Medicine and Health Sciences Commons^™

A Case Of Probable Amiodarone-Induced Pancreatitis In The Treatment Of Atrial Fibrillation: A Literature Review And Case Report., Christopher J. Mercogliano, Muhammad Khan, Mussaber Ahmad

Reading Hospital Internal Medicine Residency

Amiodarone is an effective medication used in the treatment of several different arrhythmias. Its most well-known adverse effects include pulmonary fibrosis, thyroid dysfunction, and hepatotoxicity. A less common side effect is acute pancreatitis. A 67-year-old male being treated for atrial fibrillation in rapid ventricular response with Amiodarone developed acute epigastric abdominal pain 24 hours after initiation of therapy. He was diagnosed as having acute pancreatitis based on characteristic findings seen on an abdominal CT scan. Commonly encountered etiologies of pancreatitis were ruled out through a combination of the history, laboratory values, and imaging results. Based on the temporal association of …

Accuracy Of Recall Of Musculoskeletal Injuries In Elite Military Personnel: A Cross-Sectional Study, Mita Lovalekar, John P. Abt, Timothy C. Sell, Scott M. Lephart, Erin Pletcher, Kim Beals

Physical Therapy Faculty Publications

Background Self-reported data are often used in research studies among military populations.

Objective The accuracy of self-reported musculoskeletal injury data among elite military personnel was assessed for issues with recall.

Design Cross-sectional study.

Setting Applied research laboratory at a military installation.

Participants A total of 101 subjects participated (age 28.5±5.6 years). Study participants were active duty military personnel, with no conditions that precluded them from full duty.

Primary and secondary outcome measures Self-reported and medical record reviewed injuries that occurred during a 1-year period were matched by anatomic location, injury side (for extremity injuries), and injury year and type. The …

Prevalence Of And Trends In Diabetes Among Veterans, United States, 2005–2014, Ying Liu, Sonica Sayam, Xiaonan Shao, Kesheng Wang, Shimin Zheng, Ying Li, Liang Wang

ETSU Faculty Works

Diabetes is a highly prevalent chronic disease among US adults, and its prevalence among US veterans is even higher. This study aimed to examine the prevalence of and trends in diabetes in US veterans by using data from the US National Health and Nutrition Examination Survey from 2005 through 2014. The overall prevalence of diabetes and undiagnosed diabetes was 20.5% and 3.4%, respectively, and increased from 15.5% in 2005–2006 to 20.5% in 2013–2014 (P = .04). Effective prevention and intervention approaches are needed to lower diabetes prevalence among US veterans and ultimately improve their health status.

Parent Education On Childhood Vaccinations: Implications For Nursing Practice, Kristen Sevier

The University Honors Program

Early childhood vaccination rates in Ohio have been stagnant in the past couple of years. The purpose of this project was to use current evidence regarding early childhood vaccination rates to identify how nurses can effectively educate parents to increase childhood vaccination rates. The findings from this project helped establish an educational brochure for pediatric nurses as a nurse-led intervention to address vaccination adherence among parents at the point of care. The ultimate goal is to improve vaccination coverage among early childhood populations in Yellow Springs, Ohio. The educational brochure was created and presented to pediatric nurse faculty at Wright …

Developing Effective Online Training Tools For Maine Adaptive Sports And Recreation, Kristina Jamo, Emily Gall, Shannon Bergeland, Chelsea Paul

Research Report Papers

Background: Maine Adaptive Sports and Recreation (MASR) relies on volunteers to instruct their participants with disabilities to participate in a variety of adaptive sport programs. Volunteers must have a comprehensive understanding of participants’ health conditions to assist appropriately. MASR’s traditional training program lacked a formal curriculum and assessment of volunteer learning. Our purpose was to create online learning modules and determine whether implementing a massed or distributed schedule resulted in better long term retention. Methods: Two non-randomized groups of eleven adults were assigned to either an in-class, massed format (Group A) or an at-home, distributed schedule (Group B) to complete …

Fall Reduction On The Medical-Surgical Unit, Folasayo Akinwotu

Master's Projects and Capstones

The objective of this project is to reduce patient falls by 25% at the end of September 2018 on the medical-surgical unit. Another objective is to retrain staff on fall prevention measures. The medical-surgical unit provides care to patients who are acutely ill with a wide variety of medical issues. The project started with a staff survey where the staff state their top safety concerns. Results show that 75% of the staff felt that patient falls was a top safety concern. Based on the survey findings, I began to research CINAHL Complete and PubMed databases, along with Google Scholar to …

