Medicine and Health Sciences Commons^™

Covid-19: Does The Timing Of Intubation Affect Overall Outcomes, Jennifer Burvee

Nursing Masters Papers

COVID-19 also known as coronavirus disease of 2019 is a viral illness caused by novel coronavirus SARS-CoV2 that was discovered in December 2019 in Wuhan, China. To date, there have been over 250 million cases worldwide. The severity of COVID-19 ranges from mild symptoms to critical illness warranting hospitalization within an intensive care unit to death. Current treatment modalities include supportive cares, monoclonal antibodies, interleukin inhibitors, convalescent plasma, therapeutic anticoagulants, anti-inflammatory medications and/or corticosteroids. A common complication due to COVID-19 is acute respiratory failure resulting in pulmonary insult which start as cough but progress to the need for supplemental oxygen …

The Efficacy Of Tocilizumab As A Therapeutic Treatment For Sars-Cov-2 Infections: An Integrative Literature Review, Amanda Vancene Peterson

Nursing Masters Papers

The novel coronavirus SARS-CoV-2 and resulting COVID-19 infection has spread from a cluster of unidentified pneumonia cases in Wuhan, China, into an ongoing global health crisis. The strain on the healthcare systems and loss of human life has made finding ways to treat severe COVID-19 infections of the utmost importance. Mortality from COVID-19 has been shown to result from an overwhelming inflammatory response similar to the cytokine release syndrome seen in certain autoimmune reactions (Tleyjeh et al., 2020). It also can be seen after chimeric antigen receptor T-cell (CAR-T) therapy for certain cancers. It is hypothesized that treatments targeting the …

The Effect Of Complementary And Alternative Medicine For Migraine Headaches: An Integrative Review, Katelyn Vaughn Spangler

Doctoral Dissertations and Projects

Migraine headaches continue to be a prominent health concern, affecting a large percentage of the population globally. These headaches have many negative impacts on patients’ lives, including decreased productivity, missed time at work or school, increased suicidal tendencies, and a decreased overall quality of life. Pharmacological approaches for treatment are available but often present with safety concerns, unpleasant side effects, rebound headaches, increased expenses, and a higher rate of emergency department visits. Therefore, many people seek treatment options other than conventional medication to address their migraines. Various complementary and alternative medicine therapies have shown promising results in previous clinical trials …

Mental Health Treatment In Juvenile Correctional Facilities: Utilizing Assessment To Inform Treatment, Sarah Riccio

Dissertations

Youth in juvenile correctional facilities face a wide range of mental health difficulties. Over the years, the juvenile justice system has prioritized the need for providing appropriate and effective treatment services to youth throughout their detainment. Despite these ongoing efforts, treatment practices in juvenile correctional facilities continue to fall short. This study will first focus on assessment practices within these facilities and the impact current practices have on diagnosis and subsequent treatment. Emphasis will be placed on the importance of comprehensive evaluations for informing diagnosis and determining the individual treatment needs of detained youth. An integrated approach to assessment will …

Frequency Of Lower Ureteric Stones And Their Treatment By Tamsulosin, Aden, Ali Ahmed Salem Hatroom

Hadhramout University Journal of Natural & Applied Sciences

The aim of the study is to find out the frequency of lower ureteric stones related to sex, age, and the outcome of using tamsulosin in their treatment This was a retrospective study of all patients who suffer from lower ureteral stone and seen in our Private Urology Clinic from January 2014 to December 2017 in Aden. The total patients were 160. They were 98 (61.3%) males and 62 (38.7%) females) with ratio male to female 1.6 :1. The mean age of patients is (35.2 ± 11.2) years, range (15 to 56) years. The most involved side is left ureter …

A Case Report Of Dissociative Amnesia Involving “Detective Work”, Muhammad Sharifi, Ana Turner, Traci Fuglestad, Colleen Bell

HCA Healthcare Journal of Medicine

Dissociative amnesia is a rare psychiatric disorder presenting with sudden retrograde memory impairment and inability to recall autobiographical information that is inconsistent with normal forgetting. This case report discusses dissociative amnesia with dissociative fugue in a middle aged male that led to him becoming homeless. Because of his autobiographical forgetting, he was unable to access services, and we present here the distinctive “detective work” needed to not only help treat his symptoms, but also help him legally establish who he is and gain access to housing. This patient is unique in that he only began psychiatric treatment in his late …

A Scoping Review Of Occupational Therapy Approaches To Enable Occupations For People Living With Behavioral Disturbance As A Result Of Acquired Brain Injury, Anahita Brown, Tamara Tse Dr, Tracy Fortune, Susan Petrie

The Open Journal of Occupational Therapy

Background: Behavioral disturbance impacts almost 50% of people living with acquired brain injury (ABI) and severely impedes occupational participation. Occupational therapists are appropriately qualified and well placed to address behavioral disturbance. This scoping review analyzes the literature to ascertain approaches used by occupational therapists to treat behavioral disturbance.

