Digital Commons Network^™

Implementation And Program Evaluation Pilot Study: Educating Health Care Providers About Protecting Population Health During Climate Change., Christine Fasching Maphis

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Recommendations regarding the need to prepare nurses and other health care providers (HCPs) for the health impacts of climate change (CC) have grown ubiquitous in the literature. Timely, efficient and sustainable strategies by the health care industry are necessary. Failure to act is predicted to result in catastrophic and lethal population health consequences. A growing body of research identifies related knowledge gaps and supports HCP competencies and best practice interventions to mitigate adverse population health impacts of CC. A social ecological framework and the PRECEDE-PROCEED approach were employed to develop and evaluate a series of online webinars designed to equip …

The Use Of Life-Like Robotic Animals In The Acute Care Setting To Assist In The Care Of Patients With Dementia, Abby Denby

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The purpose of this pilot project was to describe the effect of life-like robotic animals on the nurses’ ability to provide care, patients’ level of agitation, use of antipsychotic medications, restraint and sitter use for patients with dementia in an acute care setting. Nurses report challenges and feelings of helplessness while caring for patients with dementia. Dementia may cause depression, agitation, aggression (physical or verbal) and a decrease quality of life. Animal Assisted Therapy (ATT) is a growing therapy in many healthcare settings but there is a lack of literature specifically related to the use of AAT in the acute …

On The Basis Of Gender: Discrimination Against Transgender People In The Hiring Process, Aaron N. Baillargeon

Senior Honors Projects, 2020-current

The study investigated the effect of a job applicant’s gender identity (male or female) and gender history (cisgender or transgender) on the evaluated quality of the applicant and the likelihood of the applicant being hired for a vacant software engineer position. Participants from the worker pool of Amazon’s Mechanical Turk evaluated the quality of a fictitious job applicant based on a mock resume and background check created for the purposes of this study, then completed the Social Dominance Orientation. There was no significant effect of gender identity or gender history on the evaluated quality of the job applicant or on …

The Grace And Leigh Oral History Project, Spencer Law

Senior Honors Projects, 2020-current

At a critical time in examining the bias of our institutions, the Grace and Leigh Oral History Project is collecting and archiving stories of three educational institutions in Richmond, Virginia. These oral history interviews share personal experiences with race and privilege in Richmond Public Schools, the experiment of the Virginia Governor's School initiative, and the legacy of Maggie Lena Walker. An accompanying contextual essay provides background on the author’s personal connection to the project, relevant historical information, and detailed plans for the future of the project. Currently, the project includes a total of 24 oral history interviews, roughly an hour …

What Methods Can The Health Care Industry Implement To Reduce Energy Consumption And Waste Production From Patient Care To Limit Greenhouse Gas Emissions?, Danielle H. S. Good

Senior Honors Projects, 2020-current

Purpose: Climate change is a growing issue all around the world and has negative impacts on the environment and human health. The health care industry is a significant contributor to greenhouse gas emissions amplifying climate change. Health care establishments are in place to improve health but are inadvertently harming it at the same time. Methods:A review of the literature was conducted to determine the impact the health care industry has on climate change and what can be done to limit the impacts on the environment. Resources were collected from trusted organizations databases such as Healthcare Without Harm, …

My Own Distinguished People: An Analysis Of Carpatho-Rusyn Autonomy Movements, Alexandra S. Benc

Senior Honors Projects, 2020-current

What factors must a stateless nation possess in order to gain political autonomy? This question is explored through the perspective of Carpatho-Rusyns, an East Slavic stateless nation with a largely unknown, yet rich and distinct, history and culture. Throughout modern history, the Rusyns have made three significant attempts to gain political autonomy and become a semi-independent entity. I argue that stateless nations that possess high levels of the elements of political opportunity structure, cultural maintenance, and economic functioning are more likely to succeed in their efforts to gain political autonomy than those stateless nations who do not. Each of these …

The Political Theory Of The Latin American Independence Movement, Sarah H. Welsch

Senior Honors Projects, 2020-current

This project explores the historical context from which four Latin American political theorists emerged in the 19th century and analyzes the extent to which they promoted the liberal ideal of equality in the governments they worked to establish. Mariano Moreno, José de San Martín, Simón Bolívar, and Agustín de Iturbide played central roles in the Latin American independence movement and the establishment of government institutions in the years that followed. I demonstrate that each theorist neglected to include large swaths of society in their discussions of equality while advocating for systems of governance from which they would personally benefit.

