Medicine and Health Sciences Commons^™

Therapeutic Hypothermia For Neonatal Hypoxic Ischemic Encephalopathy: Effects On Neurodevelopmental Outcomes, Claire Rustad

Theses and Graduate Projects

Therapeutic hypothermia is a standardized protocol in the management of term- or near- term neonates who have suffered asphyxia in the perinatal period. Birth asphyxia, if sustained, may develop into a more serious condition known as hypoxic ischemic encephalopathy (HIE). Depending on severity, HIE is associated with adverse cognitive and neurodevelopmental outcomes, yet through various physiological mechanisms, hypothermia sustained for a 72-hour period has been shown to attenuate, or even prevent, permanent brain damage by decreasing cerebral energy demands. Unfortunately, cognitive and neurodevelopmental outcomes are difficult to prognosticate before or after completion of hypothermia protocol, but existing standards and technology …

Barriers To Contraceptive Use In Nicaragua, Ellen Motley

Theses and Graduate Projects

Many barriers to contraceptive use exist in sexually active Nicaraguan women, leading to increasingly high rates of unintended pregnancies among these women. Higher rates of depression, domestic abuse, and unemployment are also seen in this group of women. These women face more complications during pregnancy and receive higher rates of unsafe abortions, impacting the mom and the infant, as well as the community in which they live. Some of the barriers to contraceptive use include lack of access to healthcare, lack of knowledge about contraceptive methods, negative attitudes about contraceptives, providers’ fear of criticism, previous dissatisfaction or contraceptive failure, family …

In Developing Countries, Does The Implementation Of Basic Cardio-Pulmonary Resuscitation Education In The Community Improve Patient Outcomes?, Ashley Gross

Theses and Graduate Projects

Circulatory shock and cardiovascular diseases contribute to significant mortality globally, with an increased burden in developing countries. The compilation of these studies and anecdotal support gathered while in Nicaragua supports the impact education on high-quality CPR among the community can have on out-of- hospital cardiac arrest patient outcomes. Even though some studies showed guideline-compliant CPR does not improve all patient outcomes, we cannot estimate the time it will take a patient to achieve ROSC. Therefore, educating the public and refining the skills of health care professionals can have a significant positive impact on out-of-hospital cardiac arrest patient outcomes if there …

The Effectiveness Of Video And Other Electronic Media On Dnr/Dni Decisions Within Advance Care Planning, Peter Seebarg

Theses and Graduate Projects

Advance Care Planning is used to ensure patients’ wishes and preferences for treatment are in line with their medical situation. Its use has increased over the past years, but it has been implemented in a piece wise and unorganized fashion. Changes in provider billing capabilities and a recent consensus definition and implementation strategies of Advance Care Planning have created an opportunity to research and explore best use practices. A key feature of Advance Care Planning is creating autonomy for patients’ decisions. Autonomy is especially important for the use of cardiopulmonary resuscitation (CPR) in the event of a medical crisis.

Research …

Hpv Screening In Nicaragua, Claire Maccani

Theses and Graduate Projects

Cervical cancer is the leading cause of mortality due to a malignant neoplasm for young women in Latin America and the leading cause of cancer among women of any age in Nicaragua. Additionally, cervical cancer is the third most common cause of cancer death in females worldwide. This paper will focus on just the screening aspect of prevention. There are also vaccines now available for preventing certain oncologic strains of HPV which ultimately leads to prevention of cervical cancer. There is not yet an organized program offering HPV vaccination in Nicaragua due to the high cost of the vaccine. The …

Early Integration Of Palliative Care For Patients Diagnosed With Life-Limiting Illness, Jennifer M. Rivers

Theses and Graduate Projects

There are numerous reasons conversations regarding the early implementation of palliative care for patients diagnosed with life-limiting illness do not occur early in the disease trajectory. A literature search was conducted to support the benefits of earlier implementation of palliative care, specifically, implementation by patient’s primary care providers upon a qualifying disease diagnosis. The literature review revealed generous benefits of early implementation of palliative care and provided support for this scholarly project. For this scholarly project, a palliative care questionnaire and PowerPoint presentation were designed, administered, and presented to health care providers including nurse practitioners, physician assistants, pharmacists, and consultants …

