Medicine and Health Sciences Commons^™

Developing An Educational Pamphlet For Patients Undergoing Interscalene Blocks With Liposomal Bupivacaine Exparel, Steve Fankam

Doctor of Nursing Practice Projects

There are over one million shoulder arthroscopies and arthroplasties performed worldwide each year, with interscalene blocks (ISBs) the typical treatment choice for postoperative analgesia (Etkin & Springer, 2017). In 2018, Exparel® was FDA approved for use in ISBs and educational materials currently are scarce (Pacira Pharmaceuticals, 2019). The effectiveness of pamphlets in the clinical setting has been well established (Sustersic, Gauchet, Foote, & Bosson, 2017). Pamphlets improve health literacy by providing patients a tool to aid in recall and adherence to postoperative instructions (Sustersic et al., 2017). This project reviewed the available literature on Exparel® ISBs, health literacy, and pamphlet …

Improving Skin Cancer Screening In Primary Care, Jaclyn Barnhouse, Rebecca Baietto

Doctor of Nursing Practice Projects

Skin cancer is one of the most common forms of cancer in the United States, with melanoma having the highest rate of mortality of all forms of skin cancer (CDC, 2019). However, there is hesitancy among primary care providers to perform skin cancer screenings (Oliveria et al., 2011). Prevention and early detection of melanoma is key. Melanoma has been known to be highly curable when found early. This makes early detection even more important in order to prevent metastasis and potential mortality (Bruce et al, 2017). The use of targeted screening tools can potentially save lives when utilized in primary …

Interventional Techniques For Chronic Low Back Pain And Migraine Headaches: Development Of Educational Pamphlets​, Muhidin Abukar, Mathew Schilling

Doctor of Nursing Practice Projects

Keywords

Chronic low back pain, migraine headaches, radiofrequency ablation, greater occipital nerve blocks, sphenopalatine blocks, botox injections.

Abstract 

Chronic low back pain and migraine headaches affect millions of adults in the United States. Traditionally, opioid and non-opioid pain medications were the mainstay pharmacological treatment of choice. However, due to the highly addictive nature of opioids, practitioners are seeking alternatives for pain management.  Radiofrequency ablation (RFA), a minimally invasive technique has been shown to alleviate chronic back pain while botox injections and other non-invasive opioid sparing techniques, such as greater occipital nerve blocks and sphenopalatine blocks have been found to be …

Physical Well-Being And Healthy Lifestyle Options, Michael Perkins

Doctor of Nursing Practice Projects

Background

The AANA has identified stress management or wellness as a priority for all CRNA programs. The Health and Wellness Initiative put in place by the AANA in 2004 is a model designed for all SRNA programs and intended to address students’ participation in wellness events in order to combat stressors.

The primary purpose of this project was to gain information about the stress faced by SRNAs enrolled at a Midwestern University and to evaluate strategies that could help students properly deal with stress.

Methods and Evaluation

Fifty-five students participated in the survey, data were compared by year in the …

Voyage: A Passage Through Orientation, Patricia Eppel

Doctor of Nursing Practice Projects

Dedication

This DNP project is dedicated to my husband, Jim who carried my school bags to and from the car on every hockey trip, dance competition trip, camping trip, and every other trip, just so I could say I had my homework in case I found time to study. Thank you for making dinners, doing dishes, vacuuming, and providing unwavering support for me through these past years. I also dedicate this project to my children Jacob and Sophia, who always seemed to migrate their way into the dining room late at night for talks when I was up studying. No …

Continuing Education Preferences Amongst Crnas, Jamie Nichting

Doctor of Nursing Practice Projects

The Illinois Association of Nurse Anesthetists (IANA) is a professional organization representing Certified Registered Nurse Anesthetists (CRNAs). To ensure compliance with high standards of care in the profession, CRNAs are required to obtain continuing education units (CEUs) for each 4-year certification period. The IANA offers conferences in both fall and spring, however, a loss in attendance and revenue at state meetings concerns the board members as to how state members are complying with the educational requirements to remain certified. It was imperative that the IANA needed to implement new educational opportunities that actively engaged CRNAs resulting in an increase in …

Virtual Cadaver Dissection Prior To Clinical Experiences In Nurse Anesthesia, Hannah Ruholl, Kyle Smith

