Medical Specialties Commons^™

Effective Therapies And Nursing Approaches: Improving Cognition In Older Adult Stroke Patients, Selyna Baltazar

Nursing | Senior Theses

Background

Ischemic stroke occurs in thousands of older adults throughout the year. Due to the lack of oxygen entering the brain, many patients experience a decline in cognitive function due to ischemic stroke. Cognition is the ability to understand, learn, and remember information which is needed for completing daily tasks. Modern technology has allowed for patients to survive ischemic strokes but has yet to provide proper screening tools and methods for stroke-related cognitive impairment.

Objective

To investigate the best practices for identifying, treating, and caring for patients with a cognitive injury related to a stroke. A review of the research …

Safety Measures In The Epilepsy Monitoring Unit: An Organizational Assessment, Tina Yates

Doctor of Nursing Practice Scholarly Projects

Long-term video-electroencephalography (EEG) monitoring in the epilepsy monitoring unit (EMU) is an elective procedure and generally safe. Clinical experts determined the EMU protocols at a level-4 comprehensive epilepsy center were not followed correctly. The project is a retrospective chart audit incorporating Ray’s Bureaucratic Caring theoretical framework with Donabedian’s conceptual model. The project objective is to evaluate if safety measures protocols are implemented appropriately in the EMU and determine whether a need exists for quality improvements.

The project reviewed patients admitted to the EMU from September 2021 through November 2021 who developed a generalized tonic clonic (GTCs) seizure with electrographic epileptiform …

Skin And Soft Tissue Infection, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Clinical Practice Guidelines)

No abstract provided.

Urinary Tract Infection-Cystitis/Pyelonephritis, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Clinical Practice Guidelines)

No abstract provided.

Nurse Practitioner-Led Heart Failure Education Program, Ruairi Fox

The Eleanor Mann School of Nursing DNP Capstone Projects

Heart failure is a chronic, progressive disease that has a global burden on the healthcare system and on patient’s lives. HF patients who experience a hospital admission are at a greater risk of being readmitted to the hospital within 30 days, impacting healthcare spending costs and patient quality of life. Self-care activities by patients, such as monitoring weight and making lifestyle changes, are the hallmark of outpatient care, and is shown throughout the literature to reduce readmissions and impact patient quality of life. Unfortunately, many patients are either unaware of proper self-care management techniques or find them hard to follow. …

Identifying Motivators, Facilitators, And Barriers To Engaging In An Online Fine Motor Exercise Program, Kristine Ricossa, Kyndra Menefee, Lauren Rally, Mia Do, Charis Chan

Occupational Therapy | MSOT Capstone Projects

Purpose: The aim of this qualitative study was to examine the impact of the motivators, facilitators and barriers for individuals with Parkinson’s Disease (PD) in engaging in a fine motor exercise program given online. Methods: Using a phenomenological design, a purposive sample of 6 individuals with PD were recruited. Data were collected through semi-structured interviews via zoom with follow up member checks. Data were analyzed through an inductive approach by developing generalizations from themes based on the interview data. Results: Three common themes were developed, ‘integrating and forming habits’, ‘acknowledging participation in exercise can fight the disease’, ‘recognizing improvement in …

When Problems Become Solutions: Harnessing The Osteogenic Capacity Of Disease-Causing Stem Cells To Repair Bone Fractures, Mehreen Pasha

University Scholar Projects

While we often perceive disease as negative, there is potential to engineer seemingly negative biological phenomena into therapeutics to treat a variety of human illnesses. Fibrodysplasia ossificans progressiva (FOP) is a genetic disorder involving uncontrolled, widespread, extraskeletal bone growth, or heterotopic ossification (HO). In FOP patients, stem cells called fibro/adipogenic progenitors (FAPs) follow an abnormal, osteogenic pathway. In the present study, we investigate whether we can adapt these Acvr1 mutant FAPs, which are exceptional at producing bone, to repair bone fractures in otherwise normal patients. The primary aims of this study are (1) to devise and optimize a novel method …

Toddler Tibia Fracture, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

A Survey To Highlight Areas Of Focus For Patient Care In Settings Utilizing Medical Interpretation, Azayzel Deregis

Undergraduate Honors Theses

This thesis recounts my personal experience working as a volunteer medical interpreter for the Language and Culture Resource Center at East Tennessee State University. The result of my time spent volunteering as a medical interpreter, shadowing professional medical interpreters, and witnessing patient-provider interactions during interpreted sessions was an inspiration to study medical interpretation further and delve into the challenges faced by patients who require medical interpreters. During my time researching this topic, I found that the United States is severely lacking in Spanish medical interpreters—with some healthcare facilities employing no medical interpreters—even though the size of the Hispanic population is …

Case Study: Injectable Bone Cement In Treatment Of Orif Calcaneal Fractures, Michael Flores, Siraj Panchbhaiya

Posters

No abstract provided.

