Digital Commons Network^™

Photodynamic Therapy With Topical Aminolevulinic Acid Vs Placebo In The Treatment Of Actinic Keratosis, Michelle Nguyen, Katherine Shook

Physician Assistant Capstones, 2020-current

Objective: Assessing the effectiveness of photodynamic therapy with aminolevulinic acid versus placebo in the complete clearance rate of actinic keratosis.Design: Systematic literature review. Methods: An initial literature search was performed using Google Scholar using terms “photodynamic therapy”, “aminolevulinic acid,” “randomized control trial”, “actinic keratosis”, “clearance efficacy”, “safety”, “field treatment”, and “placebo”. An additional search using PubMed was performed using the same terms. Studies were excluded if they were performed on non-human subjects, did not use aminolevulinic acid as their photosensitizer, used organ transplant recipients, compared efficacy to alternate treatment modalities, used alternative light source such as laser or daylight, …

More Alike Than Different: Student Perceptions Of Academic Librarians By Genders And Subject Areas, Elizabeth Price, Jody C. Fagan

Libraries

This study explored differences in how undergraduate students of different genders and academic disciplines perceived academic librarians at a U.S. public university. No evidence indicated differences between students identifying as male or female, and few statistically significant differences were found among four Subject Areas (Arts, Humanities + Social Sciences, Business, Health + Education, and STEM). Our results have implications for local practice though they are not generalizable to other institutions. Despite a lack of significant findings, librarians should continue to explore ways to measure how students of different disciplines perceive academic libraries and/or librarians as valuable to their academic success.

Words, Music, Memory: An Exploration Of Four Soprano Song Cycles By Lori Laitman Based On Poetry By Victims Of The Holocaust, Sheena Ramirez

Dissertations, 2020-current

This Doctor of Musical Arts document is an exploration of the four soprano song cycles by Lori Laitman based on text settings from victims of the Holocaust, with a specific focus on the compositional and performance devices that both underpin the power of words to bear witness to lived experience and ensure the process of musical commemoration as an act of historical preservation. Lori Laitman (b. 1955) has composed ten distinct song cycles commemorating victims of the Holocaust, of which four are included in this study – I Never Saw Another Butterfly, In Sleep the World is Yours, The Ocean …

Infusing Evidence-Based Practice Into The Cayman Islands Health Services Authority Nursing Culture, Melissa Ring

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

Background: James Madison University and Cayman Islands Health Services Authority (HSA) entered into a collaborative agreement the summer of 2020. There was a lack of organizational structure surrounding implementation and systemization of evidence-based practice (EBP) models and a disconnect between nurse manager knowledge and EBP implementation within HSA.

Methods: The population for this evidence-based project was 21 HSA nurse managers from the inpatient setting. Pre-intervention survey results informed organizational readiness, nurse manager knowledge and ability to implement, and guided the intervention that included the creation and implementation of a website toolkit for EBP. An EBP model was selected for nursing. …

Covid-19 In A Secure Behavioral Rehabilitation Setting: A Program Evaluation, Jennifer G. Jones

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

Problem: The COVID-19 case rate as of June 5, 2020, for prisoners was 5.5 times higher than the United States (US) population case rate (Saloner et al., 2020). A secure behavioral rehabilitation facility in the US was challenged to mitigate the spread of COVID-19 and made many changes to facility and program protocol in order to meet this challenge.

Methods: The purpose of this program evaluation was to examine the COVID-19 facility response, case rates, percent positivity and attack rates between units at a secure behavioral rehabilitation facility to inform further policy and procedure recommendations for the mitigation of COVID-19 …

An Evidence-Based Project: Exploring Nurse Manager Communication Competencies And Skill Development, Micaela Ross

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

Abstract

Evidence supports effective communication skills as essential for patient safety and organizational success. Evidence is also clear regarding ineffective communication and its negative impact. The purpose of this project was to determine an area of communication skill development needed among nurse managers of the participating island hospital and support positive change in knowledge, understanding, and ability to use effective communication skills. The aim was to improve communication skills among these nurse managers.The objectives were to determine a specific skill need, provide a focused educational intervention, and evaluate skill improvement. Pre-intervention survey results revealed a self-identified priority of effective communication …

Nature And Its Place In Professional Counseling: A Qualitative Study Of Expert Views, Experiences, And Future Plans, Matthew V. Bukowski