Method: A literature search of three databases revealed 379 papers for consideration, five of which met inclusion criteria. The Critical Appraisal Skills Programme (CASP) checklists were used for the analysis. This paper employs the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) framework.

Results: Sensory modulation interventions, community-based …

Vv Ecmo For Treatment Of Severe Ards In Covid-19 Patients At Unmc, Cale J. Ewald, Levi Zehr, Shaun L. Thompson

Graduate Medical Education Research Journal

Abstract

Introduction: Veno-venous extracorporeal membrane oxygenation (VV ECMO) is an indicated treatment for severe acute respiratory distress syndrome (ARDS) refractory to conventional medical treatment. Severe ARDS is a common complication of CoVID-19 infection. Subsequently, the efficacy of VV ECMO in CoVID-19 severe ARDS patients must be investigated. ECMO is a resource-intensive treatment modality, meaning that its use must be reserved for patients with robust indications and paucity of contraindications.

Methods: We performed retrospective chart review of three patients at the University of Nebraska Medical Center that were placed on VV ECMO secondary to severe ARDS from CoVID-19 infection.

Results: All …

Endovascular Treatment For Acute Stroke Patients With A Pre-Stroke Disability: An International Survey, Sanjana Salwi, Jan A. Niec, Ameer E. Hassan, Christopher J. Lindsel, Pooja Khatri, J. Mocco, Jeffrey L. Saver, Eva A. Mistry

School of Medicine Publications and Presentations

Background: It is unclear what factors clinicians consider when deciding about endovascular thrombectomy (EVT) in acute ischemic stroke patients with a pre-existing disability. We aimed to explore international practice patterns and preferences for EVT in patients with a pre-stroke disability, defined as a modified Rankin score (mRS) ≥ 2.

Methods: Electronic survey link was sent to principal investigators of five major EVT trials and members of a professional interventional neurology society.

Results: Of the 81 survey-responding clinicians, 57% were neuro-interventionalists and 33% were non-interventional stroke clinicians. Overall, 64.2% would never or almost never consider EVT for a patient …

Gout: Current Considerations, Alexandria Fappiano, Wilson Crone

Internet Journal of Allied Health Sciences and Practice

Gout is a treatable chronic inflammatory condition that can cause severe joint pain and disfigurement. Commonly, it affects the first metatarsophalangeal (MTP) joint as a monoarticular process. It is typically caused by hyperuricemia and genetic mutations of the uricase gene. Gout is definitively diagnosed with the presence of negative birefringent needle-shaped crystals in the synovial fluid of the affected joint. Classically, seafood and alcohol are risk factors for developing gout. However, given current population trends, obesity is another major risk factor. While weight loss is the best conservative management, medications can also be used to manage gout. The treatment is …

Alterations To The Brain Following Traumatic Brain Injury, Jacqueline Mader

Honors Projects

Traumatic brain injuries (TBIs) have been labeled as a modern-day epidemic, increasing exponentially with the advancement of technology and society. Gaining a better understanding of the cognitive paths, including the chemical and electrical signals of the brain, neural correlates, and possible interventions for TBI patients allows for the best possible outcome for every patient, and allows for the further advancement of care. By revising and reassessing the ways in which TBIs are categorized and described the prognosis for recovery paints a more realistic view for each individual patient case. The symptoms and impairments that may occur post-injury can be monitored …

A “License To Kale”—Free Speech Challenges To Occupational Licensing Of Nutrition And Dietetics, Taylor J. Newman, Angela E. Surrett

St. Mary's Law Journal

State licensing of medical professions has occurred for over a century. Recently, these licensure statutes have been subject to First Amendment challenges, alleging occupational licensure impermissibly restricts freedom of speech. This Comment addresses these free speech challenges, arguing occupational licensure statutes, at least for medical professions, only incidentally impacts free speech—if at all—by permissibly regulating medical professional conduct necessarily requiring speech. Within, the authors ultimately describe, demonstrate, and recommend a legal framework, the other factor/personal nexus approach. This approach helps determine the point at which speech becomes regulable professional conduct subject to licensing, utilizing the nutrition and dietetics profession, and …

