Medicine and Health Sciences Commons^™

Treatment Options For Post Treatment Lyme Disease Syndrome, Barbara Bowman

Physician Assistant Scholarly Project Papers

With the high incidence of Lyme disease in the endemic areas of North America, it is important to appropriately diagnosis and treat this condition to prevent post treatment Lyme disease syndrome (PTLDS). Background information regarding Lyme disease is given. The purpose of this paper is to discuss the treatment options available for those patients that fit the case definition of PTLDS. A literature review was conducted using several different electronic databases finding peer reviewed research articles pertaining to the treatment options available for PTLDS. Extended antibiotic use is shown to be not beneficial in most cases. Alternative treatment options listed …

Aspirin Use Following Preeclampsia To Prevent Future Cardiovascular Outcomes, Kristi Bohlig

Physician Assistant Scholarly Project Papers

Abstract Introduction: Preeclampsia during pregnancy warrants therapy with low dose aspirin. The purpose of this review is to investigate whether these women are at increased future risk for cardiovascular morbidity and mortality, and if aspirin therapy should be continued following the puerperium to prevent future cardiovascular events. Research Questions: Do women who had preeclampsia during pregnancy, have increased future cardiovascular morbidity and mortality? Does continued aspirin use in postpartum women, who had preeclampsia during pregnancy, decrease future cardiovascular morbidity and mortality outcomes? Research Methods: Literature review was conducted utilizing CINAHL, Dynamed plus and PubMed databases. Discussion: It is found that …

Pelvic Examinations For Ovarian Cancer Screening In Asymptomatic Adult Women, Riann Sue Collar

Physician Assistant Scholarly Project Papers

There is discrepancy amongst organizations and the medical community whether bimanual pelvic examinations should be performed in asymptomatic women for routine screening. The purpose of this literature review was to determine whether bimanual pelvic examinations are beneficial for screening for ovarian cancer in comparison to no screening. In addition, research was conducted to see if healthcare providers’ professional beliefs align with the evidence and national recommendations, to determine women’s thoughts and beliefs regarding pelvic examinations, and if bimanual pelvic exams are not a valid screening tool for ovarian cancer, what are other screening methods available. Throughout reviewing peer reviewed articles …

Platelets To The Rescue? A Literature Review Of The Safety And Efficacy Of Platelet-Rich Plasma For Symptomatic Knee Osteoarthritis, Timothy Simonich

Physician Assistant Scholarly Project Papers

Osteoarthritis (OA) of the knee is one of the most common joint disorders in the United States with rising prevalence due to obesity and an aging population. Regarding non-surgical approaches to management, there has been growing interest in the use of intra-articular injections (IAI) of Platelet Rich Plasma (PRP). However, there has been a lack of strong evidence to support its use in clinical practice guidelines. In this literature review, two search methods were utilized in an effort to, first, inform clinicians about PRP and, second, to shed light on recent clinical control trials regarding the safety and efficacy of …

Benefits Of 3d Breat Tinisynthesis Combined With 2d Digital Mammography In Screening Women For Breast Cancer, Danielle M. Swanson

Physician Assistant Scholarly Project Papers

Breast cancer screening imaging options have progressed greatly over the years in sensitivity, specificity, and image quality. According to DynaMed Plus, in 2012 there were 522,000 deaths by breast cancer and 1,677,000 total cases of breast cancer documented (Dynamed, 2018). For years, traditional screening for breast cancer involved 2D digital mammography which obtains two views of each breast. With advances in technology, the use of 3D breast tomosynthesis has become an advantageous addition to routine breast cancer screening protocols at many health care facilities. My literature review of articles was found in PubMed, DynaMed Plus, Cochrane Library, and Clinical Key …

Benefits Of Hpv Vaccination In Adolescent Males, Budd Theriot

Physician Assistant Scholarly Project Papers

Human papilloma virus (HPV) is a collection of between 120-150 viral strains that effect epithelial and mucosal tissue. Infections due to HPV are extremely common and some of the more high-risk strains can lead to severe consequences later in life. HPV is the most common sexually transmitted infection in the United States, affecting approximately 75-80% of young adults at some point in their lives, and it is also known to be directly related to several forms of cancer including cervical, vaginal, penile, anal, oral, and oropharyngeal cancer. Vaccination against several high-risk strains of HPV first became available in the U.S. …