Exploring The Lives Of Retired Nurses Using The Lens Of Legacy, Verliss L. Keller-Miller

Theses and Graduate Projects

Legacy can be viewed as a summary of life. Legacy develops over a lifetime and changes and grows as one ages. How do retired nurses view their legacy? This paper looks at a select group of five female retired nurses and how each views her legacy at this time in life. Each was a professional nurse, and each is fully retired. Imogene King’s Goal Attainment Theory discusses the concepts of self and role. Through individual conversations, each retired nurse shares her life story of self and the roles she held during her working years. Literature yields little information about this …

Acute Post-Operative Pain Management: Preventing Overuse Of Opioids, Alison Hirsch

Theses and Graduate Projects

Background: Surgical pain management with opioids is common. The use of multimodal analgesia has been proposed in order to provide opioid-sparing regimens and improve pain control post-operatively. Inadequate control of surgical pain can lead to development of chronic pain. Furthermore, studies have linked acute surgical opioid use to increased risk of long-term use. Long-term opioid use has undesirable, life-altering consequences, including physical dependence and addiction which may lead to overdose or death. Use of a variety of medications in the operative setting can lead to synergistic or additive effects on pain control, thus decreasing post-operative opioid consumption.

Methods: A literature …

Strategic Recommendations For New Pas Entering The Workforce In 2020-2025, Minh A. Nguyen

Theses and Graduate Projects

The current climate of job market favors the physician assistant profession, and the trends indicate that it will continue to do so well into the near future. These opportunities do not come without challenges from other factors facing the market, and new PAs need to be aware of them and work to find ways to actively compete against them. Understanding the effectiveness and efficiency of their profession and how they perform when pitched against NPs in medicine can help PAs secure a job with an employer who are choosing between hiring one and not the other. Once hired, being involved …

Smallpox Bioterrorism Preparedness: The Importance Of Technology And Education For Early Detection And Response, D Taylor Jorgenson-Rathke

Theses and Graduate Projects

The use of biological agents as weapons has been prevalent throughout history. Only when the US experienced a bioterrorist attack in 2001 did additional funding begin to invest in preparing for other potential attacks. These initial investments, along with others, have funded preventative measures such as mass surveillance through biosensor technology and the development of preparedness programs such as the Laboratory Response Network and Hospital Preparedness Program. Based on learnings from previous outbreak events, in the event of a bioterrorist attack involving smallpox early detection will be the key to initiating a rapid and effective response. Additionally, further measures need …

The Impact Of Breastfeeding Interventions On Breastfeeding Behavior, Ryan D. Steele

Theses and Graduate Projects

Breast milk is the natural first food for all infants, and breastfeeding provides multiple benefits for both the mother and child. However, breastfeeding rates in the United States are far from optimal, despite these benefits. There are multiple complex and interrelated reasons for the suboptimal breastfeeding rates, and multiple interventions have been completed with the goal of obtaining optimal breastfeeding rates. This literature review examines the efficacy of these breastfeeding interventions, specifically examining whether antenatal breastfeeding education was associated with increased breastfeeding initiation and duration relative to individualized support. Results of the literature review suggest that a combination of antenatal …

Does Music Therapy Decrease Agitation In Patients With Dementia?, Clinton Billhorn

Theses and Graduate Projects

Dementia is an encompassing word that includes specific symptoms which alter a patient’s problem-solving ability, decision making capacity, and personality.1 Personality changes, otherwise known as Behavioral and Psychotic Symptoms of Dementia (BPSD) can have negative impacts on caregivers and families. BPSD can include agitation, depression, elation, and hallucinations. Music therapy has been proposed as a non-pharmacologic treatment for BPSD in patients with dementia. This research is intended to identify whether or not music therapy decreases agitation in patients with dementia. Although evidence for efficacy varies, there are no side effects in the literature. Widespread use may provide an increase in …

The Future Of 5-Fluorouracil Treatment Of Colorectal Cancer: Translating A Better Understanding Into Improved Patient Care, Nathan Smits

