Medicine and Health Sciences Commons^™

State Regulatory Responses To The Prescription Opioid Crisis: Too Much To Bear?, Lars Noah

Dickinson Law Review (2017-Present)

In order to prevent further overuse of prescription opioids, states have adopted a variety of strategies. This article summarizes the growing use of prescription drug monitoring programs, crackdowns on “pill mills,” prohibitions on the use of particularly hazardous opioids, limitations on the duration and dosage of prescribed opioids, excise taxes, physician education and patient disclosure requirements, public awareness campaigns, and drug take-back programs. Although occasionally challenged on constitutional grounds, including claims of federal preemption under the Supremacy Clause, discrimination against out-of-state businesses under the dormant Commerce Clause doctrine, and interference with rights of commercial free speech, this article evaluates the …

The Opioid Litigation: The Fda Is Mia, Catherine M. Sharkey

Dickinson Law Review (2017-Present)

It is readily agreed that federal preemption of state tort law alters the balance between federal and state power. Federal preemption is a high-profile defense in almost all modern products liability cases. It is thus surprising to see how little attention has been given to federal preemption by courts and commentators in the opioid litigation. Opioid litigation provides a lens through which I explore the role of state and federal courts and the Food and Drug Administration (FDA) in striking the right balance of power. My purpose here is not to resolve the divide among the few courts that have …

Safe Consumption Sites And The Perverse Dynamics Of Federalism In The Aftermath Of The War On Drugs, Deborah Ahrens

Dickinson Law Review (2017-Present)

In this Article, I explore the complicated regulatory and federalism issues posed by creating safe consumption sites for drug users—an effort which would regulate drugs through use of a public health paradigm. This Article details the difficulties that localities pursuing such sites and other non-criminal-law responses have faced as a result of both federal and state interference. It contrasts those difficulties with the carte blanche local and state officials typically receive from federal regulators when creatively adopting new punitive policies to combat drugs. In so doing, this Article identifies systemic asymmetries of federalism that threaten drug policy reform. While traditional …

Congenital Zika Syndrome - Background And Nutrition Care Of Affected Infants, Ann Gaba, Ghada Soliman

Publications and Research

This review provides a history and overview of Zika infection, with special attention to resultant birth defects and the nutrition care required by Zika affected infants.

Time For Quiet Reducing Nighttime Interruptions In The Icu (Turn In-Icu): Evaluation And Implementation Of A Nonpharmacological Sleep Bundle To Improve Sleep Quality, Delirium, And Nighttime Sedation Requirements, Christina Junker, Msn, Rn, Ccrn

Doctor of Nursing Practice Projects

Background: Undisturbed, restful sleep is essential for physiological as well as psychological well-being. For critically ill patients, sleep deprivation caused by frequent nighttime interruptions is associated with poor sleep quality and negative patient outcomes.

Objectives: The purpose of this Quality Improvement (QI) project was to promote uninterrupted sleep between the hours of 10 PM and 5 AM. Outcomes for evaluation consisted of the following three components: (1) sleep quality, (2) incidence of delirium, and (3) nighttime sedation requirements. Except for sleep quality, these variables were compared before and after the intervention.

Methods: A descriptive, before and after design for data …

Implementing The Ami Readmits Risk Assessment Score Within A Referral Protocol To Increase Referrals For Follow-Up Among Patients With Type I Myocardial Infarction, Nailya Muganlinskaya, M.S.N., M.P.H., Acnp-Bc, Dnp Graduate

Doctor of Nursing Practice Projects

Background: The hospital’s post- myocardial infarction (MI) referral protocol does not address patient risk characteristics. Referrals to a post- MI clinic have been lower than expected. Evidence suggests the AMI READMITS score can predict readmissions within 30 days after discharge among patients with acute MI.

Aim: This quality improvement study evaluated a referral protocol that integrated the AMI READMIT score to increase appropriate referrals after discharge.

Methods: Patient chart data was analyzed to assess changes in referrals and timely follow-up from pre-intervention to intervention. A survey assessed providers’ satisfaction with the new referral protocol.

Results: Among 57 patients (n=29 pre-intervention; …

The Development, Implementation And Evaluation Of An Evidence-Based Biohazard Training Program Within A Pediatric Ambulatory Practice, Lakeshia L. Evans Mba, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Communicable disease(s) such as Ebola or Coronavirus can cause a catastrophic health crisis within the United States healthcare system, especially among the pediatric and elderly population. Lack of knowledge, skills and confidence among health care professionals in the pediatric setting regarding these infectious organisms can affect early identification, proper isolation, early treatment, and increased risk of a possible pandemic and/or fatalities.