Comparison Of Pharmacologic Treatments For Postmenopausal Osteoporosis, Kaitlyn Wirtz

Physician Assistant Scholarly Project Papers

Osteoporosis is defined as a “generalized skeletal disorder characterized by compromised bone strength and deterioration of bone quality, often leading to fragility fracture” (DynaMed Plus, 2018). The prevalence of osteoporosis in the United States in adults aged greater than or equal to 50 years of age is “more than 10 million people overall and 33 million have low bone mineral density at the hip” (DynaMed Plus, 2018). Of these affected, one in two women will experience an osteoporotic fracture in their lifetime (International Osteoporosis Foundation, 2017). To combat postmenopausal osteoporosis, two treatment options include bisphosphonates and the anti-receptor activator of …

The Use Of Clinical Decision Support To Improve Nursing Practice, Kathleen Klimpel

Dissertations

Healthcare information technology is solidly entrenched in most acute care hospitals but the need to demonstrate its positive impact on patient outcomes persists. Clinical decision support (CDS) is an informatics tool that is highly customizable to promote patient improvement activities. Despite its high potential, studies have had mixed results regarding the impact of CDS and it has not been widely studied in the realm of nursing practice. One aim of this dissertation was to analyze the concept of CDS in order to inform the examination of the relationships between CDS implementation and nursing interventions. The determining factors of nurses use …

The Practice Of Dermatology Ain't What It Used To Be: The Preauthorization Catastrophe., Lawrence Charles Parish, Jennifer L. Parish, W. Clark Lambert, Carmela Ciferni

Department of Dermatology and Cutaneous Biology Faculty Papers

Many of us remember when a dermatology practice was cash only, and $5 cash was considered appropriate for a specialist. The general practitioner received $2 for an office visit and $4 for a home call. If you recall those days, “dearie you are much older than I.” 1

Not so long ago, the practitioner was confronted with obtaining a referral from the Health Maintenance Organization (HMO) in order to see the patient. Some plans permitted only four such referrals for specialists, annually, so the patient, who might have had a visit or two for gastritis and a similar number of …

Simulating Alternative Tuberculosis Diagnosis Methods In Underdeveloped Countries, Luke Turner

Industrial Engineering Undergraduate Honors Theses

Tuberculosis is the deadliest infectious disease in the world; it is especially rampant in underdeveloped countries because they do not have the infrastructure, technology, or funding to properly combat the infection. However, the development of portable point-of-care diagnosis machines can reverse this epidemic as they far surpass conventional laboratory identification. The question now is where to place these machines, which is a difficult decision with a lack of data. Therefore, a flexible simulation model is created to test the implementation of these machines with different countries and configurations. The simulation tests the baseline model and three proposed implementations of the …

The Influence Of Premarital Counseling On Marital Satisfaction For African-American Couples, Christian Brown

Electronic Theses and Dissertations

Many factors influence marital satisfaction (Ayub, 2010). Some couples prepare themselves with premarital counseling and try to help increase the likelihood of marital satisfaction. When looking at African-American couples, should researchers assume that some African-American couples take premarital education to increase their marital satisfaction? Prior literature has stated that premarital counseling has decreased marital discord and increased marital satisfaction (Parker, 2007). This study will be a qualitative study using a phenomenological design. The researcher collected data from seven participants. Once the interviews were completed, the researcher was able to analyze the data by identifying common themes as well as capturing …

Enmeshment In Military Families, Alexus Hamilton

Electronic Theses and Dissertations

While most research regarding enmeshment has been decidedly negative, researchers analyzing diverse cultures have found that enmeshment can act as a healthy tool for family members. This thesis examines the limits of healthy enmeshment and focuses on military families. It strives to answer whether enmeshment can be a tool utilized to keep the family safely together. This thesis combines narrative and grounded analysis to determine that military families can experience variations of enmeshment that can be healthy and safe.

