Medicine and Health Sciences Commons^™

Treatment Of Basal Cell Carcinoma With Vismodegib, Sunitha Johns, Katlyn Brown, Emily Loudermilk, Crystal Zheng, Anh Dao Le, Sophocles Chrissobolis

Pharmacy and Wellness Review

The most prevalent nonmelanoma skin cancers are basal cell carcinoma (BCC) and locally advanced basal cell carcinoma (aBCC). Current, effective first-line treatments for BCC aim to remove and destroy cancerous skin cells through excision surgery, Mohs surgery, radiation therapy and cryotherapy, while treatment of aBCC remains limited. An emerging treatment option for aBCC that promotes tumor size reduction is vismodegib, a pharmaceutical product approved in 2012 by the U.S. Food and Drug Administration (FDA). Vismodegib was approved for the treatment of aBCC, metastasized HCC (mBCC) or recurrent BCC after surgery as well as for use in adults who are not …

Improving Healthcare Costs And Patient Outcomes Across Healthcare Professions, Hannah Lamb, Jourdan Ujlaki, Paige Torbet, Isabel Cwikla, Rebecca Worden, Michael Rush

Pharmacy and Wellness Review

Healthcare professionals must be aware of the importance of preventive medicine and the responsibility they have in contributing to it. There are three levels of preventive medicine that a healthcare professional can provide based on the patient population that is receiving care and the goals of the particular service. Preventive medicine has the ability to improve both overall healthcare costs and have a positive impact on a patient's quality of life. All healthcare professionals have the potential to fulfill a role in each level of preventive medicine, and should understand the role of each member of the healthcare team, to …

Triple Therapy Or Triple Threat: An Analysis Of Triple Antiplatelet Therapy Compared To Dual Antiplatelet Therapy, Isabel E. Cwikla, Kara C. Horvath, Elaina Gollmar, Austin Hilverding, Erin Petersen

Pharmacy and Wellness Review

Triple antiplatelet therapy (TAPT, or triple therapy), is an oral medication regimen designed to reduce the risk of major cardiovascular events. It consists of aspirin, clopidogrel or an alternative, and an oral anticoagulant (OAC). It differs from dual antiplatelet therapy (DAPT) due to inclusion of an OAC. Multiple clinical studies have indicated that triple therapy is more effective at clot prevention, when compared to aspirin monotherapy and DAPT, but is associated with a higher risk of major bleeding. Pharmacists have a key role in determining candidates for DAPT and TAPT regimens. Other opportunities for pharmacists include patient monitoring, counseling and …

Programmed Death Pathway Inhibition: Emerging Therapeutic Options For Treatment Of Advanced Or Refractory Cancers, Katherine Elsass, Morgan Homan, Jana Randolph, Brendan Rasor, David Kinder

Pharmacy and Wellness Review

The programmed death-1 (PD-1) pathway has a significant role in the promotion of immune tolerance. The PD-1 receptor ligands are normally expressed on various inactive immune cells. When cancer cells express these ligands, they are able to interact with active T and B lymphocytes to induce this tolerance. Nivolumab and pembrolizumab are two recently approved agents that act to disrupt this binding and facilitate an immune response against cancer cells. Numerous trials, including KEYNOTE-002 and CheckMate 063, have demonstrated the superior safety and efficacy of these drugs in patients with advanced or refractory cancers. Initially approved for the treatment of …

Zika Virus Induced Neurological Disorders And Impacts On Public Health, Alexandra Herman, Martha Zimmerman, Olivia Vanscoy, Olivia Henton, Lindsey Peters

Pharmacy and Wellness Review

Zika virus is a public health emergency of international concern. Zika virus (ZIKV) is a mosquito-borne pathogen that is carried by the Aedes genus. Zika is spread through direct bite and nonvector transmission. Most individuals infected with Zika will be asymptomatic, but some may present nonspecific viral symptoms. A rising number of neurological disorders in newborns whose mothers were infected with ZIKV during pregnancy have been reported due to recent outbreaks. Neurological disorders affect both the central and peripheral nervous systems and can result from bacterial, viral, fungal or parasitic infections of the nervous system or from the immune response …

Pcsk9 Inhibitors: A Novel Class Of Pharmacotherapy For Hypercholesterolemia, Angela Chu, Austin Hilverding, Elizabeth Kramer, Brendan Rasor, Boyd Rorabaugh