Aims/Objectives: The aim of this study was to develop, implement and evaluate an evidence-based biohazard training program-using the Identify, Isolate and Inform (3I) tool within a pediatric urgent care center to increase the staff’s knowledge, skills and confidence …

Implementing A Digital Imaging Platform Using Tissue Analytics In A Level 1 Trauma Center, Victoria Donaldson, Msn, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: More than 2.5 million people develop pressure ulcers (PUs) annually. PUs cost the U.S. $9.1-11.6 billion per year and add about $43,180 to a hospital stay. The Centers for Medicare Medicaid Services (CMS) stopped reimbursement for hospital-acquired pressure ulcers (HAPUs). Documentation of PUs must indicate if they are present on admission (POA) and include accurate stages and treatment plan of PUs. Aims/Objectives: To use Digital Imaging platform using Tissue Analytics (TA) along with the standard care protocol. The objectives of this study were to (1) Improve identification of PUs, (2) Increase accuracy of PU staging and (3) Improve documentation …

Nurse’S Perception Of Safety Culture And Patient Safety Following Implementation Of A Handoff Communication Process Between Pre-Operative And Operating Room Nurses, Tracy Willett, Msn, Mba, Rn, Nea-Bc, Cnor

Doctor of Nursing Practice Projects

Background: In a hospital environment the care of the patient is transferred multiple times during his or her stay. Current needs assessment indicates that nurses’ perception of safety culture with handoff communication and patient safety is an area of focus for the practice site.

Objectives: This study aimed to improve the Pre-operative and Operating Room nurses’ perception of safety culture measured with four valid and reliable survey questions. The second study’s aim was to improve patient safety with the handoff process, measured by the number of adverse events reported by the practice site.

Methods: Pre-implementation data was collected. Nurses worked …

Improving Patient And Provider Engagement By Utilizing Ask Me 3®, Joseph G. Smith, Msn, Arnp, Fnp Bc

Doctor of Nursing Practice Projects

Background: Patient and provider engagement in healthcare has an impact on health outcomes.

Purpose: To study the implementation of the Ask Me 3 (AM3) tool, a tool that encourages patients to ask three questions about their health to their care provider. The aim of the project is to explore the level of patient and provider engagement by patients` reports of their perception of engagement with their provider and in understanding their diagnosis.

Methods: The setting was a small urban family practice in the Pacific Northwest. Every patient that checked in for their appointment, excluding pediatric and younger than 18 years …

The Victimization Of Native American Women In The United States: The Impact And Potential Underlying Factors, Kaci A. Clement

Honors Thesis

In recent decades, a topic of concern that has gained attention in the United States and throughout the world is violence against women. Surveys conducted nationally have found that there is a correlation between which racial group a woman identifies as and her likelihood to be victimized at some point in her life. American Indian/Alaskan Native women, in particular, are impacted by violence at disproportionate rates. However, definitive reasoning for the high rates of violence in these groups has not been fully investigated. There is a lack of surveillance and dissemination regarding this specific topic as well as other issues …

Optimization Of Methods For Cross-Species Infection Of Cell Cultures With Wolbachia, Sarah J. Lane

Honors Thesis

The common intracellular endosymbiont genus of bacteria called Wolbachia is of interest due to the promise it shows for playing a role in disease control. Wolbachia have a number of widely variable effects on its many species of host insects. In combination with these roles, Wolbachia largely affects reproduction and development of its host species. It can lead to feminization and cytoplasmic incompatibility (Werren et al. 2008). Furthermore, this species is vertically transmitted which means that it passes from mother to offspring (Caragata et al., 2016). In combination with its effects on reproduction, which can allow Wolbachia to propagate through …

Utilizing A Mentorship Approach To Address The Underrepresentation Of Ethnic Minorities In Senior Nursing Leadership, Kimberly Jean-Louis, Msn, Mpa, Rn, Nea-Bc

Doctor of Nursing Practice Projects

Many healthcare institutions have acknowledged the benefits of and the need for a workforce that reflects the diverse patient populations they serve. However, few healthcare organizations have made progress in increasing the diversity of their leadership teams. The American Hospital Association’s Institute for Diversity in Healthcare Management (2016) found that while minorities represent 32% of hospital patient populations across the nation, they only account for 11% of executive leadership. The objective of this DNP project was to implement a 4-month mentorship program that empowered minority nurse leaders who desire career advancement to executive leadership roles and provide them with realistic …

Increasing Chlamydia Trachomatis And Neisseria Gonorrhea Screening Among Women 15 To 24 Years Old Using A Multifaceted Approach, Mackenzie Shireman

Evidence-Based Practice Project Reports

The Centers for Disease Control and Prevention (CDC) (2017a) estimates that one-quarter of sexually active people are between 15 and 24 years old, but account for half of 20 million sexually transmitted diseases (STD) reported annually in the United States. Chlamydia trachomatis (CT) and Neisseria gonorrhea (NG) are the most common reportable STDs (CDC, 2018). The purpose of this project was to increase CT/NG screening rates among sexually active, nonpregnant women 15 to 24 years old within the primary care setting through colleague education, routine sexual history taking, and indicated testing. A 30-minute colleague in-service was provided to educate clinical …

