Medicine and Health Sciences Commons^™

Recommendation For Best Practices In The Management Of Musculoskeletal Pain: An Evidence-To-Practice Review, Laura M. Kehr, Dylan C. Rowe, Rylee M. Learn, Allison B. Smith, Zachary K. Winkelmann

Clinical Practice in Athletic Training

While musculoskeletal (MSK) pain conditions are some of the most common health issues faced internationally, the quality of patient care with MSK pain is lacking. Problems with MSK care include the overuse of imaging, surgery, opioids, and failure to educate patients. Improving the quality of care for MSK conditions is considered a priority for all involved healthcare clinicians. The 2019 guiding systematic review addressed the concerns of MSK management by identifying common recommendations for high-quality care through appraisals of clinical practice guidelines (CPGs). Data was extracted from four databases and included articles examining the most common sites of MSK pain …

Exertional Heat Stroke In A Male High School Runner With Disordered Eating: A Disablement Model Case Study, Brittni G. Hoover, Rebecca M. Hirschhorn, Allison B. Smith, Amy F. Hand

Clinical Practice in Athletic Training

A 16-year-old male high school cross country athlete collapsed at the end of an afternoon 5K cross country meet. The patient was unable to stand, and after outwardly displaying confusion and agitation, his coaches sought assistance from the athletic trainers (ATs). The patient consumed one cup of water and a granola bar on the day of the meet. The ambient air temperature was 90°F with 69% humidity. Differential diagnoses included exertional heat stroke (EHS), exertional heat exhaustion, exertional collapse associated with sickle cell trait, heat syncope, dehydration, malnutrition, and hypoglycemia. Approximately 20 minutes passed between activation of the emergency action …

Quality Improvement: Implementation Of Individualized Concussion Patient Education And Rehabilitation Treatment Plans, Briana Burgette, Tamara C. Valovich Mcleod

Clinical Practice in Athletic Training

Concussion is a significant health issue at all levels of sports participation. At Saint Luke’s Health System (SLHS) in Kansas City, Missouri, the sports medicine and concussion team discovered an issue with dissemination of patient education for concussion rehabilitation plans. A quality improvement project was launched in August 2019 to develop concussion educational rehabilitation plans, incorporating cluster symptoms into concussion profiles and improving communication during follow-up care. The project promoted improvement of patient understanding of individualized rehabilitation plans and effective communication for the treatment management team. Three cycles of a Plan-Do-Study-Act (PDSA) quality improvement project were completed over 6 months. …

Characteristics Of Sickle Cell Trait Policies And Procedures At Ncaa Division I Institutions, H Parker, B J. Warner, D M. Gallegos, S A. Cage

Clinical Practice in Athletic Training

Context: In 2010, the National Collegiate Athletic Association (NCAA) introduced a proposal addressing sickle cell trait screening. This proposal later became a policy that required student-athletes in their first year of eligibility to provide their institution with accurate information regarding their sickle cell trait status. There does not appear to be a recent study published that has examined the sickle cell trait policies and procedures currently being used by NCAA Division I institutions. The purpose of this study was to describe the characteristics of sickle cell trait policies and procedures at NCAA Division I institutions. Methods: We used a web-based …

Characteristics Of Sickle Cell Trait Policies And Procedures At Ncaa Division Iii Institutions, M A. Eilers, B J. Warner, D M. Gallegos, J A. Clark, S A. Cage

Clinical Practice in Athletic Training

Context: In 2010, the National Collegiate Athletic Association (NCAA) introduced a proposal addressing sickle cell trait screening. This proposal later became a policy that required student-athletes in their first year of eligibility to provide their institution with accurate information regarding their sickle cell trait status. There does not appear to be a recent study published that has examined the sickle cell trait screening policy and procedures currently being used by NCAA Division III Institutions. Thus, the purpose of this study was to describe the characteristics of sickle cell trait policies and procedures at NCAA Division III institutions. Methods: We used …

