Digital Commons Network^™

Effects Of Ketamine Versus Morphine In The Treatment Of Acute Pain In The Emergency Department, Dakoda Farrington, Amber Knowlton

Physician Assistant Capstones, 2016 to 2019

No abstract provided.

Effects Of Prehospital Vs. In Hospital Therapeutic Hypothermia On Neurological Status After Cardiac Arrest, Cassandra Johnson, Ingrid Brown

Physician Assistant Capstones, 2016 to 2019

Objective: To conduct an analysis of literature that examines whether the use of prehospital therapeutic hypothermia (TH) results in significant changes in neurologic outcomes that are in adults that experienced out of hospital cardiac arrest (OHCA). Methods: Systematic searches were conducted through PubMed at the James Madison University Library. The inclusion criteria included human adults who experienced out of hospital cardiac arrest and were treated by Emergency Medical Services (EMS) with and/or without prehospital TH by means of intravenous cold fluids and surface cooling. Results: Three studies involving 2180 cases were included. This review indicated that prehospital TH after …

Chlorhexidine Gluconate Vs Povidone-Iodine In The Prevention Of Clean-Contaminated Surgical Site Infections, Erin Layne, Abigail Stone

Physician Assistant Capstones, 2016 to 2019

Abstract

Background:

A patient’s skin is the major source of pathogens that can cause post-operative complications such as surgical site infections (SSIs). Optimization of pre-operative skin antisepsis is obtained with chlorhexidine gluconate (CG) and povidone-iodine (PI). These two solutions are the most widely used antiseptics for pre-operative purposes.

Objective:

Among surgical patients greater than 18 years of age undergoing clean-contaminated surgery, which antiseptic, iodophors or chlorhexidine gluconate, is more effective at reducing postoperative surgical site infections?

Methods:

A search was done in PubMed utilizing the terms chlorhexidine, infection control, iodophors, and surgical site infection. The limits applied included randomized …

The Use Of Probiotics To Prevent Ventilator-Associated Pneumonia In Adults, Michael Roper, Paige Douthett

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the efficacy and safety of preventing the acquisition of ventilator- associated pneumonia with the use of probiotic supplementation, as compared to a placebo, among hospitalized adult men and women receiving more than 24 hours of mechanical ventilation. Design: Systematic Literature Review. Methods: Systematic searches were conducted through PubMed and Scopus using the search terms “ventilator”, “probiotics”, and “prevention”. Records were excluded from the analysis if they were published before 2015, full text was not available, studies other than randomized control trial or cohort studies, and if the study population was less than 18 years old. Results: Of …

Effects Of Stem Cell Therapy On 6-Minute Walk Test Distance And Left Ventricular Ejection Fraction In Patients With Nonischemic Cardiomyopathy, Kayleigh Hunt, Alexa Maziuk

Physician Assistant Capstones, 2016 to 2019

Objective

To assess the efficacy of stem cells in the improvement of functional capacity and quality of life in the setting of nonischemic dilated cardiomyopathy.

Design

Systematic literature review

Methods

A literature search of PubMed was conducted utilizing the following search terms: “stem,” “cell,” “nonischemic,” and “cardiomyopathy.” The following limits were used: “2015-2018,” nonischemic cardiomyopathy, results of LVEF and 6MWT, randomized controlled trials, pilot studies, and sample size >22.

Results

Butler et al. found that within the itMSC group, 6MWD increased by an average of 27.40 m (95% CI 0.28–54.52; P=0.05), but it decreased by an average of 10.83 m …

Corticosteroid Vs Platelet Rich Plasma Injections In The Treatment Of Chronic Plantar Fasciitis, Elizabeth J. Meaney, Emma W. Adelman

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the effectiveness of platelet rich plasma (PRP) injections in the treatment of chronic plantar fasciitis compared to traditional corticosteroid injections. Design: Systematic literature review. Methods: A literature search was performed in Pubmed using the search terms “plantar fasciitis” and “platelet rich plasma”. Inclusion criteria included publication within 10 years, randomized control trial, human study, and containing the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot scoring system. Results: Our literature search resulted in the review of three randomized- control trials. Mahindra et al. showed that PRP was superior to corticosteroid injections in the treatment of chronic plantar …

