Medicine and Health Sciences Commons^™

Are Hearing Aids Designed For All Parts Of The World? An Ecological Momentary Assessment Study, Preeti Pandey

Dissertations, 2020-current

The affordability of hearing aids (HA) is a significant barrier to ownership in low-and middle-income countries (WHO, 2021). Crowded living conditions in developing countries intensify the complexity of listening environments compared to developed nations. No existing literature compares the listening environment and HA outcomes using real-world measures across these regions. This study aims to 1) compare HA outcomes and listening environments between India and the USA, and 2) evaluate the benefit of premium HAs over basic HAs in both locations. In an observational, multi-location, single-blinded study, nineteen hearing aid users (mean age 69.6 years) participated. Ecological momentary assessments (EMA) were …

Applying Emotionally Focused Group Therapy With Collegiate Student-Athletes Experiencing Disordered Eating And Poor Body Image, Emily Wagener

Educational Specialist, 2020-current

Rates of eating disorders and sub-clinical disordered eating continue to rise each year, with higher rates seen among athletes than non-athletes (Curry, 2010). Fueled Athletes is a group-style intervention for collegiate student-athletes that uses Emotionally Focused Therapy to help group members identify and transform emotions that contribute to poor body image and disordered eating behaviors. The mission of Fueled Athletes is to create a program that addresses eating problems and body image disturbances experienced by student-athletes by creating a safe space, building a support network which will lead to decreasing rates of ED / DE within the student-athlete population. Future …

Differences In Immigrant And U.S. Native Born Patients’ Experiences In The American Healthcare System: A Correlational Study, Betaneya W. Daniel

Virginia Journal of Public Health

Objective: To examine any perceived barriers that might exist in the United States healthcare system and gather data on how different patients experience the system.

Methods: The study utilized a correlational analysis with usage of a Likert scale survey administered to U.S.- born natives, immigrants, and healthcare providers. The survey assessed respondents of their access to healthcare services, barriers to healthcare services, healthcare provider trust/relationships, and health institutions’ relations. Another survey assessed healthcare providers’ belief in the efficacy of their services and health institutions’.

Results: No statistically significant differences were found between U.S. natives and immigrants, but notable distinctions were …

Health Equity: Communicating Impaired Water Status, Emily Potter

Virginia Journal of Public Health

Introduction: Land use changes in the Rivanna River and James River Watersheds have increased the number of impaired recreational waters, and there is a disparity in the equitable communication of these impairments to different populations. Ineffective communication contributes to inequities in access to safe, accessible, and affordable water for vulnerable populations, placing public health at risk.

Methods: This study uses secondary data from the Environmental Protection Agency’s Watershed Index Online (WSIO) Indicator Data Tables, Virginia Department of Environmental Quality (DEQ), Rivanna River Association, and James River Association. Correlations, linear regression, and percent change were used to identify statistically significant trends …

Addressing Farm Safety: Farm Safety Dinner Theaters In The Shenandoah Valley, Tammy Kiser, Michelle Seekford, Jeremy Daubert

Virginia Journal of Public Health

Statistics demonstrate that farm safety and wellness issues affect all ages in the agricultural community. However, an increased proportion of youth and older farm workers comprise the highest rates of farm-related morbidity and mortality. Engaging farmers in increasing safe practices in the agricultural community is an important, ongoing challenge.

Methodology

Farm Safety Dinner Theaters, an initiative created through community-based participatory research (CBPR) at the University of Kentucky, provide a relaxed environment where farmers and their families can identify safety and wellness issues, watch as the actors process these issues, and enjoy a meal. Seeing the situations played out in theater …

Enhancing Community Engagement: Perspectives From Researchers, Community Members, And Service Providers, Anne-Marie O'Brien, Elyssa Wood

Virginia Journal of Public Health

Purpose: Compare and contrast perspectives from Research Team Members (RT), Community Members (CM) and Service Providers/Others (SP/O) about barriers and facilitators to community engagement and participation in health research.

Methods: A cross-sectional, descriptive survey study with a convenience sample of adults who lived and/or worked in the Commonwealth of Virginia was conducted between May and July 2022. Descriptive statistics and chi-square analyses were conducted to identify similarities and differences across the three stakeholder groups.

