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The Impact of Conventional and Expanded Adverse Childhood Experiences (ACEs) on Juvenile Offending Outcomes
Get PDFPrevious research has established a correlation between conventional adverse childhood experiences (ACEs) and juvenile offending. However, the possible moderating effect expanded ACEs has on this relationship remains unclear. Using the 2019 Minnesota Student Survey (MSS), the study included 278 youth from juvenile correctional facilities in Minnesota to examine the impact of conventional ACEs on juvenile offending, the impact of expanded ACEs on juvenile offending, and the impact of conventional ACEs on juvenile offending, moderated by expanded ACEs. Findings revealed a statistically significant positive effect of conventional ACEs on juvenile offending. Expanded ACEs had a significant negative relationship with juvenile offending. However, expanded ACEs were not significantly predictive of juvenile offending when controlling for the influence of conventional ACEs. Clinical implications and implications for future research are also discussed
Thermal Ablation as an Alternative to Standard Breast Conserving Surgery in the Treatment of Invasive Ductal Carcinoma of the Elderly
Get PDFAn aging population means an inevitable increase in cancer diagnoses, and thus, a novel solution is needed to address this looming problem. Within the field of breast cancer, thermal ablation has emerged as a promising alternative to surgical excision. As a minimally invasive treatment, it significantly reduces the morbidity and mortality for geriatric patients, as well as healthcare costs overall.
The purpose of this analysis is to understand the utility of thermal ablation for the treatment of invasive ductal carcinoma. Specifically in the context of elderly patients, it is determined if this treatment modality is superior to traditional breast conserving surgery.
A comprehensive literature review was conducted using Augsburg University Lindell Library database, Google Scholar, PubMed, ScienceDirect and Wiley Online Library using the search terms breast cancer, percutaneous thermal ablation, cryoablation, radiofrequency ablation, high-intensity focused ultrasound, microwave ablation, laser ablation, histopathology, margin evaluation and geriatric. Inclusion criteria was studies published after 2015 using thermal ablation as primary treatment of breast cancer. Exclusion criteria were studies published prior to 2015 and patients were provided neoadjuvant therapy.
Cryoablation and radiofrequency ablation are the most effective in achieving complete tumor ablation and preventing local recurrence. Laser ablation, microwave ablation and high-intensity frequency ultrasound are in their infancy of development and warrant further research.
Thermal ablation is a reasonable alternative to surgical excision in the elderly and those unsuitable for surgery. Application of these techniques will be crucial to meet the healthcare demand of an aging population in the near future
A Review of Monoclonal Antibody Regimens in Small Cell Lung Cancer Compared to Chemotherapy Standard of Care
Get PDFBackground: Small cell lung cancer (SCLC) is an aggressive neuroendocrine tumor closely linked to tobacco use. Chemotherapy with platinum-etoposide is the current standard of care, with positive initial response rates and subsequently high rates of recurrence and death. Monoclonal antibodies are a therapeutic drug class attempting to block suppression of T cell activation, enabling a stronger immune response.
Purpose: The current predicament in SCLC treatment is determining if monoclonal antibodies have any effect on overall survival. Chemotherapy briefly suppresses SCLC, but given its rapid progression and recurrence, it is necessary to investigate alternative treatments. The following literature review poses the question: In patients with recurrent or extensive stage SCLC, is monoclonal antibody treatment superior to chemotherapy in overall survival and progression free survival? Secondarily, are objective response rates and patient reported outcomes better in patients treated with monoclonal antibody treatment compared to chemotherapy alone?
Methods: A comprehensive literature review was conducted utilizing PubMed. The search terms used were small cell lung cancer, monoclonal antibody, chemotherapy, not NSCLC. Inclusion criteria were randomized control trials including recurrent or extensive stage SCLC patients, published no earlier than 2015, and available in free full text. Exclusion criteria were studies investigating non-small cell lung cancer or other carcinomas and implementing therapy other than monoclonal antibodies.
