Annual Physician Assistant Studies Program Capstone Projects // Carolina Digital Repository

Works (34)

21. The Association of Single Sport Specialization and Overuse Injury in Youth Athletics

Title Tesim:: The Association of Single Sport Specialization and Overuse Injury in Youth Athletics
Creator:: Taylor, Daniel
Date of publication:: 2017
Abstract Tesim:: BACKGROUND: Youth sports in today’s society has come to represent a microcosm of the highly visible and overtly publicized professional world of sports. Children and adolescents are inundated by an unprecedented and ubiquitous sociocultural saturation not experienced by previous generations; from the most recent current global news events trending on our Twitter feeds to the latest player to sign a $200 million professional sports contract. While the former is newsworthy, the latter is what often catches the eyes of not only kids, but their parents, coaches, and other individuals that are involved with different athletic programs at the youth level. There is an evolving perception that if kids are put into the right situations at an early age, identifying a niche and “specializing” in a sport, they can advance and develop a skill set that will allow them to obtain higher social status, possibly receive college athletic scholarships, and even become professional athletes with high earning potential. This perception is not a geographically isolated concept. In China, there are over 3000 government-affiliated sportsbased schools, of which there are approximately 100 boarding schools dedicated to allowing children ages 5-16 years old to work and develop sport-specific athletic skills in hopes of being selected to train at Olympic training facilities. The amount of pressure being placed on young athletes is certainly high, and has a large impact physically and mentally.
Resource type:: Masters Paper
Affiliation Label Tesim:: Physician Assistant Program
Degree:: Master of Health Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 03017bbf-d2c5-4c32-b5ff-fb580cd5f16e
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/5bng-j236
Graduation Year:: 2017
Keyword:: youth, orthopedics, sport, and sports medicine
Language Label:: English
ORCID:
Other Affiliation:
Person:: Beal, Meg, D'Alessandro, Donald, and Taylor, Daniel
Rights Statement Label:: In Copyright

22. Incorporation of Medication-Assisted Treatment with Buprenorphine into Primary Care Practice

Title Tesim:: Incorporation of Medication-Assisted Treatment with Buprenorphine into Primary Care Practice
Creator:: Patel, Vishalee and Koch, Alexandra
Date of publication:: 2018
Abstract Tesim:: In 2015, over 3.8 million people reported misusing prescription pain medication within the last month and over 5.1 million people in the United States admitted to using heroin at some point in their lives. Despite the widespread prevalence of opioid abuse, evidence-based treatments, such as medication-assisted treatment (MAT), have yet to be made widely available and easily accessible to patients. This program plan was designed to recommend strategies to effectively incorporate MAT into the primary care setting. Interviews were compiled from key informants at primary care clinics with successful MAT programs in the Chapel Hill, North Carolina and surrounding area in order to develop a model of practice transformation that could be applied to a primary care clinic that does not currently provide MAT services. Ultimately, the key factors to consider when implementing MAT in the primary care setting include: provider buy-in, the availability of behavioral support staff, and support of key administrative and support staff.
Resource type:: Masters Paper
Affiliation Label Tesim:: Physician Assistant Program
Degree:: Master of Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 133e524a-60c1-4cf0-9390-f19b5c81290a
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/phz7-hc57
Graduation Year:: 2018
Keyword:: physician assistant, primary care, MAT, buprenorphine, and chronic pain
Language Label:: English
ORCID:
Other Affiliation:
Person:: Chelminski, Paul, Koenig, Sarah, Patel, Vishalee, and Koch, Alexandra
Rights Statement Label:: In Copyright

