Medicine and Health Sciences Commons^™

Australian General Practice Training Program: National Report On The 2018 National Registrar Survey, Rebecca Taylor, Leyna Clarke, Daniel Edwards

Higher education research

The Australian General Practice Training National Registrar Survey (AGPT NRS) is an annual, national survey of GP registrars currently training in the AGPT program. It collects information via an online questionnaire about registrar satisfaction, experience and future career plans. It also collects information about registrars’ demographics and training contexts and other aspects of their training experience. This survey was previously known as the AGPT Registrar Satisfaction Survey (AGPT RSS). From July 31 to September 7 2018, the Australian Council for Educational Research (ACER) administered the AGPT NRS to registrars enrolled in active training on the AGPT program across 11 training …

Acute Care Physical Therapy And Early Mobilization For A Patient Following Bilateral Staged Anterolateral Total Hip Arthroplasties: A Case Report, Rachel Claussen

Case Report Posters

The purpose of this case report was to add to the limited literature describing acute care physical therapy (PT) management of patients receiving staged BTHA and to document both episodes of care. Primary hip osteoarthritis (OA) is a leading cause of significant hip pain resulting in disability, joint stiffness, and loss of function. 42% of people with hip OA have it in both hips. Minimally invasive surgery using an anterolateral approach spares the hip external rotator muscles and posterior hip capsule. Staged bilateral total hip arthroplasty (THA): two separate surgical procedures during different hospitalizations. Lower risk of deep vein thrombosis …

Functional Mobility For A Patient With Myelodysplastic Syndrome, Chronic Gvhd, And Corticosteroid Use: A Case Report, Alyssa Deardorff

Case Report Papers

Background: The use of corticosteroids to treat chronic graft-versus-host-disease (cGVHD) is common in oncological treatment. However, the long-term complications of cGVHD and prolonged use of corticosteroids have not been reported in terms of the benefits of physical therapy (PT) interventions. The purpose of this case report was to report the impact of PT interventions for an individual with a cancer diagnosis having received an allogenic-stem cell transplant (allo-SCT) with the long-term complications associated with cGVHD, long-term corticosteroid use, and cancer survivorship. Case Description: The patient was a 73-year-old male diagnosed with Myelodysplastic Syndrome and received an allo-SCT two years prior …

Relieving Low Back Pain And Improving Mobility For An Adult Patient With Progressive Multifocal Leukoencephalopathy: A Case Report, Derek Schwaiger

Case Report Papers

Background and Purpose: Progressive Multifocal Leukoencephalopathy (PML) is a demyelinating disease affecting patients with compromised immune systems. It attacks the central nervous system through white matter plaques that destroy neurons. Plaques form due to the John Cunningham Virus (JCV). There is no approved JCV treatment and thus, no treatment for PML. The purpose of this case report is to examine the physical therapy interventions administered to a patient with PML to address low back pain and functional mobility deficits. Case Description: The patient chosen was a 51-year-old male referred to outpatient physical therapy services with a medical diagnosis of PML. …

When Duty Calls: A Description Of Human Conflict And Occupational Therapy, Bryce Carsone, Jonathan Pitts

OCCUPATION: A Medium of Inquiry about Health through Occupation

As violent events escalate, even within the United States, it is imperative that occupational scientists have an in-depth understanding of the level one (descriptive) research implications, and occupational therapy practitioners are prepared to meet the needs of those impacted by conflict. This article aims to (a) describe the occupations of those affected by conflict (b) inform on current interventions through an intentional review (c) present the case for a call to action of occupational therapy practitioners. A general review of literature resulting in a description of occupations, identified four distinct populations: those who fight, caregivers, those who stay home, and …

A Need For Occupational Justice: The Impact Of Racial Microaggression On Occupations, Wellness, And Health Promotion, Emily Grullon, Carlneshia Hunnicutt, Melisa Morrison, Olandria Langford, Mirtha M. Whaley

OCCUPATION: A Medium of Inquiry about Health through Occupation

“Ism,” in general terms describes a practice that denotes oppression of a group based on the characteristics of its members: racism, sexism, and ageism, are the three types most commonly identified. “Isms” often impose limits on people, and while we have been aware of those limits at the macro level, we have been less aware of acts that happen at the level of the individual, the micro level. These acts, which are frequently heard and seen in the media, have personal, occupational, and health implications for those affected by them. The purpose of this paper is to raise awareness about …