Pharmacy and Wellness Review

The recent U.S. Food and Drug Administration (FDA) approval of two new drugs, alirocumab (Praluent®) and evolocumab (Repatha®) is a breakthrough in the treatment of familial hypercholesterolemia. These drugs are a part of a new class called the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors that act by increasing the number of low density lipoprotein receptors (LDL-R) recycled to hepatocyte membranes. The increased density of LDL-R facilitates greater clearance of low density lipoproteins from the blood. Numerous clinical trials have demonstrated the efficacy of these agents, particularly for patients in whom standard cholesterol-lowering therapy is insufficient. However, data on long-term …

Zika Virus: Infectious Process And Public Health Response, Morgan Homan, Julia Dickman, Jenna Deininger, Austin Hopkins, Olivia Henton, Steven N. Leonard

Pharmacy and Wellness Review

The Zika virus has become a growing concern as a global pandemic. Since being identified in Uganda in 1947, the virus has spread around the world, recently emerging in South America with a great impact on Brazil. As of 2016, Zika has made its appearance in the United States and is now actively being transmitted in Florida. The virus is a mosquito-vectored flavivirus primarily transmitted by the Aedes mosquito which infects a human through biting. Transmission through sexual intercourse is also possible as well as transmission from a pregnant woman to her fetus. This latter form of transmission presents the …

Belsomra®: A Novel Dual Orexin Receptor Antagonist For The Treatment Of Insomnia, Shane Bogusz, Steven Blake, Michaela Wolford, Victoria Cho, Manoranjan D'Souza

Pharmacy and Wellness Review

Insomnia is a disease state characterized by a persistent difficulty in falling asleep, and results in enormous health-related and economic costs to both the individual and society. Several medications are currently available for the treatment of insomnia; however, these medications are associated with several limitations including anterograde amnesia, dependence, withdrawal symptoms upon stopping the medication and rebound insomnia. The U.S. Food and Drug Administration recently approved suvorexant (Belsomra®) as a treatment for insomnia. Suvorexant is a first-in-class dual orexin receptor antagonist for the treatment of insomnia. This review will first describe the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) …

Changing The Expectations: Disability In The 21st Century Hpr 226g, Joanna Burkhardt

Library Impact Statements

No abstract provided.

Faculty Perceptions Of Readiness To Implement Interprofessional Education In Athletic Training, Meredith M. Parry, Jennifer Jordan Utley, Sue Shapiro, Stefanie Podlog

Athletic Training Collection

PURPOSE As the athletic training profession advances, master’s degree accreditation standards aim to position athletic trainers as key players on interprofessional healthcare teams. Interprofessional education standards were recently introduced to academic leaders as key elements in the professional healthcare education of athletic trainers.

While the current standards reflect essential skills for entry-level clinicians, faculty instructing these elements may require additional development.

METHODS The objective of this study was to explore athletic training educators’ perceptions of interprofessional education and to examine perceived barriers related to the implementation of IPE in athletic training curricula. An electronic survey was administered to a stratified, …

Step It Up Macks Creek, Mo: A Community Walking Program, Amy Butler

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Amy Renee Butler, MSN, FNP-C

Physical inactivity is a major risk factor for chronic disease. Despite goals, guidelines and interventions physical inactivity continues to rise. Rural residents are at even higher risks of sedentary lifestyles highlighting the need for research and interventions focusing on this particular population.

The purpose of this study was to develop a community walking program to create an environment of favorable health resources in a rural area of mid-Missouri. The walking program provided residents with an educational meeting followed by a five week walking intervention that evaluated participants step …

Resources That Improve Medical Board Licensing Examination Performance, Frank Jackson, Ethan Duane, Robert Harmon, Ryan A. Kollar, Nicole M. Rainville, Ryan M. Smith

Primary Care Faculty Publications

Purpose: Examine the factors improving performance on national medical licensing board examinations.
Rationale: Accreditation Council for Graduate Medical Education (ACGME) accredited residency programs report the United States Medical Licensing Examination (USMLE) Step 1 and Comprehensive Osteopathic Licensing Examination-USA (COMLEX-USA) Level 1 scores as the most important criteria in selecting candidates to interview.
Hypotheses:
(1) Certain resources are superior for exam preparation.
(2) Certain practice tests better assess exam preparedness.
(3) USMLE performance will correlate with the COMLEX-USA.
Methods: One-hundred and two (102) medical students were surveyed regarding preparation for and performance on COMLEX-USA Level 1 and USMLE Step 1.
Results: …

Enhancing Timeliness Of Drug Overdose Mortality Surveillance: A Machine Learning Approach, Patrick J. Ward, Peter J. Rock, Svetla Slavova, April M. Young, Terry L. Bunn, Ramakanth Kavuluru

Kentucky Injury Prevention and Research Center Faculty Publications

BACKGROUND: Timely data is key to effective public health responses to epidemics. Drug overdose deaths are identified in surveillance systems through ICD-10 codes present on death certificates. ICD-10 coding takes time, but free-text information is available on death certificates prior to ICD-10 coding. The objective of this study was to develop a machine learning method to classify free-text death certificates as drug overdoses to provide faster drug overdose mortality surveillance.