Results: A total of 303 participants were involved in this study. In general RTs, CMs and SP/Os were similar in their responses to perceived barriers and …

Mentorship Matters: Promising Results From Vpha’S Pilot Mentorship Program, Ashley Tharpe, Stacey B. Plichta, Anna R. Robertson, Kim Baskette

Virginia Journal of Public Health

Purpose

The Virginia Public Health Association (VPHA) Pilot Mentorship Program seeks to support public health students, early career professionals, and career switchers throughout the Commonwealth of Virginia in their growth as public health professionals. The program provides opportunities for participants to gain job-seeking and professional communication skills through live webinars, to connect with each other through online networking events, to manage stress through wellness webinars, and to interact with experienced public health professionals.

Methods

VPHA formed a volunteer committee to develop and implement the program in Fall 2022. Initially, the program was envisioned as a traditional one-to-one mentoring program; however, …

Describing Trends In Virginia's Dentist And Dental Hygienist Workforce: Challenges And Opportunities, Shillpa Naavaal, Yetty Shobo, Barbara Hodgdon

Virginia Journal of Public Health

Purpose: Regular assessment of the dental workforce is essential to improve the population's oral health. This analysis aimed to understand the trends in the distribution of dentists and dental hygienists (DHs) in Virginia.

Methods: Annual survey data (2013-2022) of dentists and DHs from the Virginia Department of Health Professions Healthcare Workforce Data Center was used to examine the trends in provider distribution by age, gender, race/ethnicity, and geography across Virginia.

Results: In 2022, there were 5,720 dentists and 5,290 DH licensees in Virginia. In the dentist workforce, there was a high representation of those aged ≥60 years (23%), males (58%), …

Magnitude Estimations Of Angular Motion: Test-Retest Reliability, Elizabeth C. Pahygiannis

Dissertations, 2020-current

Dizziness and imbalance are one of the most common complaints of people 65 years and older, as it affects 20-30% of this population and puts one at a higher risk of falling (Iwasaki & Yamasoba, 2015). Vestibular impairments are identified through measures of vestibular reflexes such as the VOR. However, the extent of impairment observed through the VOR may not correlate with the patient’s perceptions of their symptoms (Kobel et al., 2021).A large portion of patients with vestibular symptoms cannot be diagnosed with the testing that is currently available (Agrawal et al., 2009). Magnitude estimation is a psychophysics technique used …

The Effect Of Listening Level On Listening Effort: A Pupillometry Study, Noelle Elizabeth Steele

Dissertations, 2020-current

Listening in adverse conditions such as in the presence of background noise or at a low intensity level can require additional listening effort. While the relationship between signal to noise ratio and listening effort has been reported previously, there is a gap in the literature on the effect of listening at different levels on listening effort. In the present study, five young, normal-hearing listeners were tested for speech understanding at two presentation levels (35 dB and 65 dB) under three signal to noise ratio conditions (0, -3, and -6 dB). Peak pupil dilation was measured using a Tobii T60 XL …

The Effect Of Dance Training On The Vor During The Video Head Impulse Test, Miranda Scalzo

Dissertations, 2020-current

The vestibulo-ocular reflex (VOR) is essential to maintain clear vision during head movements and can be assessed through the head impulse paradigm (HIMP). The suppression head impulse paradigm (SHIMP) is used to quantify the ability to suppress the VOR. MacDougall et. al. (2016) demonstrated that SHIMP gain is decreased compared to HIMP gain values in healthy adults. Previous research has supported the idea that vestibular trained athletes, such as dancers, have an enhanced capability of suppressing the VOR than those without vestibular training. The objective of this study was to assess VOR suppression capabilities at increased velocities, similar to what …

Assessing The Effects Of Emg Target Levels On Cvemp Thresholds, Melanie Johnson

Dissertations, 2020-current

Cervical vestibular evoked myogenic potentials (cVEMP) measure function of the saccule and inferior vestibular nerve by evoking inhibitory electromyogram (EMG) responses from the sternocleidomastoid muscle using short duration stimulation. Previous research has shown that cVEMP amplitude increases relative to EMG target level and latency remains constant, yet there is little to no research demonstrating the relationship between EMG target level and cVEMP threshold. The objective of this study is to determine the effects of EMG activation on cVEMP thresholds and assess whether patients who generate larger tonic EMG during cVEMP testing have lower cVEMP thresholds. cVEMPs were recorded in 20 …