Implementing The Hyperlipidemia Statin Use Guideline In Patients With Diabetes Mellitus, Ifeyinwa Eribenne

Doctor of Nursing Practice

Purpose. To implement an evidence-based hyperlipidemia guideline for statin therapy use with diabetic patients. Background. In the United States, cardiovascular disease (CVD) continues to be the leading cause of mortality and morbidity for women and men with diabetes. Dyslipidemia is a modifiable risk factor for CVD and one of the leading drivers behind the development of coronary artery disease. In 2014, the American Diabetes Association issued a new recommendation guideline for using statins as a primary intervention for CVD in patients aged 40–75 with diabetes. Despite advances in prevention and treatment guidelines, the American College of Cardiology and ADA have …

Nurse Expectations As Compared To Perceived Reality, Kathryn Mckelvy

Dissertations

Burnout and turnover in nursing have been well documented in nursing literature, but little is known about a nurse’s expectations of the profession compared to their perceived reality of the profession. Do these expectations meet the reality of the workplace, and does this cause the nurse to make a career change? What factors influence a nurse to leave the profession, job-hop, or return to school to further their education? The rate of nurse turnover is an ongoing issue with a lack of research regarding the foundation of nurse expectations compared to the realities of the profession.

The purpose of this …

Self-Care Vs. Self-Sacrifice In Medical-Surgical Nursing Culture: A Critical Ethnography, Elise Jordan Juergens

Dissertations

The critical ethnography research examines need prioritization culture among medical-surgical nurses. Grove, Burns, and Gray (2013) define the problem statement as an explicit identification of the research need. Literature search yields scarce ethnographic research on the nursing population as a culture-sharing group, and no qualitative research exists regarding medical-surgical nurses’ self-need prioritization. The purpose of this critical ethnography is to observe medical-surgical nursing culture, related to personal need prioritization, as reflected by behavior and dialogue.

Qualitative research methodology is appropriate where statistical data is not. Research motivation involves seeking insight and sociocultural understanding. Critical ethnography is the chosen qualitative research …

Male Nurse Practitioners' Views On Nursing Education As A Career Option: An Inductive Qualitative Content Analysis, James Mcdavid

Dissertations

As the nursing shortage continues, the demand for new nurses will increase. In 2015, nursing schools in the United States turned away 62,361 qualified applicants in the baccalaureate and graduate nursing programs (Fang, Li, Arietti, & Trautman, 2016). The number of funded, vacant nursing faculty positions increased from 6.9% in 2014 to 7.1% in 2015 (Fang et al., 2016). One idea to help with the nursing faculty shortage is to recruit male RNs into nurse faculty positions. Males count for 10.6% of nurses in the United States (U.S. Bureau of Labor Statistics, 2016). However, men only count for 5.5% of …

Implementing Evidence-Based Dietary Instruction Strategies In A Specialty Care Clinic, Jacobie Landers

Doctor of Nursing Practice

Cardiovascular disease is a significant health concern that increases risks for stroke, escalates the development of renal disease, and significantly increases morbidity and mortality risk. Dietary changes can significantly reduce complications in patients with heart and vascular disease. This project was designed to effectively implement and sustain provider and cardiovascular staff instructions on dietary modifications to improve hypertension control and lower cholesterol in patients with cardiac disease using staff support. The project facilitated provider evaluation of patients’ dietary habits to promote wellness in a patient population which was not receiving dietary education. Project interventions included establishing structured methods of providing …

Assessing Readmission Risks In Adolescent Psychiatric Patients, Keyamo Omokuru

Doctor of Nursing Practice

Purpose: Assess risk of readmission of adolescent patients to an inpatient psychiatric unit within 30-days post-discharge by using a clinician-rated behavioral health outcome assessment measure to rate psychiatric patient. Background: In the United States, approximately four million adolescents suffer from mental disorders. When admitted for inpatient psychiatric care, approximately 13% of adolescent mental health patients are readmitted within 30-days, 25% within one year, and 81% within 90-days, of inpatient psychiatric admission. Methods: An evidence-based quality improvement project that utilized the clinician-rated behavioral health outcome assessment tool called the Health of the Nation Outcome Scale for Children and Adolescent (HoNOSCA). The …

Food Is Medicine, Katherine Keane

Senior Honors Projects

No abstract provided.