Dissertations, 2020-current

Recent publications and initiatives within professional counseling indicate a growing interest in the connections between human wellness and the natural world. Despite consistent growth of this trend between the years 2000 and 2021, there has been little dialogue within the profession about the ethical, ideological, and social justice implications of integrating nature therapy with professional counseling and counselor education. This study investigated the views, experiences, and future plans of 10 counselor educators who integrate nature therapy into their professional roles and developed two major themes and 12 subthemes that encapsulate their responses. Participants in the study overall shared a desire …

Experiencing The Pull And Push: Influences On Independent Contractor Motivation And Job Satisfaction, Andrew D. Miller

Dissertations, 2020-current

Over the past few decades, the number of individuals engaging in non-standard employment has been increasing. Drawing on self-determination theory (SDT), this study examines the motivation and job satisfaction of independent contractors, the largest form of these alternative work arrangements. Specifically, I examine how the rationale for workers entering contracting work arrangements affect in-role contractor motivation and job satisfaction. Based on a sample of N = 241 adjunct instructors from two universities, I find that the positive relationship between those entering contracting because the work offers autonomy, flexibility and the ability to pursue personally interesting work (pull factors) and their …

The Attraction Of Fear And The Potential Therapeutic Value Of Horror Films, Mari-Peyton Kouchinsky

Educational Specialist, 2020-current

Cinematic horror has historically had a negative reputation among its peers even though it is a genre that commercially and financially thrives. There are many different perspectives as to what motivates an individual to willingly expose themselves to horror movies, ranging from psychological and metaphorical confrontation with repressed or socially unacceptable behaviors to fulfilling a somatic, thrill-seeking desire. Whatever the motivation, there is potential for harnessing both the psychological and physical reactions for therapeutic intervention. This paper aims to provide counselors with a synthesis of information on the potential therapeutic value of cinematherapy with horror movies, focusing on the relationship …

The Impact Of Insufficient Sleep And Early Class Start Times On U.S. Air Force Academy Cadet Health And Performance, Stephanie Osborn

Masters Theses, 2020-current

Emerging adults face a set of unique obstacles that combine to make getting the recommended 7-9 hours of sleep per night a challenge. Internally, adolescents and young adults have a biologically based tendency to go to sleep and wake up later. Externally, they may participate in scheduled activities that wake them up early or keep them awake late. One primary obligation that can contribute to short sleep duration in students is early class start times. Emerging adults attending a civilian college may benefit from the ability to set their bedtimes and class schedule. However, their same-aged peers attending a military …

Singers’ Experiences Of Community In The Shenandoah Valley Children’S Choir, Heidi B. King

Masters Theses, 2020-current

In the music and education fields, researchers have explored the ways people experience community in classroom and ensemble settings; however, few studies have focused on the ways adolescents experience community in the children’s choir setting. The purpose of this qualitative phenomenological study was to explore singers’ perspectives of their experience of community in the Shenandoah Valley Children’s Choir. Fifteen singers participated in focus group interviews to generate primary data; rehearsal observations and document analysis served as secondary data sources. Analysis revealed that participants’ goals and motivations aligned with the stated goals of the organization, and that these shared goals gave …

Effects Of Subthalamic Deep Brain Stimulation On Treating Motor Symptoms In Early Parkinson's Disease, Emily Reale, Gina Legaluppi

Physician Assistant Capstones, 2020-current

Objective: Assess the efficacy of subthalamic nucleus deep brain stimulation (STN DBS) versus solely optimal pharmacological use in early Parkinson's Disease to improve motor dysfunction. Design: Systematic Literature Review. Methods: Searches were completed on PubMed utilizing the MeSH terms: “subthalamic, deep brain stimulation, and early parkinson.” Using PubMed the following limits and terms were used: published in the last 10 years, randomized controlled trial, English, human, and removing duplicates. A total of three studies resulted after the search. Results: All three studies showed statistically significant results in reduction in disease progressive motor symptoms. Additionally, at the end of each study …

Post-Application Factors Affecting Community College Enrollment, Kyle L. Mccarrell

Dissertations, 2020-current

For many open-enrolled higher education institutions, including community colleges, enrollment is dropping each semester creating significant financial challenges. While much research literature focuses on four-year colleges, little is known about the students who seek to enroll at community colleges. What is known is often evaluated using college choice theoretical models, e.g., Hossler & Gallagher (1987), that focus on a limited, and often linear, student experience. Contemporary evaluation models, including Perna (2006) and Iloh (2018), seek to expand college choice understanding by incorporating contextual matters that include the diverse experiences of potential students as they consider college. These contextual theories, with …