The Impact Of Remote Optimization Of Guideline-Directed Medical Therapy In Patients With Nyha Stage Ii And Iii Heart Failure, Maurice N. Tran, Christine Doran, Trevor Laursen, Kellie Graybosch, Jacob Abraham

Providence Pharmacy PGY2 Program at Providence Medical Group 2022

No abstract provided.

Evaluating The Impact Of Ambulatory Care Clinical Pharmacy Services In The Pediatric Population, Sheila Prabhu, Bonnie Jiron, Vivian Tang

Providence Pharmacy PGY2 Program at Providence Medical Group 2022

No abstract provided.

Prescribing Patterns Of Antipsychotics For Agitation Or Delirium Management In Non-Critically Ill Patients, Emily Chang, Pamela Levine

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2022

No abstract provided.

Facilitators And Barriers To Implementing A Community Rotation To The Internship Training In Kenya, Peter Mwanza Kioko

Master of Medicine in Family Medicine

Background: Primary care is increasingly being prioritized all over the world more so in developing countries in an effort geared towards achieving health equity. The availability of skilled human resources at the community level has been shown to improve health outcomes. However, doctor numbers remain low in sub-Saharan countries. Kenya’s policy on universal health coverage aims to enable access to essential health services by all its citizens by 2022. The introduction of community placements among undergraduate medical students has proven beneficial in understanding community health problems, the role of primary care in health as well as increasing the likelihood of …

Burden In Family Caregivers Of Patients With Chronic Mental Illness In Aga Khan University Hospital And Mathari National Referral Hospital, Nairobi, Kenya., Norah Atieno Obungu

Master of Medicine in Family Medicine

Introduction: In Africa, about 60% of patients with chronic mental health disorders live with their relatives. Family caregivers bear the responsibility of managing relatives with mental illness in the home environment, and this may result in psychopathology in the caregivers. Although extensively studied in the Western world, not much is known about the caregiver burden in Kenya. Objectives: The primary objective of the study was to find out the prevalence of caregiver burden among family caregivers of patients with chronic mental illness attending two psychiatric care facilities in Nairobi. The secondary objective was to determine the socio-demographic characteristics and correlates …

Effects Of Pharmacist Intervention On Blood Pressure In Black Versus White Patients, Angela Kim, Benjamin Rosati, Dawn Fuke

Providence Pharmacy PGY2 Program at Providence Medical Group 2022

No abstract provided.

Retrospective Impact Of Covid-19 Pandemic On Hypertension Management In Primary Care, Carly Barnes, Jayme Johnston, Judy Wong

Providence Pharmacy PGY2 Program at Providence Medical Group 2022

No abstract provided.

Preoperative Phytonadione Supplementation For Mitral Valve Intervention Hemostasis, Katherine M. Nguyen, Joshua Francis, Celine Munoz, Torin P. Fitton

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2022

No abstract provided.

Evaluation Of A Beta-Lactam Antibiotic Allergy Assessment Tool For Patients Receiving Surgical Prophylaxis, Katelynn Tran, Alyssa B Christensen, Tobias Pusch, Jennifer Marfori

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2022

No abstract provided.

A Review Of The Clinical And Cost Effectiveness Of Intravenous And Intramuscular Pharmacological Treatment On Acute Agitation In Patients Admitted To The Emergency Department, Ryan Ferris, Carol Keller

Providence Pharmacy PGY1 Program at Providence Milwaukie and Providence Newberg Medical Centers 2022

No abstract provided.

Immune Checkpoint Inhibitor Induced Type 1 Diabetes Mellitus: A Pembrolizumab Case Study, Michael R. Dirks Jr.

Milwaukie Family Medicine 2022

No abstract provided.

Targeting Neuronal Nitric Oxide Synthase (Nnos) For Melanoma Treatment, Shirley Tong

Pharmaceutical Sciences (PhD) Dissertations

Human cutaneous melanoma is the most aggressive form of skin cancer and the incidence rates have continued to increase over the years. Neuronal nitric oxide synthase (nNOS) produces nitric oxide (NO) has been found to be overexpressed in human melanoma and the expression of nNOS is induced by interferon-gamma (IFN-γ). In our studies, nNOS has been implicated in IFN-γ-stimulated melanoma progression and the inhibition of nNOS using novel inhibitors effectively inhibited IFN-γ-stimulated tumor growth in a xenograft mouse model. Programmed death-ligand 1 (PD-L1) is overexpressed in melanoma and plays an important role in suppressing the immune system ^12-14. Our …

What Motivates The Choice Of Specialty Among Medical Doctors In Tanzania, Thabit Ramadhani

Master of Surgery

Background: Studies have shown there is a low specialist workforce, coupled with wide range of disparity among different specialities in the country to cater for the needs of more than 54 million Tanzanians. The theories of motivation and development have shown many theories influencing choices made by people in life. Objectives: This study aims to assess the motivation for choice of specialty among medical doctors (including registrars, residents, and specialists) in Dar es Salaam, Tanzania. Methods: A descriptive cross-sectional study was conducted at Muhimbili University of Health and Allied Sciences, Muhimbili National hospital, and the Aga Khan University Hospital Dar …