METHODS: Using 2017–2018 Kentucky death certificate data, free-text fields were tokenized and features were created from these tokens using natural language processing (NLP). Word, bigram, and trigram features were created …

Treatment Patterns And Economic Burden Of Sickle-Cell Disease Patients Prescribed Hydroxyurea: A Retrospective Claims-Based Study, Nirmish Shah, Menaka Bhor, Lin Xie, Rashid Halloway, Steve Arcona, Jincy Paulose, Huseyin Yuce

Publications and Research

Background: This study aimed to evaluate sickle-cell disease (SCD) treatment patterns and economic burden among patients prescribed hydroxyurea (HU) in the US, through claims data.

Methods: SCD patients with pharmacy claims for HU were selected from the Medicaid Analytic Extracts (MAX) from January 1, 2009 - December 31, 2013. The first HU prescription during the identification period was defined as the index date and patients were required to have had continuous medical and pharmacy benefits for ≥6 months baseline and 12 months follow-up periods. Patient demographics, clinical characteristics, treatment patterns, health care utilization, and costs were examined, and variables were …

Communication About Influenza Prevention: A Case Study Of Arkansas State University Students Health Center, Oyeronke Oyindamola Afolabi

Student Theses and Dissertations

The purpose of this case-study was to examine what and how the Arkansas State University Student Health Center (ASUSHC) communicates about influenza and influenza vaccination. To this end, the researcher conducted thematic analysis of social media posts and flyers disseminated by the ASUSCH on influenza and influenza vaccinations. ASUSHC provides an array of medical services including treatment of minor illnesses and injuries, physical exams, and immunizations. I adopted a reflective memoing in conducting a thematic analysis as recommended by Ryan and Branerd (2003). There were two research questions posed and four themes emerged from the first research question which are: …

Facilitating The Creative Process Through Collaboration, Jennifer K. Fortuna

The Open Journal of Occupational Therapy

Miles Parker Scharfenberg, an artist based in Richland, Michigan, provided the cover art for the Fall 2019 edition of The Open Journal of Occupational Therapy (OJOT). “Late Night Fireworks” is a 30” x 40” painting made from acrylic on canvas. Born 15 weeks premature, Miles’ multiple health impairments have made it difficult to engage in meaningful occupations, such as painting. With support from his mother, Carol; occupational therapy students; and members of the community; Miles creates colorful abstract expressionist paintings. Collaboration is part of his creative process. In this fifth anniversary issue of OJOT, Occupation and the Artist is following …

Perceptions And Outcomes Of Occupational Therapy Students Participating In Community Engaged Learning: A Mixed-Methods Approach, Amy Mattila

The Open Journal of Occupational Therapy

Today’s health care system requires therapists to acquire a level of confidence, flexibility, and personal growth that enables them to treat a diverse and complex clientele. Occupational therapy programs need to ensure that clinical placements can best prepare students for these demands. Community engaged learning (CEL) offers a distinctive opportunity both to meet the curricular requirements of fieldwork and to afford students the chance to develop unique sets of skills. The purpose of this mixed-methods study was to examine the experiences of graduate occupational therapy students participating in CEL fieldwork placements. The study explored the students’ self-efficacy before and after …

Occupational Therapy’S Work And Industry Area Of Practice: Content In Entry-Level Professional Occupational Therapy Curricula: A Survey, Thomas F. Fisher

The Open Journal of Occupational Therapy

The Occupational Therapy Practice Framework: Domain and Process identifies work as an area of occupation that has long been recognized by the profession as an area of practice. This study identified how entry-level professional occupational therapy programs meet educational standards required by the Accreditation Council for Occupational Therapy Education for educational programs. Standards identified were those that relate to the area of work and industry practice. One hundred and sixty-seven program directors were invited to participate in a survey directed at work and industry occupational therapy practice. Items on the survey related to content taught in their entry-level occupational therapy …