A Mixed-Methods Refugee Community Health Needs And Assets Assessment, Eleni Florakis, Rickie Brawer, Phd, Mph, Mches, Abby Cabrera, Kaushal Desai, Saya Bery

Phase 1

Introduction:

Many factors may negatively affect the experience of refugees navigating the healthcare system in Philadelphia. These factors include, but are not limited to, lack of familiarity with the healthcare system, language and cultural barriers, limited health literacy, physical and transportation barriers, and fear and/or distrust of the healthcare system. In addition, there are a large proportion of United States refugees in Pennsylvania. According to usnews.com, Pennsylvania was ranked the top 6th state for taking in the most refugees in the year 2017.

Objective:

The primary objective is to assess the experiences of refugees within the healthcare system since resettlement …

Mental Health And Resilience In Adolescent Refugees Resettled In Philadelphia, Saya Bery, Pia Ghosh, Mph, Ellen Plumb, Md

Phase 1

Introduction: Mental health in adolescents has a large impact on physical health, academic achievement, and overall well-being; moreover, refugee youth are at an increased risk for mental health disorders. While growing evidence shows that positive youth development interventions can prevent health risk behaviors, there is need for further evaluation that shows how to tailor interventions to meet population-specific needs.

Objective: The aim is to assess how targeted interventions can enhance protective factors and reduce negative adult outcomes in vulnerable refugee adolescents. The goals are to understand the current status of mental health and access to resources among resettled adolescents in …

Functional Mobility For An Elderly Patient With Amyotrophic Lateral Sclerosis: A Case Report, Gianna G. Pezzano

Case Report Papers

Background and Purpose: This case report provides a detailed description of how balance training was incorporated into physical therapy (PT) treatment to reduce fall risk and maintain functional mobility in an elderly patient diagnosed with ALS. Due to lack of research on ALS, and the terminal nature of the disease, clinicians and researchers may benefit from a palliative care PT plan to maintain functional mobility for patients with neurodegenerative diseases. Case Description: An 82-year old female presented to outpatient PT with the diagnosis of ALS, with decreased functional mobility, high fall risk, and left hip/knee pain due to arthritis. She …

Thyrotropin Receptor Blocking Antibodies, Tanja Diana, Paul D. Olivo, George J. Kahaly

2010-2019 OA Pubs

Autoantibodies (Ab) against the thyroid-stimulating hormone receptor (TSHR) are frequently found in autoimmune thyroid disease (AITD). Autoantibodies to the TSHR (anti-TSHR-Ab) may mimic or block the action of TSH or be functionally neutral. Measurement of anti-TSHR-Ab can be done either via competitive-binding immunoassays or with functional cell-based bioassays. Antibody-binding assays do not assess anti-TSHR-Ab functionality, but rather measure the concentration of total anti-TSHR binding activity. In contrast, functional cell-based bioassays indicate whether anti-TSHR-Ab have stimulatory or blocking activity. Historically bioassays for anti-TSHR-Ab were research tools and were used to study the pathophysiology of Graves' disease and Hashimoto's thyroiditis. In the …

A Scoping Review Of The Associations Between Mental Health And Factors Related To Hiv Acquisition And Disease Progression In Conflict-Affected Populations, Erica Koegler, Erica Koegler, Caitlin Kennedy

Social Work Faculty Works

The association between poor mental health and factors related to HIV acquisition and disease progression (also referred to as HIV-related factors) may be stronger among conflict-affected populations given elevated rates of mental health disorders. We conducted a scoping review of the literature to identify evidence-based associations between mental health (depression, anxiety, and post-traumatic stress disorder [PTSD]) and factors related to HIV acquisition and progression in conflict-affected populations. Five electronic databases were searched on October 10, 2014 and updated on March 7, 2017 to identify peer-reviewed publications presenting primary data from January 1, 1994 to March 7, 2017. Articles were included …

Diurnally Active Rodents For Laboratory Research, Roberto Refinetti, G. J. Kenagy

