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Stroke Prevention in Patients with Non-valvular Atrial Fibrillation: The Watchman Device versus Warfarin
Get PDFAtrial fibrillation is a common heart arrhythmia that leads to an increased risk of stroke. Warfarin was the original anticoagulant that would be used as the treatment for atrial fibrillation. However, there are people who have contraindications to anticoagulation or are a high fall risk and shouldn’t be on Warfarin. The Watchman Device was originally designed in 2005 as a way to close the left atrial appendage where clots are usually present with atrial fibrillation. The watchman may be a superior way to help reduce the risk of stroke compared to the traditional use of Warfarin. Purpose: Literature review of studies to examine if in patients with nonvalvular persistent atrial fibrillation, is the Watchman Device superior to Warfarin anticoagulation therapy for the reduction of stroke risk Methods: A comprehensive literature review was conducted using using the search terms \u3c(non-valvular atrial fibrillation) AND (Watchman)) AND (warfarin)) AND (stroke)\u3e. Inclusion criteria were studies that were published from 2015 and newer. Exclusion criteria were studies that were not in English language and did not use human subjects Conclusions: The Watchman device is a great option for treating atrial fibrillation if there are contraindications to oral anticoagulants, history of intracranial hemorrhage or severe bleeding. It was not proven yet to be superior to warfarin in the reduction of stroke but the long term risks seem to be safer compared to warfarin
Effective Models in Community and Student Run Clinics
Get PDFBackground: Over 3.5 billion people—half of the world’s population, did not have access to any healthcare facilities or services in 2017.1 In order to provide more healthcare to more individuals, student run clinics (SRCs), community-based health systems, and other low-cost clinics have opened up all over the world.
Purpose: It is important, however, to understand how these clinics run, their effectiveness, and how they may increase healthcare access. This study analyzed articles involving free or low-cost clinics to determine which models are utilized within free or low-cost clinics to provide effective standard of care resulting in increased healthcare access.
Methods: A comprehensive literature review was conducted using google scholar using the search terms “student run free clinic”, “low-cost health care facilities”, “community health care”, and “faith-based clinic effectiveness”. Inclusion criteria were studies from 2015-2022 that involved a free, low cost, religious based, or student run clinic. Exclusion criteria were studies from before 2015, involved large corporation clinics or hospitals, and were not community based, free, low cost, or student run. Conclusions: Many models were identified in this literature review. Models including, days of operation, funding and staff, HTN and diabetic programs, type of care, screening tools, and telehealth, were found to be utilized in low-cost and student run free clinics, all of which provided effective standard of care resulting in increased healthcare access
Immunotherapy versus Chemotherapy: Which Treatment Offers Better Survival to Adults with Advanced Melanoma?
Get PDFBackground: Melanoma is the most serious type of skin cancer that can lead to metastasis. The main treatment for melanoma is surgical removal — a wide excision. Patients with advanced melanoma require further treatment such as chemotherapy or immunotherapy due to the concern of continuous spread.
Purpose: Literature review of studies to examine if patients with advanced melanoma, treated with immunotherapy, enjoy better overall survival rates than patients treated with chemotherapy?
Methods: A comprehensive literature review was conducted using using the search terms \u3c(advanced melanoma) AND (immunotherapy)) AND (chemotherapy)) AND (skin cancer)\u3e. Inclusion criteria were studies that were related to immunotherapy and chemotherapy among advanced melanoma patients. Exclusion criteria were studies that were completed more than five years ago, free text was available, other languages besides English, non-human species, and any patient under the age of 18 years old.
Conclusions: Immunotherapy is a more sustainable option for treating patients with advanced melanoma. It has been proven that immunotherapy offers patients better outcomes versus treating advanced melanoma with chemotherapy
Achieving Remission in Graves’ Disease: A Comparison of Treatment Options
No full textBackground: Graves’ disease is the leading cause of hyperthyroidism in the US. Antithyroid medication, radioactive iodine, and surgery have all demonstrated success in controlling symptoms and reducing complications; however, there is debate about which modality should be considered first-line, if any. Over the last two decades, clinicians have increasingly chosen antithyroid drugs over radioactive iodine despite insufficient evidence that they can successfully induce remission of disease.
Purpose: This analysis aims to determine whether antithyroid drugs are inferior to radioactive iodine at inducing remission of Graves’ disease.
Methods: A comprehensive literature review was conducted using Augsburg University’s Lindell Library, PubMed, Cochrane Library and ScienceDirect databases using the search terms “Antithyroid drugs AND Radioactive iodine,” “Graves’ AND Remission,” “RAI OR radioactive iodine OR methimazole OR antithyroid drugs AND Remission.” Other terms were searched to draw conclusions about remission, including “Relapse,” “Treatment AND success OR failure,” and “Euthyroid state”. The research was conducted to find peer-reviewed studies that assessed both treatments’ ability to induce remission.
Conclusions: Many studies have shown that radioactive iodine can effectively induce remission of Graves’ disease. Trials that have been conducted on antithyroid drugs, however, are insufficient in answering the research question. Individual patient factors, like age, goiter size, antibody levels, etc., need to be assessed before making definitive conclusions. With the current body of evidence, it is best practice that clinicians continue to use stratification tools, like the GREAT score, to determine treatment plans for each patient until further research has been conducted
Lower Extremity Risk Assessment in Athletes Following a Traumatic Brain Injury
Get PDFBackground: According to the Centers for Disease Control and Prevention, Concussions are a major health disorder. Continued research regarding the impact of concussions on athletes has led to an increased risk for lower extremity injury across a variety of populations following head trauma. Guidelines from the CDC use a self-reported symptom and cognitive examination for return to play.