Advances In The Diagnosis And Treatment Of Krabbe Disease, David A Wenger, Paola Luzi, Mohammad Rafi

Department of Neurology Faculty Papers

Krabbe disease is an autosomal recessive leukodystrophy caused by pathogenic variants in the galactocerebrosidase (GALC) gene. GALC activity is needed for the lysosomal hydrolysis of galactosylceramide, an important component of myelin. While most patients are infants, older patients are also diagnosed. Starting in 1970, a diagnosis could be made by measuring GALC activity in leukocytes and cultured cells. After the purification of GALC in 1993, the cDNA and genes were cloned. Over 260 disease-causing variants as well as activity lowering benign variants have been identified. While some pathogenic variants can be considered “severe,” others can be considered “mild.” The combination …

A Review On Corona Virus Disease (Covid-19), Hatem Hejaz, Dalia Abo Arqoup, Rezq Basheer, Hiba Abu Znaid, Hiba Swaity, Thara’A Thara’A Rabai

Hebron University Research Journal-A (Natural Sciences) - (مجلة جامعة الخليل للبحوث- أ (العلوم الطبيعيه

Novel Coronavirus (COVID-19) is a new strain of coronavirus that may cause illness in animals or humans. SARS-CoV-2 was first identified in late December 2019, in Wuhan, China. The coronavirus infected patients ‘who suffering from Immundeficient or chronic inflammation are at higher risk of getting a severe infection from COVID-19. The symptoms such as proinflammatory and hypercoagulable, non-cardiac pneumonia, multi-organ failure, and ARDS resulting in sudden death have been seen in those patients. Supportive treatment is still the main strategy in treating this disease since there is no evidence that current medicine can prevent or cure the infection resulting from …

What Is The Most Effective Management For Patients With Concomitant Gallstones And Bile Duct Stones?, Stephanie Mccarney

Theses and Graduate Projects

Background: Gallstone disease is common with a high prevalence in developed nations and is expected to rise as the obesity and metabolic syndrome epidemic worsens. The associated relationship between gallstone and biliary tract disease is complex. The most effective treatment approach for patients with concomitant gallstones and bile duct stones is controversial. Multiple different combinations of one-step and two-step endoscopic and/or surgical techniques exist. Advancements in laparoscopic and endoscopic methods have paved the way for a minimally invasive approach to managing cholecystocholedocholithiasis (CCL).

Methods: A literature review was conducted via systematic search of Google Scholar and PubMed to …

Heart Failure, Meredith Louden

Nursing Student Class Projects (Formerly MSN)

Abstract

Background: Heart failure (HF) is the heart’s inability to maintain the blood flow needed by the body’s organs for perfusion. HF affects millions of adults worldwide annually and holds detrimental characteristics with its high hospitalization and mortality rates. As a result, healthcare systems spend exponentially more resources and money to take care of HF patients. An interactive poster is presented on HF to educate patients with HF, healthcare providers, and other related parties.

Methods: Research articles that focused on HF, including the following topics: pathophysiology, clinical signs and symptoms, treatment, complications, impact on healthcare, and etiology, were evaluated and …

Chronic Obstructive Pulmonary Disease, Aaron Mcneilan

Nursing Student Class Projects (Formerly MSN)

The following poster presentation provides a brief overview of the disease process of Chronic Obstructive Pulmonary Disease (COPD). COPD is one of the leading causes of disability and death worldwide, and its incidence does not appear to be declining. The most common factor causing COPD is cigarette smoking, which is modifiable. Other contributors are environmental air pollutants which some people may encounter depending on where they live or their occupation. This presentation is a culmination of information from different scholarly sources which discuss the symptoms, pathophysiology, causes, management, and prevention of COPD.

The Problem Of Operational Stress Injuries In An Ontario Fire & Rescue Organization, Megan Edgelow

The Dissertation in Practice at Western University

The purpose of this Organizational Improvement Plan (OIP) is to assist public safety leaders in understanding the human and financial costs of operational stress injuries (OSIs) and possible solutions to this issue. OSIs, including posttraumatic stress disorder (PTSD), are a growing problem for public safety organizations, requiring new and innovative solutions. This OIP is applied to a fire and rescue organization in a small urban centre in Ontario that faces similar OSI challenges to many other public safety organizations. The Problem of Practice (PoP) is a lack of implementation of effective practices to mitigate the impact of OSIs. The foundation …

Exploration Of Patient Variables And Characteristics Best Suited For Medical Marijuana Treatment For Anxiety And Depressive Disorders, Corey Gazoo