Dietary Adherence And Cognitive Performance In Older Adults By Nativity Status: Results From The National Health And Nutrition Examination Survey (Nhanes), 2011–2014, Md Towfiqul Alam, Elizabeth Vásquez, Jennifer L. Etnier, Sandra Echeverria

Department of Health Sciences - Faculty Scholarship

Although adherence to dietary guidelines is associated with better cognitive performance, there may be differences by nativity status. This study aimed to investigate the association between adherence to the healthy eating index (HEI) and cognitive performance (CP) among United States (US)-born and foreign-born older adults (60+ years). Data were obtained from the 2011–2014 NHANES (n = 3065). Dietary adherence was assessed with HEI quintiles. CP (adequate vs. low) was examined using word listing (CERAD), animal naming (AFT), and the digit symbol substitution test (DSST). Weighted multivariable logistic regressions were used to examine associations. The US-born participants in higher dietary quintiles …

Increasing Medication Adherence In Patients With Bipolar Disorder Using Mobile App Reminder, Emmaculate Ndifor

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

Background: Bipolar disorder (BD) is the fifth leading course of disability in the world, contributing to many co-morbid conditions and complications. Non-adherence to medication is prevalent in patients with BD. The aim of the project was to use an evidence-based technological intervention to enhance medication adherence in BD patients between 18- 65 years old at an outpatient behavioral health clinic.

Methods: Baseline assessment included a pre Morisky Medication Adherence (MMAS-4) questionnaire. The development of an intervention to improve medication adherence was based on Johnson’s (2002) Medication Adherence Model (MAM).

Interventions: Participants downloaded the Medisafe app, registered medications and set …

Shorter Duration Of Dual Antiplatelet Therapy Following Second Generation Drug Eluting Stent Placement, Alexandra Coy, Caitlyn M. Murtha

Physician Assistant Capstones, 2020-current

Heart disease is the leading cause of death in both men and women in The United States. Because advanced heart disease is often treated with percutaneous coronary intervention (PCI) for stent implantation, many patients will be put on dual antiplatelet therapy to prevent adverse effects such as stent thrombosis or restenosis. The purpose of this literature review is to determine if the development of second-generation drug eluting stents allows for a shorter, 6-month, duration of dual antiplatelet therapy (DAPT) versus the currently recommended 12 months. The articles discussed in this review were obtained on PubMed and narrowed using search terms …

Efficacy Of Dry Cupping Therapy As Treatment For Non-Specific Lower Back Pain, Lucas Albrecht, Kelly Ettari

Physician Assistant Capstones, 2020-current

Lower back pain (LBP) is one of the most common conditions affecting adults globally. Non-specific lower back pain (NSLBP) is a diagnosis based on the exclusion of other pathoanatomical causes, and accounts for over 80% of cases of LBP. 1 Current treatments typically involve a multidisciplinary approach. Dry cupping therapy is a noninvasive treatment option that is used to treat musculoskeletal pain. 2 Three studies were analyzed which assess the utility of dry cupping therapy as a treatment modality for non-acute NSLBP; two of the studies were randomized control trials, and the third was a small pilot study. All three …

Investigation Of The Effectiveness Of Intraoperative Radiotherapy In Treatment Of Unifocal Invasive Breast Cancer, Julie Schultz, Annie M. Oslund

Physician Assistant Capstones, 2020-current

Objective: Assess the 5 year local recurrence rate of intraoperative radiotherapy (IORT) in relation to the conventional treatment of external breast radiotherapy (EBRT) in eligible females diagnosed with breast cancer over age 40.

Design: Systematic literature review.

Methods: PubMed was searched using the following limits and terms: breast neoplasms, intraoperative radiotherapy, randomized control trial, clinical trial, females, English, and published in the last 10 years.

Results: Three studies were found to directly compare IORT and EBRT regarding 5 year local recurrence rates.