Doctor of Nursing Practice Projects

Anatomy and physiology (A&P) courses are the foundation of anesthesia training. Student registered nurse anesthetists (SRNAs) must be A&P experts as they perform clinical skills for the first time. Traditionally, cadaver dissection has been used to enhance comprehension of A&P. However, not all facilities can allocate the time, space, or financial resources for cadaver dissection within their programs of study, especially at institutions that lie outside of major medical centers. Despite the presence of a virtual cadaver at a nurse anesthesia program in the Midwest, its introduction to SRNAs as a resource had not been fully employed. The goals of …

Identifying Barriers To Keeping Appointments In Mental Health, Shontel Ray

Doctor of Nursing Practice Projects

Abstract

Accessing healthcare for mental illness is important but has been challenging to resolve. Due to barriers, individuals are missing appointments leading to long-term negative effects of poor patient outcomes, such as homelessness and suicide. Understanding why individuals cancel or do not show up to their appointments is crucial to resolve this nationwide problem. Further investigation is needed to identify what barriers cause individuals to miss appointments so interventions can be created to resolve it and improve patient care. For this study, those who did not attend their first or second appointments were called and given an eight-question survey. The …

Standardizing Evaluation Methods For Simulation, Jessica Antisdel, Leslie Artinger

Doctor of Nursing Practice Projects

Background: Evidence suggests that student registered nurse anesthetists (SRNAs) benefit from simulation in the educational curriculum (Turcato, Roberson, & Covert, 2008). When simulation is implemented into coursework, it is important to evaluate student learning and perceptions (Adamson & Kardong-Edgren, 2012), however, there are few standardized instruments available (Adamson et al., 2012; Doolan et al., 2016).

Objectives: The goal of this project was to provide the foundation for standardizing simulation evaluation tools within a midwestern university’s school of nurse anesthesia.

Methods: A presentation on the Value Analysis Model was developed through extensive use of the literature and collaboration with a content …

Compassion Fatigue And Burnout During The Covid-19 Pandemic, Gabrielle Giamanco, Tyler Tanzyus

Doctor of Nursing Practice Projects

Abstract

The COVID-19 pandemic has pushed nurses to exhaustion while leaving them with compassion fatigue (CF) and burnout (BO). Compassion fatigue is secondary to traumatic stress and exposure, while burnout is the state of exhaustion of one’s ability to manage with their work and personal everyday stressors. This study aimed to determine whether a daily use of a meditation app could change quality of life indicators amongst front-line nurses affected by COVID-19. With the help of the ProQol assessment tool, along with a pre and post intervention surveys, participants’ awareness and personal experiences were evaluated. The study consisted of nurses …

Evaluating Unexpected Outcomes With A Change In Practice, Justin Trexler

Doctor of Nursing Practice Projects

Abstract

Quality improvement projects improve processes for delivering safe and effective care to patients. Most protocols can be implemented successfully, but what factors lead to an unexpected outcome? This project sought feedback from anesthesia providers after a protocol for administering intranasal midazolam instead of intravenous midazolam in older adults during cataract removal had unfavorable results. Using the concepts developed by Proctor et al. (2010) to analyze the feedback from the anesthesia providers, this project sought to understand why this change in practice elicited these unfavorable results.

The goal of the change in practice was to improve turnover times and reduce …

Comparison Of Radiomic Feature Aggregation Methods For Patients With Multiple Tumors., Enoch Chang, Marina Z. Joel, Hannah Y. Chang, Justin Du, Omaditya Khanna, Antonio Omuro, Veronica Chiang, Sanjay Aneja

Department of Neurosurgery Faculty Papers

Radiomic feature analysis has been shown to be effective at analyzing diagnostic images to model cancer outcomes. It has not yet been established how to best combine radiomic features in cancer patients with multifocal tumors. As the number of patients with multifocal metastatic cancer continues to rise, there is a need for improving personalized patient-level prognosis to better inform treatment. We compared six mathematical methods of combining radiomic features of 3,596 tumors in 831 patients with multiple brain metastases and evaluated the performance of these aggregation methods using three survival models: a standard Cox proportional hazards model, a Cox proportional …

Attitudes Towards Treating Injured Patients In Urgent Care, Erin Beverly

Doctor of Nursing Practice Scholarly Projects

There has been published literature on the topic of clinician bias and the effects of bias on patient care, however, a review of the literature did not yield any research on the topic of clinician bias towards treating patients injured in motor vehicle accidents (MVA’s). There has been concern about clinicians not preferring to see patients injured in MVA’s however this is only anecdotal. If this topic is to be addressed through quality improvement efforts, there should first be scholarly evidence to support these efforts. This study employed a prospective survey of a convenience sample of clinicians who practice in …