Five Songs By Armstrong Gibbs (1889-1960): From Nostalgia To Christian Hope And The Assurance Of Heaven, James K. Richardson

Dissertations, 2020-current

During the first few decades of the twentieth century, prolific composer, teacher, and conductor, Armstrong Gibbs (1889-1960), was well-regarded for his contribution to the landscape of English art song. However, against the backdrop of Modernism and the tumult of the Second World War, his musical style was deemed “out of touch.” In a 1943 chain of correspondence with fellow songwriter Roger Quilter, Gibbs describes feeling “exceedingly sore and discouraged at neglect at the hands of the critics.” He further explains, “Just because we both write music that is intelligible & frankly tries to aim at beauty, we are considered beneath …

Breakthroughs In Hormonal Male Contraception, Alexander Patton, Seth Vann

Physician Assistant Capstones, 2020-current

Objective: Assess the efficacy of a nestorone plus testosterone gel at suppressing progestin levels and spermatogenesis.

Design: Systematic literature review.

Methods: Searches were done in PubMed and Dartmouth library using the terms nestorone, randomized control trial, human, and male. Limits used while searching included published in the last 10 years, randomized control trials, and English.

Results: Using the search criteria the following three studies were found that met the inclusion/exclusion criteria of this study: Ilani et al, Zitzmann et al, and Anawalt et al. All three studies were found on PubMed and reference the Ilani et al study.

Conclusion: Nestorone …

Effectiveness Of Tpa At Reducing Amputations In Patients With Severe Frostbite, Kylie Gravatt, Meredith Mahen

Physician Assistant Capstones, 2020-current

Objective: To determine the efficacy of tissue plasminogen activator (tPA) therapy in reducing the number of limb and digit amputations in patients with severe frostbite.

Introduction: Current treatment regimens for frostbite consist mainly of rapid rewarming measures and wound care. This regimen is unfortunately many times not sufficient in cases of severe frostbite and frequently leads to delayed amputations.

Methods: A search was conducted in Pubmed using the terms "Frostbite"[Mesh]) AND "Tissue Plasminogen Activator"[Mesh]. Articles were chosen based on relevancy to the research question and having a publication date after 2005. Case reports were excluded.

Results: All three studies reported …

Are Polypills A Viable Option To Improve Health Outcomes In Those With Cardiovascular Disease?, Alexander Voytovich, Cara Mckee

Physician Assistant Capstones, 2020-current

Objective: Does the use of polypill therapy improve systolic blood pressure and low-density lipoprotein cholesterol (LDL-C) levels more than usual care in adults with established cardiovascular disease (CVD) or with 10-year atherosclerotic cardiovascular disease risk >10%. Design: Systematic literature review. Methods: Searches were performed in PubMed and UpToDate using the following search terms polypill and cardiovascular. Other limits included: randomized control trials, adults, published in the last 10 years, LDL-C and systolic blood pressure. Results: Analysis of articles to ensure similar design, intervention and fit with the other inclusion/exclusion criteria yielded three studies: Labefer et al, Muñoz et al, and …

Sglt2 Inhibitors In The Management Of Heart Failure With Reduced Ejection Fraction, Susannah Jackson, Meghan Mathis

Physician Assistant Capstones, 2020-current

Objective: to assess whether SGLT2 inhibitors significantly reduce the risk of hospitalization for heart failure (HAHF) and cardiovascular death in patients with heart failure with reduced ejection fraction (HFrEF). Design: systematic literature review. Methods: searches were conducted in PubMed with the terms "SGLT2 Inhibitors,” “heart failure with reduced ejection fraction (HFrEF),” and "hospitalization” and the following limits: publication within the last 5 years, clinical trials, meta-analyses, randomized control trials, humans, and English. These criteria determined the selected literature: randomized control trial (RCT), use of an SGLT2i compared to placebo, and outcomes including HAHF and/or cardiovascular related death. Results: DAPA-HF: 27% …

Effects Of Cannabidiol As Adjunct Therapy For Management Of Treatment-Resistant Epilepsy, Harry Gray, Molly Anadale

Physician Assistant Capstones, 2020-current

Background. Lennox-Gastaut Syndrome (LGS) and Dravet Syndrome(DS) are two types of childhood epilepsy syndromes that are often resistant to traditional anti-epileptic drug (AED) regimens. With the development of a pharmaceutical grade purified cannabidiol (CBD), there has been increasing interest in its utility for treatment of epilepsy. We conducted a systematic review to explore the efficacy of CBD in reducing seizure frequency when added to traditional AED regimens in those who are considered to have treatment resistant epilepsy (TRE).

