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Better Nature: How nature improves our health and how we can use nature to do better
Get PDFThis research paper outlines the salubrious effects of exposure to green spaces and explores how healthcare providers in urban areas can leverage the benefits of green spaces to combat poor health outcomes from the chronic stress of urbanicity, particularly in disadvantaged populations. Focusing on the metropolitan area of Minnesota, this study acknowledges existing barriers and constraints of populations experiencing health inequities while analyzing data on green space accessibility and seeking solutions for those communities, particularly BIPOC and low-income. This paper synthesizes evidence from various studies that establish the positive associations between health and exposure to green spaces, which can also foster social cohesion and environmental sustainability. While recognizing the need for future research, providers have been encouraged to educate patients on the benefits of nature. Based on promising outcomes and ongoing studies, healthcare providers can incorporate nature prescriptions into patient care plans. Collaboration with community can further increase access to green spaces, fostering social support and community wellbeing. By integrating green spaces into cities and promoting equitable access, healthcare providers can contribute to holistic well-being, particularly among marginalized communities. While acknowledging the need for more research and addressing various limitations, this paper underscores the interconnectedness of humans with nature and highlights the potential of urban green spaces to foster social and environmental justice and create an ecologically sustainable future
Addressing Disparities in Hospice Care: Race-Based Discrepancies, Barriers to Access and Proposals: A Systematic Review
No full textThe purpose of this research paper is to summarize articles about hospice and palliative care relating to who uses these services, the financial effects, and how these services help fulfill patients\u27 and their family\u27s last wishes. Twenty original research articles published after 2018 were identified through searches in PubMed, EBSCOhost, and ScienceDirect using the search terms “hospice or palliative care AND Medicaid or Medicare AND United States or America or USA”. The final articles were chosen based on their relevance to informing hospice care patients, their families, and clinicians about the personal and financial benefits of hospice and barriers to access
Utilization and Outcomes of Experiential Learning Pedagogy in the Setting of Medical Education: A Systematic Review
No full textBackground: Experiential learning is part of the pedagogical model of educational theory. Instruction of students using this model has been shown to improve educational outcomes. Students learning medicine, with an emphasis on physician assistant students in this paper, have been traditionally taught in a lecture-based model following a more experiential model by beginning with didactic studies and then a period of time in clinical practice, respectively. This paper is intended to shed light on the current ways the experiential learning model is being utilized in medical education and in the development of educational objectives using student’s perspectives and unique learning styles. Purpose: To investigate the current literature on experiential learning and whether its use is beneficial in medical education and in particular, PA education. Methods: A comprehensive literature review was conducted using various databases focusing on literature discussing experiential learning pedagogy implementation during didactic phase of physician assistant and medical professional education. Exclusion criteria included articles published before 2017 (except for three articles used to give context to definitions and history of experiential learning theory), articles too specific to different pedagogical learning theories, and articles not related to experiential learning strategies applicable to students studying medicine. Databases used were Google Scholar, PubMed, National Center for Biotechnology Information (NCBI), National Institutes of Health (NIH), Physician Assistant Education Association (PAEA), Health Affairs, Science Direct, and Journal of Physician Assistant Education (JPAE). Conclusions: Experiential learning theory has sufficient evidence to support that its use, in conjunction with traditional lecture-based learning, is beneficial to the education of students learning medicine. Introducing experiential learning in the didactic year of PA education may be more beneficial to students than the current one year didactic with primarily lecture-based learning, and one year clinical set-up
The Efficacy of PRP Injection vs Corticosteroid Injection in the Management of Common Tendinopathies: A Systematic Review
Get PDFBackground: Tendinopathy is one of the most prevalent musculoskeletal disorders in active patients, accounting for at least 7% of physician visits in the United States. In recent years, there has been an increasing body of evidence for the use of platelet-rich plasma (PRP) in the management of tendinopathies compared to corticosteroid injections (CSI) for patients refractory to conservative treatment.
Methods: This review was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The SPORTDiscus, PubMed, and Google Scholar databases were searched for randomized controlled studies published between 2010 and 2023. The keywords utilized in the search included a combination of the following: “platelet-rich plasma”, “corticosteroids”, “rotator cuff”, “gluteal tendinopathy”, “greater trochanteric”, and “lateral epicondylitis”. The Boolean connector “AND” was utilized to connect “platelet-rich plasma”, “corticosteroids”, and the various tendinopathy sites. Studies were excluded if PRP was combined with CSI or another alternate therapy, if it was performed in conjunction with surgical repair, or if the study population included a condition closely associated with the primary conditions screened for. The primary outcome measures analyzed across all injury types were pain, functional outcome scores, imaging findings, and clinical measures.
Results: Of the 385 studies initially screened, 21 were included in this review. 2 investigated the effects of PRP vs. CSI on the management of gluteal tendinopathy, 10 studies investigated the effects of PRP vs CSI on the management of rotator cuff tendinopathy, and 9 studies investigated the effects of PRP vs. CSI on the management of lateral epicondylitis. Across all three sites, most studies found CSI outperforming PRP in the short-term follow-up period up to 12 weeks. PRP patients tended to improve over time gradually and consistently while patients who received corticosteroids regressed back towards baseline regarding pain and function. There were no consistent significant differences found regarding imaging findings and clinical measures.