Body Tempering And Its Effect On Ankle Dorsiflexion And Power, Neal Ori, Justin Goins, Jay Patel, Robbie Ingle

Clinical Practice in Athletic Training

Body Tempering (BT) is a newer myofascial release (MFR) technique that is used by athletes and healthcare professionals. The effects of BT are stated to be similar to foam rolling (FR) and other MFR techniques, but there is minimal research assessing the effects of BT on power and range of motion (ROM). The purpose of this study was to determine the effect of BT on ankle dorsiflexion ROM and power, as well as to compare the effects of BT to traditional FR. Twenty college-aged participants (10 males-10 females) were tested before and after intervention on three measurements of the broad …

Herpes Zoster As An Incidental Finding During Treatment For Thoracic Back Pain In A Collegiate Baseball Player, L E. Trail, B J. Warner, R L. Peebles, R M. Galbraith, C Cox, S A. Cage

Clinical Practice in Athletic Training

Background: A 21-year-old male collegiate baseball pitcher reported to the athletic training staff complaining of thoracic back pain when throwing during the non-traditional season. The patient did not recall a specific mechanism of injury, and noted that his pain had gradually increased over time. The patient reported no previous history of thoracic or lumbar spine injury. Further evaluation revealed multiple myofascial adhesions that did not resolve with conservative treatments. After the failure of conservative treatment, the patient was referred to the team physician for further evaluation.. Differential Diagnosis: Myofascial adhesions, Rib subluxation, Thoracic Disc Herniation Treatment: Upon referral, the team …

A Nomogram For Predicting Upper Urinary Tract Damage Risk In Children With Neurogenic Bladder, Qi Li, Miao Cai, Qingsong Pu, Shengde Wu, Xing Liu, Tao Lin, Dawei He, Jianguo Wen, Guanghui Wei

Faculty, Staff and Student Publications

PURPOSE: To establish a predictive model for upper urinary tract damage (UUTD) in children with neurogenic bladder (NB) and verify its efficacy.

METHODS: A retrospective study was conducted that consisted of a training cohort with 167 NB patients and a validation cohort with 100 NB children. The clinical data of the two groups were compared first, and then univariate and multivariate logistic regression analyses were performed on the training cohort to identify predictors and develop the nomogram. The accuracy and clinical usefulness of the nomogram were verified by receiver operating characteristic (ROC) curve, calibration curve and decision curve analyses.

RESULTS: …

The Role Of Organizational Leaders In Employee Self-Care: A Change Management Approach, Olivia Dawn Honaker

DSW Capstone Projects

Although literature demonstrates that helping professionals have had high levels of stress and burnout for decades, the COVID-19 pandemic has only exacerbated the issue. The already burdened healthcare workers, now facing increased workloads, long hours, and high-level exposure to trauma, have created an urgency to address this significant risk to helping professionals. The current capstone will bring awareness to organizational leaders regarding the importance of employee self-care and the benefits of implementing employee self-care programs. First, a systematic literature review will examine self-care in helping professions and explore how organizational leaders operationalize employee self-care programs. In addition, the capstone aims …

Healthcare Equity For Transgender Individuals, Mollie Staggs

DSW Capstone Projects

In the field of social justice and integrity, Social Work has dedicated itself to improving the welfare of the world, in which we all participate and interact. There are countless issues in our society that warrant professional attention for the fundamental purpose of positively impacting the livelihood of subcategories of people. For this particular Capstone Project, the focus is on transgender individuals’ systemic healthcare barriers that cisgender people within the United States do not similarly experience. The purpose is to unveil these disparities to then pose progressive alterations within the healthcare system to make the navigation and accessibility better for …

Bolstering The Effectiveness Of Exposure-Response Prevention In The Treatment Of Obsessive-Compulsive Disorder: Using Self-Compassion As An Adjunctive Intervention, Whitney E. Dyer