Theses and Graduate Projects

5-fluorouracil (5-FU) is a pyrimidine analog that has been successfully employed in anticancer therapy for over forty years. Over the past several decades, researchers have characterized its cellular and clinical pharmacology and uncovered multiple mechanisms of action, which include the inhibition of thymidylate synthase (TS) and incorporation of its metabolites into DNA and RNA. The purpose of this quantitative systemic review was to summarize and evaluate what is known of these mechanisms to determine which are of most significance in the anticancer effects of 5-FU in metastatic colorectal cancer (mCRC) patients. A literature search of peer-reviewed articles dating back to …

Global Health And Societal Impacts Of Schistosomiasis, William Ryan

Theses and Graduate Projects

Schistosomiasis, a parasitic infection, is classified as a Neglected Tropical Disease (NTD). While there are many NTDs that impact poor people across the world, schistosomiasis is one of the most prevalent. Currently 200 million people worldwide are infected with schistosomiasis and 800 million more are at risk for infection. Like other NTDs, this infection is preventable and treatable. Mass drug administration of the anti-parasitic drug praziquantel (the only drug available to treat schistosomiasis) is currently the main method of control. Although, China has recently demonstrated success by employing strategies that involve controlling the infection in the livestock population. Epidemiological surveys …

Increased Antibiotic Resistance Of Escherichia Coli In Nicaragua: Potential Causes And Future Implications, Ryan S. Paukert

Theses and Graduate Projects

Since 1987, no new structural class of antibiotic has been introduced into human medicine. Aside from the absence of a new structural class of antibiotics, there has been a startlingly low number of new antibiotics approved since 1987. With the lack of new antibiotics, finding current antibiotics that are effective is becoming an alarming challenge due to the worldwide emergence of antibiotic resistance. Antibiotic-resistant bacteria presents a major threat to public health because they reduce the effectiveness of antibiotic treatment leading to increased morbidity, mortality, and healthcare expenditure. Without treatment for common infections, like uropathogenic Escherichia coli (UPEC), resistant infections …

Impact Of Medical Scribes In Healthcare: A Systematic Review, Eryn Johnson

Theses and Graduate Projects

Background: The utilization of medical scribes has increased significantly in healthcare facilities over the last ten years. Medical scribes are hired to assist providers with documentation in the electronic health record (EHR). The purpose of this systematic review is to evaluate how scribes impact productivity/throughput, revenue, provider satisfaction, and patient satisfaction in healthcare.

Methods: A database search from January 2000 to May 2017 of PubMed, Google Scholar, and Academic Search Premier was done using the keywords medical scribe, scribes, and healthcare. Based on inclusion criteria, this review includes studies from 5 emergency departments, 2 primary care clinics, and 1 cardiology …

Sprengel's Deformity, Muhammad Younus Khan Durrani, Amir Humza Sohail, Inamullah Khan, Pervaiz Hashmi

Section of Orthopaedic Surgery

Various shoulder bone deformities have been identified in the pediatric age group, with the most common being undescended scapula. Sprengel's deformity is dysplasia and malposition of the scapula, especially in the supraspinatus portion, mainly due to abnormal descent in the embryonic period. The clavicle is shorter and has a different contour. In some patients cervical spine deformities are also noted. This is a case of 3 years old girl presented to the clinic with difficulty in abducting right shoulder and sleeping with an internal rotation of the right arm. With physical examinations and radiological investigations sprengel's deformity was diagnosed. Sprengel's …

Role Of Extent Of Resection On Quality Of Life In Patients With Newly Diagnosed Gbm, Usama Khalid Choudry, Huzaifa Ismail Shaikh, Areeba Nisar, Saad Akhtar Khan, Muhammad Shahzad Shamim

Section of Orthopaedic Surgery

Glioblastomas known for their adverse outcomes are most reportedly managed by surgical resection. Studies on the impact of (Extent of Resection) EOR against Quality of Life (QOL) are very limited. We have collected data from recent studies in this review to extract a general consensus among the neurosurgeons regarding the EOR. Key parameters like functional independence, neurocognitive improvements and global health status have been explored in the context of QOL. The currently available data suggests that an increased EOR may help improve QOL in GBM patients. With the help of recent advancements it may be possible to attain a better …

Primary Total Hip Arthroplasty: Staying Out Of Trouble Intraoperatively, Shahryar Noordin, Riaz Hussain Lakdawala, Bassam A. Masri