Discussion: This review has demonstrated the potential for successful treatment outcomes when utilizing PRP for chronic tendinopathies. The results generally show that while corticosteroids outperform PRP injections in the short term, PRP patients tend to slowly improve over time and surpass the results of the CSI group. Positive effects were demonstrated amongst all three tendinopathy sites, primarily with improvement in pain and function. With respect to imaging findings and clinical improvement, results varied between studies and no consistent conclusion can be drawn
The Efficacy of Limbic System Retraining and Neuroplasticity in the Management of Chronic Pain and Disease: A Systematic Review
Get PDFBackground: Chronic pain and disease are prevalent, affecting 51.6 million people in 2023. Therefore, due to the high complexity of chronic disease, many providers try different interventions to alleviate pain and improve their patient\u27s quality of life. The limbic system is a critical component of the brain involved in pain perception and emotional regulation. With an overactive limbic system, the perception of pain is enhanced and continues to cause discomfort for the patient. By retraining the limbic system to alter the fight or flight response, a significant reduction in pain can be achieved, which results in better emotion regulation. The primary interventions considered for limbic system retraining are neurofeedback and electrical stimulation. Purpose: This review aims to evaluate the efficacy of limbic system retraining and neuroplasticity in managing chronic pain and disease. Methods: The author conducted an extensive literature review to evaluate the evidence and conducted a thorough annotated bibliography. Inclusion criteria for this study included articles that contained the key terms, were original research, could be obtained freely, and were published later than 2019. Any articles that didn’t meet the inclusion criteria were excluded. Data was collected using these key terms: amygdala neuromodulation, amygdala and insula retraining, limbic system neuromodulation, amygdala and chronic pain, limbic system retraining, neuroplasticity, and chronic pain management. Further, the following search engines were used to obtain articles: PubMed, Google Scholar, Jane Biosematic, National Institute of Health (NIH), UpToDate, and Science Direct. Data gathered was synthesized by evaluating the study\u27s sample size and the statistical significance of the results while considering any potential bias. A limitation of the data collection was that only freely available articles through Augsburg Library sources were reviewed. Results: After a thorough literature review, evidence supports the efficacy of limbic system retraining and neuroplasticity using neurofeedback and electrical stimulation. Of the articles reviewed, 19 met inclusion criteria, with 11 supporting neuromodulation using neurofeedback and eight for electrical stimulation. Studies ranged in sample size, and of the 11 articles supporting neurofeedback for neuromodulation, all were randomized controlled studies, with three not randomized. Further, of the eight randomized controlled studies, two were double-blind studies. Additionally, of the eight papers supporting the use of electrical stimulation, all were randomized controlled, with three being double-blinded. Evidence to support limbic system retraining using neurofeedback included amygdala plus insula retraining with MBSR and using real-time fMRI and amygEFP. These articles have shown efficacy in reducing pain and overall functional impairment. For patients with post-traumatic stress disorder, a significant reduction in symptoms of 75% continued for up to 6 months. When considering articles supporting electrical stimulation, the results indicated that transcutaneous direct stimulation is effective for neuromodulation and reduced abdominal pain for inflammatory bowel disease. Additionally, 73% of participants noted reduced pain for patients who underwent electrical intramuscular stimulation. Further, transcutaneous vagus nerve stimulation also proved effective in modulating pain and reducing the number of chronic migraine attacks. Discussion: A review of the literature and studies noted a few limitations. Across multiple papers, the primary limitation was the small sample size. Additional considerations were specific to each modality. The primary limitation of articles supporting neurofeedback for neuromodulation included the time to learn neurofeedback techniques. However, other limitations had too few fMRI scans, which were noted in two studies, and there was a concern about not considering the control variable of different therapists for teaching MBSR. Additionally, electrical stimulation papers also emphasized the need for research conducted over a more extended period, varied participants, and a greater sample size. Further, for the vagus nerve articles, the primary future consideration was to evaluate the influence of the sham intervention on the overall results. In conclusion, limbic system retraining and neuroplasticity are possible and effective. However, additional research is needed to evaluate the efficacy across a larger population and consider the long-term outcomes and benefits
The differences between the quality of life and personal health profile between individuals diagnosed with celiac disease and those who follow a gluten-free diet for non-celiac reasons
Get PDFBackground: Celiac disease is an autoimmune disorder triggered by gluten proteins in wheat, barley, and rye, necessitating a strict gluten-free diet. However, many individuals without celiac disease are adopting gluten-free diets for various health reasons.
Purpose: This study compares the quality of life and health profile of individuals with celiac disease and those following a gluten-free diet for non-celiac reasons.
Methods: A survey was conducted and distributed via social media to people diagnosed with celiac disease and those adhering to a gluten-free diet non-celiac. The results were analyzed via Google Forms and Excel to better interpret the data for visualization.
