Medicine and Health Sciences Commons^™

The Ethics Of An Unlicensed Medical Practitioner, Charles C. Escott

Writing Across the Curriculum

For option A of this assignment, the prompt is that Harry, a manufacturer of medical equipment and an avid reader of medical textbooks, has developed a program that will allow its users to self-diagnose and self-treat their ailments, without a doctor’s help. Harry wants to sell his program to “ordinary folk” as a replacement for consulting licensed medical practitioners. An important point here is that Harry is not licensed to practice medicine and has only read books on the subject. The posed question is whether or not his program should be published (from an ethical standpoint—not necessarily a profit-driven one). …

Pressure To Be Perfect: Eating Disorders In Sports, Genevieve Nitzsche

Writing Across the Curriculum

Eating disorders have become more prevalent in recent years as societal standards have gotten harsher. Typically, when people think about the type of people who develop eating disorders, the first thing that pops into their head is not athletes. There is an association between athletes and the need for great amounts of food to fuel their bodies. However, in sports such as wrestling and aesthetic sports, like gymnastics and figure skating, the emphasis of image and the pressure from their coaches can be extremely harmful to their mental health. This paper discusses specific statistics of the incidence of eating disorders …

Efficacy Of Statin Therapy In The Elderly, Alyssa M. B. White, Hillary R. Mishcon, John Redwanski, Ronald D. Hills Jr

Pharmacy Student Posters

Statins are one of the most heavily prescribed medications. The 2018 ACC/AHA guidelines support statin therapy for most older adults, but recommendations are less clear for those over 75. The literature was systematically reviewed for evidence of the efficacy of statin treatment in different patient populations. Significant evidence was found supporting a decreasing association between low-density lipoprotein cholesterol (LDL-C) and mortality as well as decreasing statin efficacy with increasing age. The consequences of unnecessary statin therapy can be severe for older adults. Improved methods for evaluating atherosclerotic cardiovascular disease (ASCVD) risk, such as using negative markers to help identify those …

Violent Death Rates In The Us Compared To Those Of The Other High-Income Countries, 2015, Erin Grinshteyn, David Hemenway

Nursing and Health Professions Faculty Research and Publications

Violence is a serious public health issue in the U.S. This research compares the US and other high-income countries in terms of violent death. we used data from the World Health Organization for populous, high-income countries. Data from CDC's WISQARS and WONDER systems were used to assess mortality data among US white and non-white populations and in low-, medium-, and high-gun states in 2015. Death rates per 100,000 population were calculated overall, by age, and by sex. Poisson and negative binomial regression were used to test for significance. The homicide rate in the US was 7.5 times higher than the …

Tolle Lege Works Published In 2019, Mcquade Library

Bibliographies

Compiled Tolle Lege bibliography of works published by members of the Merrimack College Community in 2019. Works include journal articles, books, book chapters, conference presentations and posters, and more.

Sex Differences In The Outcomes Of Mild Traumatic Brain Injury In Children Presenting To The Emergency Department, Taylor M. Yeates

Master of Public Health Program Student Publications

Mild traumatic brain injuries (mTBI) put children and adolescents at risk for short and long-term health risks. The purpose of this study was to evaluate sex differences in post-acute outcomes among children and adolescents presenting to the Emergency Department (ED) for mTBI. The study is a secondary analysis of a de-identified dataset which was drawn from a concurrent cohort, prospective, and longitudinal study design that included 8 to 16 year-old children with mTBI and a comparison group of children with mild orthopedic injuries (OI) not involving the head. Participants were recruited and completed an initial assessment during their initial visit …

College Of Health Care Sciences Audiology, Nova Southeastern University

Health Professions Divisions Course Catalogs and Course Descriptions

No abstract provided.

The Relationship Between Advanced Degrees And Performance On Usmle Step 1, Martha E. Orozco Cortes

Scholarship in Medicine - All Papers

While previous studies have analyzed the relationship of pre-admission factors on USMLE Step 1 scores few studies have looked at the effects obtaining a graduate degree prior to medical school matriculation. Therefore, this study sought to determine if there was an advantage between obtaining a graduate degree before medical school when it came to step 1 board scores. This retrospective study analyzed step 1 scores and medical school application data from 718 students who matriculated at a public midwestern medical school between 2014 and 2016. A combination of analyzes of variance, chi-square tests, and multiple regression analyses were used. When …

The Role Of Activin A Signaling In Gastric Reflux-Related Diseases And The Progression To Esophageal Adenocarcinoma, Cedric J. Roudebush

Honors Undergraduate Theses

Gastroesophageal reflux disease (GERD), or acid reflux, affects 6-9 million people in the United States. It is characterized by a reflux of gastric acid and bile salts from the stomach into the esophagus, causing injuries to the esophagus known as Barrett's esophagus (BE). BE is the main risk factor for the development of esophageal adenocarcinoma (EAC), a devastating cancer in the esophagus whose molecular roots remain poorly understood. In recent years, evidence points to the esophageal epithelium itself as responsible for causing and promoting inflammation upon injury by gastric reflux, namely via an increase in inflammatory cytokine secretion. This project …

Women’S Perceptions, Knowledge, And Attitudes Towards Reproductive Health And Contraceptives, Audrey Mcfarland, Abigail Jonker, Adejoke Ayoola

Summer Research

To review the research that has been done since 2008 on women’s perceptions, knowledge, and attitudes towards female reproductive health and contraceptive use within the United States.