Influence Of Testosterone On Male-Male Competition In The Red-Sided Garter Snake, Thamnophis Sirtalis Parietalis, Isabella M. G. Bukovich

Senior Honors Projects, 2020-current

Female mimicry in the red-sided garter snake, Thamnophis sirtalis parietalis, is described in several well-studied evolutionary advantages, but an aspect that remains elusive is how reproductive traits are linked to the 3-fold higher circulating androgens in males with this phenotype. In this study, we implanted male garter snakes (n=15 per group) with either a blank implant (SHAM; control) or a T implant, the latter simulating the female mimic phenotype. Following simulated low-temperature dormancy, males were scored for courtship intensity over three days of behavioral trials with females housed in the same facility. Males were sacrificed, and sperm were collected …

Women's Representation In European Parliament Committees, Reagan E. Harrison

Senior Honors Projects, 2020-current

Increasing globalization and growing importance of the European Union has facilitated an important discussion about who makes policy decisions within the EU, specifically within the European Parliament. This thesis aims to discuss women’s representation within the EP at the committee level. By compiling a database of MEPs from 1^st July 2014 to 18^th January 2017, it looks into the question of whether or not committees are gendered. It argues that committees have gendered patterns, with women disproportionately focused within certain committees, that left parties have less gender discrepancies than right parties, and less women have committee leadership positions …

Exploring The Effect Of Cultural Sensitivity In Public Relations Campaigns, Amanda N. Christian

Senior Honors Projects, 2020-current

This study examines the importance of perceived cultural sensitivity on consumer attitudes and intent to support. Participants were randomly assigned to campaign messaging with a perceived high level of cultural sensitivity or a perceived low level of cultural sensitivity. Findings reveal that higher perceived levels of culturally sensitive messages generate more positive attitudes and increase the willingness of consumers to demonstrate supportive communication and intent to purchase. Other hypotheses comparing the response between two groups—self-identifying Hispanic and non-Hispanic respondents— aimed to distinguish the role origin plays in determining how important cultural sensitivity is to the perception of the organization. These …

Improving A Wireless Localization System Via Machine Learning Techniques And Security Protocols, Zachary Yorio

Masters Theses, 2020-current

The recent advancements made in Internet of Things (IoT) devices have brought forth new opportunities for technologies and systems to be integrated into our everyday life. In this work, we investigate how edge nodes can effectively utilize 802.11 wireless beacon frames being broadcast from pre-existing access points in a building to achieve room-level localization. We explain the needed hardware and software for this system and demonstrate a proof of concept with experimental data analysis. Improvements to localization accuracy are shown via machine learning by implementing the random forest algorithm. Using this algorithm, historical data can train the model and make …

Predicting Attrition Of New Student Affairs Professionals Through Perceptions Of Work-Related Quality Of Life, Synergistic Supervision, And Executive Servant Leadership, Wendy Lushbaugh

Dissertations, 2020-current

Abstract

New professional attrition in Student Affairs has been established as a concern for the field (Bender, 1980; Lorden, 1998; Renn & Hodges, 2007; Marshall, Gardner, Hughes, & Lowery, 2016). The debilitating impacts on university finances, productivity, organizational stability, team disruption, and innovation as a result of this problem creates urgency for the field to understand its predictors. The current study reviewed the impact of new professionals’ work-related quality of life, their perception of the use of synergistic supervision by their direct supervisors, and their perception of the use of executive servant leadership by divisional leaders as potential predictors of …

Facemasks For Source Control: Testing Influenza Transfer To Bedside Tables, Adriane M. Biggio

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

The idea of using facemasks for source control is not new. The concept has been published since 1918 during the Spanish Flu. However, there is limited research testing human subjects on the effectiveness of facemasks in preventing influenza transfer or transmission. The objective of this study was to answer the question, “In influenza-positive Veterans, what is the effect of facemask wearing in comparison to not wearing a facemask on influenza transfer to bedside tables measured for two hours per condition over a ten-week time frame during the 2019/2020 influenza season?” A quasi-experimental evidence-based project pilot study design was used. …