Results: According to the survey, celiac disease patients experienced a lower quality of life, had strict dietary restrictions, and were better informed and less anxious. In contrast, non-celiac gluten/wheat-sensitive individuals reported a better quality of life, fewer diet restrictions, and improved overall health. Both groups faced micronutrient deficiencies, raising concerns about the nutritional value of gluten-free products.
Conclusion: Understanding these differences is crucial for providing better healthcare and nutritional support for individuals adhering to gluten-free diets. However, the study has limitations due to self-reporting bias and small sample size, requiring further investigation to establish causative relationships
Barriers to HPV Screening and Prevention in Latin America: A systematic Review
Get PDFIn Latin America, cervical cancer is the second most common female cancer and the fourth most leading cancer of women around the world, with an estimated 342,000 deaths in 2020.1 This systematic review of literature gives insight into Latin Americas barriers to Human Papillomavirus Virus (HPV) screening and prevention. A comprehensive literature review was conducted using google scholar, the WHO, and the CDC. Search terms included: barriers to HPV screening, cervical cancer, Latin America, Central America, Costa Rica, Prevention of HPV, and Human Papillomavirus. Three main barriers to HPV screening and prevention were found including, fear, lack of education, and access to care. In 2020 the World Health Assembly adopted the “Global Strategy towards eliminating cervical cancer,” proposing specific targets that countries must meet by 2030. This strategy includes goals such as having 90% of girls vaccinated with the HPV vaccine by 15 years old, 70% of women screened by 35 years old, and 90% of women with cervical cancer receive treatment.1 More research is needed to help implement screening and vaccination programs in low-income Latin American countries
Holy Yoga as a Complementary Therapy for Women With Post-traumatic Disorder
No full textUnresolved trauma can result in Post-Traumatic Stress Disorder (PTSD) and can affect a
woman’s mental, physical, emotional, and spiritual health. Women presenting to the primary clinical setting with symptoms or a diagnosis of PTSD are commonly prescribed medications and psychotherapy. Medications and psychotherapy address emotional and mental health but fail to address the woman’s spiritual and physical health. Primary Health Care Providers need to be aware of possible complementary therapies that would be beneficial to their patients with PTSD that would address the spiritual and physical aspects of the disease process. Traumatized women tend to ‘wear’ the identity given to them by their abuser, which hinders the woman in their healing process. This project aims to see if the implementation of Holy Yoga as a complementary therapy would be a viable treatment option for women with PTSD. Holy Yoga is the practice of physical poses and breath work while meditating on God’s Word. A particular focus was on creating Holy Yoga sessions that spoke to who God says they are to develop new neuropaths. Two 45- minute Holy Yoga sessions were held at an urban primary care Christian counseling office and were overseen by a licensed sponsor therapist. A total of 17 women attended the Holy Yoga sessions, and 16 out of 17 women enthusiastically stated they felt Holy Yoga would be an excellent addition to their PTSD treatment. Jean Watson’s concept of Caring plays an integral part in the overarching theme of this scholarly project
Effects of Meditation on Chronic Pain Management among Older Adults
No full textThe older adult population is expected to continue to grow. This population is more susceptible to facing chronic health conditions that often contribute to pain. Pain affects many aspects of an individual\u27s life and can be debilitating, affecting physical and mental wellbeing. Chronic pain among older adults is often not well managed. Mindfulness meditation is a holistic healing modality that literature supports for pain mitigation (Creswell & Khoury, 2019). This scholarly project provided mindfulness meditation sessions to older adults in an independent and assisted living facility setting to help educate and guide them in reducing chronic pain. Pain reduction scores occurred after implementing mindfulness meditation sessions at the residential facility among these older adults. These promising results suggest the effectiveness of mindfulness meditation pain reduction. Further, mindfulness meditation can help advance the nursing practice by educating patients on using this modality to reduce pain and improve quality of life and patient outcomes
Best Practices for the Retention and Graduation of Minority Nursing Students in 2 Year Programs
No full textSystemic health inequities are rooted in the historical trauma that has targeted communities of color. The lack of diverse nurses is consistent with institutional racism in nursing education. Nursing schools must acknowledge the lack of minority students enrolled in their programs to begin to cultivate an understanding of the embedded institutional bias. Educational systems should incorporate culturally aware concepts within the nursing curriculum to foster a transculturally aware institution. It is important to shift the paradigm in nursing schools to create an inclusive, safe environment, and to ultimately prepare students to care for culturally diverse patients. This project begins with having nurse faculty from two 2-year nursing programs read a fast facts page describing facts about minority student retention and graduation and strategies to help retain minority students in nursing. Two schools, one urban and one rural 2-year nursing school, will read the fast facts page and complete a survey and evaluation tool. This project aims to identify current strategies that two-year nursing schools have implemented to help retain and graduate minority nurses. Anonymous and confidential online surveys will be collected and analyzed for the project. There is a need for more minority nurses to care for communities of color. In addition, more minority nurses may reflect in an increase of minority faculty who will teach future students to provide culturally aware care. This is important as there is a need for more diverse nurses to help close the gap in health inequities