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Increasing Continuous Positive Airway Pressure Compliance With Various Telemedicine Interventions: An Integrated Literature Review, Tracy Partington

Doctor of Nursing Practice (DNP) Projects

Aims and Objectives. This literature review's objective was to synthesize evidence from previously published literature on telemedicine interventions' effectiveness on CPAP (Continuous Positive Airway Pressure) therapy compliance.

Background. It is estimated that 22 million Americans suffer from a form of Sleep Apnea (SA), and those up to 80 percent of the cases of moderate to severe Obstructive Sleep Apnea (OSA) are undiagnosed (Sleep Apnea, n,d). The first-line therapy for OSA is CPAP. However, CPAP therapy is associated with low compliance rates.

Design. Systematic review.

Method. A multi-database literature search was conducted to identify published literature between 2009 and 2020. …

3-In-1 Medical Lancet, Jonathan J. Panella, Gage Vogtlin, Marissa Koski, Benjamin Neyland

Mechanical Engineering

First responders need a quick, sterile, and convenient way to sample blood for glucose testing because glucose levels are a vital metric in assessing time-critical emergency situations. The blood sampling process consists of pre-sterilizing the sample site on the skin with an alcohol pad, pricking the skin with a lancet, and lastly, after sampling, putting a bandage over the prick site. The scope of this project is to design a device which integrates and streamlines the use of the three sub-processes (sterilization, lancing, and bandaging) while upholding the necessary requirements of a single-use medical device and considering other factors which …

Evaluation Of Root-End Resection With Conventional And Ultrasonic Methods: A Single-Blind, Randomized In-Vitro Study, Mohammad Al Shammaa, Roula S. Abiad, Nayer Abo Elsaad

BAU Journal - Creative Sustainable Development

The root-end resection is considered critical endodontic surgical procedure. Three millimeters of the root tip is resected and root-end cavity with parallel walls and comparable depth is cut to receive a root-end filling. The literature discussed dentinal cracks after root canal instrumentation and/or root dentine cutting. The aim of the present study was to assess cracks at root ends after resection with conventional versus ultrasonic techniques. Material and Methodology: Thirty-two extracted human lower premolar teeth with single root were used. Their root canals were prepared and received gutta-percha. Sixteen roots Group 1 were resected using tungsten carbide fissure burs, while …

Mobile Phone Sensors Can Discern Medication-Related Gait Quality Changes In Parkinson's Patients In The Home Environment, Albert Pierce, Niklas König Ignasiak, Wilford K. Eiteman-Pang, Cyril Rakovski, Vincent Berardi

Psychology Faculty Articles and Research

Patients with Parkinson's Disease (PD) experience daytime symptom fluctuations, which result in small amplitude, slow and unstable walking during times when medication attenuates. The ability to identify dysfunctional gait patterns throughout the day from raw mobile phone acceleration and gyroscope signals would allow the development of applications to provide real-time interventions to facilitate walking performance by, for example, providing external rhythmic cues. Patients (n = 20, mean Hoehn and Yahr: 2.25) had their ambulatory data recorded and were directly observed twice during one day: once after medication abstention, (OFF) and once approximately 30 min after intake of their medication …

Determining The Perception And Willingness Of Primary Care Providers To Prescribe Advanced Diabetes Technologies, Alexander O’Donovan, Sean M. Oser, Jessica Parascando, Arthur Berg, Donald E. Nease Jr., Tamara K. Oser

Journal of Patient-Centered Research and Reviews

Advanced diabetes technologies have produced increasingly favorable outcomes compared to older treatments. Disparities in practice resources have led to a treatment disparity by clinical setting, where endocrinologists typically prescribe far more such technologies than primary care providers (PCPs). Fully automated artificial pancreas systems (APS), which combine technologies to deliver and adjust insulin dosing continuously in response to automatic and continuous glucose monitoring, may be more straightforward for PCPs to prescribe and manage, therefore extending their benefit to more patients. We aimed to assess willingness of PCPs to prescribe advanced diabetes technologies through a cross-sectional survey of PCPs from 4 geographically …

Use Of Point Of Care Ultrasound In The Emergency Department For Diagnosis Of Femoral Pseudoaneurysm, Stephen Janssen, Jeffrey Gardecki, Giovanna Finocchio

Rowan-Virtua Research Day

Iatrogenic pseudoaneurysm after puncture or intervention of the femoral artery is a rare complication of arterial surgical intervention occurring in 0.05-0.50% of diagnostic and therapeutic catheterizations and can present weeks after initial presentation. Today we present a 57-year-old gentleman 3 months status post femoral artery stent who presented with swelling to his right groin. Point of care ultrasound was used to diagnose an actively bleeding pseudoaneurysm with hematoma that ultimately led to repeat stenting. This case shows how point of care ultrasound can expedite diagnosis and intervention and is a useful tool for the emergency physician at initial presentation.