Section of Orthopaedic Surgery

Total hip Arthroplasty is one of the most successful and commonly performed procedures in Orthopaedic Surgery. Meticulous preoperative planning allows to surgeon anticipate potential problems to reduce postoperative complications and optimize patient outcomes. Currently, the posterior approach is the most common approach utilized in the United States. In order to prevent errors in stem version, especially with cementless fixation, the entry point should be posterior, and the initial entry point should be aligned in the correct anteversion as this will determine the ultimate version of the stem. Preoperative evaluation should asses for true and apparent lengths. For successful osseointegration of …

Congenital Prepubic Sinus: An Aborted Dorsal Urethral Duplication Or A Cloacal Remnant?, Zafar Nazir, Muhammad Arif Mateen Khan, Javaria Qamar

Section of Paediatric Surgery

Background: Congenital Prepubic Sinus (CPS) is an uncommon urogenital anomaly characterized by a blind tract between the skin over the pubis to anterior of the urinary bladder, Urethra or umbilicus. We report four such cases to emphasize varied clinical presentation and embryological conundrum.
Methods: Following Ethical Review Committee (ERC) approval, medical records of pediatric patients (<16 >years) presenting with CPS (identified through operating room records and Hospital Information Management System (HIMS) between 1994 and 2018 were reviewed for demographics, clinical presentation, investigations including histopathology, management and outcome.
Results: Four cases of CPS, 3 females and 1 male, age range …

Tackling Stunting And Anemia In Egypt, Abeer Alanwar, Hend Ahmed, Sabreen Mahmoud, Wessam Adly

Papers, Posters, and Presentations

Stunting and anemia rates in children between the age of 0-24 months (0-2 years) have been two of the most persistent public health problems facing the Egyptian society and government. Based on the researchers' analysis of the problem, current policies, and on the opportunities Egypt has, this policy paper targets the Egyptian Ministry of Health and Population and recommends reformulating a specific nutrition policy to tackle stunting and anemia as well providing awareness and education about the appropriate IYCF and to give high priority to strengthening the health provision of the required micronutrients in family care units (FCU), as well …

Anti-Psychotics, Weight Gain, And Children’S Health: Making Informed Choices, Edith Kanyongo

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Second generation antipsychotics (SGA) can cause weight gain. Increased weight gain increases the risk of metabolic complications such as, type 11 diabetes mellitus, myocarditis, prolonged QTC interval, extrapyramidal side effects and hyperlipidemia. SGAs are often prescribed to children with mental illness putting them at higher risk of obesity and other related complications. Unhealthy weight gain due to SGA therapy in children is a significant public health problem considering the association of obesity and the risk of cardiovascular disease. Purpose: The purpose of this quality improvement project was to educate and encourage participants to act in preventing SGA related weight …

Effect Of Low-Intensity Long-Duration Ultrasound On The Symptomatic Relief Of Knee Osteoarthritis: A Randomized, Placebo-Controlled Double-Blind Study, Dominic Klyve, Ralph Ortiz, Davie O. Draper, Thomas M. Best

Mathematics Faculty Scholarship

Background: Wearable long-duration low-intensity ultrasound is an emerging non-invasive and non-narcotic therapy for the daily treatment of musculoskeletal pain. The aim of this randomized, double-blind, placebo-controlled study was to examine whether long-duration low-intensity ultrasound was effective in treating pain and improving function in patients with knee osteoarthritis. Methods: Ninety patients with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren-Lawrence grade I/II) were randomized for treatment with active (n = 55) or placebo (n = 35) devices applied daily to the treated knee. Investigators and subjects were blinded to treatment groups. Ultrasound (3 MHz, 0.132 W/cm2, 1.3 W) …

Epithelial Cell Lysates Induce Exos Expression And Secretion By Pseudomonas Aeruginosa, Victoria Hritonenko, Matteo Metruccio, David J. Evans, Suzanne Fleiszig

Faculty Publications & Research of the TUC College of Pharmacy

No abstract provided.

