Medicine and Health Sciences Commons^™

Injury Prevention Inclusion In Pre-Licensure Baccalaureate Nursing Curricula, Ali Marie Galindo

Student Theses, Dissertations and Capstones

Integrating injury prevention into healthcare education has been recommended for over 10 years. However, the literature reveals little about how injury prevention is incorporated into nursing curricula. This study aimed to evaluate if unintentional injury prevention was being taught in pre-licensure baccalaureatenursing education. The Essentials of Baccalaureate Education for Professional Nursing Practice (2008), the Recommended Baccalaureate Competencies and Curricular Guidelines for Public Health Nursing (2018), and the Institute of Medicine’s Initiative on the Future of Nursing: Leading Change, Advancing Health (2011) were utilized as the driving forces to support injury prevention inclusion. The research questions inquired if pre-licensure baccalaureate CCNE-accredited …

Com Outlook Winter 2019, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Physical And Optical Properties Of Provisional Crown And Bridge Materials Fabricated Using Cad/Cam Milling Or 3d Printing Technology, Niranjan Joshi

Student Theses, Dissertations and Capstones

Objective: This study compared the physical and optical properties of provisional crown and bridge materials fabricated using CAD/CAM or 3D printing technology. Aim: To compare the biaxial flexural strength, microhardness, translucency parameter and gloss of provisional resin discs fabricated by milling PMMA blocks, versus two different resins printed using 3D printers. Hypothesis: There is no difference in the flexural strength, hardness, translucency and gloss of provisional resins fabricated by different digital technologies. Materials and methods: 90-disc shaped specimens for provisional resins were fabricated using a common digital file. These samples were equally distributed in three groups of 30 each. Group …

Knowledge, Attitudes And Practice Behaviors About Caries Risk Assessment And Management, Ahmad Malluh

Student Theses, Dissertations and Capstones

Brief Background: The World Health Organization (WHO), the International Association for Dental Research (IADR) and the World Dental Federation (FDI) in 1981 established the first global oral health goals and promoted the development of oral health objectives targeting reduction in key oral health indicators by 2020. Among the oral health indicators identified in this initiative was the reduction of caries. While there is evidence to suggest that from a global perspective the prevalence of caries is decreasing, there are geographical locations, like Saudi Arabia, where the prevalence of caries is exceeding worldwide statistics. Hence, dental professional, research, and educational associations …

Correlation Of Body Mass Index Percentile And Craniofacial Morphology: A Retrospective, Cross-Sectional Study, Adam G. Danze

Student Theses, Dissertations and Capstones

Introduction: Obesity rates are rising exponentially in many countries around the world, particularly in the United States. This epidemic is affecting people of all ages, and little to no progress has been made it slow it down. Lack of physical activity and increased consumption of energy rich foods and caloric intake have been recognized as contributing factors for the concerning increase in the prevalence of obesity in child and adult populations. The high prevalence of obesity is believed to be a complex interplay of genetic, environmental, socioeconomic, cultural, and psychological factors. Childhood obesity is occurring at progressively younger ages, leading …

The Relationship Of Parent-Reported Symptoms Of Sleep-Disordered Breathing With The Presence Of Malocclusion And Craniofacial Disharmony In Pediatric Orthodontic Patients, Astin Barnes

Student Theses, Dissertations and Capstones

Introduction: Sleep-disordered breathing (SDB) is a term for breathing difficulties occurring during sleep and encompasses frequent loud snoring to Obstructive Sleep Apnea (OSA). SDB in children has been linked to daytime sleepiness, poor school performance, hyperactivity, cardiovascular complications, impaired overall growth, development of malocclusion, and craniofacial disharmony. The American Academy of Pediatrics and the American Association of Orthodontists (AAO) urge more studies to educate about etiology, symptoms, and sequelae of SDB. Therefore, this study proposed to investigate the association between symptoms of SDB and malocclusion and craniofacial disharmony in children. Methods: The Pediatric Sleep Questionnaire (PSQ) was used to obtain …

Determining Efficacy Of Anti-Cancer Drug From Detection In Plasma Using The Hplc Method, Nili Modi

BIO4950: Internship in Biology

Extraction of anti-cancer drug in plasma from in vivo organism models were studied to examine and differentiate the different methods. Along with extraction, detection of the amount and the retention period of the anti- cancer drug in plasma in the test subjects were focused on to analyze the ways of the HPLC method. The HPLC (High Performance Liquid Chromatography) method is the most frequently used method for detection in many labs due to its ability to be programed quick with minimal training and to ensure accurate results. Using animal models to detect plasma drug levels in pre-clinical trials is valuable …