Exposure To Environmental Microbiota Explains Persistent Abdominal Pain And Irritable Bowel Syndrome After A Major Flood, Nurfadhilah Yusof, Nurhazwani Hamid, Zheng Feei Ma, Rona Marie Lawenko, Wan Mohd Zahiruddin Wan Mohammad, Deirdre Collins, Min Tze Liong, Toshitaka Odamaki, Jinzhong Xiao, Yeong Yeh Lee

Research outputs 2014 to 2021

Background

After an environmental disaster, the affected community is at increased risk for persistent abdominal pain but mechanisms are unclear. Therefore, our study aimed to determine association between abdominal pain and poor water, sanitation and hygiene (WaSH) practices, and if small intestinal bacterial overgrowth (SIBO) and/or gut dysbiosis explain IBS, impaired quality of life (QOL), anxiety and/or depression after a major flood.

Results

New onset abdominal pain, IBS based on the Rome III criteria, WaSH practices, QOL, anxiety and/or depression, SIBO (hydrogen breath testing) and stools for metagenomic sequencing were assessed in flood victims. Of 211 participants, 37.9 % ( …

Of Pools, Oceans, And The Dead Sea., Samir K. Ballas

Department of Medicine Faculty Papers

In a comprehensive study in this issue of Blood, Carden and colleagues describe the importance of the tonicity of IV fluids used in the treatment of patients with sickle cell disease (SCD) during vaso-occlusive crises (VOCs). Hypertonic fluids decreased sickle red blood cell (sRBC) deformability, increased occlusion, and increased sRBC adhesion in microfluidic human microvasculature models. Hypotonic fluids decreased sRBC adhesion but prolonged sRBC transit time. Fluids with intermediate tonicities resulted in optimal changes that reduced the risk of vaso-occlusion. © 2017 by The American Society of Hematology.

An In-Depth Look At Stall Contamination: A Total Of 28 Substances Were Identified In Charles Town Ship-In Stalls As A Mix Of Human Medications And Recreational Substances With Some Actual Equine Medications, Clara Fenger, Maria Catignani, Jake Machin, Thomas Tobin

Maxwell H. Gluck Equine Research Center Faculty Publications

No abstract provided.

Integration Of Animal-Assisted Therapy Standards In Pediatric Occupational Therapy, Sara J. Shue, Melissa Y. Winkle, M J Mulcahey

People and Animals: The International Journal of Research and Practice

The primary purpose of this study was to describe how the best practice recommendations and standards of practice related to animal-assisted therapy (AAT) are being incorporated into pediatric occupational therapy (OT). The study design was a nonexperimental survey that identified the qualifications of pediatric occupational therapists that are incorporating AAT, the AAT standards of practice that are or are not used in practice, and the barriers and facilitators to being an AAT qualified occupational therapist. There were 21 respondents to the survey. The majority of respondents had a master’s degree, more than 10 years working as an occupational therapist, less …

The Italian Agreement Between The Government And The Regional Authorities: National Guidelines For Aai And Institutional Context, Martina Simonato, Marta De Santis, Laura Contalbrigo, Daniele Benedetti, Elisabetta Finocchi Mahne, Vincenzo Ugo Santucci, Silvio Borrello, Luca Farina

People and Animals: The International Journal of Research and Practice

Animal-assisted interventions (AAI) have developed considerably in the last half century, prompting various private and public realities dealing with AAI worldwide to work on and establish standards and best practice. However, AAI are still far from being regulated harmoniously. In this context, Italy offers a unique example at world level: here the spread of AAI has set in motion an ethical and legal reflection that led to the creation of the Italian National Reference Centre for AAI (NRC AAI) by ministerial decree in 2009 and the approval of National Guidelines for AAI in 2015. The Italian legislation on AAI is …

Quality And Access To Care For Cardiovascular Disease Prevalence In Women Veterans: Population Estimate Using Electronic Health Records, Meena Marie Kim-Dopp, Vanessa Gow-Lee, Linda Ferry, Sharon Jamie, Ralph Clark, Suma Singh

Loma Linda University Student Journal

Electronic Health Records are used to measure quality indicators for cardiovascular disease (CVD), but have not been tested for sensitivity and specificity. Computerized Patient Record System (CPRS) used by the Veterans Health Affairs (VHA), has active CVD clinical reminders from Healthcare Effectiveness Data & Information Set (HEDIS) that are compared nationally. San Bernardino County, CA has a 7.8% prevalence of self-reported CVD in both genders. For HEDIS measures, there is only a 4 point CVD composite score gender difference for VHA nationally, but at the Loma Linda VHA there is an 18 point gender difference (2016). Women Veterans (WV) are …

