart Association (ACCF/AHA) and Heart Failure Society of America (HFSA) guidelines define HF as “a complex …

A Comparison Of Therapeutic Regimens In The Treatment Of Hypothyroidism, Christina M. Cranley

Doctor of Medical Science (DMSc)

Hypothyroidism is a chronic medical condition that results in the inadequate production of thyroid hormones. Thyroid hormones are essential for the metabolism of almost every organ in the body. The prominent symptoms of hypothyroidism include lack of energy, weight gain, constipation, and intolerance to cold temperatures. Medical therapies aim to replenish thyroid hormones enough to meet the body's metabolic demands. Unfortunately, many individuals experience persistent symptoms despite stable thyroid hormone levels. Current treatment options for hypothyroidism include Levothyroxine, Liothyronine, and Desiccated Thyroid Extract (DTE). Levothyroxine contains synthetic T4 and is the current gold-standard medical therapy in hypothyroid patients. Liothyronine, synthetic …

The Walking Well: Effects Of Hypothalamic Amenorrhea On Athletic Performance, Annalise H. Lau

Doctor of Medical Science (DMSc)

Hormonal balance and normal menstrual cycles are key factors in athletic performance. Unfortunately, female athletes themselves are often under the impression that a lighter weight will improve their performance. Even many healthcare providers do not emphasize or are unaware of the health consequences of prolonged irregular menstruation. The main purpose of this article is to review the health consequences hypothalamic amenorrhea has on female athletes and to provide education for healthcare providers regarding the importance of recovery. A literature search was conducted utilizing PubMed, Scopus, PLOS One and EBSCO. The following keywords were input into the search bar: hypothalamic amenorrhea, …

Cook's "The Asperkid’S Secret Book Of Social Rules:The Handbook Of (Not-So-Obvious) Neurotypical Social Guidelines For Autistic Teens (10th Anniversary Edition)" (Book Review), Amber C. Wessies

The Christian Librarian

No abstract provided.

Perceptions And Utilization Of A Multimedia Teaching Strategy To Prevent Student Nurse Attrition, Lorretta Krautscheid, Pamela Fifer, Rebecca Hernandez, Taryn Blum

Faculty Publications - College of Nursing

Untethered Lecture Capture (ULC) is a teaching method facilitating student classroom engagement while simultaneously creating audiovisual lecture capture (LC) resources. This single-site, convergent parallel mixed-methods study qualitatively described how nursing students with attrition risk factors perceived ULC influenced learning and quantified how such students utilized LC. Study participants (N = 28) reported watching most LC resources (57.1%) and 42.9% watched entire LC videos from start to finish. Qualitative findings produced new evidence about untethered faculty proximity in the classroom and ULC techniques supporting in-class focus and post-class self-paced learning efficiencies. Findings help nurse educators prioritize instructional methods among students with …

The Impact Of Adverse Childhood Experiences On Type 2 Diabetes Mellitus And The Role Of Early Intervention, Alexus S. Yang

Doctor of Medical Science (DMSc)

ABSTRACT

Purpose: The purpose of this article is to provide an understanding of negative health effects of adverse childhood experiences (ACEs) on Type II Diabetes Mellitus and the role of primary healthcare providers in decreasing morbidity and mortality through screening and intervention. Method: A literature search was conducted through PubMed, EBSCO, ProQuest Education and PLOS ONE using keywords such as: adverse childhood experiences (ACEs), type 2 diabetes mellitus, primary care intervention. The most relevant articles were selected with additional selectivity based on the publication year as the basis for this piece.