23. Prescribing Prep: A Guide to Oral HIV Prophylaxis

Title Tesim:: Prescribing Prep: A Guide to Oral HIV Prophylaxis
Creator:: Moses-Lebron, Alyse
Date of publication:: 2017
Abstract Tesim:: Background: Currently, the war on Human Immunodeficiency Virus (HIV) focuses on prevention in the forms of condoms, abstinence, and status awareness. However, once an individual is diagnosed with HIV, the focus on prevention switches to treatment. A patient’s knowledge of personal HIV status, use of barrier methods during sexual activity, and adherence to Highly Active Antiretroviral Therapy (HAART) can help prevent new infections in the HIV negative population. An additional method to limit seroconversion and subsequent HIV infection from exposure is pre-exposure prophylaxis (PrEP). Tenofovir disoproxil fumarate (TDF) is a commonly utilized PrEP agent; it is generally considered safe, however it is associated with renal, endocrine and bone toxicity. This paper aims to address the risks of PrEP administration in HIV negative patients.
Resource type:: Masters Paper
Affiliation Label Tesim:: Physician Assistant Program
Degree:: Master of Health Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 03017bbf-d2c5-4c32-b5ff-fb580cd5f16e
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/2h4s-2s68
Graduation Year:: 2017
Keyword:: prophylaxis and HIV
Language Label:: English
ORCID:
Other Affiliation:
Person:: Bludorn, Janelle, Barzin, Amir, and Moses-Lebron, Alyse
Rights Statement Label:: In Copyright

24. The effectiveness of packing post incision and drainage among patients with skin abscesses in improved wound healing and reduced recurrence

Title Tesim:: The effectiveness of packing post incision and drainage among patients with skin abscesses in improved wound healing and reduced recurrence
Creator:: Ford, Natalie
Date of publication:: 2017
Abstract Tesim:: Introduction: A skin abscess is an accumulation of pus beneath the skin and is among one of the most common skin and soft tissue infections. Skin abscesses can occur in anyone including healthy patients with no comorbidities. They can occur anywhere on the body, but are common in friction-prone areas such as the buttocks, breast and groin. Patients present with tender nodules with fluctuance, induration, and erythema. Definitive management for abscesses is incision and drainage, with or without the placement of packing material. The purpose of this article is to review the necessity of wound packing in the healing outcomes and recurrence of infection after incision and drainage compared to no packing in patients with a skin abscess. Evaluation of this topic has the potential to improve patient care while reducing overall health care costs. First, we will discuss the epidemiology, pathophysiology, diagnosis and management options for skin abscess. Then, we will review the most recent literature to answer the aforementioned question at hand.
Resource type:: Masters Paper
Affiliation Label Tesim:: Physician Assistant Program
Degree:: Master of Health Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 03017bbf-d2c5-4c32-b5ff-fb580cd5f16e
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/dqjw-bd50
Graduation Year:: 2017
Keyword:: drainage, skin abscesses, packing, and recurrence
Language Label:: English
ORCID:
Other Affiliation:
Person:: Graham, Barry, Bludorn, Janelle, and Ford, Natalie
Rights Statement Label:: In Copyright

25. Prescription drug monitoring programs: a response to the opioid epidemic

Title Tesim:: Prescription drug monitoring programs: a response to the opioid epidemic
Creator:: Tiu, Tricia
Date of publication:: 2018
Abstract Tesim:: Background: The non-medical use of prescription opioids is a significant problem in the United States, with significant health and economic consequences. The nationwide implementation and expansion of prescription drug monitoring programs (PDMPs) has been utilized to reduce the incidence of doctor shopping, influence prescribing practices, and improve patient treatment decisions. Objective: The purpose of this paper is to describe the available primary literature on prescription drug monitoring programs. Methods: Peer reviewed research articles, literature reviews, and opinion articles on prescription drug monitoring programs from 2000 to 2017 were identified by searching PubMed/Medline, CINAHL, Embase, PsycInfo, using ‘prescription drug monitoring programs’ OR ‘PDMP’ OR ‘prescription monitoring programs’ AND ‘opioids’ as search terms or MeSH terms. Article bibliographies were also search manually for applicable papers. Results: Nineteen primary research articles were included for analysis. Evidence of impact of prescription drug monitoring programs on opioid-related outcomes is inconclusive. Conclusions: As PDMP implementation continues to expand, there needs to be continued focus on specific PDMP characteristics to determine what is the most effective at reducing opioidrelated outcomes.
Resource type:: Masters Paper
Affiliation Label Tesim:: Physician Assistant Program
Degree:: Master of Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: fd750114-5fb4-4502-b9bb-d2810d4bb02d
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/qvar-qf66
Graduation Year:: 2018
Keyword:: opiate, presecribing, physician assistant, prescription drug monitoring programs, and opioid
Language Label:: English
ORCID:
Other Affiliation:
Person:: Naumann, Rebecca, Chelminski, Paul, and Tiu, Tricia
Rights Statement Label:: In Copyright