Supply, Demand, And Quality: A Three-Pronged Approach To Blood Product Management In Developing Countries, Kyle L. Gress, Karina Charipova, Ivan Urits, Omar Viswanath, Alan D. Kaye

Journal of Patient-Centered Research and Reviews

While transfusion of blood and blood products is instinctively linked to the provision of emergent care, blood and blood products are also routinely used for the treatment of subacute and chronic conditions. Despite the efforts of the World Health Organization and others, developing countries are faced with a three-part problem when it comes to access to and delivery of transfusions: insufficient supply, excessive demand, and inadequate quality of available supply. Developing countries rely heavily on replacement and remunerated donors rather than voluntary nonremunerated donors due to concerns regarding donation- and transfusion-transmitted infection as well as local and cultural beliefs. While …

Smartphone-Based Prediction Model For Postoperative Cardiac Surgery Outcomes Using Preoperative Gait And Posture Measures, Rahul Soangra, Thurmon Lockhart

Physical Therapy Faculty Articles and Research

Gait speed assessment increases the predictive value of mortality and morbidity following older adults’ cardiac surgery. The purpose of this study was to improve clinical assessment and prediction of mortality and morbidity among older patients undergoing cardiac surgery through the identification of the relationships between preoperative gait and postural stability characteristics utilizing a noninvasive-wearable mobile phone device and postoperative cardiac surgical outcomes. This research was a prospective study of ambulatory patients aged over 70 years undergoing non-emergent cardiac surgery. Sixteen older adults with cardiovascular disease (Age 76.1 ± 3.6 years) scheduled for cardiac surgery within the next 24 h were …

Intermittent Catheter Reimbursement In The United States: The Experience Of Nine Stakeholders Through The Lens Of Actor-Network Theory, Manon M. Schladen, Amanda K. Rounds, Terrence Mcmanus, Alexandra Bennewith, Henry Claypool, Suzanne L. Groah

The Qualitative Report

A narrow interpretation of “medical necessity” can result in poorer health as well as a more restricted life for people with disabilities. We examined the impact of US policy on reimbursement of intermittent catheters (ICs) on the lives of people with neurogenic bladder (NB) who require catheters to urinate. We conducted in-depth, longitudinal interviews with nine stakeholders. Actor-Network Theory was used to describe interactions among human agents, IC products, and policies in the reimbursement arena. Restrictions on the type and quantities of ICs reimbursed emerged as the most potent inhibitor to health and wellbeing among consumers with NB. IC suppliers, …

Community Opioid Overdose Prevention And Naloxone Distribution Programs: An Evidence-To-Practice Review, Madison M. Hauge, Kathryn C. Downs, Zachary K. Winkelmann

Clinical Practice in Athletic Training

According to the Centers for Disease Control and Prevention, 100 people die of drug overdose in the United States every day. This frighteningly high mortality rate has created the need for community-based opioid overdose prevention programs (OOPPs). Currently, there are more than 188 community-run programs operating in the United States. These programs teach individuals how to distribute naloxone and respond properly to a drug overdose situation. This guiding systematic review depicts the current literature available on OOPPs and their effectiveness. The authors performed an article search to discover the most relevant and recent articles, which were graded using a quality …

Management Of Refractory Ventricular Fibrillation With Double Sequential Defibrillation, Kaitlyn A. Brown

Capstone Showcase

Patients experiencing cardiac arrest are treated according to ACLS protocols, however current protocols lack recommendations for the treatment of refractory Ventricular Fibrillation which persists after more than 3 cycles of CPR and defibrillation. One potential intervention for these cases that is being researched is the use of simultaneous or sequential activation of two defibrillators. This literature review analyzed the results of several studies to determine if double sequential defibrillation (DSD) is a viable treatment to achieve return of spontaneous circulation (ROSC) and improved patient survival. The results of the studies were mixed with some showing positive outcomes, and others showing …

Effectiveness Of Take-Home Naloxone Programs In Athletic Training: An Evidence-To-Practice Review, Michael J. Palm, Amanda N. Flanscha, Zachary K. Winkelmann

Clinical Practice in Athletic Training

The number of opioid overdoses (ODs) has risen in recent years and has become more complex due to the co-involvement of both prescription and illicit opioid drug use. Provisional programs for take-home naloxone (a medication designed to rapidly reverse opiate OD symptoms) kits have been distributed to combat this potentially fatal epidemic. Although there is strong evidence to support the efficacy of naloxone in the reversal of opiate OD, there is limited evidence to support the efficacy of take-home naloxone (THN) kits. The purpose of this evidence-to-practice review was to summarize a systematic review on the efficacy of THN programs. …

Harnessing Acoustic Streaming For Bioanalysis In Microfluidics, Xiaojun Li

Graduate Theses, Dissertations, and Problem Reports (ETD)