Method. A search of PubMed was performed in September 2020 using the terms “cannabidiol”, “Lennox-Gastaut Syndrome”, “Dravet Syndrome”, and “epilepsy” with …

Paracetamol Compared To Nsaids As Treatment For Patent Ductus Arteriosus In Neonates, Toné Boykins, Carly Anne C. Wilson

Physician Assistant Capstones, 2020-current

Objective: To evaluate the use of paracetamol in the treatment of closure of patent ductus arteriosus (PDA), as well as to investigate the amount of adverse side effects. Design: Systematic literature review. Methods: Searches were done in PubMed and Google scholar, using the search terms Paracetamol for patent ductus arteriosus and alternative treatment patent ductus arteriosus. In PubMed the following limits and terms were used: randomized control trial, English, and secondary endpoints. Results: Randomized control trial studies by Dash et al., El-Mashad et al., and El-Farrash et al. were included based on inclusion/exclusion criteria of the meta-analysis and with secondary …

Assessing Moral Distress And Substance Use Among Nurses In The Time Of Covid-19 To Improve Patient Safety, Lauren Childers

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

The COVID-19 pandemic has brought rapid changes, increased stress, and ethical challenges to nurses across the globe. These factors may place nurses at increased risk for developing moral distress and substance use disorder. This stress can also increase nurse vulnerability to substance use. Previously there was little evidence about the rates of moral distress and substance use disorder among nurses during the COVID-19 pandemic. The primary objective of this evidence-based project was to describe levels of moral distress and substance use among nurses in a community hospital during the COVID-19 pandemic and to make recommendations for interventions to improve nurse …

Baseline Bmi, Gender, & Age As Predictive Factors For Intragastric Balloon Weight Loss Outcomes, Nirali Shah, Miranda A. Myers-Burton

Physician Assistant Capstones, 2020-current

Objective: To determine whether obese and morbidly obese patients aged 18-75 with a lower baseline BMI (BMI 30-39.9 kg/m2) who received an intragastric balloon (IGB), have a higher percentage of total body weight loss (%TBWL) and percentage of excess weight loss (%EWL) compared to those with a higher baseline BMI (BMI > 40 kg/m2). Secondary objective was to ascertain whether gender and age are also predictors of weight loss outcomes following an IGB procedure.

Design: Systematic literature review

Methods: Literature searches of PubMed and SpringerLink were conducted using the search terms: “intragastric balloon, weight loss, and “BMI” and then limited to …

Peer Support Wellness Groups In Physician Assistant School, Allison Pingston, Alexa Wagoner

Physician Assistant Capstones, 2020-current

Objective: To investigate the effect of peer support wellness groups on the perceived stress, anxiety, and depressive symptoms encountered in Physician Assistant (PA) school in order to implement a wellness program for James Madison University (JMU) PA students. Design: Systematic literature review. Methods: Searches were done in PubMed and Google Scholar using the search terms: “wellness,” “peer support,” “small group(s),” “medical school,” and “PA school.” The limits used were: randomized controlled trials, meta-analysis, and completed in the past 10 years. Results: Search results revealed three articles that met inclusion and exclusion criteria. Conclusion: No articles showed statistical significance. However, all …

The Effect Of Hydroxychloroquine On Mortality In Hospitalized Covid-19 Patients, Misha Suresh, Jeff Abraham

Physician Assistant Capstones, 2020-current

As of October 2020, there are no commonly accepted or proven effective treatments for coronavirus disease 2019 (COVID-19). Hydroxychloroquine (HCQ) is an established anti-malarial drug with demonstrated action against SARS-CoV-2 (the virus that causes COVID-19) in-vitro and early observational studies and anecdotal evidence supported its use in treatment of COVID-19. In this review, three of largest and most statistically powerful studies to date (two cohort studies and one randomized controlled trial [RCT]) are synthesized for the purpose of determining whether HCQ is effective in reducing mortality in patients hospitalized with COVID-19. All three studies found no statistically significant difference in …

The Necessity Of Implementing A Wellness Curriculum Into Physician Assistant Programs, Jessica K. Erim, Darryl Bines Jr.