DSW Capstone Projects

Individuals suffering with Obsessive-Compulsive Disorder (OCD) face many challenges receiving proper diagnostics and evidence-based treatment. Furthermore, Exposure-Response Prevention (ERP), the empirically supported gold standard approach for targeting OCD, presents its own challenges. Examining the influences of ERP treatment reluctance is paramount to bolstering the effectiveness of outcomes and safeguarding participant adherence and ultimate success. This Capstone highlights the overlooking of addressing shame within traditional ERP protocol and posits a practice application model that supports the adjunctive use of self-compassion, a potent antidote for shame, within the use of ERP. As treatment hesitation is an inhibitor to relief for OCD sufferers, …

Neuroleadership A New Burnout Prevention Strategy, Zakery David Sloan

DSW Capstone Projects

This capstone project examines the current state of burnout, prevention strategies, prevalence, and introduces neuroleadership as a new leadership theory to advance burnout prevention among the public human service population. Neuroleadership presents a new conceptualization of leadership practice and burnout prevention method by utilizing neuro-informed leadership practices. This new neuro-informed leadership strategy is explored throughout the three major products of this capstone project including a systematic literature review, conceptual paper, and practice application paper.

The first product completed was a systematic literature review. This literature review included a total of 13 articles which were used to answer the research question, …

Postpartum Depression: Mitigating Treatment Barriers For Women In Appalachia, Tabitha Simpson

DSW Capstone Projects

This capstone focuses on maternal mental needs, specifically postpartum care and postpartum depression. Each article in this capstone centers on postpartum depression, treatment barriers, introducing standard care of practice for women in rural communities, and identifying gaps leading to further research in postpartum education. Countless articles were read and utilized in conducting the systematic literature review to begin this process.

The first article in the capstone, the Systematic literature review, details the signs and symptoms of postpartum depression and how it differs from a major depressive disorder. A thorough review of the literature was conducted, identifying the central concern of …

Iatrogenic Arteriovenous Fistula After Distal Transradial Coronary Angiography, Wah Wah Htun, Myo Maw, Tak Kwan

The Texas Heart Institute Journal

No abstract provided.

Left Ventricular Assist Device Support And Longitudinal Sleeve Gastrectomy Combined With Diet In Bridge To Heart Transplant, Mandy Ng, Beverly Rodgers, Saadiya Rehman, Sriram S Nathan, Kulvinder S Bajwa, Shinil K Shah, Bindu H Akkanti, Marwan F Jumean, Sachin Kumar, Jennifer L Dressel, Rajko Radovancevic, Melissa M Felinski, Biswajit Kar, Igor D Gregoric

The Texas Heart Institute Journal

Combining left ventricular assist device (LVAD) implantation and longitudinal sleeve gastrectomy may enable patients with morbid obesity to lose enough weight for heart transplant eligibility. In a retrospective study, we evaluated long-term outcomes of patients with body mass indexes ≥35 who underwent LVAD implantation and longitudinal sleeve gastrectomy during the same hospitalization (from January 2013 through July 2018) and then adhered to a dietary protocol. We included 22 patients (mean age, 49.9 ± 12.5 yr; mean preoperative body mass index, 43.3 ± 6.2). Eighteen months after gastrectomy, all 22 patients were alive, and 16 (73%) achieved a body mass index …

Left Ventricular Dysfunction In Outpatients With Frequent Ventricular Premature Complexes, Kyoung-Min Park, Sung Il Im, Sung Ho Lee, Hye Bin Gwag, Youngjun Park, Seung-Jung Park, June Soo Kim, Young Keun On

The Texas Heart Institute Journal

Frequent ventricular premature complexes (VPCs) and VPC QRS duration are risk factors for left ventricular (LV) dysfunction. To determine which clinical characteristics and electrocardiographic features are associated with LV dysfunction (ejection fraction,

We identified 412 consecutive outpatients (mean age, 54.7 ± 16.8 yr; 227 women [55.1%]) who were diagnosed with frequent VPCs and had no structural heart disease from January 2010 through December 2017. Available transthoracic echocardiograms and 24-hour Holter monitoring data were evaluated to correlate the occurrence of VPCs and symptoms.