In the past few decades, microfluidic technology has been developed rapidly in both fabrication methods and multifunctionality integrations, making it a powerful tool for a wider variety of biological applications. The device fabrication method has expanded from conventional polymer-based micro devices to 3D-printed micro devices, and allows multiple functions such as electric, optic, magnetic and acoustic to be integrated on a single platform. This dissertation focuses on method development of acoustic streaming-based microfluidics in bioanalysis such as immunoassay, enzyme kinetics and DNA fragmentation analysis. In this dissertation, a micromixer was developed based on acoustic streaming generated from sharp-edge structure vibration …

Effectiveness Of Point-Of-Care Ultrasound Education For Advanced Practice Providers, Nicole Brumfield

DNP Projects

Abstract

Background: Provider shortages and demands for inpatient providers have led to an increase in the utilization of Advanced Practice Providers (APPs). The increased use and specialization of APPs has brought attention to education and skills that have been instituted for other provider types but remains missing from the APP curricula. One such example is point-of-care ultrasound (POCUS) education. This technology and skill set have been shown to enhance clinical skills, confidence levels, and provide useful information for the provider to enhance clinical decision making for the patient.

Purpose: The purpose of this project was to evaluate the effectiveness of …

Hips That Harm: When Medical Devices Fail Women, Sophie N. Putka

Capstones

Medical devices that save the lives of thousands of Americans each year advance at a rapid pace - but some of them consistently leave women behind. When it comes to joint replacements and even heart devices, women have worse health outcomes. Behind this preventable problem is a system that overlooks women from start to finish. Female bodies are different from male bodies, but women are often underrepresented in medical trials for device approval. Women’s participation in clinical testing for devices has increased, but there’s rarely a detailed analysis of performance by sex, and even less information on women by race …

Evaluation Of An Intervention To Maintain Therapeutic Pressure Of The Endotracheal Tube Cuff During Intraoperative Surgery, Jamare Reed

Doctoral Projects

The current practice of intraoperatively assessing the cuff pressure of the endotracheal tube (ETT) is arbitrary and potentially leads to negative impacts on patients. This best practice project aimed to review and synthesize the existing evidence-based literature on measuring ETT cuff pressure and to establish a policy guideline for anesthesia providers to measure ETT cuff pressure in the intraoperative environment. Based on the star model of the knowledge transformation framework model provided by the Academic Center for Evidence-Based Practice (ACE), the creation of evidence-based policy on ETT cuff measurement is expected to potentially prevent poor patient outcomes, patient expenses, and …

The Role Of Adhesives In Dermatologic Surgery: Tips, Tricks And Review, Adam Chahine, Stefanie Lynn Altmann, Mariam Salman, Karthik Krishnamurthy

Dermatology

Background: The utilization of tissue adhesives for wound closure has historically been well established in the emergency department setting. More recently, it has been adopted by dermatologists and other surgical specialties as an alternative or adjunct to more traditional bilayered wound closures.

Purpose: This serves as a comprehensive review of the available scientific literature on the utilization of tissue adhesives compared to traditional bilayered closures. We discuss benefits, drawbacks, as well as novel surgical techniques, as applicable to dermatologic surgery.

Methods: A literature review was performed using Pubmed and MEDLINE for relevant articles related to the use of adhesives and …

Transcutaneous Energy Transmission: Can We Do It Now?, Yuriy Pya

The VAD Journal

The percutaneous driveline used in contemporary LVADs presents a continuous risk of infection for the duration of support. Minimizing infection in durable mechanical circulatory support systems requires total implantation of all components and energy transfer by means other than percutaneous drivelines. A novel coplanar energy transfer (CET) system, similar to the original transcutaneous energy transfer (TET) design, is unique by incorporating two large rings with coil-within-the-coil topology to ensure strong resonance power. The CET system consists of an internal integrated controller, a battery coupled with an internal thoracic coil ring, and the LVAD pump. External equipment includes a power transmission …

Resolving Tensions Between Disability Rights Law And Covid-19 Mask Policies, Elizabeth Pendo, Robert Gatter, Seema Mohapatra

All Faculty Scholarship

As states reopen, an increasing number of state and local officials are requiring people to wear face masks while out of the home. Grocery stores, retail outlets, restaurants and other businesses are also announcing their own mask policies, which may differ from public policies. Public health measures to stop the spread of the coronavirus such as wearing masks have the potential to greatly benefit millions of Americans with disabilities, who are particularly vulnerable to the impact of COVID-19. But certain disabilities may make it difficult or inadvisable to wear a mask.
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Non-Invasive Peripheral Venous And Arterial Line Air Detector For Embolization Prevention, Alexandria Kwong, Kevin Shu, Dylan Meinster

Biomedical Engineering

The scope of this project includes designing a non-invasive bubble detector for peripheral venous and arterial lines. For minimally invasive cardiac procedures, arterial and venous access is necessary for these procedures as is constant flow through the tubing to prevent clotting and to administer drugs. Air bubbles are common in these lines and can be consequential if enough air is introduced into the human system. Air embolisms are the most common and relevant issues during these procedures. The goal of this device is to create an attachable detector for air bubbles in saline that can also terminate flow and alert …