Purpose: Current recommended guidelines increase the risk of lower extremity injury due to failure of identifying neurological deficits that persist following a concussion. This literature review aims to identify if athletes diagnosed with a concussion are at an increased risk of sustaining a lower extremity injury compared to non-concussed athletes.
Methods: A comprehensive literature review was conducted using using search terms \u3c(athletes) and (Head injury, TBI, Traumatic brain injury, Concussion) and (Lower extremity injury, ankle injury, Knee injury)\u3e. Inclusion criteria were studies published in 2015 and newer. Exclusion criteria were studies that were not in English.
Conclusions: Following a concussion, neurological deficits linger for an unestablished period, increasing the risk of lower extremity injuries. Studies have observed altered postural control, gait, stiffness, and jumping ability leading to lower extremity injuries. Current Center for Disease Control and Prevention guidelines recommend a symptom and cognitive approach for returning athletes to participation. By establishing a return to play examination that identifies neurological deficits lower extremity injuries may decrease
Socioeconomic Determinants of Antibiotic Resistance
Get PDFBackground: Antibiotics were first developed to treat wounded soldiers and cases of pneumonia in World War II. By the 1940s, antibiotics became widely used to treat several infectious processes. It was not long after antibiotics were being used frequently by clinicians that resistant strains began to emerge. Today, antibiotic resistance is a growing global health concern seen in many parts of the world. There are many factors that contribute to the prevalence of antibiotic resistance.
Purpose: This paper aims to demonstrate how socioeconomic factors play a role in the development and spread of antibiotic resistance. The literature review focused on economics, education, culture, and environment as potential causes for the acceleration of antibiotic resistance seen globally.
Methods: Databases such as PubMed, Google Scholar, and ScienceDirect were used to find articles that help provide evidence on this topic. Cross-sectional Studies, surveys, and longitudinal studies were included in the paper.
Conclusion: After analyzing the studies, results showed that poor economics, lack of access to health, poor health literacy, and poor infrastructure all contribute to the rise of resistant pathogens. In conclusion, to improve antibiotic resistance, public health initiatives need to take place to improve education and awareness surrounding socioeconomic determinants of resistance
Living Life to the Fullest With Sjögren’s: an Online Resource
No full textChronic illnesses such as autoimmune diseases are a leading cause of death and disability. Sjögren’s syndrome is an autoimmune disease that affects approximately four million Americans, yet this disease is not well known to the public. Additionally, credible online resources are lacking for those patients seeking more support and information about the disease. Therefore, the development of a nurse-led online resource, a website, is proposed. With a credible online resource, users will have an increased understanding of the disease which will lead them to have more informed choices for a better patient outcome. Newman’s Health as Expanding Consciousness Theory served as a guide in the development of the project. Creating the website is discussed in detail, and a five-point Likert scale will be utilized to evaluate the effectiveness of the project. The wave was used as a metaphor to represent the disease; the ups and downs of the wave represent the highs and lows of those afflicted with Sjögren’s syndrome. The goal of the project is to educate, raise awareness, provide support, and help empower patients diagnosed with Sjögren’s syndrome, so they can live life to the fullest
The Benefits of the Hmong Chicken Diet Among Postpartum Hmong Women
No full textMaternal mortality is a worldwide crisis. The rate of maternal deaths continues to rise, with pregnancy-related death highest during the postpartum period making it a critical timeframe for health restoration and care promotion. Diet and rest are essential precursors to preventing and treating postpartum complications that may lead to deaths during the postpartum period. Postpartum Hmong Women (PHW) practice a cultural tradition known as the Hmong Chicken Diet (HCD) to promote and restore health in the postpartum period. The HCD contains herbs that are believed to be effective in preventing and treating postpartum complications. The diet has been followed by PHW for many generations, but it remains foreign to modern medicine. Through Leininger’s Cultural Care Theory, the HCD represents culture care that is essential for health and care among PHW. The purpose of this scholarly project is to examine the benefits of the HCD through an analysis of the herbs in the diet and the lived experiences of 14 PHW who followed the tradition. Through one-on-one interviews and focus group discussions, the benefits of the HCD are understood. The HCD is effective in treating common postpartum complications and enhances healing for PHW. This project introduces innovative knowledge to the practice world highlighting the significance of culture on post-partum care
Adolescent Anxiety: Implementing Mindfulness Techniques To Lessen Mental Health Crises
Get PDFAdolescence is one of the most challenging times in life as many transitions occur while a child grows into a young adult. In a school-based program, this doctoral of nursing practice project implemented mindfulness techniques to lessen mental health crises in anxious adolescents. This scholarly project educated adolescents in a small town in rural southeast Minnesota on the effective coping exercises of mindfulness and deep breathing to lessen anxiety and decrease mental health crises. Jean Watson’s Theory of Human Caring is the framework for the project and three of her Carative Factors guided this project. A literature review identified opportunities for further examination. Mindfulness techniques are shown to lessen adolescent anxiety and improve self-awareness such as one’s mind going blank before an exam or sweaty hands before asking a question in front of others. Future research efforts should be aimed at understanding the process at work in mindfulness techniques by mentoring adolescents to create a guided daily routine to incorporate mindfulness techniques
Catastrophizing in Catastrophe: Poems for Benefactors Fall 2017-21
Get PDFPoems dedicated to donors to the Augsburg University English Department Speaker and Event Fund from 2017-2021.https://idun.augsburg.edu/monographs/1078/thumbnail.jp