Dynamic Effects Of Habituation And Novelty Detection On Newborn Event Related Potentials, Cathryn S. Cortesa, Caitlin M Hudac, Dennis Molfese

Center for Brain, Biology, and Behavior: Faculty Publications

Newborns habituate to repeated auditory stimuli, and discriminate syllables, generating opportunities for early language learning. This study investigated trial-by-trial changes in newborn electrophysiological responses to auditory speech syllables as an index of habituation and novelty detection. Auditory event-related potentials (ERPs) were recorded from 16 term newborn infants, aged 1–3 days, in response to monosyllabic speech syllables presented during habituation and novelty detection tasks. Multilevel models demonstrated that newborns habituated to repeated auditory syllables, as ERP amplitude attenuated for a late-latency component over successive trials. Subsequently, during the novelty detection task, earlyand late-latency component amplitudes decreased over successive trials for novel …

Concussion Competencies: A Training Model For School-Based Concussion Management, Arthur C. Maerlender, Jonathan D. Lichtenstein, Jennifer Parent-Nichols, Kate Higgins, Peggy Reisher

Center for Brain, Biology, and Behavior: Faculty Publications

This study reports on the use of ten knowledge competencies related to the behavioral management of concussion in schools. Trainings using these competencies as learning objectives were delivered to school personnel. This aims of the use of competencies in this way are to streamline the education of key stakeholders, to establish clear roles and responsibilities for constituents and equip individuals working with students following a concussion with the relevant knowledge to optimize outcomes. The majority of participants, primarily speech language pathologists working as related service providers in the schoolswhere the trainings occurred, judged the use of the competencies to be …

Confirmatory Factor Analysis Of Two Computerized Neuropsychological Test Batteries: Immediate Post-Concussion Assessment And Cognitive Test (Impact) And C3 Logix, Caitlin Masterson, Julie Tuttle, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

Introduction: Tests of memory and speed of cognitive and motor responses have been the primary foci in sports-related concussion assessment. This study sought to assess the construct validity of neuropsychological tests within C3 Logix.

Method: Results of both baseline C3 Logix and the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) computerized tests from 86 Division I collegiate athletes were submitted to a two-factor confirmatory analysis using structural equation modeling. The two factors of Speed and Memory have been confirmed in previous studies of ImPACT.

Results: Results confirmed the two-factor model of ImPACT, whereas C3 Logix did not …

Functional Source Separation For Eeg-Fmri Fusion: Application To Steady-State Visual Evoked Potentials, Hong Ji, Badong Chen, Nathan M. Petro, Zejian Yuan, Nanning Zheng, Andreas Keil

Center for Brain, Biology, and Behavior: Faculty Publications

Neurorobotics is one of the most ambitious fields in robotics, driving integration of interdisciplinary data and knowledge. One of the most productive areas of interdisciplinary research in this area has been the implementation of biologically-inspired mechanisms in the development of autonomous systems. Specifically, enabling such systems to display adaptive behavior such as learning from good and bad outcomes, has been achieved by quantifying and understanding the neural mechanisms of the brain networks mediating adaptive behaviors in humans and animals. For example, associative learning from aversive or dangerous outcomes is crucial for an autonomous system, to avoid dangerous situations in the …

Population Structure And Genetic Diversity In Solitary Andrena Sp. Bees, Drew Van Andel, Sage Riley, Kelli Laube, William L. Miller

Summer Research

We evaluated the genetic structure and diversity of miner bees (Andrena sp.) in an area potentially impacted by agricultural land-use to assess possible effects on bee population health.