Dissertations

Individuals with posttraumatic stress, anxiety and depressive disorders are currently being prescribed medical marijuana as a treatment in many states across the United States. However, marijuana is still considered a schedule one narcotic by the Drug Enforcement Administration and federal government, which provides several barriers and challenges to conduct research such as approval from the U.S. Food and Drug Administration and following guidelines from the National Institute on Drug Abuse issued by the DEA. Additionally, individuals prescribed medical marijuana for mental health disorders are not always thoroughly instructed on the type of medical marijuana, the dosage, and how frequently to …

Methods Of Educating Nursing Students On Proper Handwashing To Enhance Infection Control During The Covid Pandemic, Yulanda King

Doctor of Nursing Practice Projects

Background: Medical professionals have commonly been urged to use soap and water to sanitize their hands to prevent contamination and disease transmission. However, thorough handwashing requires a couple of minutes to clean hands thoroughly. Considering that health professionals must sanitize their hands' multiply times during a day, handwashing consumes a significant amount of time away from bedside care. Time spent away from patients may also result in a substantial decrease in the quality of healthcare services provided by the medical institution.

Purpose: This project evaluates the current policy and procedure for appropriate use of handwashing versus hand sanitizer in the …

Takotsubo Cardiomyopathy, Aimee Baker

Nursing Student Class Projects (Formerly MSN)

This poster evaluates the current understanding of Takotsubo Cardiomyopathy (TTC) and describes current treatment recommendations, long-term prognosis, and advanced practice nursing implications. TTC is a relatively rare disease and is present in about 2% of suspected ST-segment myocardial infarctions in women. (Sattar et al., 2017) TTC is not well understood and has several current hypotheses regarding cellular pathology. This poster explores the current understanding of pathophysiologicderangements from an organ system and two pathologic hypotheses at the cellular level. Current treatment recommendations include subclasses of treatments stratified by types of complications. Also, this poster introduces a new subclass of heart failure …

Epidemiology, Pathogenesis, And Clinical Manifestations Of Acute Esophageal Necrosis In Adults, Obaid Rehman, Urooj Jaferi, Inderbir Padda, Nimrat Khehra, Harshan Atwal, Mayur Parmar

HPD Articles

Acute esophageal necrosis (AEN), also termed "black esophagus," is a unique and uncommon occurrence observed in severely sick patients. Other terminologies include acute necrotizing esophagitis and Gurvits syndrome. This condition is described as a darkened distal third of the esophagus observed on endoscopy and presents as an upper gastrointestinal (GI) bleed, difficulty swallowing, abdominal pain, fever, syncope, nausea, and vomiting. The etiology of AEN has been linked to several possibilities, such as excessive gastric acid reflux, hypoperfusion, and ischemia due to impaired vascular supply and hemodynamic instability. Risk factors include increased age, sex (male), heart disease, hemodynamic insufficiency, alcohol use, …

Investigating The Role Of Schizophrenia-Associated Gene Expression In The Developing Human Brain Using Machine Learning, Katie Kelly

Masters

Schizophrenia is a debilitating condition that affects 1% of the population, causes significant hardship and though there are treatments available they are characterised by several limitations. It is a complex mental disorder where some individuals show mild subclinical cognitive symptoms before psychosis onset in adolescence. The treatments available only target a portion of the symptoms and although extensive research has been conducted, a comprehensive understanding of the nature of schizophrenia remains elusive. Unlike other neurodevelopmental disorders, schizophrenia symptoms do not typically present themselves until adolescence. This study aimed to discover gene co-expression networks at multiple developmental stages to identify candidate …

Topical Timolol Versus Oral Propranolol For The Treatment Of Hemangioma In Children, Saad M. Abd Elnaby, Tamer A. Sultan, Tamer F. Abd Elaziz

Menoufia Medical Journal

Objective To evaluate the clinical efficacy and adverse effects of oral propranolol in comparison with topical timolol for the treatment of hemangioma. Background Previous research declares that hemangioma is the most common tumor of infancy and childhood, occurring in 4–10% of white infants. Patients and methods To reach the goal of this research, a prospective randomized study was performed by selecting 20 patients with hemangioma attending the Pediatric Surgery Clinic at Menoufia Main University Hospital and Damanhur National Medical Institute. All patients were subjected to detailed history taking, clinical examination, echocardiogram, complete blood picture, liver and kidney functions, and blood …

Unsupervised Machine Learning For Identifying Challenging Behavior Profiles To Explore Cluster-Based Treatment Efficacy In Children With Autism Spectrum Disorder: Retrospective Data Analysis Study, Julie Gardner-Hoag, Marlena N. Novack, Chelsea Parlett-Pelleriti, Elizabeth Stevens, Dennis Dixon, Erik Linstead

Engineering Faculty Articles and Research

Background: Challenging behaviors are prevalent among individuals with autism spectrum disorder; however, research exploring the impact of challenging behaviors on treatment response is lacking.