Pulling Heart Strings: Quality Improvement Algorithm For Temporary Epicardial Pacing Wire Removal Post Cardiac Surgery, Jessica Norman

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The placement of temporary epicardial pacing wires (TEPW) is considered standard practice post cardiac surgery and is dependent on the patient’s cardiac function intra-operatively and their electrophysiologic profile after weaning from cardiopulmonary bypass (Reade, 2007; Elmistekawy et al, 2016). Complications associated with TEPW removal include myocardial damage, infection, perforation, tamponade, disruption of anastomoses, ventricular arrythmias, and death (Bojar, 2009; Carroll et al, 1998;Timothy & Rodeman, 2004). Currently there is no standard practice on the removal of TEPW and there is wide variation in removal practices involving patients who are routinely on medications such as dual antiplatelet therapies and systemic anticoagulation. …

Postpartum Depression: Educating The Provider And Staff About The Importance Of Screening, Referrals, Follow-Up And Adherence To The Maternal Mental Health Safety Bundle Toolkit, Natalie Regis

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Background: Postpartum depression (PPD) affects approximately 10%-20% of women after childbirth. PPD is a disabling condition that can have serious health implications on mothers and their infants. Experts estimated that only 50% of women with PPD are diagnosed. Lack of education about screening practices can cause the disorder to go undiagnosed and untreated.

Purpose: The purposes of this quality improvement (QI) project were 1). To increase the provider and staff knowledge about the importance of screening with the implementation of a standardized screening tool 2). To increase PPD screening rates to 100% 3). To increase appropriate referrals to mental …

A Program Evaluation Of Violence Prevention Task Force To Address Type Ii Workplace Violence Utilizing Precede/Proceed Model, Stephanie Autry

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Aim: The primary aim of this project was to complete a program evaluation of the institution’s Violence Prevention Task Force. Evaluation allowed for assessment of outcomes including 1). decrease in assaultive incidents; 2). decrease in assaults leading to injury; 3). increase in team member reporting of assaultive incidents; and 4). demonstrate the program’s adherence to published guidelines on workplace violence prevention.

Background: Violence against healthcare workers has been an increasing problem in our nation’s healthcare system. Type II workplace violence is defined as patient, family member, or visitor as the perpetrator directing violent/aggressive behavior towards healthcare worker and is described …

Watchman Compared To Warfarin In Reducing Risk Of Stroke In Patients With Non-Valvular Atrial Fibrillation, Peyton Parrish, Matt Isherwood

Physician Assistant Capstones, 2020-current

Objective: To determine if the WATCHMAN device is as efficacious as warfarin for stroke prevention in patients with non-valvular atrial fibrillation (NVAF) using a systematic review. Methods: Pubmed and Google Scholar databases were used to evaluate clinical trials using the search terms atrial fibrillation, watchman, warfarin, and stroke prevention. Results: Three studies met inclusion criteria, with 2 being randomized control trials (RCT), and 1 being a prospective cohort study. Reddy et al found that after 3.8 years of follow-up, patients with percutaneous closure of Left atrial appendage (LAA) met criteria for both non-inferiority and superiority, compared with warfarin for preventing …

Efficacy Of Fecal Microbiota Transplant In Conjunction With Oral Vancomycin For The Treatment Of Recurrent Clostridium Difficile, Abigayle Afflick, Jackson Laboue

Physician Assistant Capstones, 2020-current

Objective: To determine the effectiveness of fecal microbiota transplant in addition to traditional therapy of oral vancomycin for the treatment of recurrent Clostridium difficile infections. Methods: Google Scholar was searched to identify randomized control trials using the terms vancomycin, fecal transplant, c. diff, and recurrent. Results: Three studies met inclusion criteria and two found a statistically significant benefit to the addition of fecal microbiota transplant to vancomycin therapy. Cammarota, et al. reported a 90% cure rate when administering fecal microbiota transplant in addition to vancomycin as opposed to a 26% cure rate with vancomycin alone with a P value …

Angiotensin Ii In The Treatment Of Distributive Shock, An Old Theory Revitalized, Jennifer D. Leach, Daniel P. Curran

Physician Assistant Capstones, 2020-current

Objective: To assess whether or not angiotensin II in combination with current treatment has a favorable outcome in the treatment of distributive shock in terms of decreasing duration of vasopressor usage, increasing mean arterial pressure (MAP) above 65 mmHg, and improving mortality.