Results: Currently, minimal information exists on the …

Ketamine Use For Prehospital Status Seizures That Are Refractory To Benzodiazepines, Kyle B. Safko

Doctor of Medical Science (DMSc)

In North America, epilepsy affects between 16 and 51 people 100,000, with the most affected being those with lower socioeconomic status¹. Most ambulance services carry benzodiazepines, but what happens if administration of these drugs do not terminate seizure activity? The American Epilepsy Society concluded that 50% of patients do not respond to benzodiazepines if they have been stable and compliant on typical antiepileptic drugs and they experience a seizure⁷. A literature review was done looking at alternative treatment options for status seizures, specifically ketamine administration. Multiple case reviews, literature reviews and retrospective studies demonstrate the effectiveness …

Interdisciplinary Integration: Linking Differentiated P(Arts) To Create Accessible Dance Experiences, Kate Corby, Mariah M. Lefeber, Mary L. Patterson

Faculty Publications - Graduate School of Counseling

This article introduces Performing Ourselves, an interdisciplinary community dance program that utilizes principles from dance education and dance/movement therapy to serve beginning dancers in grades PK-8 in schools and community centers. After defining the integrative elements of the curriculum, the article outlines how Performing Ourselves used the shift to virtual programming during the COVID-19 pandemic as a means of creating accessible dance opportunities. In addition to the exploration of how one arts organization approached this challenging time, the article offers ideas and further questions for integrative interdisciplinarity in the arts.

Considerations Of Pocus Vs Manual Pulse Check In Predicting Rosc For Patients Presenting In Pea, Steven M. Shockley

Doctor of Medical Science (DMSc)

Background: Point of care ultrasound (PoCUS) has enabled providers to draw a contrast between true PEA (Pulseless Electrical Activity) and pseudo-PEA. The incorporation of PoCUS pulse checks in PEA and pseudo-PEA has been shown to more accurately predict Return of Spontaneous Circulation (ROSC) when compared to standard manual pulse checks. However, concerns have been raised in recent observational studies regarding increased duration of PoCUS pulse checks compared to manual pulse checks leading to suboptimal CPR and subsequent deterioration of ACLS protocol integrity. Objective: This clinical review aims to examine the utility and practical implementation of PoCUS versus manual pulse …

Utilizing Vitamin D Supplementation In Heart Failure, Rachel Alexanian

Doctor of Medical Science (DMSc)

Background: The purpose of this article is to procure a literature review on a relatively new area of research, ultimately aimed at improving the lives of those with heart failure. This article sheds light on the benefits of vitamin D supplementation, and it contributes significantly to the conversation regarding mitigating the complications of heart failure. Herein we aim to offer insight into whether vitamin D supplementation is beneficial for a patient with heart failure.

Method: PubMed, MeSH, and PLOS One literature searches were conducted with the following search terms: heart failure, hospitalization, vitamin D, quality of life, and …

Diet Recommendations For Patients With Irritable Bowel Syndrome, Tia M. Kinilau

Doctor of Medical Science (DMSc)

Introduction

Irritable bowel syndrome (IBS) is a very common chronic functional gastrointestinal (GI) disease that is characterized by abdominal pain in association with defecation and change in bowel habits.1 The condition has a multifactorial and incompletely understood pathophysiology, including altered brain-gut interactions, microbiome changes, differed GI motility, psychological factors, and food hypersensitivity.2 With the heterogenicity of the disorder, there is no standardized treatment for IBS, leading its therapy to rely on symptomatic treatments.2 The influence of dietary triggers on the generation of IBS symptoms is well-known and includes different mechanisms including immune activation, mast cell inflammation, and luminal distention.2 Studies …

Shaul's "The Asd And Me Picture Book: A Visual Guide To Understanding Challenges And Strengths For Children On The Autism Spectrum" (Book Review), Susanah J. Wilson Hanson

The Christian Librarian

No abstract provided.