Objective: The purpose of this study was to identify types of autism spectrum disorder based on engagement in different challenging behaviors and evaluate differences in treatment response between groups.

Methods: Retrospective data on challenging behaviors and treatment progress for 854 children with autism spectrum disorder were analyzed. Participants were clustered based on 8 observed challenging behaviors using k means, and multiple linear regression was performed to test interactions between skill mastery and treatment …

Development Of An Ehealth Harm Reduction Resource To Address Opioid Use Among Youth In Rural Northern California, Carolyn Perrotti Lake

Doctor of Nursing Practice (DNP) Projects

Problem: Opioid use and misuse is a leading cause of injury and death among adolescents and young adults in the United States, with a three-fold increase in opioid overdoses since 2000 (Carney et al., 2018; Hudgins et al., 2019). Opioid misuse correlates with misuse of other substances, which exponentially increases health risks over time. The most effective treatment for opioid use disorder (OUD) among adolescence is through effective prevention interventions that either prevent the development of the OUD or enable timely diagnosis and treatment in order to prevent poor health outcomes.

Context: The use of eHealth technology, which has …

Exploring The Role Of Core Positive Selves With Men Convicted Of Child Sexual Offenses: A Character Strengths Initiative, Tiffany A. Miner

Individual, Family, and Community Education ETDs

The aim of this study was to help men convicted of child sexual offenses learn to recognize and engage their character strengths over 12 months. Participants were six men convicted of contact and noncontact (internet) child sexual offenses. All participants were members of a community-based reintegration group for registered citizens. In the first weeks of the study, participants received the Values in Action Inventory of Strengths survey. The survey, containing 240 questions—10 items for each of the 24 character strengths outlined—helped participants identify their top character strengths. The study explored (a) how the men could use their character strengths to …

Implementation Of A Cost-Effective Treatment Algorithm For The Management Of Acne Vulgaris In College Students, Cristina Borsilli

Evidence-Based Practice Project Reports

Acne is one of the most common skin disorders in the United States, occuring in over 5.1 million Americans. Of those with acne, 53.8% are adults between the ages of 18 and 44 years old (American Academy of Dermatology [AAD], 2017). Acne can lead to multiple issues such as scarring, poor self-esteem, anxiety, and depression (Zaenglein et al., 2016). Acne can also negatively impact quality of life (Cengiz & Gurel, 2020). The purpose of this evidence-based project was to develop a cost-effective treatment algorithm for the management of acne vulgaris in adult college students. A literature search determined the best …

Virtually Building A Community Of Experts In The Medication-Assisted Treatment (Mat) Of Opioid Use Using The Project Echo Model, Matthew Momjian, Justin Canakis, Faraz Yousefian, Hayden Pond, Adrienne White, Gregory Mayer, Alison Essary

Research Day

Purpose: Project Extension for Community Healthcare Outcomes (ECHO) utilizes telemedicine to connect a multidisciplinary team of experts with a network of primary care physicians to enable rapid dissemination of evidence-based guidelines and practices at scale. In this study, the Project ECHO model disseminated the Arizona Pain and Addiction Curriculum to providers in rural Arizona with the goal to educate providers on MAT.

Methods: Participants engaged in biweekly, virtual teleECHO sessions and post-session surveys were used to collect data on provider satisfaction, self-efficacy, knowledge, barriers to change and changes in practice behavior. Results: Between February 2020 – November 2020, the MAT-ECHO …

The Theory Of Maternal Administration Of Meclizine: An Achondroplasic Review And The Proposed Treatment Of Foramen Magnum Stenosis Within A Murine Model, Ava Perez Erickson

Senior Honors Theses

Arising from mostly de novo mutations, achondroplasia (ACH) is one of the most common, non-lethal forms of chondrodysplasia. The short stature indicative of ACH stems from a gain of function mutation within the complex FGFR3 signaling pathway—mutations mitigating the too-rapid ossification of cartilage to bone. Meclizine, an FDA-approved drug long prescribed for motion sickness, halts such a conversion and allows the reconstitution of chondrodysplasia cell lines in attempts at following a normal growth pattern. Evinced by various cell line rescues as well as increased long bone growth, it can be hypothesized that maternally administered meclizine can rescue the ACH phenotype …