Typical VPC-related symptoms (palpitations or dropped beats) were observed in 251 patients (61.1%). Electrocardiograms revealed VPCs with a …

Very Late Aortic Endograft Infection With Listeria Monocytogenes In An Elderly Man, Jorge A Miranda, Ahmed Khouqeer, James J Livesay, Miguel Montero-Baker

The Texas Heart Institute Journal

Endograft infection with Listeria monocytogenes is a rare, potentially devastating complication of endovascular aortic aneurysm repair. To our knowledge, only 8 cases have been reported. We describe the case of a 72-year-old man who presented with L. monocytogenes endograft infection and a 19-cm degenerative aneurysm 9 years after having undergone endovascular repair of an abdominal aortic aneurysm. The infection was successfully treated with open surgical excision of the infected aortoiliac endograft and its replacement with a rifampin-soaked, bifurcated Dacron graft.

Aadej Comm 8 1 2022

AADEJ - The Communicator

The Communicator is the official journal of the American Association of Dental Editors and Journalists (AADEJ). It is published quarterly, distributed digitally via email to members, and posted on the Association's website, AADEJ.org. Each issue includes regular updates from the editorial team and AADEJ board, as well as feature articles on current issues in the field.

An Asian Case Of Combined 17Α-Hydroxylase/17,20-Lyase Deficiency Due To Homozygous Pr96q Mutation: A Case Report And Review Of The Literature, Qian Liao, Rufei Shen, Mingyu Liao, Chenxi Ran, Ling Zhou, Yuling Zhang, Guiliang Peng, Zheng Sun, Hongting Zheng, Min Long

Center on Aging Staff Publications

Background: Combined 17α-hydroxylase/17,20-lyase deficiency (17-OHD) is a very rare form of congenital adrenal hyperplasia (CAH) caused by mutations in the CYP17A1 gene. Almost 100 different mutations of the CYP17A1 gene have been reported, including p.R96Q mutation, but no case of p.R96Q mutation has been described in Asian populations.

Case presentation: We describe a 22-year-old female patient of 46,XY karyotype, who presented with pseudohermaphrodism, primary amenorrhea, underdeveloped secondary sexual characteristics, delayed epiphyseal healing, hypertension, and hypokalemia. The diagnosis of 17-OHD was reached by measurement of steroid hormones and abdominal CT scan and confirmed by genetic sequencing, which revealed a homozygous p.R96Q …

Safety And Efficacy Of Electrical Stimulation For Lower-Extremity Muscle Weakness In Intensive Care Unit 2019 Novel Coronavirus Patients: A Phase I Double-Blinded Randomized Controlled Trial, Alejandro Zulbaran-Rojas, Ramkinker Mishra, Naima Rodriguez, Rasha O Bara, Myeounggon Lee, Amir Behzad Bagheri, James P Herlihy, Muhammad Siddique, Bijan Najafi

Center on Aging Staff Publications

Background: Intensive care unit (ICU) prolonged immobilization may lead to lower-extremity muscle deconditioning among critically ill patients, particularly more accentuated in those with 2019 Novel Coronavirus (COVID-19) infection. Electrical stimulation (E-Stim) is known to improve musculoskeletal outcomes. This phase I double-blinded randomized controlled trial examined the safety and efficacy of lower-extremity E-Stim to prevent muscle deconditioning.