Is Engagement Alone Sufficient To Ensure “Active Learning”?, Reed Krause, Amy C. Hayton Md, Jeff Wonoprabowo, Lawrence Loo

Loma Linda University Student Journal

“Active Learning” is commonly defined as any instructional method that engages students in the learning process. However, active learning encompasses a broad range of educational methods and its impact on learning outcomes has been variable. In 2015, our IM clerkship redesigned its half-day learning sessions from a largely passive didactic style of lecturing to more active learning approaches. We further revised the curriculum in 2016 to further convert the sessions to primarily case based learning led by a faculty or resident. The goal of our intervention was to increase the Self-Reported Engagement Measure (STOBE) of each didactic session and improve …

Does Ecg And Arrhythmia Simulation Training In Adjunct To Didactics Improve Medical Students’ Clinical Skills Compared To Didactics Alone?, Reed Krause, Amy C. Hayton Md

Loma Linda University Student Journal

Medical Schools continue to face the challenge of bridging the gap between classroom education and its application in the clinical environment. Several studies have shown utility of incorporating simulation training into a variety of healthcare related topics. We hypothesize that incorporating ECG and arrhythmia simulation training in adjunction to ECG and arrhythmia didactics; it would improve Year-3 medical students’ preparedness for managing arrhythmias in the clinical setting.

Percutaneous Externally Assembled Laparoscopic (Peal) Donor Nephrectomy: A Cohort Pain Comparison, Tyler Miskin, Isaac Kelly, Matthew Pierce, Samuel Abourbih, Duane D. Baldwin

Loma Linda University Student Journal

Donor nephrectomies can be technically demanding. Donors also may not be fully psychologically prepared for their post-operative pain or cosmetic outcome. A novel Percutaneous Externally Assembled Laparoscopic (PEAL) paradigm was developed to decrease incisional pain and laparoscopic scars. The aim of this study is to compare the post-operative outcomes between donor nephrectomies performed with and without the PEAL instruments.

Glycemic Control In Insulin And Non-Insulin Dependent Diabetic Patients With St Elevation Predicts Time To Presentation, Jonathan Evans, David Hamilton, Tigran Khachatryan, Daniel K. Amponsah, Andrew Stewart, Islam Abudayyeh, Kenneth Jutzy, Eric Suh, Anthony Hilliard

Loma Linda University Student Journal

Worldwide, the annual number of people diagnosed with diabetes continues to increase. Classically, Diabetes Mellitus (DM) has been associated with silent or atypical initial symptoms and increased time to presentation in patients presenting with ST elevation myocardial infarction (STEMI) compared to non-DM patients. It is less clear whether the type of treatment or the adequacy of glycemic control impacts the time to presentation and type of symptoms. Therefore, we sought to evaluate the impact of poor glycemic control on these outcomes as measured by hemoglobin A1c.

Magnetically Focused Proton Irradiation Of Small Volume Radiosurgery Targets Using A Triplet Of Quadrupole Magnets, Patrick Mcgee, Grant Mcauley, Andrew Wroe, James M. Slater, Jerry D. Slater

Loma Linda University Student Journal

Proton therapy is an advantageous choice for the irradiation of tumors in proximity of critical structures due to rapid dose fall off and high dose deposition at target compared to dose at the surface of the patient (ie, peak-to-entrance dose ratio (P/E)). However, with target fields below 1.0 cm, as often encountered in proton radiosurgery, multiple Coulomb scattering (MCS) broadens proton beams leading to diminished P/E advantages and reduced dose delivery efficiency (DDE). Magnetic focusing tends to counteract MCS and is a promising method to reduce these undesirable effects. The purpose of this research is to investigate the advantages of …

Diffusion Tensor Imaging Findings In Pediatric Patients With Mild Traumatic Brain Injury, Tshea Dowers, B L. Bartnik, Barbara Holshouser, Stephen Ashwal, Samuel Barnes

Loma Linda University Student Journal

Approximately 14% of school age children with sports-related concussions (SRC) remain symptomatic 3 months after injury. Previous studies have used diffusion tensor imaging (DTI) to detect white matter tract changes in regions of interest in symptomatic patients; however data in the pediatric population remains limited. This study was undertaken to determine whether DTI metrics can provide valuable information in pediatric mTBI patients with persistent symptoms.