Objective Detection Of Vestibular Evoked Myogenic Potentials, Daniel J. Romero

Dissertations, 2020-current

Cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs, respectfully) are considered objective tests of vestibular function measured using surface electromyography (EMG). In addition, VEMPs are visually detected by an examiner, often requiring a high level of stimulation to the ear to easily visualize a waveform plotted across time. However, a high level of stimulation, like those used during routine VEMP testing, is problematic since it has been shown to be unsafe in children when compared to adults. Visual interpretation can also vary between examiners in cases of reduced vestibular function or when the level of required muscle contraction …

Fucoxanthin: A Review Of Potential Benefits Relative To Human Health, Michael R. White

Masters Theses, 2020-current

Fucoxanthin is a carotenoid sourced and extracted mainly from dark orange and brown seaweeds found in the pacific ocean, such as the wakame algae. The allenic bonds and unique oxygen groups give fucoxanthin its unique structure and are thought to be part of the reason fucoxanthin has unique physiological functions. Fucoxanthin has potentially numerous effects on the physiology of human health, ranging from skin health to metabolic health, which have been demonstrated in animal model research. The goal of this review is to examine current literature to discuss fucoxanthin’s potential application as a nutraceutical, treatment for obesity, type 2 diabetes, …

A Phase I Trial Of The Met/Alk/Ros1 Inhibitor Crizotinib Combined With The Vegf Inhibitor Pazopanib In Patients With Advanced Solid Malignancies, Sarina A Piha-Paul, Ecaterina E Dumbrava, Binoj C Nair, Wendy Xiong, Li Xu, Rosa Mostorino, Vivek Subbiah, Nizar Tannir, Siqing Fu, Aung Naing, Filip Janku, Daniel D Karp, Shreyaskumar Patel, Najat C Daw, David Hong, Funda Meric-Bernstam, Ralph G. Zinner

Department of Medical Oncology Faculty Papers

Background: Crizotinib inhibits ALK, MET and ROS1 tyrosine kinases but the development of resistance to monotherapy is an issue. The anti-angiogenic properties of pazopanib could overcome crizotinib drug resistance. Additionally, the anti-angiogenic properties of crizotinib could augment the clinical efficacy of pazopanib.

Methods: We evaluated the safety and responses in patients with advanced solid tumors treated with crizotinib and pazopanib.

Results: Eighty-two patients (median age 53 years, range 18-78 years) were enrolled. The median number of prior systemic therapies was 3 (range, 0-8). We were able to dose escalate to dose level 8 (crizotinib 250 mg twice daily and pazopanib …

Effectiveness Of Prenatal Screening Tests On Predicting Cardiac Anomalies, Stephanie Wong, Zeynep Alpay Savasan

Conference Presentation Abstracts

INTRODUCTION Congenital heart disease (CHD) is the leading cause of birth defect-associated infant death. With 1 in 111 newborns born with CHD and an elevated infant mortality rate of 30-50%, early detection is imperative. Current prenatal screening mainly focuses on detecting chromosomal anomalies. However, the accuracy of these exams on detecting fetal cardiac abnormalities is not well researched. The primary goal of this study is to compare three prenatal screening tests’ potential, i.e anatomy ultrasound, nuchal translucency (NT), and cell-free DNA (cfDNA), in identifying a risk for fetal cardiac anomalies. METHODS A retrospective chart review utilized a convenience sample of …

Associations Of Perceived Overall Health, Psychological Distress, Functional Impairment, And Alcohol Use Among Older Adults Of Sexual Minority Status And Heterosexual Peers, Carolyn Tran

Dissertations and Theses (Open Access)

Background: Lesbian, gay, and bisexual (LGB) adults, 50 and older, are likely to have experienced mistreatment and discrimination, contributing to poor physical and mental health and risky behaviors, such as alcohol misuse. Few studies have examined the relationships between perceived health, psychological distress, functional impairment, and alcohol use of older LGB adults and heterosexuals.