The Implementation Of A No-Show And Cancellation Policy In The Primary Care Setting: Quality Improvement Project, Dwayne Hall

DNP Projects

The purpose of this quality improvement project is to evaluate the implementation of a no-show and cancellation policy in an urban out-patient primary care setting. The high occurrence of patient no-shows and cancellations in primary care settings is a persistent problem affecting how efficiently healthcare is delivered. No-shows occur when a patient makes an appointment and does not attend the appointment. It diminishes the practice opportunity to schedule other patients in the missed appointment time slot, thus leading to a loss of revenue. It tends to affect practice resource allocation, thereby worsening the quality of healthcare services. The current problem …

From Head To Hilum: Angiosarcoma With Pulmonary Metastasis, Tanaz Salimnia, Lauren A. Abplanalp, Raashi Chawla, K Hughes, R Ghandchi, Matthew Weatherhead, Sanjay Dogra

Conference Presentation Abstracts

With an estimated five-year survival of less than 40 percent, angiosarcomas are rare and often misdiagnosed fataltumors originating from blood or lymphatic vessels with a predilection for the head and neck. They account for 1percent of all soft tissue sarcomas and are often mistaken for benign mimickers leading to the late-stage diagnosiswhen the body is already riddled with metastatic disease with the lung being the most common site of metastases.This case illustrates the myriad of pulmonary complications associated with this uncommon but fatal vasoformativemalignancy. The patient is a 73-year-old male diagnosed with angiosarcoma of the right scalp status post excision,reconstruction, …

Concurrent Covid19 Pneumonia And Systemic Inflammatory Syndrome In A Two-Week-Old Requiring Ecmo, Jennie Godwin, Ayan Rajgarhia, Johanna I. Orrick, Jenna Miller, John M. Daniel Iv

Posters

Objectives: * Initially, newborns seemed to be relatively spared from severe COVID-19. However, with the emergence of the B.1.617.2 (Delta) variant hospitalization rates among children aged 0-4 years increased by 10-fold by the middle of August 2021. We present a case of a 2-week-old previously healthy preterm, twin, male infant who developed severe COVID-19 pneumonia, subsequent acute respiratory distress syndrome (ARDS), and an inflammatory syndrome requiring VA – ECMO support for 22 days. Methods: * A retrospective chart review was performed after successful weaning from ECMO. Parental permission for a case report was obtained in compliance with institutional standards. Results: …

Treatment Of Recurrent Wilms Tumor With Irinotecan/Temozolomide, Meagan Vacek, Terrie Flatt

Posters

Background: Despite improvement in relapse free survival (RFS) in recurrent Wilms tumor, the 4-year RFS rate for patients treated with vincristine/dactinomycin/doxorubicin is approximately 40%. Ifosfamide, carboplatin and etoposide are commonly used in relapsed solid tumors, but have significant toxicities and require hospital admission for administration. Our patient focused on quality of life, and this led to exploration of other treatment options. Objective: Describe a case of multiply relapsed Wilms tumor with management on oral irinotecan/temozolomide for improved quality of life and remission for almost 1 year. Design/Method: Case Report Results: The patient is an 11-year-old female diagnosed with Wilms tumor …

Covid-19 And Incidence Of Necrotizing Fasciitis: A Case Study, Tehreem Sajjad, Carmen Johnson, Janet Baatile-Ajrouche

Posters

COVID-19 manifests as a flu-like respiratory infection affecting multiple organ systems. Symptoms range from mild viral illness to severe acute respiratory infection. There is no definitive relationship between COVID-19 and cellulitis, inflammatory myositis, vasculitis, or necrotizing fasciitis. It is interesting to note that angiotensin-converting enzyme 2 (Receptor for SARS-CoV-2) is present on endothelial cells in multiple organs, including dermal blood vessels and arterial smooth muscle cells. There are several theories that have formed to explain the relationship between COVID-19 and a necrotizing fasciitis infection. This study presents one unique case of an unvaccinated COVID+ patient and the necrotizing fasciitis infection …

An Exploration Of Covid-19 Impact On Healthcare Workers’ Mental Health In China, Jenny Yang

Nursing | Senior Theses

Background

In December 2019, the first confirmed human case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 occurred in Wuhan, China. By March 2020, the World Health Organization (WHO) had classified the COVID-19 outbreak as a pandemic due to the rapid spread of the virus to other countries. Many people have been affected by the COVID-19 pandemic in various aspects, especially front-line healthcare workers. Hospital working conditions are constantly changing to cope with the problems that arise from the pandemic. These problems can result in an unsafe patient-to-nurse ratio, understaffed healthcare workers in hospitals, equipment shortage, and increased …

Filleted Toe Flap For Closure Of Neuropathic Wound With Osteomyelitis, Robert Boguski, Danniyal Shahid

Posters

No abstract provided.