Medicine and Health Sciences Commons^™

Heparin Induced Thrombocytopenia (Hit), Tanya Yatskiv

Doctor of Medical Science (DMSc)

Introduction:

Heparin was first discovered in 1915 and is still widely used to this day.1 In 1958 however, it was noted that a small percentage of recipients of heparin develop antibodies to the drug which cause a mild to moderate thrombocytopenia and can progress the patient into a severe prothrombotic state.2 The prothrombotic state can be detrimental due to venous and arterial thromboembolisms that lead to life and limb-threatening manifestations. The mechanism of the thrombocytopenia and immune reaction was not identified until 1973.2 The adverse drug effect is induced by platelet-activating antibodies against platelet factor 4 (PF4) and heparin.3 These …

Meta-Analysis Of The Rate Of Unplanned Pregnancies In Rural Areas Of The United States And The Use Of Technology-Based Sexual Education Programs, Hannah Audiss

Doctor of Medical Science (DMSc)

Objective

To discuss rural-urban disparities of adolescent unplanned pregnancies and sexual education availability. The potential of virtual sexual education programs are discussed by examining two studies that have used technology-based interventions to assess variables related to pregnancy prevention.

Data Sources

A review was conducted by gathering randomized controlled trials and systematic reviews utilizing databases such as ScienceDirect, PubMed and Wiley Online Library. Research articles included in this paper were from 1995 to present day and are inclusive of all races.

Study Eligibility Criteria

Studies were included if the interventions worked with young adolescents ages 13-24 year old, utilized technology-based interventions …

The Association Between Prenatal Acetaminophen Use And Adhd Development In Childhood, Jocelyne Blanco

Doctor of Medical Science (DMSc)

Background: The purpose of this article is to produce a review of the literature on a recently growing topic of interest. We believe the widespread use of acetaminophen in pregnancy makes the rising concern for acetaminophen use in pregnancy and the development of childhood attention deficit hyperactivity disorder (ADHD) a national public health matter. The mechanism of action of acetaminophen, the pathophysiology of drug transfer through the placental barrier, and the most up-to-date research studies were analyzed with the goal of bringing clarity and promoting healthy pregnancies for all.

Methods: PubMed, PLOS One, and Google Scholar served as the cornerstone …

Thoughtful Integration Of Active Learning Teaching Strategies Into Physician Assistant Education, Daniel Berger

Doctor of Medical Science (DMSc)

Introduction:

The future of healthcare relies upon how we train student clinicians. It is integral to continually reevaluate our methodologies of teaching and work to better approach the challenging task of educating competent and compassionate physician assistants in a short two-to-three-year window. While the traditional modality of teaching has been primarily lecture-based, there has been a growing movement to incorporate active learning into medical education. This learner-driven model puts students in the driver’s seat and allows for greater amounts of self-directed learning prior to class followed by the reinforcement of concepts during class time. Though lecture-based teaching could be the …

The Role Of Self-Sampling For Hpv In The Primary Prevention Of Cervical Cancer, Divya Patel

Doctor of Medical Science (DMSc)

Introduction:

Cervical cancer is a striking women's health problem worldwide. It is the fourth most common cancer in women and the seventh most common cancer worldwide1. There were roughly 604,000 new cases of cervical cancer and 342,000 deaths in 20202. Most of these cases occur in developing countries due to ineffective screening initiatives2. Screening essentially allows pre-cancerous lesions to be identified at stages where they can easily be treated; screening methods include cytology and HPV testing (Human Papillomavirus)1. HPV has over 100 strains and is one of the most common risk factors for cervical cancer. HPV testing is more sensitive …

Lipoprotein(A): Review Of Existing Guidelines And Application For Practicing Clinicians, Daniella Manarang

Doctor of Medical Science (DMSc)

Purpose A growing amount of research has constituted lipoprotein(a) as an independent risk factor for cardiovascular disease. The main objective of this review is to summarize the current guidelines for testing and managing Lp(a) and provide guidance to clinicians on how to practically utilize Lp(a) with what is known today. Methods: EBSCO, PubMed, and Ovid were searched for this review. Search terms included lipoprotein(a), clinical practice, guidelines, screening, and cardiovascular disease. Sources within ten years were obtained to cover recent material. Results: The current literature on the association between Lp(a) and CVD outcomes and up-to-date guidelines on testing and management …