Determinants Of State Average Life Expectancy, Alex Grimes, Spencer Sprague, Cole Thomas

Student Scholarship - College of Business

In this paper, our dependent variable is average life expectancy by state in the United States. The purpose is to determine which factors have an impact on average life expectancy, as well as the magnitude of these impacts. While other studies have been conducted on life expectancy, our focus is different in a subtle but important way. Rather than centering on individual life expectancy, studying factors like “activity” or “genetics,” we focus on the broader population in a state and which factors affect life expectancy on a macro-scale. There is little known about this topic that isn’t in direct reference …

Commentary On “Infants With Torticollis Who Changed Head Presentation During A Physical Therapy Episode”, Kathryn Knudsen, Ryan Jacobson, Kirsten Pepperling

Faculty Publications - College of Physical Therapy

This article highlights the importance of differential diagnosis in infants with congenital muscular torticollis (CMT), particularly those with atypical presentation or change of side for range-of-motion (ROM) restriction. Per the clinical practice guideline (CPG), patients who change sidedness with CMT should be reevaluated by the physical therapist and referred back to the primary care provider for consideration of other diagnoses.1 This recommendation is important to parents who are seeking accurate information on cause and severity and who want to know that the home exercises being prescribed for their infant are effective

Psychological Factors That Interfere With Provider Use Of Medication Assisted Treatment For Opioid Use Disorder, Courtney Spencer

Doctor of Psychology (PsyD)

Since the implementation of Medication Assisted Treatment (MAT) for treatment of Opioid Use Disorder (OUD), providers have struggled to obtain the necessary waiver (X-waiver) due to required federal applications, training, and guidelines around prescribing. Nevertheless, prescribers have gone through this arduous process to gain their X-waiver, but a unique phenomenon has occurred where some providers with an X-waiver are not utilizing their ability to prescribe MAT. The current study sought to uncover trends in providers prescribing practices while assessing possible factors involved including personality, compassion, compassion fatigue, personal connection, and confidence factors that may be associated with a willingness to …

A Consensus Method For Estimating Physical Activity Levels In Adults Using Accelerometry, Kimberly A. Clevenge, Kelly A. Mackintosh, Melitta A. Mcnarry, Karin A. Pfeiffer, M Benjamin Nelson, Joshua M. Bock, Mary T. Imboden, Leonard A. Kaminsky, Alexander H.K. Montoye

Faculty Publications - Department of Kinesiology

Identifying the best analytical approach for capturing moderate-to-vigorous physical activity (MVPA) using accelerometry is complex but inconsistent approaches employed in research and surveillance limits comparability. We illustrate the use of a consensus method that pools estimates from multiple approaches for characterising MVPA using accelerometry. Participants (n = 30) wore an accelerometer on their right hip during two laboratory visits. Ten individual classification methods estimated minutes of MVPA, including cut-point, two-regression, and machine learning approaches, using open-source count and raw inputs and several epoch lengths. Results were averaged to derive the consensus estimate. Mean MVPA ranged from 33.9–50.4 min across individual …

Improving Interpretation Of The Patient-Reported Outcomes Measurement Information System (Promis) Physical Function Scale For Specific Tasks In Community-Dwelling Older Adults, Jeff Houck, Ryan Jacobson, Michael Bass, Chris Dasilva, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Background and purpose: New generic patient-reported outcomes like the Patient-Reported Outcomes Measurement Information System (PROMIS) are available to physical therapists to assess physical function. However, the interpretation of the PROMIS Physical Function (PF) T-score is abstract because it references the United States average and not specific tasks. The purposes of this study were to (1) determine convergent validity of the PROMIS PF scale with physical performance tests; (2) compare predicted performance test values to normative data; and (3) identify sets of PROMIS PF items similar to performance tests that also scale in increasing difficulty and align with normative data.

Methods: …

Telehealth Assessment Of Frailty In Community Dwelling Older Adults Using The Modified Physical Performance Test (Poster), Sara Duran, Jessica Yeadon, Forest Bingham, Kordell Mcpherson, Elyse Grant, Jaime Ball, Lyndsay Stutzenberger

Faculty Publications - College of Physical Therapy

Frailty in Older Adults

● Frailty is a health condition that effects increasing numbers of the population past the age of 65

● The modified Physical Performance Test (mPPT) is a test that assesses multiple dimensions of physical function with different levels of difficulty. It has been shown to assess frailty in an older adult population.