Psychological Sciences Faculty Publications and Presentations

Although inbred domesticated strains of rats and mice serve as traditional mammalian animal models in biomedical research, the nocturnal habits of these rodents make them inappropriate for research that requires a model with human-like diurnal activity rhythms. We conducted a literature review and recorded locomotor activity data from four rodent species that are generally considered to be diurnally active, the Mongolian gerbil (Meriones unguiculatus), the degu (Octodon degus), the African (Nile) grass rat (Arvicanthis niloticus), and the antelope ground squirrel (Ammospermophilus leucurus). Our data collected under 12L:12D light-dark cycles confirmed and expanded …

Variables Predicting The Severity Of A Mass Shooting: The Connection To White Supremacy, Sarina Resnick

Honors Projects in History and Social Sciences

Since mass shootings have become increasingly relevant in today’s society, the subject of what makes a mass shooting deadly has become more and more popular. This project focuses on how selected variables correlate with the severity of a mass shooting, and especially focuses on the impact of white supremacy ideology. Theoretically, a shooter imbued with this ideology will likely be more violent, thus causing a higher victim count (injuries + deaths). The other variables included in the model are: the use of a long gun, the use of multiple guns, the use of semi-automatic guns, mental illness, and shooter suicide. …

Improving Satisfaction For Patients With Diabetic Foot Ulcer Using A Diagnosis Specific Written Education Packet, Douglas W. Kozeluh

Doctor of Nursing Practice Scholarly Projects

Diabetes mellitus is a significant health care concern affecting 30.2 million Americans in 2015. One of the most common, costly, and serious sequela of diabetes is diabetic foot ulceration (DFU), which may lead to lower extremity amputation. Up to 50% of DFUs and lower extremity amputations can be prevented through effective patient education (PE). PE provided through written information is one intervention designed to improve patient understanding and self-management practices in order to reduce the risks and complications of DFU. The purpose of this Doctorate in Nursing Practice (DNP) project was to determine if implementation of a DFU specific written …

Clostridium Sporogenes Bacteremia In An Immunocompetent Patient, Waiel Abusnina, Mena Shehata, Emhemmid S. Karem, Zeynep C. Koc, Elie Khalil

Internal Medicine

Of the 200 Clostridium spp. known to exist, approximately 30 have been associated with human disease. Commonly found in soil, marine sediment and mammalian intestinal tracts, these gram-positive bacilli are known to cause infections ranging from cellulitis to septicemia. Isolates that are identified by clinical microbiology laboratories include Clostridium perfrigens species in 20–40% of cases. However, when Clostridium sporogenes is identified, is rarely considered to be pathogenic. We present a case of Clostridium sporogenes bacteremia secondary to lower limb cellulitis and osteomyelitis in an immunocompetent patient.

Project Renew Worcester, Danni Yue, Amy Zhang, Jing Han, Omid Ashrafi, Yiming Xu

School of Professional Studies

n The client for this capstone project is RENEW Worcester which is a fledgling solar power project whose main goals are to bring renewable energy in the form of solar power into local, primarily low-income communities and are committed to the mission of making the transition off of fossil fuels to clean, renewable power. Based in Worcester, Massachusetts, they are a local chapter of Co-op Power which is a consumer-owned sustainable energy cooperative (co-op) made up of numerous different local chapters all over the New England area as well as the state of New York. The problem that we will …

Conservative Management Of A Complete Rupture Of The Long Head Of The Biceps: A Case Report, Ali Woller

Case Report Papers

Background/Purpose: The long head of the biceps plays an important role stabilizing the shoulder. Most of the current literature supports surgical intervention following a complete rupture, but there is little evidence that supports conservative management. Due to a lack of evidence supporting conservative management of a complete rupture of the long head of the biceps, the purpose of this case study was to evaluate the progress this patient made over a six-week period with outpatient physical therapy addressing his impairments resulting from his injury. Case Description: The patient was a 51-year-old male with a confirmed diagnosis of a complete rupture …

The Use Of Medical Therapeutic Yoga On A Patient With Adhesive Capsulitis: A Case Report, Cameron Vallie