Early Management Of Nutritional Deficiencies To Reduce Musculoskeletal Disabilities Of Pediatric Populations In Africa, Kristin Freitas

Doctor of Medical Science (DMSc)

An estimated 1.3 billion individuals live with disabilities across the world, however many of these impairments are developed throughout childhood and could be prevented or treated with prompt and early intervention. In Africa, nutritional deficiencies are a common reason for disability in pediatric populations, often due to a limited supply of resources and diets high in grains and beans. This results in the development of genu varum and valgum deformities, which are most commonly caused by rickets attributed to calcium deficiencies in these areas. The children often go untreated, evidently causing musculoskeletal disabilities and further complications of osteomalacia or fractures …

The Role Of Niacinamide In Skin Cancer Risk Reduction, Britny Ruilova Tellez

Doctor of Medical Science (DMSc)

The contents of this article are the author’s original unpublished findings.

Background: Each year, approximately 6 million Americans are treated for skin cancer, resulting in a total annual medical expense of $8.9 billion 1. The two most common types of skin cancer are basal cell carcinoma (BCC) followed by squamous cell carcinoma (SCC)2. The metastatic potential of these cancers is minimal; however, their treatment may involve severe scarring and disfigurement2. In contrast, melanoma is an aggressive skin malignancy that grows rapidly and can metastasize in a quick manner2. Risk factors of these skin cancers include UV exposure, fair skin complexions, …

Review Of "The #Actuallyautistic Guide To Advocacy: Step-By- Step Advice On How To Ally And Speak Up With Autistic People And The Autism Community", Jennifer M. Brady

The Christian Librarian

No abstract provided.

Sodium-Glucose Cotransporter 2 Inhibitor (Sglt2-I) In The Prevention Of Diabetic Kidney Disease Progression, And Its Role As An Antihypertensive Agent In The African American Population, Aran Michael G. Manalang

Doctor of Medical Science (DMSc)

Introduction:

Needs Assessment:

Originally used as antidiabetic medications, later clinical trial data showed beneficial effects in reducing the onset and progression of renal complications in people with and without diabetes. 13 Randomized clinical trials and ‘real world’ observational studies involving mostly type 2 diabetes patients showed that SGLT2-i can slow the decline in glomerular filtration rate (GFR), and reduce the onset of microalbuminuria and slow or even reverse the progression of proteinuria.13 Additionally, with diabetes being one of the many chronic conditions still primarily managed by primary care providers (PCP), it falls upon these professionals to have the knowledge and …

Review Of The Literature: Analysis Of The Effectiveness Of Mobile Integrated Health - Community Paramedicine Programs In Reducing Pre-Hospital Ems Calls And Transportations, Annika N. Schultz

Doctor of Medical Science (DMSc)

Pre-hospital Emergency Medical Service (EMS) systems, including fire departments and ambulance transport services, are increasingly overburdened with high call volumes and unnecessary utilization of services leading to provider burnout, depletion of resources and rising healthcare costs. Many local EMS systems have recognized a need for a more sustainable solution to help reduce the number of unnecessary 9-1-1 calls and transportation to the Emergency Department (ED). Local agencies are beginning to expand the role and scope of practice for paramedics through programs referred to as Mobile Integrated Health – Community Paramedicine (MIH-CP). This new branch of medicine aims to provide patient-centered …

The Role Of Pharmacogenetics On Breast Cancer Treatment Efficacy And Toxicity, Noor Alani

Doctor of Medical Science (DMSc)

Purpose: This research article aims to shed light on the pivotal role of pharmacogenetics in breast cancer treatment by examining genetic variations that influence the efficacy and toxicity of commonly used drugs. Furthermore, this study highlights the significance of personalized treatment approaches in optimizing patient outcomes.

Method: A comprehensive literature search was conducted using databases such as PubMed. Search terms included "pharmacogenetics," "breast cancer treatment," "genetic markers," and "adverse effects." This review critically analyzes relevant studies that focus on the impact of genetic variations on the response to drugs used in breast cancer treatment.