26. Treatment Approach to a Patient with Lewy Body Dementia

Title Tesim:: Treatment Approach to a Patient with Lewy Body Dementia
Creator:: Harris, Kami
Date of publication:: 2017
Abstract Tesim:: Although LBD [Lewy Body Dementia] and AD [Alzheimer's Disease] share many of the same symptoms, their etiologies differ as does their approach to treatment. Therefore, it is important for the clinician to be able to assess for differences between the two. LDB has earlier detrimental effects on quality of life in comparison to AD. The approach to therapy should be targeted and an intervention should be initiated as early as possible. There is no cure for either at this time, therefore the mainstay of therapy is symptom management. The goal of treatment is to improve quality of life, maintain as much independence as possible, and minimize adverse reactions to medications. Among available medications, cholinesterase inhibitors have shown some benefit in cognitive functioning for AD, but less for LBD. Even within the subset of LBD, DLB patients respond better to cholinesterase inhibitors compared to PDD patients. This is likely because the pathology of DLB is more similar to AD than PDD. In contrast, treatment with levodopa is more effective in treating parkinsonian symptoms in patients with PDD compared to LDB. This is likely due to PDD being more similar to Parkinson’s disease pathology than DLB. Research continues to investigate appropriate therapies for both AD and LBD. Unfortunately, LBD lags behind most other neurological disorders in research, treatment, and awareness.
Resource type:: Masters Paper
Affiliation Label Tesim:: Physician Assistant Program
Degree:: Master of Health Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 03017bbf-d2c5-4c32-b5ff-fb580cd5f16e
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/hx6v-zv40
Graduation Year:: 2017
Keyword:: Lewy Body Dementia
Language Label:: English
ORCID:
Other Affiliation:
Person:: Faurot, Kim and Harris, Kami
Rights Statement Label:: In Copyright

27. The Use of Dexamethasone vs Prednisone in the Treatment of Asthma Exacerbation

Title Tesim:: The Use of Dexamethasone vs Prednisone in the Treatment of Asthma Exacerbation
Creator:: Higgins, Leana
Date of publication:: 2017
Abstract Tesim:: Asthma accounts for 2.1 million unscheduled ED visits annually, with a prevalence of 8.4% of the US population. Systemic corticosteroids serve as a cornerstone of acute asthma therapy, decreasing relapse rate, length of stay, and hospitalization rates. Since prednisone has multiple side effects and problematic compliance, studies have been conducted to determine if dexamethasone is as effective in the treatment of asthma exacerbation. This review evaluated a Cochrane systematic review, as well as three additional studies not included in that review. The conclusion was that dexamethasone is a promising alternative to prednisone in treating asthma exacerbation in both adults and children. However, in order for this possibility to be readily adopted into guidelines and clinical practice, higher quality and more consistent data needs to be obtained.
Resource type:: Masters Paper
Affiliation Label Tesim:: Physician Assistant Program
Degree:: Master of Health Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 03017bbf-d2c5-4c32-b5ff-fb580cd5f16e
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/adn4-b033
Graduation Year:: 2017
Keyword:: dexamethasone, prednisone, and asthma
Language Label:: English
ORCID:
Other Affiliation:
Person:: Faurot, Kim, Tintinalli, Judith, and Higgins, Leana
Rights Statement Label:: In Copyright