Specific Aims: The specific aims were: (1) to determine if perceived overall health status is associated with psychological distress and functional impairment in sexual minority older adults compared to heterosexual older adults, and (2) to determine if sexual minority status moderates the relationship between psychological distress …

Fundamental Causes Of Racial And Ethnic Covid-19-Related Health Disparities, Hana Neutz

Student Scholar Symposium Abstracts and Posters

Underserved low-income communities of color in the U.S. have endured an unequal burden of COVID-19 morbidity and mortality. This pattern of pandemic-related health disparities has been pervasive throughout history. However, no known studies have simultaneously examined social and biological factors that contribute to these concerning health disparities. Therefore, this paper aims to bridge the gap by employing a scoping literature review of (1) the deleterious impacts of systemic racism on COVID-19-related outcomes; and (2) the cellular and molecular mechanisms connecting COVID-19 and hypertension (a comorbidity known to exacerbate COVID-19 severity). My findings indicate that systemic racism manifests in inequitable access …

Acute Renal Failure And An Acid-Base Dilemma, Kamil Sardarli, Russell Leong, Matthew Weatherhead, Bhavinkumar Dalal

Conference Presentation Abstracts

Introduction: Acute renal failure (ARF) is well-recognized to result in metabolic acidosis. The acidosis of ARF is associated with decreased ammoniagenesis and anion excretion. Alkalosis in the presence of ARF presents diagnostic uncertainty and therapeutic challenges. This vignette describes a case of ARF resulting in several electrolyte imbalances and metabolic alkalosis. Case Description: A 54-year-old female with past medical history of small bowel resection with colostomy presented for nausea and vomiting for two weeks. On presentation, she was noted to be tachycardic and lethargic. Her workup revealed a serum creatinine of 6.8 mg/dL, blood urea nitrogen of 147 mg/dL, bicarbonate …

Utilization Of The Ballast Long Guiding Sheath For Neuroendovascular Procedures: Institutional Experience In 68 Cases, Ameer E. Hassan, Elizabeth M. Burke, Marlon Monayao, Wondwossen G. Tekle

School of Medicine Publications

Background: The rise of neurointerventional devices has created a demand for guide systems capable of navigating to the carotid artery consistently regardless of tortuosity. The shift toward large distal access catheters (DACs) and desire for greater trackability have inspired the creation of flexible, supportive, large-lumen long guiding sheaths. Recently, the Ballast long guiding sheath was introduced to provide stability and flexibility while navigating neurointerventional devices through tortuous intracranial anatomy.

Objective: To report our experience using the Ballast long guiding sheath in a series of patients undergoing a variety of neuroendovascular procedures.

Methods: We retrospectively identified all patients who underwent neuroendovascular …

Model Organisms Contribute To Diagnosis And Discovery In The Undiagnosed Diseases Network: Current State And A Future Vision, Dustin Baldridge, Michael F Wangler, Angela N Bowman, Shinya Yamamoto, Undiagnosed Diseases Network, Tim Schedl, Stephen C Pak, John H Postlethwait, Jimann Shin, Lilianna Solnica-Krezel, Hugo J Bellen, Monte Westerfield

2020-Current year OA Pubs

Decreased sequencing costs have led to an explosion of genetic and genomic data. These data have revealed thousands of candidate human disease variants. Establishing which variants cause phenotypes and diseases, however, has remained challenging. Significant progress has been made, including advances by the National Institutes of Health (NIH)-funded Undiagnosed Diseases Network (UDN). However, 6000-13,000 additional disease genes remain to be identified. The continued discovery of rare diseases and their genetic underpinnings provides benefits to affected patients, of whom there are more than 400 million worldwide, and also advances understanding the mechanisms of more common diseases. Platforms employing model organisms enable …

Invasive Therapies For Acute Coronary Syndromes In The Covid-19 Era, Sanket Borgaonkar, Joshua Hahn, Marilyne Daher, Waleed Kayani, Hani Jneid

Faculty, Staff and Students Publications

PURPOSE OF REVIEW: To identify and address the challenges associated with the care of ACS patients during the coronavirus 2019 pandemic.