Reanalysis Of The Nccn Pd-L1 Companion Diagnostic Assay Study For Lung Cancer In The Context Of Pd-L1 Expression Findings In Triple-Negative Breast Cancer, David L. Rimm, Gang Han, Janis M. Taube, Eunhee S. Yi, Julia A. Bridge, Douglas B. Flieder, Robert Homer, Anja C. Roden, Fred R. Hirsch, Ignacio I. Wistuba, Lajos Pusztai

Journal Articles: Pathology and Microbiology

The companion diagnostic test for checkpoint inhibitor immune therapy is an immunohistochemical test for PD-L1. The test has been shown to be reproducible for expression in tumor cells, but not in immune cells. Immune cells were used in the IMpassion130 trial which showed PD-L1 expression was associated with a better outcome. Two large studies have been done assessing immune cell PD-L1 expression in lung cancer. Here, we reanalyze one of those studies, to show that, even with an easier scoring method, there is still only poor agreement between assays and pathologist for immune cell PD-L1 expression.

Observations Of Shear Stress Effects On Staphylococcus Aureus Biofilm Formation, Erica Sherman, Kenneth W. Bayles, Derek E. Moormeier, Jennifer L. Endres, Timothy Wei

Journal Articles: Pathology and Microbiology

Staphylococcus aureus bacteria form biofilms and distinctive microcolony or "tower" structures that facilitate their ability to tolerate antibiotic treatment and to spread within the human body. The formation of microcolonies, which break off, get carried downstream, and serve to initiate biofilms in other parts of the body, is of particular interest here. It is known that flow conditions play a role in the development, dispersion, and propagation of biofilms in general. The influence of flow on microcolony formation and, ultimately, what factors lead to microcolony development are, however, not well understood. The hypothesis being examined is that microcolony structures form …

An Evidence Based Evaluation Of Patient Outcomes After The Implementation Of A New Model Of Care For Adolescent Inpatient Psychiatry, Karen Dorr

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The use of seclusion and restraint on psychiatric units can result in physical harm or even death to patients and may inflict further harm on those who have a history of abuse (Valenkamp, Delaney, & Verheij, 2014, p. 170) (Greene, Ablon, & Martin, 2006) (Martin, Krieg, Esposito, Stubbe, & Cardona, 2008). Reduction in seclusion and restraint is a basic tenant of trauma informed care. This retrospective review and program evaluation examines the implementation of a new care model on an adolescent psychiatry unit at a large suburban hospital. The new care model incorporated the use of collaborative problem solving, an …

The Effect Of Provider Education On Discharge Information Grade Level And Readability, Amber V. Balzer

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Problem: The peri-discharge period for patients can be a complex and dangerous time. A large urban academic medical center with a readmission rate approaching 16% utilizes a standardized template called a Discharge Information Form (DIF) to convey information to inpatients at the time of their discharge. The problem is a lack of individualization with a universal template such as the DIF. Moreover, the readability and literacy level of the DIF have not been previously assessed.

Methods: A random sample of DIFs was assessed for literacy level using the Flesch-Kincaid Readability Test Tool. An in-person educational intervention was administered to a …

Video Education: A Quality Improvement Project For Patients With Type Ii Diabetes, Brandon Lipscomb

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Abstract

Background: Quality diabetes education is a key to successful diabetes treatment. Factors that hinder quality diabetes education include: allotted time for appointments, provider-patient communication, inter-personal relationship between provider and patient, and patient’s educational level. Locally speaking, the Central Virginia area has a higher rate of diabetes then compared to the average rate of diabetes in the State of Virginia. To complicate this more, the local area has a higher percentage of poverty when compared to the average poverty level of the state. Combining these two characteristics places these individuals at a higher risk for disease complications and expresses a …

An Evaluation Of A Pilot Inpatient Hospice Unit And The Impact It Has On End-Of-Life Care At An Academic Medical Center, Cynthia Minetree

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Background: Research shows that acute care hospitals with inpatient hospice units have an increase in hospice resource utilization and provide end-of-life care that is more aligned with patients’ end-of-life goals compared to hospitals that do not have inpatient hospice units.

Methods: A pilot six-bed General Inpatient (GIP) hospice unit was implemented at an acute care hospital, located in Washington, D.C., to provide hospice care for patients that were not able to transfer to another inpatient setting for hospice care. A six-month evaluation of the pilot GIP hospice unit was done to evaluate the feasibility of the unit and the impact …

What Is Baseline? A Concussion Policy Analysis, Jenny H. Crance

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Abstract Concussion symptoms are nonspecific and may be related to other causes. Symptom scores and timeline of return to activity at many institutions are based on having no symptoms at baseline with the current measurement tools. This assumption in the diagnosis and treatment of concussions may lead to prolonged return to activity, compounded concussion symptoms, and unintended psychological and social sequelae. More baseline data is needed, especially in military academies, according to the CARE Consortium Study. During the high-stress initial training period at one mid-Atlantic military college a no-symptom baseline is unlikely for first-year students. The potential overlap of concussion …

Improving Staffing At A Southern Virginia Hospital Using Bardach’S Policy Analysis And The Ihi Triple Aim Framework, Caitlin Crowder