Crystalloids Or Colloids… What’S In Your Iv? Determining Fluid Type For Septic Shock Resuscitation, Eleanor L. Jordan, Amy K. Lansing

Physician Assistant Capstones, 2016 to 2019

Objective: To compare the efficacy of crystalloid versus colloid solutions, specifically normal saline versus albumin, in decreasing mortality among patients with septic shock requiring resuscitation fluids in the intensive care unit (ICU) setting. Design: Systematic literature review. Methods: Research was conducted in PubMed and UpToDate, utilizing the search terms sepsis, septic shock, fluid resuscitation, colloids and crystalloids. Specifically, in PubMed, the following limits and terms were used: randomized control trial, human subjects, English, and within the last 7 years. Results: The Annane et al study found no significant difference in colloid fluid resuscitation versus crystalloid fluid resuscitation in the decreasing …

Subanesthetic Iv Ketamine Reduces Acute Suicidal Ideation In Patients With Mood Disorders, Kimberly Jenko, Jack Anzilotti

Physician Assistant Capstones, 2016 to 2019

Background. Depression and suicide are common in the United States and present a significant problem in the healthcare landscape. Currently, there are few options that can rapidly reduce suicidal ideation in patients with depression. Ketamine, a glutamate N-methyl-D-aspartate (NMDA) receptor antagonist, has been shown to reduce acute suicidality in patients with depression. Previous studies have a reduction of suicidal ideation compared to saline placebo, but few studies have shown a significant effect compared to a similar psychoactive drug such as midazolam.

Method. A search of PubMed and PsychNET was performed in September 2018 using the terms “ketamine,” “suicide,” …

Comparing Effectiveness Of Colonoscopy Versus Fecal Immunochemical Testing In Screening For Colorectal Cancer, Hannah Vanrooyen, Lindsay Burns

Physician Assistant Capstones, 2016 to 2019

Introduction: Colorectal cancer (CRC) is deadly neoplasm that takes many lives in the United States and is a leading cause of cancer worldwide. If CRC is detected early through screening, there is a higher chance of remission which makes screening an important tool in CRC prevention. Currently, colonoscopy is the gold standard, but due to the undesirable preparation needed for a colonoscopy, patient compliance is low. Giving patients a screening option that requires less preparation may help to increase the compliance for CRC screening. Fecal Immunological testing has been shown to have higher compliance rates among patients as compared to …

Effect Of Metformin On Adolescent Obesity, Mackenzie Mcnamee, Victoriya Eggen

Physician Assistant Capstones, 2016 to 2019

Objectives: Metformin is the first line treatment for type 2 diabetes mellitus (T2DM) in both adults and children and has been shown to result in weight loss. Pediatric obesity is a major risk factor for the development of T2DM as well as several other diseases. Recently, physicians have reported using Metformin off-label to treat obesity in adolescent patients. The purpose of this study is to investigate whether Metformin is effective in reducing BMI in obese adolescents.

Methods: Studies were found using PubMed, MeSH, Medline, and CINAHL. The search terms used were: “obesity,” Metformin,” “adolescents,” “children,” “metformin and weight,” …

Effect Of Postpartum Protocols On Maternal Outcomes, Kelsey Grimm, Emily Harnish

Physician Assistant Capstones, 2016 to 2019

Objective: To determine whether postpartum hemorrhage (PPH) protocols lead to decreases in maternal morbidity and mortality.

Design: Systemic literature review.

Methods: The clinical question investigated is whether the implementation of PPH protocols has measurable impact on maternal morbidity and mortality. Searches were done through PubMed using the keywords: “maternal hemorrhage postpartum protocol.” Studies were eliminated if they were more than 10 years old, conducted outside the United States, published in a non-English language, used other animal subjects besides humans, used non-female subjects, if they did not answer the clinical question, or were review articles. Eventually, three cohort …

The Effect Of Yoga On Fatigue In Breast Cancer Patients Undergoing Radiotherapy, Magdalene Bredehoeft, Karli Ribsam