Design: Systematic Literature Review

Methods:Searches were conducted in PubMed, Google Scholar, and the James Madison University Library Database for the key terms angiotensin II, shock, septic shock, vasodilatory shock, distributive shock, blood pressure, double-blind, humans, and vasoconstrictor agents. Search results were filtered by year, for animal trials, irrelevant therapies, meta-analysis, retrospective studies, and case studies. Only original …

Evaluation Of Hyperhomocysteinemia In The Progression Of Parkinson's Disease, Marisa A. Ducach, Pritpal S. Saggu

Physician Assistant Capstones, 2020-current

Abstract:

Objective:To assess the prevalence of hyperhomocysteinemia in Parkinson’s Disease (PD) and if this elevated serum level can be used as a predictive biomarker in risk assessment for the progression of cognitive decline in PD.

Design:Systematic Literature Review

Methods:A literature search was conducted through Google Scholar and Pubmed using phrases such as, “Parkinson's Disease”, and “homocysteine”, “Parkinson’s progression. Three articles, measuring serum homocysteine levels and cognitive functioning in PD patients, were selected, analyzed, and compared to assess for a relationship between homocysteine levels and cognitive decline in PD.

Results: Elevated homocysteine levels are associated with worse cognitive …

Induction Of Hypothermia In Patients With Traumatic Brain Injury, Frank Hadden, Courtney Lennix

Physician Assistant Capstones, 2020-current

Common Abbreviations:

TBI = Traumatic Brain Injury

Glasgow Outcome Scale = GOS

Glasgow Outcome Scale Extended = GOSE

Objective: To determine whether hypothermia induction improves long-term morbidity and mortality in patients with severe traumatic brain injury

Methods: A search was conducted using PubMed database and the search terms “induced hypothermia” and “traumatic brain injury”. Studies were excluded if the publication dates were over 10 years old, children were the population being studied, and the researchers were looking at other independent variables.

Results: The results from all three randomized control trials showed that the induction of hypothermia did not show effectiveness …

Short Term Effects Of Electronic Cigarettes On Pulmonary Function In Healthy Adult Smokers When Compared To Conventional Cigarette Use, Kayleen Lynch, Rachel Bastianelli

Physician Assistant Capstones, 2020-current

Background: Electronic cigarettes (e-cigarettes) first appeared on the U.S. market in 20071 , but to date, little is known about their safety. Concern about long term adverse effects on overall health continues to increase as we explore the potential of e-cigarettes to aid in smoking cessation practices. E-cigarettes have gained popularity and support through this idea that by using them to help patients quit smoking, the benefits of ultimately abstaining from tobacco use will outweigh the harms associated with e-cigarette use¹ . While the idea of reducing tobacco usage by any means possible remains the goal for most providers, …

Transcatheter Vs. Surgical Aortic Valve Replacement In Patients At Intermediate Surgical Risk, Nichole M. Bonzano, David M. Milligram

Physician Assistant Capstones, 2020-current

Abstract

• Objective: To compare the safety and efficacy of transcatheter aortic valve replacement (TAVR) to surgical aortic valve replacement (SAVR) in patients with severe symptomatic aortic stenosis at intermediate surgical risk.
• Design: Systematic literature review.
• Methods Literature searches were done in PubMed and Scopus search engines using key terms: TAVR, trans-catheter aortic valve replacement, SAVR, surgical aortic valve replacement, severe aortic stenosis, and intermediate risk. Filters included primary research only. Inclusion criteria were articles which studied an intermediate risk patient population (STS-PROM 3-15%), primary research, and compared outcomes of TAVR and SAVR in patients with severe aortic stenosis requiring replacement. …

Efficacy Of Mdma-Assisted Psychotherapy In The Treatment Of Chronic Ptsd, Alexis Coleman, Nicole Blixt

Physician Assistant Capstones, 2020-current

Objective: To assess the effectiveness of MDMA-assisted psychotherapy in treating patients with chronic refractory PTSD using a systematic review.