Evaluation And Treatment Of Musicians From A Holistic Perspective, Annie Ting, Janice Rocker

The Open Journal of Occupational Therapy

Throughout the past 3 decades, treatment of injured musicians in a health care setting has been reported; however, the quality of care from a musician’s standpoint is poor. As musicians are speaking up more about their pain, the profession of occupational therapy has the capacity to make an impact on the way musicians are treated from a rehabilitative perspective. Musicians often do not trust medical practitioners who follow the traditional medical model because their symptoms and concerns are not addressed. Occupational therapists, especially those working in the realm of hand rehabilitation, are well equipped to treat injured musicians using our …

Effect Of Verbal Directions On Grip Strength Evaluated Using The Handheld Dynamometer, Laura Walsh, Marie-Christine Potvin

The Open Journal of Occupational Therapy

Background: Grip strength measurement using the handheld dynamometer is a key aspect of the evaluation of an upper extremity injury. The handheld dynamometer manufacturer has established research-based guidelines outlining body positioning during grip strength measurement. However, verbal direction guidelines, while provided, have not yet been shown to be most effective through research. This study seeks to determine whether the use of one of two types of verbal directions, with and without encouragements, resulted in greater grip strength as measured by the handheld dynamometer.

Method: The grip strength of healthy females (n = 60) was compared using two sets of prerecorded …

Use Of Standardized Assessments And Online Resources In Stroke Rehabilitation, Susan H. Lin, Pamela R. Bosch, Veronica T. Rowe, Susan E. Fasoli, Jeanne Langan

The Open Journal of Occupational Therapy

Background: The extent to which movement-related standardized assessments and online resources are used in stroke rehabilitation is unclear in the United States.

Method: The researchers used a cross-sectional descriptive survey that examined (a) therapists use of movement-related standardized assessments, (b) factors influencing learning of new assessments, and (c) use of frequency of online resources by occupational therapists and physical therapists in the United States.

Results: Of 151 respondents (46.4% occupational therapists, 53.6% physical therapists), the most frequently used movement-related assessments by occupational and physical therapists were the Berg and Fugl-Meyer Assessment, respectively. More physical therapists use motor-related …

Health Management: Occupational Therapy’S Key Role In Educating Clients About Reliable Online Health Information, Amy Armstrong-Heimsoth, Melissa L. Johnson, Meredith Carpenter, Tincey Thomas, Ashley Sinnappan

The Open Journal of Occupational Therapy

Background: Only 12% of Americans possess proficient health literacy skills. Among those with the lowest health literacy are individuals with chronic health conditions. Occupational therapists are well prepared to assist these clients with health literacy, given our roles in teaching new health management skills and health promotion.

Methods: An educational course was designed and taught to over 100 individuals and caregivers with chronic health conditions to assist in finding and determining trustworthy health information online. An author designed pre postsurvey was used to evaluate effectiveness.

Results: There was a significant pre-post change in four categories: finding quality …

Productivity Standards And The Impact On Quality Of Care: A National Survey Of Inpatient Rehabilitation Professionals, Leslie E. Bennett, Vanessa D. Jewell, Linda Scheirton, Molly Mccarthy, Brittney C. Muir

The Open Journal of Occupational Therapy

Background: Skyrocketing health care costs have resulted in significant changes to reimbursement rates in health care. The result has increased pressure to be as efficient as possible while maintaining high-quality care. The purpose of this exploratory study was to examine health care professionals’ perceptions on whether and how productivity pressures have impacted the quality of care in therapy practice.

Method: A survey was disseminated nationally to inpatient rehabilitation facilities.

Results: Two hundred and fifty-seven surveys were opened. Of these completed surveys, 154 participants completed the closed-ended questions and 109 participants completed the open-ended questions. Outcomes indicated that …

Yoga And Autism: Students’ Perspectives On The Get Ready To Learn Yoga Program, Lauren E. Milton, Selena Bantel, Kayelee Calmer, Marlee Friedman, Elizabeth Haley, Lauren Rubarts

The Open Journal of Occupational Therapy

Background: Yoga, a complementary health approach known for various therapeutic effects, is used with diverse populations, including students ASD. Limited evidence exists inclusive of the first-hand perspective of students with ASD who participate in yoga. The purpose of this study is to understand the perspective of students 10 and 14 years of age with ASD who participated in a portion of the GRTL yoga program as part of a physical education class.