Methods: Critically ill COVID-19 patients admitted to the ICU were randomly assigned to control (CG) or intervention (IG) groups. Both groups received daily E-Stim (1 h) for up to 14 days on both gastrocnemius muscles (GNMs). The device was functional in the IG and …

Patient Perceptions Of Shared Decision-Making In The Acute Care Hospital And Their Association With Patient Experience And Readmission, Jill Haladay

Electronic Theses and Dissertations, 2020-2023

Avoidable hospital readmissions continue to be a concerning and costly healthcare issue. While the emphasis on reducing avoidable hospital readmissions persists, incentivization strategies are evolving. Initial strategies prioritized medical care delivery, but recent regulation highlights the value of effective transitional (discharge) care planning, and particularly, patient involvement in that process. This latter aspect of care has a clear indication for the application of shared decision-making. Shared decision-making (SDM) practice in the acute care setting largely represents a gap in the literature; yet understanding patient perceptions of SDM during hospitalization is an important and timely first step in exploring the effectiveness …

An Examination Of Street-Level Drug Enforcement Tactics And Court Outcomes, Nicholas Paul

Electronic Theses and Dissertations, 2020-2023

While there is a substantial body of placed-based evaluations of drug enforcement strategies, little is known about the nature and effectiveness of the routine tactics used by local police to target individual drug offenders. This study used a mixed-method approach to build on existing research on the efficacy of drug enforcement by documenting the nature and consequences of street-level drug enforcement at the local level. First, a focus group of drug enforcement experts was conducted to identify the tactics used to generate arrests and various types of evidence believed to strengthen drug cases. Next, official data in the form of …

Evaluation Of Magnesium Hydroxide Particles Coated With Betaine And Citrate As A Magnesium Delivery System For Migraine Treatment, Ashton Holderness

Electronic Theses and Dissertations, 2020-2023

Migraines affect an estimated 1.04 billion people worldwide annually. To address the global prevalence of migraines, new migraine treatments should be of utmost importance. To date, magnesium hydroxide [Mg(OH)2] and magnesium sulfate are two common treatments for delivering magnesium to patients with low intracellular levels, which are believed to be linked to migraines. One major downside to using Mg(OH)2 as an over-the-counter treatment for magnesium delivery is the possibility of side reactions in the acidic environment of the stomach, further affecting the pH stability necessary during uptake in the small intestine. To address these downfalls, Mg(OH)2 was synthesized with capping …

Effects Of Gaba On Inflammation And Intestinal Barrier Disruption, Tyrel W. Long

EWU Masters Thesis Collection

Gut dysbiosis and intestinal barrier disruption have been linked to multiple sclerosis (MS). Our previous works show that experimental autoimmune encephalomyelitis (EAE) induction modifies the gut's microbiota composition, reducing frequencies of gamma-aminobutyric acid (GABA)-producing bacteria. GABA levels are reduced in the brains and circulation of MS patients. We engineered Lactococcus lactis with extra copies of gadB (glutamic acid decarboxylase) and gadC (glutamate/GABA antiporter) to increase GABA levels produced by the bacterium (GAD-L. lactis). EAE studies showed that the treatment with GAD-L. lactis and not with a L. lactis control expressing an empty plasmid (P-L. lactis) reduced the severity of the …

A Mixed Methods Approach To Understanding Participant Perspectives On Return Of Individual Research Results, Jyoti Angal

Dissertations and Theses

Provision of individual research results to participants is a critical component of the research process. While there is general interest amongst researchers in returning individual research results, a lack of understanding of the personal value of results for participants has hindered the return of individual results. This is especially true for non-genomic research results such as surveys, laboratory test results, or imaging results. This study examined the participant perspectives on the return of individual research results in a diverse cohort of 1587 mothers currently enrolled in the Environmental Child Health Outcomes (ECHO) program. A mixed-methods approach was used to delineate …

Feasibility And Acceptability Of Administering A Functional Cognitive-Communication Assessment To Individuals With Self-Reported Concussion, Mackenzie Ann Brown

Graduate Student Theses, Dissertations, & Professional Papers

Purpose: Individuals who experience ongoing symptoms after sustaining a mTBI may not receive the help they need because the deficits they endorse on self-report measures are not identified on current standardized cognitive assessments. The purpose of the current investigation is to determine how to better document ongoing cognitive-communication deficits and to characterize the nature of how these deficits impact daily life and communicative participation, using a multidimensional assessment protocol.