Physician Assistant Capstones, 2016 to 2019

Objective: Assess the effect of yoga on levels of fatigue among women with breast cancer currently undergoing radiotherapy. Design: Systematic literature review. Methods: Searches were done on PubMed, utilizing the terms “yoga,” “fatigue,” “breast cancer,” and “radiotherapy.” Limits that led to inclusion of studies included: published after 2008, studies researching breast cancer, and studies that were randomized controlled trials. Results: Randomized controlled trials studied were by Chandwani et al. (2010), Chandwani et al. (2014), and Vadiraga et al. (2009). Conclusion: Yoga can improve quality of life among women with breast cancer undergoing radiotherapy, specifically by decreasing levels of fatigue. We …

Assessment Of Structural Competency In Baccalaureate Nursing Students: A Descriptive Study, Elle J. Del Gallo

Senior Honors Projects, 2010-2019

Cultural competence has been investigated extensively in nursing education to better prepare nurses to care for individuals of diverse backgrounds. While developing cultural competence is important to address individual care needs, it may not address the social and structural factors that influence health. Structural competency describes the ability to assess not only cultural factors that affect health disparities, but also structural inequalities and stigmas that can alter a patient’s presenting symptoms and risk for certain diseases.

How Does Access To Healthcare Affect Life Expectancy?, Yara Mahmoud

Senior Honors Projects, 2010-2019

Access to health care is a pressing issue in the United States, whether it be the cost of care or not having enough of it. To emphasize the importance of this topic, this paper assesses the impact of access to health services on life expectancy. A comparison is made between the universal health systems in France and Spain and the mixed system in the United States. Even though the United States spends the most on health care in the world, its statistics fall below those of other developed countries. After addressing other risk factors, it was found that individuals under …

El Vph Y El Cáncer Cervical En El Perú: Diferencias De Accesibilidad Entre Las Mujeres De Las Zonas Rurales Y Urbanas / Hpv And Cervical Cancer In Peru: The Differences In Accessibility For Rural And Urban Women, Jemma Stratton

James Madison Undergraduate Research Journal (JMURJ)

Este informe examina el estado actual del tratamiento y prevención del VPH en el Perú, y pone énfasis con problemas específicas que han contribuido al riesgo alto de cáncer cervical entre las mujeres rurales. Perú ha tomado grandes pasos en las décadas últimas para establecer programas que se dirigen al VPH y la salud de las mujeres. Sin embargo, las mujeres peruanas tienen una población más probable para contraer cáncer cervical en el mundo. Este informe compara los esfuerzos de prevención del VPH entre las poblaciones rurales y urbanas en el Perú y identificar las barreras que causando esta crisis …

The Effects Of Caffeine Ingestion On The Hemostatic Response To Simulated Firefighting Activities, Sierra Wassell

Showcase of Graduate Student Scholarship and Creative Activities

The leading cause of death among firefighters is sudden cardiac event, and it is acknowledged that most ischemic events are due to an occlusive thrombus formation. In addition, due to the demanding job requirements and shift work, firefighters are commonly known to overuse caffeine as an ergogenic aid. The purposes of this study were to examine the potential effects of caffeine on the hemostatic response to simulated firefighting activity.

Bout Vs. Non-Bout Physical Activity Minutes As Predictors Of Waist Circumference In College Students, Valerie Olijar, Matt Scott, Brooke Ferraro, Elizabeth Edwards, Trent Hargens

Showcase of Graduate Student Scholarship and Creative Activities

Physical activity recommendations to reduce all cause mortality consist of 10 minute bouts of a moderate-vigorous intensity, for a total of 150 min/week. This study investigates if those 10 minute bouts really matter. We found that step count was the best predictor of waist circumference. This finding supports many new technological devices that use step counts as a form of measuring activity. It provides support that the more steps you take, the likelier you will have a small waist.

The Effect Of Oral Contraceptives On Caffeine Metabolism And Cycling Performance, Annette M. Lemanski

Showcase of Graduate Student Scholarship and Creative Activities

This project objectives were to determine the effects of oral contraceptives and menstrual cycle on the benefits of caffeine supplementation for cycling performance. Seventeen recreationally trained female cyclists completed four trials consisting of 3 kilometer time trials. Subjects ingested either caffeine or a placebo one hour prior to each trial. The magnitude of the ergogenic aid of caffeine was compared between oral contraceptive users and eumenorreheic females. In addition, the effect of caffeine was compared across different phases of the menstrual cycle, specifically the follicular and luteal phases.