Method: Using a qualitative design, this study examined the student perspective on the GRTL yoga program. A convenience sample of seven male participants between 10 and …

Use Of The Star Process For Children With Sensory Processing Challenges, Sarah A. Schoen, Lucy Jane Miller, Stephen Camarata, Andrea Valdez

The Open Journal of Occupational Therapy

Background: This study examined the effectiveness of the STAR PROCESS, an intensive, short-term intervention that combines principles of sensory integration, relationship-based therapy, and parental-therapist collaboration for children with sensory processing challenges.

Method: A nonconcurrent multiple baseline, repeated measures design was used. Four boys, aged 5 years 0 months to 7 years 9 months, participated in this study. The mean length of intervention was 22 sessions delivered 3 to 5 times per week. A behavioral coding system was used to measure change in four areas: play level, positive affect, joint attention, and novel use of equipment. The theory of …

Effects Of Maternal Views And Support On Childhood Development Through Joint Play, Amiya Waldman-Levi, Sherraine Grinion, Laurette Olson

The Open Journal of Occupational Therapy

Background: Playful interactions draw a mother and child toward each other in positive ways; therefore, time spent in playful interactions with a responsive mother may be a developmental asset for a child. It is critical to examine how mothers support their children in joint play as well as their views of joint play.

Methods: This mixed-methods study consisted of 32 mothers and their typically developing children. The Parent’s/Caregiver Support of Young Children’s Playfulness, the Test of Playfulness, the Environmental Supportiveness Assessment, and seven open-ended interviews were used to assess joint play and maternal perceptions of this experience.

Results …

Effectiveness Of Two Keyboarding Instructional Approaches On The Keyboarding Speed, Accuracy, And Technique Of Elementary Students, Denise K. Donica, Peter Giroux, Young Joo Kim

The Open Journal of Occupational Therapy

Background: Keyboarding skill development is important for elementary students. Limited research exists to inform practice on effective keyboarding instruction methods.

Method: Using a quasi-experimental design, we examined the effectiveness of Keyboarding Without Tears® (n = 786) in the experimental schools compared to the control schools who used the district standard instructional approach of free web-based activities (n = 953) on improving keyboarding skills (speed, accuracy, and technique) in elementary students.

Results: The results showed significant improvements in keyboarding speed and accuracy in all schools for all grades favoring the experimental schools compared to the control schools. Significant differences in improvements …

Handwriting Performance Of Typical Second-Grade Students As Measured By The Evaluation Tool Of Children's Handwriting - Manuscript And Teacher Perceptions Of Legibility, Diane M. Long, James Conklin

The Open Journal of Occupational Therapy

Background: The purpose of the study was to describe scores achieved by typical second-grade students on the Evaluation Tool of Children’s Handwriting – Manuscript and to compare scores with teacher perceptions.

Method: As part of a larger study, the ETCH-M was administered to 74 second-grade students. Teachers scored classroom samples of handwriting assignments using a researcher-developed scale and scores were compared to ETCH-M scores to determine cutoff values for good versus poor handwriting.

Results: Mean scores for total word legibility, total letter legibility, and total numeral legibility were 88.82%, 84.30%, and 89.26%, respectively. Cutoff scores below 82% …

From Manuscript To Article: The Ojot Publication Process, Diane Powers Dirette

The Open Journal of Occupational Therapy

No abstract provided.

A Baker's Dozen Of Top Antimicrobial Stewardship Intervention Publications In 2018, Elias B. Chahine, Spencer H. Durham, Krutika N. Mediwala, Daniel B. Chastain, Timothy P. Gauthier, Brandon K. Hill, Bruce M. Jones, Jamie J. Kisgen, Ashley H. Marx, Kayla R. Stover, Marylee V. Worley, Christopher M. Bland, P. Brandon Bookstaver

Faculty and Student Publications

© The Author(s) 2019 Phytochemical investigation of methanolic extract of Limonium leptophyllum (Plumbaginaceae), led to the isolation of 1 new isoflavonoid with a rare 5-membered dihydrofuran ring (1, leptoisoflavone A) and 8 known compounds. The known isolated compounds were identified as euchrenone b9 (2), auriculasin (3), kaempferol (4), avicularoside (5), myrice-tin-3-arabinoside (6), trans-N-feruloyltyramine (7), trans-N-caffeoyltyramine (8), and β-sitosterol (9). The crude methanolic extract exhibited moderate activity toward endocannabinoid receptors. Auriculasin (3) showed activity toward cannabinoid receptor type 1 (86.7% displacement with IC50 8.92 μM).