Multimodality Minimally Invasive Treatment Of Large Joint Osteoarthritis: A Pilot Trial Of Stromal Vascular Fraction From Autologous Fat Combined With Platelet-Rich Plasma, Phil Giddings, Insiyah Campwala, Subhas Gupta

Loma Linda University Student Journal

Osteoarthritis (OA) is a degenerative joint disease that can cause severe pain in those affected. Currently, there are no therapeutic drugs available to treat osteoarthritis. While total joint arthroplasties (TJA) allow for improved function, there are no less invasive, yet effective procedures that can be done for patients unwilling or unable to undergo major surgery.

Platelet-rich plasma (PRP) has been shown to reduce the symptoms of OA when injected into the affected joint. Patients treated by this method alone have improved self-reported pain (at least a 50% reduction from original value) as well as lower extremity function. While the effects …

Identification Of Unreported Sources Of Objects Containing High Release Nickel, David J. Eng, Mary A. Rasmussen, Chandler Rundle, James K. Parker, Daniel Bergman, Sharon E. Jacob

Loma Linda University Student Journal

Globally, nickel is the leading cause of allergic contact dermatitis (ACD). Nickel is ubiquitous, and published literature continues to index items most frequently associated with Ni-ACD. Unregulated nickel exposure in North America is evident by the unprecedented rates of sensitization seen in patch-tested cohorts, 18.5% in children (ages 0-18 years) and 28.1% in adults.¹ Conservative estimates of ACD within the pediatric population suggest at least one million cases in the US yearly with roughly one-quarter of those cases due to nickel.^2-3 The United States could potentially save $5.7 billion annually in health care costs, extrapolating current cost-saving data …

The Feasibility Of Percutaneous Externally Assembled Laparoscopic Nephrectomy: A New Surgical System, Benjamin West, Jerry Thomas, Mohamed Keheila, Nazih Khater, Samuel Abourbih, Salim Cheriyan, Matthew Pierce, Duane D. Baldwin, Jim Shen

Loma Linda University Student Journal

Laparoendoscopic single-site (LESS) nephrectomy provides excellent cosmetic outcomes, but is technically challenging due to loss of triangulation and increased instrument collision. A novel Percutaneous Externally Assembled Laparoscopic (PEAL) surgical system was developed to simplify minimally invasive surgery while providing a nearly scarless outcome. In this study, the feasibility of the PEAL system for nephrectomy was determined.

Comparing The Vaginal Wall Sling With Autologous Rectus Fascia And Polypropylene Sling On Outcome And Patient Satisfaction, Mohamed Keheila, Salim Cheriyan, Jim Shen, Catalino J. Bautista, Josianne Bailey, Kevin Kim, Marina Germanos, Isaac Kelly, Matthew Pierce, Andrea Staack

Loma Linda University Student Journal

Since 2011 FDA safety update on transvaginal synthetic mesh for treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP), providers are encouraged to counsel patients on risks related to synthetic mesh slings, such as dyspareunia, erosion, and extrusion. As an alternative to synthetic slings patients often choose autologous slings. We aim to compare outcome and patient satisfaction in patients, who received an autologous vaginal wall sling (VWS), rectus fascia sling (RFS), or synthetic suburethral sling (SSS) for treatment of SUI.

Assessing Dietary Advancement For Dysphagia Patients At Risk For Aspiration, Cedric Thiel, Thomas Murry, Brianna Crawley, Priya Krishna

Loma Linda University Student Journal

Fiberoptic endoscopic evaluation of swallowing (FEES) evaluates oral intake safety by allowing direct observation of laryngeal function before and after swallowing. The purpose of this study was to delineate the impact of abnormal vocal fold mobility and altered laryngeal sensation on dietary management in hospitalized patients previously diagnosed with aspiration.

Impact Of Macra Legislation And Mips Scores On Cost Effective Analysis For Negative Pressure Wound Therapy Devices, Jeremy W. Kubiak, Subhas Gupta

Loma Linda University Student Journal

The Medicare Access and CHIP Reauthorization Act (MACRA) changes reimbursement from a fee-for-service payment system to fee-for-value. Physicians will be scored according to the quality of their care in the MIPS program and will receive a positive or negative modifier to their Medicare reimbursement based on that score.