Distractions In Hearing: Measuring Impulsivity In Service Members With Mtbi, Kathleen Burns

Showcase of Graduate Student Scholarship and Creative Activities

Service Members who have experienced mild traumatic brain injury (mTBI) tend to experience a degradation of focus and attention capabilities. The purpose of this initial pilot study is to measure the false alarm rates and thresholds of Service Members with mTBI during contralateral and informational masking tests and compare their outcomes to adults without mTBI. Contralateral and informational masking tasks both involve different levels of uncertainty and different forms of central masking. These two tasks will be used to quantify the participants’ accuracy in identifying the target stimulus and their associated levels of distractibility and impulsivity. Preliminary data obtained from …

Development Of A Questionnaire To Assess Attitudes Toward Hearing Aids, Corinne O'Shaughnessy, Ayasakanta Rout, Joseph Smaldino

Showcase of Graduate Student Scholarship and Creative Activities

Many reasons have been postulated as to why persons with hearing loss are reluctant to engage in the hearing rehabilitation process. While not the only determinant, an individual’s attitudes toward hearing loss and hearing aids have been shown to affect adoption of amplification adversely and eventual outcomes of hearing aid use. Several attempts have been made to develop test instruments for attitudes toward hearing loss, but nothing specific to attitudes toward hearing aids or hearing aid technology. The primary objective of this study was to develop a questionnaire to assess attitudes toward hearing aids using the ABC model of attitude …

Exploring The Impact Of An Occupation-Based Group On Self-Esteem And Self-Concept, Christie E B Briskey, Elyse Marie Powderly

Showcase of Graduate Student Scholarship and Creative Activities

Due to the need for an occupation-focused intervention for childhood cancer survivors, we will be conducting a five week group occupation-based program to explore its impact on self-concept and self-esteem in childhood cancer survivors through occupational exploration and participation. The purpose of our study is to determine the efficacy of a group occupation-based intervention on enhancing areas of psychological well-being such as self-esteem and self-concept in childhood cancer survivors in order to support their transition from childhood to adolescence. Each week we will guide the participants through various activities with creative and self-expressive components such as poetry writing, creative movement, …

The Effect Of Parent-Infant Swim Classes On Maternal Parenting Competence, Emotional Availability, And Aquatic Handling, Hope Sadowski, Chanele Molano

Showcase of Graduate Student Scholarship and Creative Activities

Low parenting competence and limited emotional availability decrease the quality of the parent-infant relationship (Young, 2011; Sturge-Apple et al., 2012). However, co-occupations, or reciprocal relationships where the occupations of two or more individuals are interactively shaping each other, have been associated with strengthening parent-infant relationships (Pierce, 2009; Price & Stephenson, 2009). Parent-infant swim classes are co-occupation based interventions that facilitate close bodily contact and teach parents handling skills that can generalize into the home. Numerous websites allude to the benefits of these classes; however, there are currently no evidence-based claims supported by the occupational therapy literature. The researchers hypothesized that …

Community-Based Participatory Research In Diabetes Prevention Programs, Raihan Khan, Ranjita Misra

Department of Health Sciences - Faculty Scholarship

Background: The purpose of this study was to determine how community-based diabetes prevention programs utilized the concept and contents of the Community Based Participatory Research approach. Methods: Keyword search in PubMed and Scopus electronic databases from January 1, 2000, to December 31, 2019, was conducted to search and extract peer-reviewed articles that included words “Community-Based Participatory Research (CBPR)” and “diabetes mellitus” in the title, abstract or in the main article. The initial search yielded 1122 articles. After the final screening, a total of 67 articles were extracted for review. Results: Findings suggested that an advisory board was used by most …

American And British Speech Differences In Low Socioeconomic Status Homes, Jennifer Markfeld

Senior Honors Projects, 2010-2019

Background: Infants living in low socioeconomic status (SES) homes display lower developmental functioning by 12 months than mid- and high-SES infants, and speak fewer words on average as they grow older. Maternal speech is especially important for language development and has been found to be the largest predictor of SES-related differences in children’s vocabulary. Although there are documented differences between British and American infant language development, for example American infant lexicons are typically larger than age matched British infants, there is little research looking at caregiver speech across these countries in low SES groups.