Thrust Joint Manipulation To The Cervical Spine In Participants With A Primary Complaint Of Temporomandibular Disorder (Tmd): A Randomized Clinical Trial, Breanna C. Reynolds

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Temporomandibular disorder (TMD) is a common and costly problem often leading to chronic pain. There exists moderate evidence for physical therapy (PT) interventions in the management of TMD. A known relationship between TMD and the cervical spine exists with some evidence to support cervical intervention treatments. Cervical spine thrust joint manipulation (TJM) is an effective PT intervention explored in a limited fashion for this population. Objectives: To determine the immediate and short term (1 and 4 week) effects of cervical TJM on pain, dysfunction, and perception of change in individuals with a primary complaint of TMD. Methods: In this …

Cognitive Load Theory Principles Applied To Simulation Instructional Design For Novice Health Professional Learners, Susan M. Grieve

Department of Physical Therapy Student Theses, Dissertations and Capstones

While the body of evidence supporting the use of simulation-based learning in the education of health professionals is growing, howor why simulation-based learning works is not yet understood. There is a clear need for evidence, grounded in contemporary educational theory, to clarify the features of simulation instructional design that optimize learning outcomes and efficiency in health care professional students.

Cognitive Load Theory (CLT) is a theoretical framework focused on a learner’s working memory capacity. One principle of CLT is example based learning. While this principle has been applied in both traditional classroom and laboratory settings, and has shown positive …

Effects Of Generic Group-Based Versus Personalized Individual-Based Exercise Programs On Balance, Gait, And Functional Performance Of Older Adults With Mild Balance Dysfunction And Living In Residential Care Facilities - A Randomized Controlled Trial, Varatharajan Lingam

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: To investigate the effect of an individualized exercise program versus a generic group-based exercise program on balance, gait, and functional performance of older adults categorized as having mild balance dysfunction and living in residential care facilities. Methods: Single blind randomized control design. One hundred-twenty residents fulfilled screening criteria for mild balance dysfunction based on the BioSwayTM balance and the Multi-Directional Reach Test (MDRT) primary outcome measures. Secondary assessment was completed using the Modified Physical Performance Test (PPT), hand-held dynamometer (lower-limb muscle strength testing), and gait speed analysis. Sixty subjects received individualized treatment from physical therapists (8 weeks). …

Effectiveness Of A Manual Therapy Approach In Treatment Of Patients With Lumbar Spinal Stenosis, Haitham Ramadan

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: The use of manual therapy for the management of lumbar spinal stenosis (LSS) has not been adequately systematically reviewed in an attempt to determine its effectiveness on patients with LSS. The lack of evidence in support ofcommonly used conservative interventions continues to result in a lack of clarity regarding what interventions should be used to manage patients with LSS. Objective: To use a randomized comparative trial to compare the functional clinical outcomes achieved by patients with LSS receiving two different physical therapy interventions. Methods: In this randomized controlled trial, a total of40 participants diagnosed with LSS were randomized into …

Mental Health Disorders In Dpt Students: Identifying Needs, Support Systems, & Challenges, Jennifer M. Bogardus

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: There is an increase in the incidence and severity of mental health disorders in university students. Doctor of Physical Therapy students are at increased risk due to physiological, environmental, and generational factors. Design: Mixed-Methods, multi-site, descriptive study Participants: Current DPT students (N= 1228 ) completed a survey and DASS-42; 20 students demonstrating moderate severity on the DASS participated in telephone interviews. Methods: Surveys were emailed to 238 DPT program directors with a request to forward to students. Following the survey, a total of 20 interviews were completed. Results: DPT students were found to have higher DASS scores than their …

Lived Experience Of Exemplary Physical Therapist Students In Clinical Education: A Phenonenological Study, Laura Hagan

Department of Physical Therapy Student Theses, Dissertations and Capstones

Introduction and Review of the Literature. The academic community has made it priority to determine best practice in the clinical education (CE) of Physical Therapist (PT) students. The perspective of various stakeholders has been considered inthe profession’s pursuit of excellence. Previous research highlighting the characteristics of expert clinicians and clinicalinstructors in physical therapy has served as a model for those who strive for excellence. The student and critical stakeholder, however, has not been given the opportunity to be heard. To date, no literature has explored the experience of PT student who demonstrate excellence. This study aims to understand the lived …