Ischemic Time And Risk Factors Associated With The Incidence Of Cardiogenic Shock In Patients Presenting With St Elevation Myocardial Infarction, Daniel K. Amponsah, Jonathan Evans, David Hamilton, Tigran Khachatryan, Andrew Stewart, Islam Abudayyeh, Kenneth Jutzy, Anthony Hilliard

Loma Linda University Student Journal

Cardiogenic shock (CS) is the number one predictor of mortality in patients with ST-elevation myocardial infarction (STEMI). Emergent evaluation and treatment including revascularization when indicated is recommended upon arrival to hospital. There is variation in time to presentation and total ischemic time in this patient population. We sought to evaluate the impact of ischemic time on incidence of CS and variables which may influence its presentation.

Moving Myths: A Heuristic Inquiry Into The Role Of Jungian Concepts In The Theoretical Framework Of A Dance/Movement Therapy Student, Maura Reagan

Creative Arts Therapies Theses

The purpose of this heuristic study was to develop a personal dance/movement therapy approach and interventions that utilize the Jungian concepts of myth and archetypes. The researcher, a 24-year-old graduate student, is grounded in a humanistic-existential therapy approach and is interested in bringing additional symbolism and metaphor to my theoretical lens by examining how these specific elements of Carl Jung’s psychoanalytic theory can enhance my current framework. Data collection and analysis took place over five Authentic Movement Skype sessions with the researcher and research collaborator participating from private rooms in their respective homes in Chicago, IL and Seattle, WA. The …

Obesity And Diabetes: Evaluating The Impact Of Promotores As A Prevention And Intervention Strategy In The Latino Community, Jessica Castaneda

Master's Projects and Capstones

This paper aims to examine obesity and diabetes among the Latino population as a health problem. As the largest minority racial group in the U.S, Latino rates of obesity and diabetes are greatly higher than whites. The prevalence of obesity in Latinos is 45% compared to that of whites at 34.5% (CDC, 2015). The disproportionate rates at which Latinos are affected by obesity and diabetes have prompted numerous programs to combat this health problem. Promotores or Latino community health workers have been able to provide the important piece of culturally and linguistically appropriate education for the population. Evidence shows Promotores …

Social Marketing For A Farmer's Market In An Underserved Community: A Needs Assessment, Meg Skizim, Melinda Sothern, Ondrej Blaha, Tung-Sung Tseng, Lauren Griffiths, Jonathan Joseph, Henry Nuss

School of Public Health Faculty Publications

The aim of the present paper is to assess local residents' awareness of utilizing Supplemental Nutrition Assistance Program (SNAP) benefits to purchase fresh produce at local farmers' markets, and to determine internet use and media preferences of study participants prior to implementation of a social marketing campaign. A needs assessment was conducted to collect baseline data in an underserved neighbourhood in New Orleans (La, USA). The study was carried out August 2014-May 2015. The assessment revealed that 73% of the respondents were unaware that the SNAP benefits could be used to purchase food in farmers' markets; 63% of low-income participants …

Cholesterol Regulation Of Pulmonary Endothelial Calcium Entry Following Chronic Hypoxia, Bojun Zhang

Biomedical Sciences ETDs

Chronic hypoxia (CH)-induced pulmonary hypertension (PH) is associated with diminished ATP-induced endothelial Ca2+ entry as well as membrane cholesterol in pulmonary arteries. Store-operated Ca2+ entry (SOCE) and depolarization-induced Ca2+ entry are major components of the response to ATP and are similarly decreased after CH. Because endothelium-dependent vasodilation is closely associated with pulmonary endothelial [Ca2+]i, the blunted agonist-induced Ca2+ influx in pulmonary artery endothelial cells (PAEC) may contribute to the development of CH-induced PH. Interestingly, impaired agonist-induced Ca2+ influx in PAEC following CH can be restored by membrane cholesterol supplementation. In the current studies, we hypothesized that impaired Ca2+ entry in …

Patient-Provider Relationship And Perceived Provider Weight Bias Among American Indians And Alaska Natives, Kelly L. Gonzales, Ginny Garcia, Michelle M. Jacob, C. Muller, Lonnie A. Nelson, Spero M. Manson

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective The objective of this study was to examine patient–provider relationships among American Indians and Alaska Native (AI/AN) patients by examining associations between patient activation, perceived provider weight bias and working alliance. Patient activation is generally defined as having the knowledge, skills and confidence to manage one's health.

Methods Among a sample of 87 AI/AN adults presenting for general medical care at an urban clinic in the north-west region of the USA, ordinary least squares regression analysis was completed to examine associations.

Results Better working alliance scores were associated with increased patient activation, while perceived provider weight bias was associated …