The 5-Ht1a-R Knockout Mouse As A Model Of Later Life Anxiety Disorders: Implications For Sex Differences, Tatyana Budylin

Dissertations, Theses, and Capstone Projects

Anxiety affects nearly twice as many women as it affects men across all cultures and economic groups. Importantly, girls have a higher chance of inheriting anxiety disorders than boys, and many anxiety disorders appear at a very young age. However, little is known about sex differences in brain and behavioral development and how they relate to anxiety in adulthood. Serotonin 1A receptor (5-HT_1A-R) mediated signaling has been implicated in depression and anxiety, however most studies that focus on the involvement of the 5-HT_1A-R have been conducted in adults. Little is known about how the 5-HT_{1A …}

A Pretargeted Spect Imaging Strategy Employing Technetium-99m Based On Bioorthogonal Diels-Alder Click Chemistry, Justin H. Walsh

Dissertations, Theses, and Capstone Projects

A series of related N₃S ^99mTc-peptide complexes were synthesized and tested for use in pretargeting SPECT imaging that utilizes the bioorthogonal Diels-Alder click reaction between tetrazine (Tz) and transcyclooctene (TCO). The objective was to optimize the excretory pathways of the ^99mTc-peptide complexes for maximum tumor targeting with the in vivo “click” and minimum non-target uptake. The ^99mTc–tetrazine constructs were prepared by reaction of ^99mTc-peptide complexes (^99mTc-FKC, ^99mTc-FKCR, ^99mTc-DKC, and ^99mTc-SKC) with Tz-NHS or Tz-PEG₅-NHS to form ^99mTc FK(Tz)C, ^99mTc-FK(PEG₅-Tz)CR, ^99mTc-DK(PEG₅-Tz)C, …

Power Shift Within A Couple’S Journey Through Addiction, Carly Brack Marketto

Electronic Theses and Dissertations

Addiction is a rapidly growing problem for many couples, but most treatment plans focus solely on the individual with a substance abuse diagnosis rather than taking a systemic approach. Investigating the power dynamics of couples who have been through addiction and recovery could assist future treatment plans to include underlying factors in relationships instead of only addressing symptoms of the problem. This grounded theory research study strives to understand the power shift within couples when one partner goes from being in active addiction to being sober for one year or more. Power is viewed through the four aspects that Knudson-Martin …

Female Perspectives On Mountain Biking, Rebecca Irvin

Graduate Theses and Dissertations

This study strived to inquire about females’ perspectives of learning to mountain biking. Through an online survey, the present study explored the constraints (White, 2008) that keep women from trying the sport. Respondents (N=150) answered an online survey. Results of this study will be useful for outdoor education professionals, parks and recreation programming, cycling advocacy organizations, and any who make marketing materials for the outdoor industry. The study is designed to provide a description of the female perspectives regarding constraints and motivation towards learning to mountain bike.

Shifting Abortion Attitudes Using An Empathy-Based Media Intervention: A Randomized Controlled Study, Mary Ellen Hunt

Graduate Theses and Dissertations

U.S. abortion restrictions diminish access and perpetuate a culture of hostility toward abortion seekers. Support for restrictions is high—potentially, because restriction knowledge is low and attitudes are complex. The current study focused on knowledge and support of restrictions and empathy for abortions seekers among Arkansans. The purpose was to evaluate the effectiveness of a video intervention intended to increase awareness of Arkansas abortion restrictions and induce empathy for abortion seekers.

Using a randomized controlled trial with pre-, post-, and follow-up design, a sample of Arkansans (N = 369) were randomly assigned to one of five video conditions--either a control or …

A Phenomenological Study Of The Lived Experiences Of Counseling Students In A Co-Facilitated Experiential Group, Alexandra Meyers

Graduate Theses and Dissertations

Research in the fields of experiential learning, group psychotherapy, and neuroscience has supported the inclusion of the experiential group in counseling training programs due to the potential for positive impact on students’ personal and professional development (Badenoch & Cox, 2010; Denninger, 2010). Investigations exploring counseling students’ experiences of the experiential group have been primarily limited to quantitative studies, while in-depth qualitative inquiry has been minimal. Additionally, an extensive review of the literature has found there have been no qualitative studies examining experiential groups co-facilitated by a course instructor and a doctoral student. The purpose of this phenomenological study was to …