Conclusion: IORT was shown to be non-inferior to EBRT in two of the three studies that were examined; …

Reducing Adverse Event With Single And Double Bundle Acl Reconstruction Techniques, Alicia Hudalla, Caroline Casey

Physician Assistant Capstones, 2020-current

Objective: Assess whether athletes or individuals who live an active lifestyle or occupation between the ages of 18-40, who have had an ACL reconstruction done by either single bundle or double bundle repair to compare whether or not double-bundle ACL reconstructive surgery reduce rates of adverse events (re-tear rates, graft failure and laxity) post ACL reconstruction as compared to single-bundle ACL reconstruction. Design: Systemic literature review. Methods: Searches were done in PubMed, utilizing the terms “single bundle vs. double bundle ACL reconstruction.” The following limits and terms were used wrong ligament discussed, systematic reviews or review, not enough participants, 10+ …

Does Probiotic Supplementation Help Decrease Symptoms In Adults Previously Diagnosed With Major Depressive Disorder?, Alexa Hammock, Hayley Loiselle

Physician Assistant Capstones, 2020-current

Objective: To assess the effect of probiotic supplementation on clinical symptoms of major depressive disorder in adults. Design: Systematic literature review. Methods: Searches were performed on PubMed using the terms “adults with depression and probiotics”. The limits on PubMed were set to include randomized control trials, studies on adults, studies done within the last 10 years, studies done on patients that did not have depression, studies that did not use the Beck Depression Inventory, and studies that focused on other conditions. Results: Three studies were found that met search criteria: Reninghaus et al., Schaub et al., and Chahwan et al. …

Utility Of Bariatric Surgery In The Remission Of Type 2 Diabetes Mellitus, Christine Ercoline, Alyssa Bower, Corinne Singh

Physician Assistant Capstones, 2020-current

Objective: Assess whether bariatric surgery is more effective than lifestyle modification and medication in the long-term reduction of hemoglobin A1c (HbA1c) and fasting plasma glucose among obese adults with type 2 diabetes mellitus. Design: Systematic literature review. Methods: A PubMed search was performed utilizing the terms bariatric surgery, type 2 diabetes and remission. In PubMed the following limits and terms were used: published in the last 10 years, humans, full text, clinical trial, randomized control trial, and English. Results: An analysis of three randomized control trials (RCTs) supports bariatric surgery as a modality to induce the remission of type 2 …

Is Racial Diversity Important When Applying To Jmu Pa Program?, Gaelyn E Young, Deonte J. Hope

Physician Assistant Capstones, 2020-current

The Physician Assistant profession is predominantly female and Caucasian. In order to increase the diversity of the profession at the level of the workforce, it is necessary to examine PA programs' role as the entryway into the profession. To that end, this evaluation aimed at surveying current and future PA students at James Madison University to understand whether racial diversity of both the program's cohort and/or its faculty was a factor in their decision to apply and/or attend the school.

Focused Assessment With Sonography Exams Vs Ct Scan, Anne Kresge, Charlotte Mueller, Briar Tures

Physician Assistant Capstones, 2020-current

Blunt trauma is a common reason patients present to the emergency department. Providers must evaluate these patients quickly to get them the correct treatment, especially for intra-abdominal bleeding. Focused assessment with sonography for trauma (FAST) exams are growing in use to evaluate trauma patients for free fluid in the abdomen. To be valuable to emergency providers, it must be known how FAST exams compare to the gold standard evaluation, computed tomography (CT) scans. Searches were done on Pubmed and Scopus databases using terms “focused assessment with sonography for trauma” and “FAST exam CT blunt abdominal trauma.” Limits were added to …

Virginia Refugee’S Access To Covid 19 Health Information, Krunal Patel, Sarah R. Blackstone, Fern R. Hauck

Virginia Journal of Public Health

Background: This study examined how refugees in central Virginia, United States were able to access public health information about COVID-19 and any barriers to following COVID-19 prevention guidelines.

Methods: Individual interviews were conducted with refugees (n = 40) attending a family medicine clinic serving refugees and immigrants. Participants answered questions about their primary methods of obtaining COVID-19 and COVID-19 vaccine information, how they prefer to receive this information, information given by employers, precautions taken at their place of work, and current vaccination status.