Results: The review …

Emerging Evidence For Diagnosis And Treatment Of Wake Up Stroke Patients, Asa Di Carlo

Doctor of Medical Science (DMSc)

Strokes are the leading cause of permanent disability and the second leading singular cause of death in more developed countries.3 Over 13 million individuals worldwide suffer strokes annually, 1 with the vast majority of these being from an ischemic event. Out of these, 20-25% actually occur in individuals who wake up with stroke symptoms, which historically has been considered outside of the time window for treatment.2,3 Previous guidelines indicate that in patients with acute ischemic strokes IV thrombolytic therapy should be administered within 4.5 hours for symptom onset, and is not recommended in patients with an unknown time of symptom …

Discussion Of The Risks And Benefits Of Intensive Blood Pressure Control In The Elderly, Kennedy Emerson

Doctor of Medical Science (DMSc)

PURPOSE:

The primary purpose of this paper is to review the current available evidence on benefits and risks of intensive blood pressure control (< 120 mmHg systolic) in the greater than 75-year-old population. The secondary purpose will focus on discussion of general recommendations for blood pressure treatment in non-diabetics in this population.

METHOD:

A PubMed and NEJM literature search was directed towards search terms: hypertension, intensive, standard, older, and elderly, as well as search terms surrounding risk: adverse event, fall, fracture, syncope, AKI, and mortality. Fourteen articles are used for the basis of this paper, six of which are large scale RCTs.

RESULTS:

Though there has been a general lack of consensus on appropriate hypertensive management in the elderly, data has increasingly shown that lower blood pressure goals …

Measurement And Assessment Of Grief In A Large International Sample, C. Killikelly, A. Kagialis, S. Henneman, H. Coronado, D. Demanarig, H. Farahani, A.A. Ozdo ̈ Gru, B. Yalçın, A. Yockey, C.L. Gosnell, F. Jia, M. Maisel, E. Stelzer, D. Wilson, J. Anderson, K. Charlesj, J.P. Cummings, C. Faasl, B. Knapp, B. Koneczny, Chris Koch, L.M. Bauer, C. Cuccolo, J.E. Edlund, G.F. Heermanss, S. Mcgillivray, C. Shane-Simpson, A. Staples, Z. Zheng, M.S. Zlokovich, M.S. Irgens

Faculty Publications - Psychology Department

Background: In 2022, the International Classification of Diseases (ICD-11) and an update of the Diagnostic Sta- tistical Manual of Mental Disorders (DSM 5 TR) were released for implementation worldwide and now include the new Prolonged Grief Disorder (PGD). The newest definition of PGD is based on robust clinical research from the Global North yet until now has not been tested for global applicability. Methods: The current study assesses the new PGD ICD-11 criteria in a large international sample of 1393 bereaved adults. The majority of the sample was included from the USА. Additionally, we conduct a sub-sample analysis to evaluate …

Impacts Of Stigma On Female Service Members, Alisha Weatherly-Kershaw

Doctor of Psychology (PsyD)

There are a variety of factors that prevent people from seeking mental health treatment. The stigma associated with mental health disorders or seeking treatment is a primary deterrent. This stigma is particularly impactful within the armed forces when they are assessed for fitness for duty. Because most research examines stigma’s impact on male military members, this study aims to identify the type of stigma that creates the most significant barrier to female service members seeking mental health treatment. Results indicate that stigmatizing perceptions of service members significantly impact female service members holding negative views towards seeking treatment.

It's Time To (Again) Recognize The Considerable Clinical And Public Health Significance Of Cardiorespiratory Fitness, Leonard A. Kaminsky, Mary T. Imboden, Cemal Ozemek

Faculty Publications - Department of Kinesiology

In this issue of the Journal of the American College of Cardiology, Kokkinos et al5 studied the relationship of both a single CRF value, and change in CRF, with all-cause mortality in a large (n 1⁄4 93,060) sample from the ETHOS (Exercise Testing and Health Outcomes Study) cohort. In this cohort, CRF was estimated as the peak metabolic equivalents (METs) derived from the peak speed and grade obtained on a treadmill exercise test. The findings from the single measure of CRF showed, compared with the low-CRF group (w5 METs), reductions in mortality rate across each higher-CRF group in both those …