Biological And Social Links Between Eating Behavior And Stress Among College Students, Kailyn M. Mutsch

Honors Thesis

Stress and eating behaviors are known to be correlated in all ages but is primarily associated with young adults. This correlation can be attributed to both biological and social links. In this review, I detail the effects of stress on the brain in a biological manner and the areas of the brain associated with eating behavior. I will also discuss social factors that could contribute to the correlation between stress and eating behavior in college students. Stress is a major factor in optimal digestion and health. A majority of students report experiencing times of stress or feeling overwhelmed throughout their …

Abduction Contractures Within Infants With Developmental Dysplasia Of The Hip, Nathan Stanton

Doctoral Dissertations and Master's Theses

Developmental Dysplasia of the hip is a condition that affects 1 to 3 of every 1000 infants born globally. It is a pathology that involves the instability, subluxation, or dislocation of the femoral head from the acetabulum. Through a rating system by the International Hip Dysplasia Institute or Graf System, hips are rated based on their level of instability or dislocation and the infant is then prescribed a treatment. While Finite element models of dysplastic hips have been developed previously, a study that seeks to understand the contribution of an abduction contracture of the hip has yet to be performed. …

Recognizing The Need For Mental Health Reform In The Texas Department Of Criminal Justice, Kara Mchorse

St. Mary's Law Journal

The ways in which mental health care and the criminal justice system interact are in desperate need of reform in Texas. The rate of mental illness in Texas is higher than the current state of mental health care can provide for. While state hospitals were once the primary care facilities of those with mental illness, the Texas Department of Criminal Justice (TDCJ) has taken on that role in the last few decades; and when the criminal justice system becomes entangled with mental health care, it often leads to “unmitigated disaster.” If Texas continues to allow the TDCJ to act as …

Case Studies In Medical Ethics In The 20th & 21st Centuries As Told Through The Perspective Of A Human Life, Madelynn Wildes

Senior Theses

This paper is an analysis of different case studies in medical ethics in the 20th and 21st century. The case studies are divided into three different categories of a human life: beginning of life, middle of life, and the end of life. Each of these chapters includes a little excerpt about a person named Jane as she goes through each stage of her life. This merely serves to humanize the topics covered a little more. The beginning of life covers topics such as abortion and eugenics and discusses court cases and ethical dilemmas surrounding them. The middle of life covers …

Perceived Effectiveness Of Stem Cell Injections In Adults With Joint Injuries, Delaney Marie Merrill

Senior Theses

Introduction: Osteoarthritis plagues around 27 million Americans. Stem cell injections are a new method of treatment that could potentially cure this by regenerating cartilage in joints. Purpose: The purpose of this study is to examine the perceived effectiveness of stem cells at regenerating cartilage in joints, specifically the knees, hips, and shoulders. Methods: Participants were recruited via social media, forums, and from healthcare clinics that offer stem cell treatments. They were asked to complete a survey focusing primarily on the treatment protocol and how the injured joint felt post-stem cell injection. Frequencies were calculated to describe problematic joints, treatment history, …

Influenza Vaccination Coverage In Pediatric Patients With Inflammatory Bowel Disease, Kelly Brown

Senior Theses

Background: Children with chronic health conditions, including inflammatory bowel disease (IBD), are at especially high risk for influenza infection and complications. The Crohn’s & Colitis Foundation and American College of Gastroenterology recommend that IBD patients should receive annual influenza vaccination. The aims of this study were to evaluate influenza vaccination coverage over time and identify predictors of flu vaccination in pediatric IBD and non-IBD patients.

Methods: We utilized longitudinal data (2000 to 2016) from South Carolina Medicaid to conduct a matched cohort study. The primary exposure of interest was IBD diagnosis based upon ICD-9/10 diagnosis codes. Children with IBD were …

The Usefulness Of The Left Atrial Dilation Rate In Determining Severity Of Heart Failure, Laura B. Snyder

Senior Theses

Hypertension and vascular stiffness are two physiological conditions that strain the left ventricle (LV) and cause it to gain muscle mass. Eventually, the LV is unable to fill correctly and the patient develops Heart Failure with a preserved Ejection Fraction (HFpEF). Clinically, a patient’s left atrium (LA) area is measured as a diagnostic parameter of HFpEF severity. However, this doesn’t offer a prognosis or threshold of LA size necessitating hospitalization because of variation in patient demographics, genetics, and lifestyle which affect rates of HFpEF progression.