Fertility Awareness Based Methods (Fabms): Evaluating And Promoting Female Interest For Purposes Of Health Monitoring And Family Planning, Amylynn Smith

Graduate Theses and Dissertations

Natural or fertility awareness-based methods (FABMs) help users monitor, interpret, and systematically chart female biological markers. FABMs are used as family planning methods and sometimes as reproductive health monitoring methods. The American College of Obstetricians and Gynecologists (ACOG) encourages medical professionals to use female reproductive cycle patterns, ‘the female fifth-vital sign’, as a means of improving the diagnosis and treatment of reproductive health diseases, disorders, and conditions. Patients need to have accurate knowledge of healthy and unhealthy cycle patterns. The general public does not have a sufficient level of fertility health knowledge. This study examined whether females that are interested …

The Effect Of Osmotic Stimulation Of Copeptin On Glucose Metabolism In Healthy Adults, Lisa Tjorven Jansen

Graduate Theses and Dissertations

Diabetes is currently affecting 30 million Americans. To combat disease onset, lifestyle interventions have been focused on. Low water intake, alongside elevated concentrations of circulating copeptin, has been linked to increased risk for. However, it is unknown whether this effect on glucose regulation is acute or chronic. Furthermore, no study to date assessed the effects of copeptin independent of the renin-angiotensin-aldosterone system (RAAS). Purpose: The purpose of these studies was therefore two-fold: 1) to establish high endogenous copeptin concentrations independent of RAAS, and 2) to assess glucose metabolism following a standardized oral glucose tolerance test (OGTT) during high concentrations of …

Male Nurses’ Experience Of Gender Stereotyping Over The Past Five Decades: A Narrative Approach, Michael W. Finnegan

Theses & Dissertations

Negative stereotyping of men in nursing has been a chronic problem that has a direct effect on males and detracts from efforts to recruit and retain them. At this time in American history (2018), traditionally male-dominated professions are making significant progress toward the goal of a gender-balanced workplace. However, the opposite is not true. Traditionally female-dominated professions are not attracting or appealing to men. In the nursing profession, the number of male nurses is relatively small and has remained relatively fixed over time. Estimates vary between 6-15 percent, with the current average being approximately 11 percent (American Nurses Association, 2014). …

The Impacts Of Administering Metabolites Of Saccharomyces Cerevisiae On Broiler Performance, Yields And Salmonella Content Of Component Portions, Bill Douglas Potter

Graduate Theses and Dissertations

The impacts of using health-promoting Saccharomyces cerevisiae fermentation metabolites in poultry production and processing can be measured in respect to multiple measures of success. Traditionally this yeast-based compound has been administered to poultry, livestock, poultry, and other species to improve animal performance and production volume output. In addition, Saccharomyces cerevisiae fermentation metabolites have also been shown in more recent research to reduce colonization of pathogenic bacteria in the host organism’s gastro-intestinal tract. In this dissertation, the impacts of administering a functional ingredient containing Saccharomyces cerevisiae metabolites on broiler performance measures and pathogen reduction were measured. One of the studies in …

The Incidence, Aetiology, And Adverse Clinical Consequences Of Less Severe Diarrhoeal Episodes Among Infants And Children Residing In Low-Income And Middle-Income Countries: A 12-Month Case-Control Study As A Follow-On To The Global Enteric Multicenter Study (Gems), Karen L. Kotloff, Dilruba Nasrin, William C. Blackwelder, Yukun Wu, Tamer Farag, Sandra Panchalingham, Samba O. Sow, Anita K. M. Zaidi, Shahida Qureshi, Farheen Quadri

Department of Paediatrics and Child Health

Background: Diarrheal diseases remain a leading cause of illness and death among children younger than 5 years in low-income and middle-income countries. The Global Enteric Multicenter Study (GEMS) has described the incidence, aetiology, and sequelae of medically attended moderate-to-severe diarrhoea (MSD) among children aged 0-59 months residing in censused populations in sub-Saharan Africa and south Asia, where most child deaths occur. To further characterise this disease burden and guide interventions, we extended this study to include children with episodes of less-severe diarrhoea (LSD) seeking care at health centres serving six GEMS sites.
Methods: We report a 1-year, multisite, age-stratified, matched …