Cardiorespiratory Fitness As A Vital Sign Of Cvd Risk In The Covid-19 Era, Matthew P. Harber, James E. Peterman, Mary Imboden, Leonard Kaminsky, Ruth E.M. Ashton, Ross Arena, Mark A. Faghy

Faculty Publications - Department of Kinesiology

The severe health consequences of the corona virus disease 2019 (COVID-19) pandemic have been exacerbated by the prevalence of cardiovascular disease (CVD) risk factors, such as physical inactivity, obesity, hypertension, and diabetes. Further, policy decisions during the pandemic augmented unhealthy lifestyle behaviors and health inequalities, likely increasing the global disease burden. Cardiorespiratory fitness (CRF) is a well-established biomarker associated with CVD risk. Emerging data demonstrate that high CRF offers some protection against severe outcomes from COVID-19 infection, highlighting the importance of CRF for population health and the potential for limiting the severity of future pandemics. CRF is best assessed by …

Muscle Fascicle Length Changes Of The Long Head Of Biceps Femoris Muscle During Various Physical Activities, Rusty Batykefer, Austin Hardin, Kyla Gomes, Octavio Tan, Bryce Yamashita, Alwin Sacro, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

We predict that the muscle fascicles of the biceps femoris long head will behave similarly to the ankle plantar flexors in that they will undergo smaller length changes during dynamic activities (running, walking) and greater changes during static activities (single leg Romanian deadlift, standing hamstring curl).

Effects Of Context Perception And Haptic Feedback On Sway, Andrew Meszaros, Tess Swake, Robin Dorociack, Catherine Enger, Gavin Boen, Alex Johnston, Braedon Miller

Student-Faculty Research - College of Physical Therapy

The purpose of this research is to assess whether framing the context of haptic feedback as an "error" signal or "helpful" signal can impact sway control.

How Does Perception Influence Motor Output: An Investigation Into The Size-Weight Illusion, Andrew Meszaros, Robin Dorociak, Alex Anderson, Cassie Allen, Jennifer Vargas Vega

Student-Faculty Research - College of Physical Therapy

Purpose

❏ To assess whether the SWI exists during whole body loading such as a deadlift

❏ Determine if the body is able to adapt to the illusion with repetitions

❏ Identify mechanical factors that explain or overcome the respective illusion/perception

Hypothesis

❏ The SWI will be observed and will be reflected in the VAS ratings

❏ The magnitude of the SWI will decrease over additional repetitions

❏ Mechanical variables will reflect the degree of illusion perceived

Effects Of A Parkinson's Disease Community Exercise Group On Self Reported Promis Measures, Desiray Anderson, Alexis Creighton, Jillian Studer, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

Parkinson’s Disease (PD) is an upper motor neuron disorder that results in bradykinesia, rigidity, shuffling gait patterns, and balance impairments. Non-motor issues include depression, anosmia, GI issues, pain, and more. Approximately 90,000 people in the U.S. are diagnosed every year.

Hypothesis: Self efficacy and satisfaction roles will positively correlate with participation in the 6 week exercise program.

"My Kid Said What?!" Participation And Promis Self-Report In Children With Long-Term Physical Disabilities, Ashlyn Fast, Emma Powley, Kauionalani Kekuawela, Natalie Teegarden, Samuel Miller, Thomas Ratana, Tyler Hammond, Winnie Lee, Ryan Jacobson

Student-Faculty Research - College of Physical Therapy

Purpose:

Determine how the following are associated in kids with physical disabilities:

• Perceived life participation
• Physical abilities
• Social functioning

Perturbation-Based Balance Training Added To A Fall Prevention Exercise Program And Its Effect On Fall Risk And Fear Of Falling In Community-Dwelling Older Adults, Joseph Espero, Jeremiah Everett, Leanne Gehrke, Sage Goodman, Spencer Hall, Melody Hansen, Lyndsay Stutzenberger, Rebecca Dobler, Gabe Haberly

Student-Faculty Research - College of Physical Therapy

Background:

● Falls lead to decreased independence, increased disability, and increased risk of death