Case Report Papers

Background and Purpose: Shoulder pain is the third most common site of musculoskeletal pain leading to substantial financial burden for patients. Adhesive capsulitis (AC) is a disabling condition defined by a progressive loss of upper extremity (UE) range of motion (ROM) and leading to limitations in functional mobility. The purpose of this case report is to investigate the implementation of medical therapeutic yoga (MTY) in combination with manual therapy and therapeutic exercise in the treatment of a patient with AC. Case Description: The patient was a 51-year-old female with left shoulder AC and associated deficits in ROM, strength, and functional …

Gait Training A Patient Who Was Deaf With Multiple Total Hip Revisions: A Case Report, Natalie Slattery, Kirsten Buchanan

Case Report Posters

93% of patients who have a total hip arthroplasty (THA) are due to end-stage osteoarthritis. 15-30% of patients who survive a stroke continue to live with a long-term disability. The most common abnormal gait pattern after surviving a stroke is due to hemiparesis. Patients who are deaf require greater visual and tactile cueing during gait training. Gait training has been shown to normalize gait patterns and increase functional mobility in patients after a total hip replacement (THR), THA revision and/or stroke. There is a lack of research investigating the optimal gait training plan of care (POC) for a patient with …

Conservative Management Of A Complete Rupture Of The Long Head Of The Biceps: A Case Report, Ali Woller

Case Report Posters

The purpose of this case study was to assess conservative management of a complete rupture of the long head of the biceps over a six-week period. The long head of the biceps (LHB) stabilizes the shoulder by reducing anteroposterior and superior inferior translation of the humeral head in the glenoid fossa. A tear of the LHB most commonly occurs when the biceps is suddenly loaded against flexion and supination of the elbow. Surgical repair of the LHB has seen 94% satisfaction rates, but with complications. Fifty-six percent of patients who initially chose conservative methods ultimately choose surgery. There is a …

Functional Mobility For An Elderly Person With Amyotrophic Latera Lsclerosis: A Case Report, Gianna G. Pezzano, Amy J. Litterini

Case Report Posters

The purpose of this case study was to describe a palliative care physical therapy (PT) plan for maintenance of functional mobility and fall risk reduction for a patient with ALS. Ice Bucket Challenge began in 2014 to increase public awareness and funding for ALS. Need for further research was highlighted, in the campaign, for medical treatment and rehabilitation. Typical Presentation for Amyotrophic Lateral Sclerosis (ALS) is male, 60 years old, limb onset. This patient was female, 82 years old, with bulbar onset, limb weakness, and fall risk.

Intra-Rater & Inter-Rater Reliability In 2nd Year Dpt Students Performing The Navicular Drop Test, Kirsten Buchanan, Nick Allard, David Buchan, Mike Curtin, Andrew Dipartolo

Research Report Posters

The Navicular Drop Test (NDT) is used as a clinical measure of mid-foot pronation. Objective measurements are rooted in the trust of the tool. When utilizing the NDT, the tool is the practicing clinician. Research has revealed that experienced clinicians have good-excellent intra- and inter-rater reliability when measuring navicular drop (ND). Current data reports ~25,000 practicing US PTs have < 3 years experience. There is limited research exploring the intra- and inter-rater reliability of less experienced DPTs when performing the NDT. The purpose of this research report was to determine the intra- and inter-rater reliability of three 2^nd year DPT students.

"Planting The Seed": Perceived Benefits Of And Strategies For Discussing Long-Term Prognosis With Older Adults, Jayaji More, Sean Lang-Brown, Rafael D. Romo, Sei J. Lee, Rebecca Sudore, Alexander K. Smith

NYMC Student Publications

OBJECTIVES: To characterize the goals and approaches of clinicians with experience discussing long-term prognostic information with older adults. DESIGN: We used a semistructured interview guide containing 2 domains of perceived benefits and strategies to explore why and how clinicians choose to discuss long-term prognosis, defined as life expectancy on the scale of years, with patients. SETTING: Clinicians from home-based primary care practices, community-based clinics, and academic medical centers across San Francisco. PARTICIPANTS: Fourteen physicians, including 11 geriatricians and 1 geriatric nurse practitioner, with a mean age of 40 and a mean 9 years in practice. MEASUREMENTS: Clinician responses were analyzed …