Opposing Effects Of Impulsivity And Mindset On Sources Of Science Self- 5 Efficacy And Stem Interest In Adolescents, Lisa K. Marriott, Leigh A. Coppola, Suzanne H. Mitchell, Jana L. Bouwma-Gearhart, Zunqiu Chen, Dara Shifrer, Alicia Feryn, Jackilen S. Shannon

OHSU-PSU School of Public Health Faculty Publications and Presentations

Impulsivity has been linked to academic performance in the context of Attention Deficit Hyperactivity Disorder, though its influence on a wider spectrum of students remains largely unexplored, particularly in the context of STEM learning (i.e. science, technology, engineering, and math). STEM learning was hypothesized to be more challenging for impulsive students, since it requires the practice and repetition of tasks as well as concerted attention to task performance. Impulsivity was assessed in a cross-sectional sample of 2,476 students in grades 6-12. Results show impulsivity affects a larger population of students, not limited to students with learning disabilities. Impulsivity was associated …

Effects Of School Meal Consumption On School-Related Factors In Elementary School-Aged Children, Megan Reynolds

Honors Undergraduate Theses

The purpose of this study was to examine teacher perception of student school meal preferences in an elementary school setting. This was a cross-sectional mixed-methods study that is part of a larger study to develop a nutrition education program for elementary school children. Focus groups and surveys were administered to faculty at a charter school in downtown Orlando to gain insight into the types of food offered at school and student response to these food items. All members of the faculty were invited to participate in the study, and seven teachers volunteered to take part in this study. Focus groups …

Nursing Students' Attitude And Commitment Toward Substance-Abusing Patients, Amy L. O'Conner

Honors Undergraduate Theses

The topic of substance-abuse has received increasing attention in recent years, as the number of individuals experiencing drug abuse and addiction is on the rise. With substance-use on the rise, the number of patients admitted to the hospital with this disorder is increasing also. It is important hospital staff are aware and educated on how to provide adequate care to these patients without judgement regarding their choices or their lifestyle. This study was done to determine how prepared nursing students are to care for patients with drug abuse or addiction. Specifically, the project explores student nurses' attitudes and commitment toward …

The Effects Of Wearable Fitness Devices On Pediatric Obesity: An Integrative Literature Review, Kevin Sabina

Honors Undergraduate Theses

Childhood obesity is a foremost concern throughout the health care community. Approximately 17.6% of the pediatric population meet the criteria for obesity, which can lead to health disparities later in life, such as hypertension, type 2 diabetes mellitus, and metabolic syndrome. Emerging mobile and wearable lifestyle tracking devices can be a viable solution to the challenging problem of childhood obesity through behavior changes, feasibility, and adherence. The purpose of this literature review was to determine the effect that mobile and wearable activity tracking devices have on the obese pediatric population. A centralized review of the literature was conducted using various …

Parasympathetic Nerve Derived Exosomes Inhibit Hyperglycemia Induced Apoptosis In Cardiomyoblast Cells, Reetish K. Singla

Honors Undergraduate Theses

Diabetic cardiomyopathy involves both forms of cardiac cell cell death such as apoptosis and necrosis. However, this remains unknown whether hyperglycemia induced apoptosis in the cell culture system is inhibited by parasympathetic nerve derived exosomes. We isolated parasympathetic and sympathetic nerves and derived exosomes. We developed hyperglycemia induced apoptosis in H9c2 cells. H9c2 cells were divided into 4 groups: 1) Control, 2) H9c2+ Glucose 100 mmol, 3) H9c2+ Glucose +parasympathetic-exo, 4) H9c2+ Glucose+sympathetic-exo. We determined cell proliferation and viability with MTT assay kit and apoptosis with TUNEL staining and cell death detection ELISA kit. Data was further confirmed with pro-apoptotic …

The Role Of Stress In The Differential Diagnosis Of Apraxia Of Speech And Aphasia, Jennifer G. Ferranti

Honors Undergraduate Theses

The intent of this thesis is to explore and develop the quantification of AOS features, particularly the deficits of prosodic elements, lexical stress and duration. This study investigated whether PVI can be used as a sensitive tool for the differential diagnosis of AOS. Specifically, we sought to determine whether analysis of vowel length of stressed and unstressed syllables is helpful in differentiating between individuals with AOS and aphasia versus aphasia alone. Significant differences support the hypothesis that PVI, analyzed from vowel length, is uniquely affected in AOS. This yields reason for further research in prosodic deficits in differential diagnosis, as …