● Falls occur in more than one out of four older adults each year

Research Suggests:

● 50 hours of a structured strength and balance exercise program supplemented with fall prevention education over 12 weeks decreases fall risk in community dwelling older adults

● One session of perturbations provided at the appropriate dosage can decrease fall risk by 50%, with multidirectional perturbations having the greatest benefit

Hypothesis:

● Adding one session of perturbation-based training to a structured strength and balance exercise program will reduce the risk …

Perception Of Workload And Task Importance During Complex And Dual Task Conditions, Alicia Maul, Cody Lamont, Erin Zurbrugg, Gillian Berry, Katherine Armstrong, Lea Keenantasker, Patricia Eckart, Cindy Zablotny, Theresa Raudsepp, Ryan Jacobson

Student-Faculty Research - College of Physical Therapy

Background

• "cognitive processes and movement need to occur concurrently as part of social engagement; voluntary movement is not wholly automatic and when movement occurs, it leads to changing cognitive demands." (McIsaac et al, 2015)

• Current practice for creating dual-task challenges in the clinic include serial subtraction and carrying a glass of water (complex walking task) however these do not always translate to a patient's individualized challenges and goals

• Research has shown that a patient's engagement and performance improves when the task they are performing is meaningful in their lives. (McIsaac et al, 2015)

• Would including items …

Proximal And Distal Effects Associated With Vascular Occlusion During Stationary Cycling, Jason Brumitt, Colton Cypert, Kelli Young, Kira Negrete, Kristin Dunn, Mckenzie Moore, Rainey Stoner

Student-Faculty Research - College of Physical Therapy

Purpose

To compare strength gains in the supraspinatus and shoulder external rotators in subjects who performed 10 minutes of stationary cycling with or without bilateral occlusion.

Effects Of Changing Work Environments On Employer Support For Physical Activity During Covid-19, Elizabeth Ablah, Matthew P. Buman, Liz Petersen, Chia-Chia Chang, Ann Wyatt, Sarah Ziemer, Mary T. Imboden, Janet R. Wojcik, Neil E. Peterson, Anna Zendell, David R. Anderson, Laurie P. Whitsel

Faculty Publications - Department of Kinesiology

COVID-19 dramatically accelerated evolving changes in the way we define the “work environment” in the United States. In response to COVID-19, many employers have offered increased flexibility for where employees work, including remote (an employee’s workstation is at home) and hybrid work (an employee works both at the employer worksite and remotely, on predetermined schedules). Accordingly, worksite physical activity (PA) and sedentary behaviors (SB) such as extended sitting time (ST) may have changed.^1,2 However, little is known about whether these work arrangements are associated with changes in employer support for PA. Interviews were conducted to assess this …

Physical Activity Promotion In The Evolving Work Landscape, Laurie P. Whitsel, Elizabeth Ablah, Nicolaas P. Pronk, Frederique Huneycutt, Mary T. Imboden, David Anderson, Neil E. Peterson, Samantha Yocke, Chase Sterling, Anna L. Zendell, Janet R. Wojcik

Faculty Publications - Department of Kinesiology

How and where we do our work is changing in the United States across industry, government, and non-profit sectors. This evolving landscape includes downsized office space, the reduction of corporate fitness centers, decreased daily commutes, increased hybrid or remote work environments, and experiments with the length of the work week. While some of these changes may prove transient, others will likely be permanent changes affecting the context of work. Some occupations require in-person work settings, especially in the health care, education, travel and food processing sectors. Many of these employees are experiencing burnout after prolonged overtime work and stressful pandemic-related …

Transgenerational Wellness: Trauma Informed Christian Spiritual Formation, Winford Amos

Doctor of Ministry

Certain mindsets, processes, and practices produce health inequities and disparities including poor spiritual health. Young adults between the ages of eighteen and twenty-five years old are experiencing challenges with mental health and substance use resulting in a high rate of suicides and overdose related deaths. Many are experiencing co-occurring substance use and mental health challenges and have a history of trauma. There are limited options available for integrated treatment. Accessibility to services is very difficult due to limited providers and limited resources at this age. Church attendance has decreased significantly for young adults which limits the capacity of the church …