28. Efficacy of SSRIs for treating depression in Alzheimer’s disease

Title Tesim:: Efficacy of SSRIs for treating depression in Alzheimer’s disease
Creator:: Nhor, Cherry
Date of publication:: 2018
Abstract Tesim:: Contrary to popular belief, memory loss and other cognitive abilities severe enough to interfere with daily life are not a normal part of aging. Worldwide, 50 million people are living with a degenerative brain disease known as dementia. In the U.S., 5.7 million Americans are living with the most common form of dementia: Alzheimer’s disease (AD).1 AD is a type of dementia that causes problems with memory, thinking, and behavior. It is often difficult to distinguish depression in older adults without cognitive changes versus depression in those affected with Alzheimer’s dementia. Depression is one of the most frequent psychiatric complications of AD, affecting as many as 50% of patients. To address this disparity, one must first understand the criteria in diagnosing depression in AD. Current guidelines such as the National Institute of Mental Health-depression in Alzheimer’s disease (NIMH-dAD) and the Cornell Scale for Depression in Dementia (CSDD) have been used to diagnose depression in AD. Once the diagnosis of depression in AD has been made, consideration of effective treatment is required. Depression in AD is associated with greater morbidity and mortality, which does not only affect the patient but the families and caregivers, and society as a whole. The estimated societal costs due to AD are between $100 billion per year, and are projected to double by 2020 and triple by 2040. In addition, depression in AD may also be associated with increased risk of suicide. This review evaluated a Cochrane review as well as two other clinical trials to examine the efficacy of SSRI’s at reducing depressive symptoms in AD. The conclusion suggested that there is weak evidence to support the use of SSRI’s in the treatment of patients with AD and depression. However, this conclusion is based on a small number of studies with small sample sizes. In order to decrease morbidity and mortality among patients with AD who suffer with depression, there must be further research to support the efficacy of SSRI’s.
Resource type:: Masters Paper
Affiliation Label Tesim:: Physician Assistant Program
Degree:: Master of Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 33fa1662-04e7-4892-93cd-2b1c54c7f5b6
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/2wtp-4s91
Graduation Year:: 2018
Keyword:: physician assistant, dementia, depression, Alzheimer's, and SSRI
Language Label:: English
ORCID:
Other Affiliation:
Person:: Li, Winston, McGranaghan, Mary Beth, and Nhor, Cherry
Rights Statement Label:: In Copyright

29. Therapeutic Hypothermia to Reduce Cardiac Arrest-Related Neurological Deficits and Mortality

Title Tesim:: Therapeutic Hypothermia to Reduce Cardiac Arrest-Related Neurological Deficits and Mortality
Creator:: Legare, Angel
Date of publication:: 2017
Abstract Tesim:: Purpose: The purpose of this clinical review is to determine if induced therapeutic hypothermia is effective in reducing neurological deficits and mortality in cardiac arrest patients. Methods: PubMed, Cochrane Review Database, Embase, and Trip database were utilized. A common set of search terms including "induced hypothermia", "therapeutic hypothermia”, "cardiovascular resuscitation", “cardiac arrest”, "neurological deficits", “neurological outcome” and “mortality” guided the search. A total of three individual studies that were included for final results review. Results: Clinically based trials revealed that induced therapeutic hypothermia can improve both survival rates and neurological outcomes in cardiac arrest patients compared to cardiac arrest patients that do not receive therapeutic hypothermia. Conclusion: Although more research needs to be done to make therapeutic hypothermia implemented across all cardiac arrest patients, current research has suggested that therapeutic hypothermia implantation in cardiac arrest protocols can prove to be extremely beneficial in improving patient survival rates and neurological outcome.
Resource type:: Masters Paper
Affiliation Label Tesim:: Physician Assistant Program
Degree:: Master of Health Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 03017bbf-d2c5-4c32-b5ff-fb580cd5f16e
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/sqvt-nz15
Graduation Year:: 2017
Keyword:: neurological, hypothermia, and cardiac arrest
Language Label:: English
ORCID:
Other Affiliation:
Person:: Bludorn, Janelle, Kirkland, Lindi, and Legare, Angel
Rights Statement Label:: In Copyright

30. Exertional Rhabdomyolysis: Effect of High Intensity Exercise

Title Tesim:: Exertional Rhabdomyolysis: Effect of High Intensity Exercise
Creator:: Potter, Kendra
Date of publication:: 2018
Resource type:: Masters Paper
Affiliation Label Tesim:: Physician Assistant Program
Degree:: Master of Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: ddc6561f-ee02-43ba-8437-173d5da2481d
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/jzne-2x78
Graduation Year:: 2018
Keyword:: creatinine kinase, rhabdomyolysis, athlete, exercise, and physician assistant
Language Label:: English
ORCID:
Other Affiliation:
Person:: Lane, Nicole, Bludorn, Janelle, and Potter, Kendra
Rights Statement Label:: In Copyright