Conclusions: Monoclonal antibodies targeting PD-L1 inhibitors seem to be most effective in prolonging SCLC overall survival. Furthermore, these therapies seem to work best as first line treatment combined with chemotherapy regimens
Differences in Outcomes and Complications in Graves’ Disease in Patients Treated with Antithyroid Drugs, Thyroidectomy, and Radioiodine Ablation
No full textBackground: Graves’ Disease is an autoimmune disease that is the most common cause of hyperthyroidism in the United States. Treatment options include antithyroid drugs, radioactive iodine ablation, and thyroidectomy. Each route of treatment has its own side effect and risk profile that needs to be taken into account. Studies are still conflicting on success rates of these treatments.
Purpose: To give further knowledge of outcomes and risks to providers to help guide treatment of Graves’ Disease
Methods: A comprehensive literature review was conducted using google scholar using the search terms Graves’ Disease, antithyroid drugs, methimazole, thyroidectomy, radioiodine ablation, radioactive iodine, complications, adverse reactions. Inclusion criteria were studies that were conducted in 2016 of later, and had a focus on treatment protocols and outcomes of treatment of graves’ disease. Exclusion criteria were studies that didn’t have clinical relevance. Focus was to find individual studies and not meta analyses.
Conclusions: Antithyroid drugs are an effective tool of treatment for lesser disease and in preparatory phase of a more definitive treatment. Relapse rates are concerning for antithyroid drugs and radioiodine ablation especially in populations with any extra thyroid symptoms such as Graves’ orbitopathy. Surgery provides a better relapse and risk profile than radioactive iodine that has possible cancer mortality risks as long as patients are a good candidates for a surgical operation
Integration of Sexual Assault Nurse Examiners (SANE’s) Care Program
Get PDFSexual assault is a public health issue, especially for individuals experiencing homelessness, violence, and victimization. Barriers to post-sexual assault health care must be addressed to ensure individuals experiencing homelessness receive effective and adequate care. Traditionally found in Emergency Departments, Sexual Assault Nurse Examiners (SANEs) offer patient-centered, comprehensive health care to sexual assault survivors. To reduce barriers for individuals experiencing homelessness, SANEs must be accessible where health care services are utilized. Guided by Jean Watson’s Theory of Human Caring and trauma-informed principles, this project aims to embed a SANE program into a homeless-specific Midwest Health Care Center. The SANE program will consist of trained nurses completing a 40-hour training offering physical exams, care coordination, and community referrals. Through nurses’ leadership, a holistic and multidisciplinary approach to sexual assault care will be developed, implemented, and evaluated through continuous improvement methods. Bringing SANE services into a community-based homeless-specific health care center allows sexual assault services at the point of relationships and care access
Exploring Modeling with Data and Differential Equations Using R
No full textExploring Modeling with Data and Differential Equations Using R provides a unique introduction to differential equations with applications to the biological and other natural sciences. Additionally, model parameterization and simulation of stochastic differential equations are explored, providing additional tools for model analysis and evaluation. This unified framework sits at the intersection of different mathematical subject areas, data science, statistics, and the natural sciences. The text throughout emphasizes data science workflows using the R statistical software program and the tidyverse constellation of packages. Only knowledge of calculus is needed; the text’s integrated framework is a stepping stone for further advanced study in mathematics or as a comprehensive introduction to modeling for quantitative natural scientists.https://idun.augsburg.edu/monographs/1083/thumbnail.jp
Can CRISPR gene editing provide a definitive treatment for sickle cell disease?
No full textBackground: Sickle cell disease is a genetic disorder that causes several morbidities and increased mortality. The only definitive treatment currently available is an allogenic bone marrow transplant with strict criteria for participation. CRISPR gene editing could be a solution to fixing the gene itself to create healthy hemoglobin and be a more inclusive curative treatment option.
Purpose: Can CRISPR gene editing technology be used to definitively treat sickle cell disease? Methods: A comprehensive literature review was conducted used Trip Medical Database using the search terms ‘sickle cell disease,’ ‘gene editing therapy,’ ‘curative or definitive treatments.’ Inclusion criteria included modern studies relating to the history and progression of finding a definitive treatment for sickle cell disease by altering a person’s DNA.