Method: This retrospective study compared 10 …

The Effects Of Post-Exercise Nutrient Intake On Hydration Status And Muscle Soreness Ratings In Youth Cyclists, Allison Cadematori

Senior Honors Projects, 2010-2019

PURPOSE:Muscle soreness levels and hydration status are important indicators of recovery from high intensity endurance exercise, and can be influenced by post-exercise nutrient intake. Chocolate milk has been reported to be an effective recovery beverage in adults, as it contains carbohydrate, protein, and water/electrolytes at levels that are appropriate for refueling, muscle repair, and rehydration. However, few studies have tested the efficacy of chocolate milk for post-exercise recovery in adolescents. METHODS:Eight competitive teenage cyclists (5 male, 3 female; 16.1 ±1.1 y; 174.0 ±10.7 cm; 138.4 ±5.6 lbs; 61.8 ±8.2 ml/kg/min) completed three experimental trials, in randomly counterbalanced order. …

Increasing Food Security: Developing And Testing A Nutrition Education Curriculum For A Mobile Food Pantry, Alexandra Lepecha, Kathleen M. Kraft

Senior Honors Projects, 2010-2019

Background: The Neighborhood Produce Market (NPM) is a food distribution model similar to a mobile food pantry. NPM stakeholders observed a lack of community engagement and familiarity with produce offered.

Project Description: The objective was to develop a nutrition education curriculum for NPM volunteers to better engage families and community members by providing food samples, recipes, and nutrition education. A stakeholder steering committee guided the needs assessment, curriculum development, volunteer training, and pilot test. The curriculum consisted of food safety, cultural considerations, and nutritional information for nine produce items and food tasting procedures and recipes. Seven student volunteers were trained …

Moral Distress In Critical Care And Emergency Department Nurses, Morgan Timberlake, Nicole Phillips

Senior Honors Projects, 2010-2019

Moral distress is a phenomenon that occurs when a person is unable to carry out what they believe is the ethically appropriate action due to various external constraints. This literature review seeks to explore the interventions that are most effective in reducing moral distress in critical care and emergency department nurses who have experienced moral distress in practice.

Innovative Care Of Individuals In The Athletic Training Room: A Case Series, Kathryn E. Young

Senior Honors Projects, 2010-2019

This work follows three unique cases of athletic injuries and/or injuries in patients. These cases were selected because of the innovative nature of the rehabilitation process conducted by the sports medicine team via the athletic training room or the unique nature of the injury/case.

The first is a concussion sustained from a motor vehicle accident in a collegiate female thrower. This is unique because it’s a non-sport related concussion handled as an athletic trainer would handle a sports related concussion. It also demonstrates a new unique protocol for concussion management.

The second case is a patient with two complete anterior …

Examining The Effectiveness Of Interprofessional Collaboration For Preprofessional Speech-Language Pathology And Occupational Therapy Graduate Students, Morgan Cornwell

Senior Honors Projects, 2010-2019

This study explores the effects of an emergent writing interprofessional collaboration experience for preprofessional speech-language pathology (SLP) and occupational therapy (OT) graduate students. The preprofessionals were split into two groups (SLP only and SLP-OT pairs) and delivered emergent writing interventions to preschoolers either individually (SLP only) or collaboratively (SLP-OT pairs). The purpose of this study was to investigate how working collaboratively versus working individually to deliver the interventions to preschoolers influences the preprofessionals’ knowledge of theInterprofessional Education Collaborative’s (IPEC) core competencies and emergent writing concepts. The results showed that paired preprofessionals reported higher levels of interprofessional competency than unpaired preprofessionals. …

The Reproducibility Crisis In Scientific Research, Sarah Eline

Senior Honors Projects, 2010-2019

Following the push for evidence based practice, came a huge proliferation of research journals and journal articles. With this increase in quantity came an increased concern about the quality of these articles being published, which led to a multifield investigation regarding the reproducibility of scientific research. With studies in the fields of psychology and biomedicine only reaching approximately a 30% reproducibility rate, a conversation has been sparked that spans across every field of research. Upon further investigation, various causes for this reproducibility crisis have surfaced which include, lack of data sharing/ transparency, statistical errors, funding corruption, and the culture surrounding …