● Due to health care barriers, it may be advantageous to assess individuals via telehealth.

● It is critical to determine the concurrent validity of telehealth delivery of mPPT with that of a clinical setting to determine if it can increase access to care

Positive Psychosocial Attributes Associated With Parent-Appraised Quality Of Life In Children With Movement Limitations (Poster), Ryan Jacobson, Rebecca Giglio, Carolyn Grimm, Sarah Kotel, Kylie Ronning

Faculty Publications - College of Physical Therapy

No abstract provided.

In Primary Care, Are Health Outcomes Consistent With Physical Therapists Judgement For Musculoskeletal Care? (Poster), Ross Dixon, Sheila Perkins, Brian Schaudt, Josh Thoreson, Kendra Woodson, Jeff Houck

Faculty Publications - College of Physical Therapy

No abstract provided.

Sway-Referenced Haptic Input Improves Static Standing Stability (Poster), Andrew Meszaros, Robin Dorociak, Cameron Hofer, Joshua Todd, Emma Powley

Faculty Publications - College of Physical Therapy

No abstract provided.

Biomechanical Foot Factors, Social Participation, And Self-Participation In Sedentary Versus Non-Sedentary Adults (Poster), Sarah Jones, Amanda Mcconaughey, Kelly Milliken, Lindsey Wallace, Beau Yamamura, Marcey Keefer Hutchison, Jeffrey Houck, Rebecca Dobler

Faculty Publications - College of Physical Therapy

Purpose:

Compare biomechanical foot factors, activity level, satisfaction with participation in social roles, and self-related level of activity between sedentary and non-sedentary adults

Hypotheses:

1. Step count will positively correlate with: Medial longitudinal arch (MLA) recoil, intrinsic and extrinsic muscle strength, muscle CSA, neutral foot posture, satisfaction with participation in social roles, and self-efficacy

2. Step count will negatively correlate with: Plantar fascia thickness. self-reported pain interference, and BMI.

Size-Weight Illusion With A Squatting Task (Poster), Amanda Laron, Maryssa Becker, Mason Flores, Mikaela Raudsepp, Nicole Seidl, Robin Dorociak, Andrew Meszaros

Faculty Publications - College of Physical Therapy

Hypothesis:

The SWI will be observed during a squat movement, resulting in initially a larger GRF through the lower extremity on the side of the larger cube and more vertical displacement of the side of the bar with the large cube.

The bilateral GRF and bar displacement will become symmetrical after 10 repetitions.

Participants will initially predict the larger cube is heavier and after completing the squatting task will perceive the smaller cube as heavier.

What Unique Skills Are Associated With Strong Psychosocial Beliefs In Orthopedic Physical Therapists? (Poster), Jeff Houck, Grace Atherton, Maggie Haworth, Casey Ebelt, Sally Guildehaus, Fred Chang, Chris Hoekstra, Daniel Kang

Faculty Publications - College of Physical Therapy

No abstract provided.

Comparing The Effects Of Vegan Diets Versus Ketogenic Diets On Glycemic Control In Type 2 Diabetes Mellitus, April Mccune

Doctor of Medical Science (DMSc)

Purpose: The purpose of this review is to explore whether plant-based (vegan) diets result in greater reductions in hemoglobin A1c (HbA1c) than high-fat carbohydrate-restricted (ketogenic) diets in adults with type 2 diabetes mellitus.

Search Criteria: PubMed and Cochrane library databases were systematically searched for all relevant studies using MeSH terms (("diet, high fat" AND "diet, carbohydrate restricted") OR "diet, ketogenic" OR "diet, vegan") AND "diabetes mellitus, type 2/therapy". Limiting the research to meta-analyses and systematic reviews narrowed the results to six articles. One systematic review was excluded because it examined the effects of ketogenic diets on the quality …