Method: A multiple case study design was selected to comprehensively document the cognitive-linguistic functioning of multiple individuals with concussion. Five participants completed one session over a telehealth platform that included four …

Phenotype-Genotype Analysis Of Caucasian Patients With High Risk Of Osteoarthritis, Yanfei Wang, Jacqueline Chyr, Pora Kim, Weiling Zhao, Xiaobo Zhou

Faculty, Staff and Student Publications

Background: Osteoarthritis (OA) is a common cause of disability and pain around the world. Epidemiologic studies of family history have revealed evidence of genetic influence on OA. Although many efforts have been devoted to exploring genetic biomarkers, the mechanism behind this complex disease remains unclear. The identified genetic risk variants only explain a small proportion of the disease phenotype. Traditional genome-wide association study (GWAS) focuses on radiographic evidence of OA and excludes sex chromosome information in the analysis. However, gender differences in OA are multifactorial, with a higher frequency in women, indicating that the chromosome X plays an essential role …

The Detrimental Impact Of Alcohol Intoxication On Facets Of Miranda Comprehension, Amelia Mindthoff, Jacqueline R. Evans, Andrea C. F. Wolfs, Karina Polanco, Naomi E. S. Goldstein, Nadja Schreiber Compo

Psychology Faculty Articles and Research

Objective: Law enforcement officers often encounter alcohol-intoxicated suspects, suggesting that many suspects are presented with the challenge of grasping the meaning and significance of their Miranda rights while intoxicated. Such comprehension is crucial, given that Miranda is intended to minimize the likelihood of coercive interrogations resulting in self-incrimination and protect suspects’ constitutional rights. Yet, the effects of alcohol on individuals’ ability to understand and appreciate their Miranda rights remain unknown—a gap that the present study sought to address. Hypotheses: Informed by alcohol myopia theory (AMT), we predicted that intoxicated individuals would demonstrate impaired Miranda comprehension compared to sober …

Is More, Better? Relationships Of Multiple Psychological Well-Being Facets With Cardiometabolic Disease, Anna-Josée Guimond, Claudia Trudel-Fitzgerald, Julia K. Boehm, Farah Qureshi, Laura D. Kubzansky

Psychology Faculty Articles and Research

Objective: Cardiometabolic disease (CMD) is a leading cause of death and disability worldwide. Assessments of psychological well-being taken at one time point are linked to reduced cardiometabolic risk, but psychological well-being may change over time and how longitudinal trajectories of psychological well-being may be related to CMD risk remains unclear. Furthermore, psychological well-being is a multidimensional construct comprised of distinct facets, but no work has examined whether sustaining high levels of multiple facets may confer additive protection. This study tested if trajectories of four psychological well-being facets would be associated with lower risk of self-reported nonfatal CMD. Method: Participants were …

Predictors Of E-Cigarette Initiation And Use Among Middle School Youth In A Low-Income Predominantly Hispanic Community, M Yvonne Gaddy, Denise Vasquez, Louis D Brown

Faculty, Staff and Student Publications

Introduction: E-cigarette use among middle and high school youth increased from 2. 5 million in 2014 to 9.2 million in 2019, becoming the most common tobacco product used among youth. Hispanic youth, the largest ethnic minority in the United States, have higher rates of tobacco use, including e-cigarettes, than non-Hispanics. Identifying factors that put youth at risk for future e-cigarette use is vital to focusing prevention efforts. Informed by social cognitive theory, this study identifies predictors of e-cigarette uptake among e-cigarette naïve youth in a predominantly low-income Hispanic community.

Methods: 1,249 students (6-8th grades) from two middle schools in El …