Caring For Children With Severe Cerebral Palsy: The Lived Experience Of Parents, Jason Eric Cook

Department of Physical Therapy Student Theses, Dissertations and Capstones

The purpose of this study is to explore the lived experience of parents who care for their child withcerebral palsy who function at Gross Motor Function Classification System (GMFCS) Level V. Additionally, the study also explores the parent’s understandings and beliefs about pain and non-pain related emotional distress, and the meaning of caring, providing care, and providing comfort for their child with GMFCS Level V cerebral palsy. The study was conducted using a qualitative, hermeneutic phenomenology approach with semi-structured interviews and participant-initiated journaling. The study included 11 participants who are caregiving parents of their child with GMFCS Level V cerebral …

An Exploration Of The Lived Experience Of Women Who Had Abortions And The Effects Of The Abortion Secret On Their Relationships: An Interpretive Phenomenological Analysis, Marckdaline Johnson

Department of Family Therapy Dissertations and Applied Clinical Projects

The United States Supreme Court decision in the Roe v. Wade (1973) case provides women with a right to privacy and the liberty to make decisions concerning their reproductive lives. With this, women who become pregnant are offered the right to choose between keeping their pregnancy and terminating the pregnancy by way of abortion. Since Roe v. Wade (1973), many women have exercised their reproductive liberties, as evidenced by the termination of over 60 million pregnancies via legal abortion in the United States. Still, secrecy among women with a history of abortion remains a common phenomenon. Studies conducted on abortion …

Effectiveness Of Plant Species For Removing Atmospheric Ammonia, Marife B. Anunciado, Sheryll B. Jerez, Hans Williams, Joey Bray, Dean W. Coble, Rena Saito

Faculty Publications

Six plant species of Yaupon, Eastern red cedar, American holly, Arizona cypress, Arborvitae and Roughleaf dogwood were utilized to determine their effectiveness in the removal of atmospheric ammonia. All species were exposed to three ammonia levels (1, 5 and 10 ppm) in an environmental chamber. Foliar ammonia content was quantified using an enzymatic technique. The effects of exposure to ammonia on the physiological responses (e.g. photosynthetic activity, stomatal conductance, and transpiration rate) of plants in ambient condition were also determined using an open design photosynthetic gas exchange system. Foliar ammonia content was significantly different among the six plant species (p<0.0001) with Eastern red cedar exhibiting the highest content. The physiological responses differed significantly depending on the plant species and the ammonia treatment level. The photosynthetic response of plants to the presence of ammonia was mixed. At low exposure level, all species except Arborvitae had decreased photosynthetic activity, reducing by as much as 44.5% for Yaupon. At the highest concentration, however, Yaupon’s photosynthetic activity improved by about 10%. Exposure to ammonia caused increased stomatal conductance and transpiration rate on American holly and Arizona cypress, making them more susceptible to water loss.

First Impressions Online: The Inclusion Of Transgender And Gender Nonconforming Identities And Services In Mental Healthcare Providers’ Online Materials In The Usa, Natalie Holt, Debra A. Hope, Richard Mocarski, Nathan Woodruff

Trans Collaborations Academic Papers

Background: When accessing mental healthcare services, transgender and gender nonconforming (TGNC) individuals face systemic barriers to gender-affirmative care. Initial points of contact, like intake forms, may show limited consideration for the heterogeneity of TGNC identities and can lead to negative consequences prior to face-to-face interaction with providers.

Aims: The first aim was to mimic a likely pathway a TGNC individual may follow to seek mental healthcare services in the USA and to describe the extent to which they may encounter enacted stigma or affirmative messages that may impede or facilitate access to care. The second aim was to determine if …

Multimodal Imaging And Asymmetry Of Disease Progression In Rhodopsin-Associated Autosomal Dominant Retinitis Pigmentosa, Lawrence Chan

Yale Medicine Thesis Digital Library

Retinitis pigmentosa (RP) is a group of genetically and clinically heterogeneous inherited retinal degenerative diseases with no known cure to date. The recent gene therapy treatment for Leber’s congenital amaurosis and RP caused by mutations in RPE65 have resulted in dramatic improvements in vision, leading to excitement for other potential gene therapies on the horizon. Upcoming clinical trials will be targeting patients with specific mutations, and measurements of disease progression will be needed for each genetic subtype of RP in order to determine whether treatments are successful. In this retrospective cohort study, we examined 27 RP patients with confirmed autosomal …