RECENT FINDINGS: The COVID-19 pandemic has had a considerable global impact with over 2.0 million deaths worldwide so far. There has been considerable evidence suggesting that COVID-19 increases the risk of acute coronary syndromes (ACS). We propose characterizing ACS patients into 3 distinct categories to better assist in appropriate triage and management: critically ill patients, non-critically ill ST elevation myocardial infarction (STEMI) patients, and non-critically ill non-ST elevation myocardial infarction (NSTEMI)/unstable angina (UA) patients. We thoroughly review treatments strategies, …

The Incidence Of Acute Pulmonary Embolism With Covid-19 Pneumonia In Saudi Arabia: A Retrospective Single-Center Study, Samah I. Abohamr, Mubarak A. Aldossari, Hala A. Amer, Hiba M. Saadeddin, Sara W. Abdelhamid, Fayaz A. Bhat, Eman Abdul Aziz Elsheikh

Journal of the Saudi Heart Association

Background: Computed tomography (CT) plays a significant role in the treatment of coronavirus disease 2019 (COVID-19) and has helped to identify patients with serious complications. We investigated the clinical characteristics and chest CT findings of COVID-19 positive patients complicated with acute pulmonary embolism (APE). Methods: A retrospective, record-based, case-series study was performed examining 483 patients admitted to King Saud Medical City during the pandemic, from April 2020 to June 2020. Of these, 92 patients who underwent chest CT scans were included in the final analysis. The incidence of APE, clinical presentations, radiological patterns, and patient outcomes were assessed …

Constructing The Panama Canal: A Brief History, Ian E. Phillips

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Seeking to commemorate the construction of the Panama Canal, an engineering marvel widely considered a contender for the eighth wonder of the world, this article attempts to retell the story of the Canal's construction by synthesizing a narrative centered on the Canal under French and American leadership, worker segregation, and labor conditions at the Isthmus.

Pharyngeal Constriction As A Cause For Late Acquisition And Speech Sound Disorders Of Rhotic Sounds In English, Spanish, And French, Connor Mahon

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

This paper attempts to explain why rhotic sounds are cross-linguistically late developing among the sound inventory of children. Included is a summary of the current literature regarding classification of rhotic sounds, an examination of the articulatory movement of the tongue root, and an overview of the clinical implications on the field of speech-language pathology. The evidence presented supports the hypothesis that pharyngeal constriction is characteristic of rhotic sounds in many languages, and that it is related to the relative late acquisition and higher rate of speech sound disorders, as seen in English, Spanish, and French.

2021-05-06_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …

Comparing The Health And Welfare Of Refugees And Non-Refugees At The Outset Of The Covid-19 Pandemic: The Results Of A Community Needs Assessment., Matthew J. Lyons, Mary Helen O'Connor, Iris Feinberg, Daniel J. Whitaker, Michael Eriksen, Ashli Owen-Smith, Saiza Jivani, Mohammad Tamer, Esther Kim, Ganaro Makor

Journal of Refugee & Global Health

Refugees are a vulnerable population who experience significant health disparities. They may also be at disproportionately high risk of adverse outcomes due to the COVID-19 pandemic. This paper presents the results of a community needs assessment to investigate the impact of the pandemic on health and welfare in a refugee relocation community in the United States. A multilingual data collection team made up of refugees surveyed 179 participants (128 refugees vs. 51 non-refugees). Only 55.9% of refugee respondents said they would be able to provide enough food for their family this week, compared with 84.0% of non-refugees (p < 0.01), and this difference was even greater for food next week …

Caring Calls: A Weekly Phone Call Intervention And The Correlation With Loneliness In Rural Dwelling Adults, Abigail Jumbeck, Jennifer Timm, Mieca Valen, Chris Malone

Nursing DNP Projects

Purpose: This pilot study’s aim was to examine the impact of weekly phone calls from interprofessional students on loneliness in rural dwelling adults.

Design: A pretest and posttest quasi-experimental design was utilized.

Setting: The intervention was based in southeastern Minnesota, although the participants could have lived anywhere. Zoom for Healthcare © was utilized, and students were able to make the phone calls from their homes, therefore, no travel was necessary.

Subjects: The subjects were rural dwelling adults (over the age 18 years old).

Intervention: Interprofessional students made weekly social phone calls to rural dwelling adults over ten weeks.

Measures: The …

The Power, (Problem), And Potential Of Prayer, Meghan E. Stretar

School of Theology and Seminary Graduate Papers/Theses

This paper illuminates the complex and nuanced relationship between mental health and prayer, particularly seeking theologically grounded understandings of prayer and of our relationship with God in times of mental distress that goes beyond intercessory prayer. The paper begins with an evaluation of social structures that cause mental health problems (notably in college students). A discussion on emotional agility, scarcity, and vulnerability serves as a transition to examining this question from a theological perspective, the second main section of this paper. In this section, I claim that a misunderstanding of the divine-human relationship and of prayer is one potential source …