Conclusions: There are two methods highlighted in this report that have shown potential to be curative treatment options for sickle cell disease; using a lentiviral vector to correct the mutated nucleotide that causes the disease itself and using electroporation to since BCL11A to induce the production of more fetal hemoglobin. Both methods are in the beginning phases of being tested and proven successful in human patients. More time and participants are needed to investigate the long term effects and sustainability of the genetic modifications
3D and Bio-printing as an Efficient and Safe Alternative to Traditional Methods and Materials in Cardiovascular Diseases
Get PDFBackground: Cardiovascular diseases are the leading cause of death globally. Therefore, there is the need for more resources to be poured into the research of more treatment options, diagnostic methods and preventative steps for patients. Though several technological advancements are being made in the world of medicine, it is not a bad idea to look at other avenues that have great potential to improve patient outcomes in cardiovascular diseases. 3D and bioprinting, though a relatively new technology in the world of medicine, is showing a promising future. It is already being applied in the field of orthopedic surgery and other specialties are jumping on this band- wagon as well.
Purpose: The question at hand that this literature review seeks to answer is that, can 3D and bioprinting serve as an efficient and safe alternative to traditional methods and materials in cardiovascular diseases?
Methods: In an attempt to answer this question, a comprehensive literature review was conducted via Google Scholar, Google and Trip Database by using the search terms, 3D printing, bioprinting, tissue engineering, cardiovascular diseases, and orthopedic implants, to name a few. Inclusion criteria were primary research, clinical trials, and exclusion criteria were studies before 2017 and systematic reviews.
Conclusions: Looking at some of the marvelous already performed and ongoing studies, there is a strong potential for 3D and bioprinting to become a potential alternative to traditional methods and materials in cardiovascular diseases in the near future. This new technological advancement just needs time, dedication and hard work to bear relevant fruit in realm of cardiovascular diseases
Effectiveness of Oral versus Topical Antibiotics in the Treatment of Pediatric Otitis Media
No full textBackground: Acute otitis media (AOM) is an infection of the middle ear and mastoid cavity. If left untreated, AOM may progress to chronic otitis media and may be difficult to treat leading to permanent loss of hearing and socioeconomical problems. Current evidence suggests that most children diagnosed with AOM are treated with immediate oral antibiotics; however, the use of topical antibiotics is on the rise.
Purpose: There is little consensus on the effectiveness of oral antibiotics versus topical antibiotics in the treatment of otitis media in children. The purpose of the current review was to present the most recent (since 2015) available knowledge regarding the effectiveness of both oral and topical antibiotic treatments and weigh their efficacies.
Methods: A comprehensive literature search was conducted using the PubMed database and the search term otitis media AND topical antibiotics AND oral antibiotics AND outcomes . Only original research studies on the pediatric population were considered. All outcomes included in the reviewed studies that helped compare the efficacy of the oral and topical antibiotics were considered. The comparative effect of the two types of drugs on each outcome was studied separately.
Conclusions: Finally, nine studies were considered for the review. Compared to oral antibiotics, topical antibiotics showed a better effect on the outcomes of ear discharge, hearing, ear pain, being unwell, sleep disturbances, microbial eradication, recurrence, and parent satisfaction. In general, the topical antibiotic treatment seems to be a better choice in treating AOM
Social Determinants of Health in the Diagnosis, Prevention, and Treatment of Psychosis
No full textBackground: Psychosis is a prominent mental illness prevalent in our society. Social determinants factor into effect the diagnosis, prevention, and treatment of psychosis. For the best outcomes for individuals suffering from psychosis identifying those social determinants is essential.
Purpose: Social determinants negatively impact the onset, progression, and treatment of psychosis. Figuring out the role specific social determinants have on psychosis can further prevention and continuity of care. This literature review intends to figure out specific social determinants of health that effect the diagnosis, prevention, and treatment of psychosis.
Methods: A comprehensive literature review was conducted using Pub Med using the search terms social determinants of health, psychosis.
Conclusions: Neighborhood determinants such as the racial composition of a neighborhood, neighborhood disruption, and instability were found to increase the likelihood of developing psychosis. Childhood trauma negatively impacts the expression comorbid conditions related to psychosis such as diabetes and adipose dysregulation. Childhood trauma and stress negatively impact the development and management of psychosis. Specific markers were found to be associated with psychosis. Future research should focus on incorporating biomarkers and biosocial markers with social determinants of health, and methods to increase mental healthcare access to immigrants and minority populations