A Review Of Asthma Treatments: Monoclonal Antibody, Corticosteroid, Leukotriene Modifier, And Bronchodilator, Alec Williams

Biology and Microbiology Graduate Students Plan B Research Projects

Medical research has created multitudes of medications to help control the symptoms of asthma. Asthmas effects the respiratory system in different ways, creating unique challenges to researchers and doctors alike to create or a manage the symptoms of asthma. Identifying the common treatment methods and understanding their effect on the human physiology can aid in treating patients. The goal of this review is to identify the common medications used to treat asthma, how these medications work on the human’s physiology, as well as bring to light a new upcoming medication with greater asthma control. As asthma research continues, the need …

Population Based Patient Navigation : 24-Hour Personalized Cancer Care For The Entire Cancer Continuum, Jenna Cowan, Jennifer Kerkvliet

College of Nursing Faculty Publications

Cancer One word that bears immense significance for so many individuals For some, it is the word that took them by surprise, imposing new routines and adjustments to daily life as quickly and succinctly as it rolls off the tongue For others, the word evokes complex and multifaceted emotions fear, strength, apathy, gratitude, anger, hope, grief, determination the list is endless and ever changing The impact of this diagnosis extends far beyond the patient to their family, their care team, their community and more In 2017 there will be an estimated 1 688 780 new cancer cases diagnosed in the …

Teaching Primer For Future Interns, Nina Mingioni, Md

Medical Education Teaching Tools

This session was designed for senior medical students who will soon be interns and will be expected to teach medical students. Knowles’ Adult Learning Theory principles is used to explain principles of effective teaching principles. RIME model is introduced as a way to define students’ clinical performance expectations. A discussion of teaching tools provides concrete examples to help new interns become better educators.

Learning Objectives

• Describe core tenets of adult learning theory
• Reflect on own educational experiences through the prism of adult learning
• Identify characteristics of “great teachers”
• Use RIME model to describe learner performance expectations
• Develop a list of …

A Randomized, Double-Blinded Trial Comparing The Effectiveness Of Tranexamic Acid And Epsilon-Aminocaproic Acid In Reducing Bleeding And Transfusion In Cardiac Surgery, J. Leff, A. Rhee, S. Nair, D. Lazar, S. Sathyanarayana, L. Shore-Lesserson

Journal Articles

© 2019 Annals of Cardiac Anaesthesia. Objectives: To compare the effectiveness of epsilon aminocaproic acid (EACA) to tranexamic acid (TA) in reducing blood loss and transfusion requirements in patients undergone cardiac surgery under cardiopulmonary bypass. Design: Randomized, double blinded study. Outcome variables collected included; baseline demographic characteristics, type of surgery, amount of 24 hour chest tube drainage, amount of 24 hour blood products administered, 30 day mortality and morbidity and length of stay. We analyzed the data using parametric and non-parametric tests as appropriate. Setting: Single center tertiary-care university hospital setting. Participants: 114 patients who had undergone cardiac surgery under …

Anticoagulation Management And Heparin Resistance During Cardiopulmonary Bypass: A Survey Of Society Of Cardiovascular Anesthesiologists Members, R. M. Sniecinski, E. Bennett-Guerrero, L. Shore-Lesserson

Journal Articles

We surveyed Society of Cardiovascular Anesthesiologists members regarding anticoagulation practices for cardiopulmonary bypass and attitudes on heparin resistance. Of 550 respondents (18.5% response rate), 74.9% (95% CI, 71.3%-78.5%) used empiric weight-based dosing of heparin, and 70.7% (95% CI, 66.9%-74.5%) targeted an activated clotting time of either 400 or 480 seconds to initiate cardiopulmonary bypass. Of note, 17.1% (95% CI, 13.9%-20.2%) of respondents reported activated clotting time targets lower than those recommended by recent 2018 Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society of Extracorporeal Technology guidelines or failed to monitor heparin effects at all. When heparin resistance was encountered, 54.2% …

Peak Left Atrial Strain As A Single Measure For The Non-Invasive Assessment Of Left Ventricular Filling Pressures, A. Singh, D. Medvedofsky, A. Mediratta, B. Balaney, E. Kruse, B. Ciszek, A. P. Shah, J. E. Blair, F. Maffessanti, R. M. Lang, +2 Additional Authors

Journal Articles

No abstract provided.