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Nurse staffing is a major concern for healthcare organizations. Ensuring adequate staffing is crucial to providing quality, patient-centered care. The purpose of this project was to explore staffing policy options at a Southern Virginia Hospital using Bardach’s policy analysis and the IHI Triple Aim as frameworks. This policy analysis was conducted to offer a solution for staffing. The current staffing model at this rural Southern Virginia hospital resulted in ongoing, escalating costs that cannot be sustained over time. The three staffing options reviewed included: allowing the current staffing plan to stay in place, implementing a staffing committee, and implementing a …

Reducing Inpatient Falls On A Cardiovascular Progressive Care Unit: A Quality Improvement Study To Implement Interprofessional Intentional Rounding, Deidra Pennington

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Patient falls remain a significant concern for hospitals despite years of focus and research on the topic. Most hospitals have robust fall prevention policies in place containing numerous interventions, yet few demonstrate evidence of long-term sustainability in fall reduction. Patient falls impact overall health outcomes and result in higher costs for the patient and facility due to increased lengths of stay and more medical tests. The location for this study was the cardiovascular progressive care unit (CVPCU) at a Level 1 Trauma Center and academic hospital. This unit underwent a relocation and merger of two nursing units in the fall …

Improving Hepatitis C Screenings In The 1945 To 1965 Birth Cohort In Outpatient Primary Care, Betina Muse Nakoda

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Background: Hepatitis C virus (HCV) is a silent epidemic affecting a vulnerable patient population in our society. Among those considered high risk for having HCV are those individuals born between 1945 and 1965, termed the baby boomer population. Baby boomers are five times more likely to have and suffer mortality from HCV than any other patient population (CDC, 2018). HCV may not present with signs or symptoms until 20 to 30 years post contraction of the virus (CDC, 2018). In 2012, the Centers for Disease Control and Prevention (CDC) updated its recommendations for Hepatitis C screenings to include the baby …

Measuring Levels Of Preparation For Decision-Making And Patient Satisfaction In A Breast Cancer Support Group, Catherine Hagan Aylor

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The Carilion Clinic Breast Diagnostic Center diagnoses approximately 250 women with breast cancer annually, all of whom are invited to attend the Carilion Clinic Breast Cancer Support Group (CCBCSG). The primary aim of this project was to evaluate if participants with more frequent attendance of CCBCSG had increased levels of preparation for decision-making (PDM) and higher satisfaction with breast cancer treatment decisions. A REDCap survey was emailed to 137 patients who participated in at least one CCBCSG within the past five years, with a 39.4% response rate. The survey assessed levels of patient PDM, patient satisfaction about treatment decisions, and …

The Effect Of Implementing Symptom Feedback Into Psychiatric Care At A Non-Profit Clinic, Deirdre Rea

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Background: Healthcare is moving toward a value-based system with reimbursement based on performance. Charitable organizations providing health services need to demonstrate positive outcomes for continued grant funding. Measurement-Based Care (MBC) is evidence-based, can improve patient outcomes and objectively document success. Studies show most psychiatric providers do not utilize MBC in their own practices citing lack of time, and a belief that their clinical judgment supersedes a measurement tool. The purpose of the study was to establish the use of patient-reported symptom measurement tools in a non-profit psychiatric clinic and determine if an office-based strategy to proactively and regularly report to …

Controlling Latent Tb Tuberculosis Infection In High-Burden Countries: A Neglected Strategy To End Tb, Gavin J. Churchyard, Susan Swindells

Journal Articles: Infectious Diseases

In a Perspective, Gavin Churchyard and Sue Swindells discuss the importance of strategies to target latent tuberculosis infection in high risk populations and thus disrupt a reservoir for new infections in high burden countries.

A Report Of Us Physicians’ Beliefs About Physician-Assisted Suicide And A Bioethical Analysis Of The Practice, Peter Theodore Hetzler

Yale Medicine Thesis Digital Library

A REPORT OF US PHYSICIANS’ BELIEFS ABOUT PHYSICIAN-ASSISTED SUICIDE AND A BIOETHICAL ANALYSIS OF THE PRACTICE.

Peter T. Hetzler III, James Nie, Amanda Zhou, and Lydia S. Dugdale. Department of Internal Medicine, Yale University, School of Medicine, New Haven, CT.

The goals of this work were two fold. The first was to assess the beliefs of US physicians about the national legalization of physician-assisted suicide (PAS). The second was to determine the moral permissibility of PAS through a bioethical analysis. For the former, we sent a survey to 1000 randomly chosen physicians from around the US. For the last, we …

Dr. Seuss Fine Motor Development Club, Nicole Borcyk, Madelyn Beck

Honors Program: Expanded Learning Clubs

After school club that helps students develop fine motor skills by doing hands-on activities relating to Dr. Seuss's most popular books.