Methods: Literature search was performed on PubMed and PsychINFO using search terms “PTSD” and “MDMA” to identify randomized control trials within the past 10 years.

Results: Two out of the three studies found statistically significant data in the treatment of refractory PTSD. Mithoefer, M. et al and Ot’alora, M. et. al found a statistically significant decrease in CAPS-IV total scores, decrease in depression symptoms, decreased in dissociative symptoms, and increase in sleep quality.

Conclusion: The use of …

Efficacy Of Pulmonary Ultrasound Compared To N-Terminal Prohormone Brain Natriuretic Peptide As A Diagnostic Tool For Congestive Heart Failure In Patients Presenting With Acute Dyspnea In The Emergency Setting, Leah Krohn, Michael Burns

Physician Assistant Capstones, 2020-current

Objective: To determine the efficacy of using pulmonary ultrasound as a diagnostic tool in acute dyspnea of undetermined cause compared to the use of serum N-Terminal prohormone Brain Natriuretic Peptide (NT-proBNP) in the diagnosis of heart failure.

Design: Systematic literature review

Methods: Searches were conducted in PubMed and Scopus using the terms pulmonary ultrasound and congestive heart failure and studies within the last 10 years. Studies that used pulmonary ultrasound compared to BNP as a marker for the diagnosis of heart failure were included.

Results: All three studies found that the use of pulmonary ultrasound was a more specific …

Routine Versus Selective Episiotomies Causing Severe Perineal Tears, Hannah Brown, Anneliese Trader

Physician Assistant Capstones, 2020-current

Objective: To determine if the use of routine episiotomies decreases the rate of severe perineal tears in comparison to selective episiotomies during vaginal delivery. Methods: PubMed and Google Scholar were used to generate a set of random control trials which all had the objective of comparing severe perineal tears in routine compared to selective episiotomies during vaginal delivery. Three trials were reviewed and included in this study. Results: The results of each trial were not all statistically significant in the rate of severe perineal tears when comparing the two interventions. However, a downward trend of third-degree perineal tears amongst …

Determining Faculty Capacity For Transdisciplinary Instruction, Dominic Swayne

Dissertations, 2020-current

The purpose of this study was to develop a reliable and valid survey instrument that would prove useful in identifying faculty with the capacity and inclination to succeed in team-taught, hands-on, transdisciplinary course programming. Using an exploratory, mixed-methods design, the qualitative component consisted of semi-structured interviews of nine experienced X-Labs faculty. The qualitative analysis process identified attributes that were vital to transdisciplinary teaching and demonstrated patterns that were consistent with complex leadership development. During the mixing process, these data were translated into a quantitative instrument. A panel of experts reviewed the prototype instrument and reduced the number of items included …

Mindfulness Based Stress Interventions In Physician Assistant Programs, Lucas Vance

Physician Assistant Capstones, 2020-current

Mindfulness based interventions (MBI) have been used successfully in a variety of venues from the treatment of chronic pain to reducing stress in the workplace. The benefits of MBI programs that have been studied range from self-reported anxiety, depression, and empathy levels to levels of cortisol¹ to amygdala changes seen on magnetic resonance imaging.² MBI programs have been studied in pre-medical, medical, and graduate schools, as well as, nursing programs, and generalized healthcare cohorts.

Deep Brain Stimulation Of The Subcallosal Cingulate Gyrus In The Treatment Of Treatment Resistant Depression, Megan Caravas, Melanie Sov

Physician Assistant Capstones, 2020-current

Objective: a systematic review to determine the efficacy of deep brain stimulation (DBS) targeting the subcallosal cingulate gyrus (SCG) for the treatment of treatment resistant depression (TRD). Methods: PubMed database was utilized in a search for clinical randomized control trials that were completed after the year 2000, using the terms deep brain stimulation, treatment resistant depression, and subcallosal cingulate gyrus. Results: Three clinical trials were chosen based on specific inclusion criteria as noted in the PRISMA flow chart (Chart 1). The results of the three articles showed various discrepancies. Two of the three studies demonstrated some statistical significance in reduction …

Diagnostic Accuracy Of Mcmurry’S Test In The Diagnosis Of Meniscal Tears, Jessica Smyth, Hartwell Rainey

Physician Assistant Capstones, 2020-current

No abstract provided.