Physician Assistant Capstones, 2020-current

Purpose: In response to the decline of mental health and wellness of students within medical school programs, recent research has been exploring the effects of implementation of wellness curriculums. The purpose of this review is to highlight the research that has been conducted in the medical school environment and to establish the need for further research. This review will specifically discuss the implementation of a student-led wellness curriculum at James Madison University’s Physician Assistant Program and its impact on students. Methods: A thorough search was conducted using Google Scholar using specific inclusion and exclusion criteria (see Table 1). …

Unscrambling Egg Allergies: Examining The Impact Of Introduction Timing Of Egg Protein On The Development Of Food Allergies, Emily Sherald, Mark Peterson

Physician Assistant Capstones, 2020-current

Objective: To assess the efficacy of early egg protein introduction in the reduction of later childhood egg allergy development. Design: Systematic literature review. Methods: Searches were done using PubMed and cross referenced with articles on UpToDate, using the search strings ‘egg‘, ‘allergy‘, ‘randomized controlled trial‘, ‘early‘, and ‘introduction‘. Our inclusion criteria included: published in the last 5 years, human trial, randomized controlled trials only. Results: Our selection process yielded 3 quality studies: the “Beating Egg Allergy Trial” (BEAT)¹, “Start time of egg protein to prevent egg allergy” (STEP)², and “Two-step Egg Introduction for Prevention of Egg …

Dm Ii Bugging You? Probiotics May Help Reach Your Glycemic Goals, Robert Kime, Kayla Siford

Physician Assistant Capstones, 2020-current

Objective: To determine the effects of probiotics on glycated hemoglobin (HbA1c) and fasting blood glucose (FBG) in patients with Type II Diabetes (T2DM) controlled with oral medications. Design: Systematic Literature Review. Methods: Searches were conducted on PubMed using the terms: prebiotic, probiotic, type 2 diabetes, non-insulin dependent, and microbiota. Searches refined with parameters for Randomized Control Trials, written in English, and available texts. Results: Firouzi et al. did not show a significant change in the FBG between groups and a decrease in the HbA1c in the intervention group. Ejtahed et al. showed a significant decrease in …

The Effect Of Platelet Rich Plasma On The Treatment Of Androgenetic Alopecia Compared To Placebo, Mackenzie D. Comstock, Hannah E. Stephenson

Physician Assistant Capstones, 2020-current

Objective: To assess the efficacy of plasma rich proteins (PRP) compared to placebo in the treatment of androgenetic alopecia (AGA).

Design: Systematic literature review

Methods: Searches were done in PubMed utilizing the terms PRP, plasma rich protein, autologous activated PRP, autologous activated plasma rich protein, androgenetic alopecia, placebo, hair count, hair density, hair follicles, hair loss, therapeutic effect, growth factors, dermatology, and regenerative medicine. Articles were excluded if they were published before 2013, involved animal studies, compared minoxidil only in their research, included only female participants, non-English articles, studies with no quantifiable data, review research articles, and injections besides the …

Ketamine As A Treatment Modality For Treatment-Resistant Depression, Tracy Wulff, Shen Cao

Physician Assistant Capstones, 2020-current

Many recent studies have demonstrated the ability of ketamine, an NMDA receptor antagonist, to produce antidepressant effects that may be effective in helping reduce treatment-resistant major depression. In particular, three double-blinded randomized control trials have been conducted to assess the viability and effectiveness of this medication for treatment. This systematic literature review will analyze these studies and determine if the overall research indicates that ketamine is useful in improving depression as measured by the Montgomery–Asberg Depression Rating Scale (MADRS)¹.

Objective: Assess the effectiveness of IV Ketamine in reducing treatment-resistant major depressive disorder as measured by the Montgomery–Asberg …

Multicultural Music Education: Preparedness, Perceptions, And Practice Among Virginia Elementary Music Educators, Benjamin J. Luna

Masters Theses, 2020-current

Benjamin Joel Luna, M. M.

James Madison University, 2021

Supervisor: Lisa M. Maynard

The purpose of this study was to examine the Multicultural Music Education (MME) practices of established (i.e. more than three years of music teaching experience) Elementary Music Teachers in the state of Virginia by examining their responses to a series of survey questions specific to the topic. Participants (N=18) were all current Elementary Music Teachers in the state of Virginia with more than three years of experience.

Participants were asked to use Likert-scale ratings for the majority of the questions but were also given the …