Quality Initiative To Reduce Cardiac Ct Angiography Radiation Exposure In Patients With Congenital Heart Disease, Fatima Ali, Arjumand Rizvi, Huzaifa Ahmad, Phillip Mcgonagill, Muneeb Khan, Rajesh Krishnamurthy, Zafar Jamil, Naila Nadeem, Mohammad Yousuf, Babar Hasan

Department of Paediatrics and Child Health

Background: The use of cardiac computed tomography angiography (CCTA) as a complementary diagnostic modality to echocardiography in patients with congenital heart diseases (CHDs) is expanding in low- and middle-income countries. The adoption of As Low As Reasonably Achievable techniques is not widespread, resulting in significant unintended radiation exposure, especially in children. Simple quality improvement measures geared toward reducing radiation dose can have a impact on patient safety in resource-limited centers in low- and middle-income countries.
Objectives: To determine how a quality improvement initiative can reduce radiation exposure during CCTA in patients with CHD.
Methods: We designed a key driver -based …

Differences In Kaplan Integrated Exam Scores Based On Institutional Factors, Lee Ann Danner

Graduate Theses and Dissertations

Registered Nurses constitute the largest health care occupation in the United States. Current entry-level education for the profession of nursing is either an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) (Altman, 2011). After successful completion of a nursing program, all nursing graduates must apply to take the National Council Licensure Examination (NCLEX-RN). The pass rate for first time United States educated NCLEX-RN exam test takers in 2017 was 87.11% leaving 12.89% unsuccessful (NCSBN, 2018). A nursing programs quality and recruitment are often influenced by a students’ ability to pass the NCLEX-RN on the first attempt. …

Preoperative Physical Therapy Results In Shorter Length Of Stay And Discharge Disposition Following Total Knee Arthroplasty: A Retrospective Study, Sheldon R. Garrison, Kelly E. Schneider, Maharaj Singh, Jennifer Pogodzinski

College of Nursing Faculty Research and Publications

Objective: Total knee arthroplasty is an effective surgical approach used to treat arthritis and knee trauma. Its utilization has grown, as has the accompanying financial impact, resulting in an equal need to advance physical therapy practice. One emerging approach improving patient outcomes and reducing cost is the inclusion of a preoperative physical therapy visit. The aim of this study was to quantify the economic impact of a standardized preoperative physical therapy visit in the healthcare setting. Design: This study is a retrospective review of 1,043 adult patients who underwent total knee arthroplasty. Methods: Patients who underwent total knee arthro-plasty were …

A Novel Radiographic Classification Of Severe Spinal Curvatures Exceeding 100°: The Omega (Ω), Gamma (Γ) And Alpha (Α) Deformities, Isaac Obiri Karikari, Henry Pang, Kwadwo P. Yankey, Henry Ofori Duah, Harry Akoto, Rick Hodes, Oheneba Boachie-Adjei, Focos Spine Research Group

College of Nursing Faculty Research and Publications

Purpose For spine curvatures with Cobb angles > 100°, curve classification and characterization become more difficult with conventional radiographs. 3-D computerized axial tomography scans add relevant information to categorize and describe a new classification to aid preoperative assessment in communication and patient evaluation. The purpose of this study is to describe a radiographic classification system of curves exceeding 100°. Methods A consecutive series of patients with curves exceeding 100° underwent a full spine radiographic review using conventional radiographs and 3-D CT. A descriptive analysis was performed to categorize curves into 4 main types (1, 2, 3 and 4) and 6 subtypes …

Relapsing Hcv Associated Glomerulonephritis Despite Sustained Virologic Response (Svr) To Direct-Acting Antivirals (Daa), Joseph Scurozo Do, Wael Hanna Md, Grace Chong Do, Frederick S. Fleszler Md

Department of Medicine

No abstract provided.

Massive Hemoptysis In The Setting Of Acute Mitral Regurgitation, Joseph Moran Do, George Prousi Md, Ross Biggs Do, Nirupama Kakumanu Md, Fccp

Department of Medicine

No abstract provided.

Mycosis Fungoides: A Master Of Disguise, Amogh M. Joshi Do, Emilee E. Kurtz Do, Yehia Y. Mishriki Md

Department of Medicine

No abstract provided.