A Prospective, Single-Arm, Multicenter Trial Of Catheter-Directed Mechanical Thrombectomy For Intermediate-Risk Acute Pulmonary Embolism The Flare Study, T. Tu, C. Toma, V. F. Tapson, C. Adams, W. A. Label, M. Silver, S. Khandhar, R. Amin, M. Weinberg, K. Rosenfield, +8 Additional Authors

Journal Articles

No abstract provided.

Opportunities For Research In Mental Health Emergencies: Executive Summary And Methodology, M. P. Wilson, C. Shenvi, L. Rives, K. Nordstrom, S. Schneider, M. Gerardi

Journal Articles

© 2019 Wilson et al. Introduction: Despite the ever-increasing numbers of mental health patients presenting to United States emergency departments, there are large gaps in knowledge about acute care of the behavioral health patient. To address this important problem, the Coalition on Psychiatric Emergencies convened a research consensus conference in December 2016 consisting of clinical researchers, clinicians from emergency medicine, psychiatry and psychology, and representatives from governmental agencies and patient advocacy groups. Methods: Participants used a standardized methodology to select and rank research questions in the order of importance to both researchers and patients. Results: Three working groups (geriatrics, substance …

Integration Of Entrustable Professional Activities With The Milestones For Emergency Medicine Residents, D. Hart, D. Franzen, M. Beeson, R. Bhat, M. Kulkarni, L. Thibodeau, M. Weizberg, S. Promes

Journal Articles

© 2019 Hart et al. Introduction: Medical education is moving toward a competency-based framework with a focus on assessment using the Accreditation Council for Graduate Medical Education Milestones. Assessment of individual competencies through milestones can be challenging. While competencies describe characteristics of the person, the entrustable professional activities (EPAs) concept refers to work-related activities. EPAs would not replace the milestones but would be linked to them, integrating these frameworks. Many core specialties have already defined EPAs for resident trainees, but EPAs have not yet been created for emergency medicine (EM). This paper describes the development of milestone-linked EPAs for EM. …

Simulation-Based Remediation In Emergency Medicine Residency Training: A Consensus Study, N. A. Nadir, D. Hart, M. Cassara, J. Noelker, T. Moadel, M. Kulkarni, C. S. Sampson, S. Bentley, N. K. Naik, C. Strother, +4 Additional Authors

Journal Articles

© 2019 Nadir et al. Introduction: Resident remediation is a pressing topic in emergency medicine (EM) training programs. Simulation has become a prominent educational tool in EM training and been recommended for identification of learning gaps and resident remediation. Despite the ubiquitous need for formalized remediation, there is a dearth of literature regarding best practices for simulation-based remediation (SBR). Methods: We conducted a literature search on SBR practices using the terms "simulation," "remediation," and "simulation based remediation." We identified relevant themes and used them to develop an open-ended questionnaire that was distributed to EM programs with experience in SBR. Thematic …

A Research Agenda For Assessment And Management Of Psychosis In Emergency Department Patients, J. Peltzer-Jones, K. Nordstrom, G. Currier, J. S. Berlin, C. Singh, S. Schneider

Journal Articles

© 2019 Peltzer-Jones et al. Introduction: Emergency departments (ED) manage a wide variety of critical medical presentations. Traumatic, neurologic, and cardiac crises are among the most prevalent types of emergencies treated in an ED setting. The high volume of presentations has led to collaborative partnerships in research and process development between experts in emergency medicine (EM) and other disciplines. While psychosis is a medical emergency frequently treated in the ED, there remains a paucity of evidence-based literature highlighting best practices for management of psychotic presentations in the ED. In the absence of collaborative research, development of best practice guidelines cannot …

Assessment Of Physician Well-Being, Part Two: Beyond Burnout, M. D. Lall, T. J. Gaeta, A. S. Chung, S. A. Chinai, M. Garg, A. Husain, C. Kanter, S. Khandelwal, C. S. Rublee, N. T. Himelfarb, +3 Additional Authors

Journal Articles

© 2019 Lall et al. Part One of this two-article series reviews assessment tools to measure burnout and other negative states. Physician well-being goes beyond merely the absence of burnout. Transient episodes of burnout are to be expected. Measuring burnout alone is shortsighted. Well-being includes being challenged, thriving, and achieving success in various aspects of personal and professional life. In this second part of the series, we identify and describe assessment tools related to wellness, quality of life, resilience, coping skills, and other positive states.