Since there are no medications or effective treatment options for HFpEF patients, there is a …

Examining Prevalence Of Eating Disorder Risk And Body Image Dissatisfaction In Female Adolescent Cheerleaders, Kelsi K. Mariner

Senior Theses

Content: Cheerleading has evolved into a highly competitive and physically demanding sport where athletes must balance academics, intense training, and pressure to maintain expected aesthetic qualities of the sport. These requirements can cause distress which may lead athletes to suffer from eating disorder (ED) risk and body image dissatisfaction (BID). Objective: To examine the prevalence of risk for ED and determine the presence of body image dissatisfaction within adolescent cheerleaders. Design: This study was conducted as a part of a larger concurrent study with Dr. Torres-McGehee and Allison Smith. It is a cross sectional study. Setting: Online survey. Participants: Female …

First Aid And Emergency Preparedness: Improving Health Outcomes Among Aging Adults, Anna J. Kulangara

Senior Theses

As the United States population demographic shifts and the baby boomer population enters seniority, the health sector must adjust and prepare to provide efficient and adequate healthcare to the people. The Silver Tsunami, a metaphor for the expected wave of aging adults, will inevitably strain healthcare professionals and can be partly relieved by promoting risk-minimizing behavior in baby boomers before severe conditions develop. Through this effort, a health education course, titled First Aid and Emergency Preparedness, was developed and taught twice at a local senior center to target senior citizens and promote proactivity and healthy behaviors. Course development founded largely …

Health Insurance Coverage And Factors That Affect Access To Healthcare, Bryce A. Jerin

Senior Theses

The modern landscape of the U.S. healthcare economy is a culmination of many decades of debate and growth. The system of health insurance coverage in the United States allows millions of Americans to participate in the delivery and access to care, while keeping millions out. Health insurance coverage, the availability of pharmaceuticals, and hospital billing practices are factors that affect the level of access to care. Healthcare has developed into a complex system with various stakeholders who act on their own incentives. Encouraging rational pricing for health care services is an important step toward ensuring access to care for everyone …

Treatment Of Chronic Pain In U.S. Veterans: The Effectiveness Of Interdisciplinary Programs, Morgan L. Compton

Senior Theses

Chronic pain is a prevalent issue amongst US veterans. Experts suggest that interdisciplinary pain treatment is the most effective method of treating chronic pain, specifically due to targeting functioning and quality of life. These programs combine cognitive behavioral therapy and physical therapy by utilizing a variety of exercise and education regimens. The pain department at Columbia VA Health Care System offers both a comprehensive interdisciplinary treatment, Outpatient Interdisciplinary Pain Program (OIPP), and a flexible, multidisciplinary option (OIPP-Lite) for veterans suffering from chronic pain. The goal of this program is to improve knowledge for coping with chronic pain and to create …

The Impact Of Perceptions About Influenza And The Yearly Influenza Vaccine On Vaccine Behaviors Among Undergraduate Students At The University Of South Carolina, Julia G. Fuller

Senior Theses

Background: Undergraduate students are at an increased risk for developing respiratory infections as a result of the proximity in which they live, study, and eat. Despite being a target population for the Centers for Disease Control and Prevention’s yearly flu vaccine, several studies of undergraduate populations have found vaccine uptake to be much lower than other at-risk populations. This study aims to understand how perceptions about influenza and the influenza vaccine affect University of South Carolina undergraduate students’ vaccine behavior. Methods: A cross-sectional study was completed using survey data from 165 undergraduate students at the University of South Carolina. The …

The Write Stuff - Spring 2020 (Vol. 17, No. 2), Research Medical Library

Write Stuff 2020

• How to discuss your study's limitations effectively
• Reference letters vs. letters of support for NIH grant applications: What's the difference?
• NCI Bottom Line blog offers insight into grant funding and budgets
• Dissertations, Text Recycling, and Self-Plagiarism
• NIH Increases the use of Notices of Special Interest
• Tips for using Track Changes in Microsoft Word

Literature Review Of Retained Surgical Instruments Left In The Body, Michelle L. Mccalmont

Honors Capstone Enhancement Presentations

No abstract provided.

How Data Is Changing The World Of Healthcare, Cameron Marous

Honors Capstone Enhancement Presentations

No abstract provided.

Augmenting The Access And Involvement Of Student Pharmacists In Research Opportunities Through Engaging Programming At An Academic Institution, Samantha Gruber

Honors Capstone Enhancement Presentations

A research study completed by Kritikos et al. investigated student pharmacists and their characteristics in order to find a relationship with their views of research and attitudes towards pharmacy practice research. The study also recognized perceived barriers to pursuing or completing pharmacy practice research and identified ways that pharmacy educators could promote research interest in pharmacy practice. The research study concluded that student pharmacists perceive a lack of awareness of the needs, benefits, and career opportunities associated with pharmacy practice research. In addition, the Accreditation Council for Pharmacy Education (ACPE) mentions in section 6.3 of the 2016 Standards that PharmD …