Results: We found that television and social media played a large role for refugees in obtaining COVID-19 …

Predictors Of Lung Cancer Screening Recommendation In Virginia Using The Community Health Assessment Survey, Aashish Batheja, Carrie Miller, Sunny Jung Kim, Bernard Fuemmeler F., Rajsh Balkrishnan

Virginia Journal of Public Health

Purpose: The purpose of this analysis was to determine the factors that may influence the probability of being recommended a lung cancer screening by a health professional in Virginia.

Methods: Data were obtained from the Community Health Assessment Survey conducted by the University of Virginia (UVA) Health System and Cancer System in collaboration with Virginia Commonwealth University (VCU) Cancer Center. SAS software was used to conduct a logistic regression with the following variables: age, sex, race, current smoking status, cancer history, education level, income level, insurance, and rurality.

Results: Statistically significant positive predictors included being a current smoker (OR: 3.504, …

Promoting Community Health Research Partnerships Through A Small Grants Program: Processes And Lessons Learned, Sophie G. Wenzel, Amanda J. Nguyen, Kristin Miller, Leigh Guarinello, Allison Mckell, Kathryn Hosig

Virginia Journal of Public Health

While there are multiple ways to engage communities in health research, one approach is through partnership-based research in which community representatives are involved as intentional partners in the research process, from conceptualization and co-creation to implementation, analysis, interpretation, and dissemination. However, there remain numerous challenges to supporting and sustaining such partnerships.

Since its launch in 2019, the integrated Translational Health Research Institute of Virginia (iTHRIV) has sought to foster community engaged health research among its four research/clinical institutions through a community partnership-based grant program. Over five funding cycles, iTHRIV has awarded 14 one-year research grants addressing topics such as opioid …

Empowering Community Health Workers In Guatemala, Oswald M. Attin, Gineska Castillo, Grace Sibert, Andrea Harper

Virginia Journal of Public Health

Introduction:

Community health workers (CHW) have been integral in helping middle- and low-income countries. This research paper discusses the benefits of the involvement of CHWs in health screenings.

Methods:

Health screenings were performed for three rural communities in Guatemala, in 2021, alongside a church in Zacapa, to identify community wide health risks. The screenings included a detailed questionnaire that collected demographic data, height and weight, a blood glucose check, a hemoglobin check, and a blood pressure reading. Additional nutritional data was collected to understand diet patterns and habits. In-depth educational sessions were done with the CHWs, emphasizing preventative care, and …

Detection Of Suicide Clusters Using Small-Area Geographic Data From The Virginia Violent Death Reporting System, 2010 – 2015, Kurtis M. Anthony, Allison Ertl, Rachel A. Leavitt, Alexander E. Crosby, Ryan M. Diduk-Smith, Kevin A. Matthews

Virginia Journal of Public Health

Introduction: From 1999 to 2020, the suicide rate in Virginia increased from 13.1 to 15.9 per 100,000 persons aged 10 years and older. Few studies have examined spatial patterns of suicide geographies smaller than the county level.

Methods: We analyzed data from suicide decedents aged ≥10 years from 2010 through 2015 in the Virginia Violent Death Reporting System. We identified spatial clusters of high suicide rates using spatially adaptive filtering with standardized mortality ratio (SMR) significantly higher than the state SMR (p < 0.001). We compared demographic characteristics, method of injury, and suicide circumstances of decedents within each cluster to decedents outside any cluster.

Results: We identified 13 high-risk suicide clusters (SMR between 1.7 and 2.0). Suicide decedents in the clusters were …

Social Determinants Of Health, Telehealth, And Hiv/Aids: Implications For Public Health Research And Practice In The State Of Virginia, Sonal S. Sathe, Adati Tarfa

Virginia Journal of Public Health

Purpose: The purpose of this commentary is to assert the importance of addressing the social determinants of health to support HIV/AIDS control efforts, to describe the importance of telehealth in HIV/AIDS control, and to recommend courses of action to support HIV/AIDS control efforts within the state of Virginia.

Discussion: We provide an overview of the social determinants of health and their role in HIV/AIDS control, telehealth and its uptake within the HIV/AIDS community, and issues in Virginia facing HIV/AIDS control.

Conclusion and Recommendations: We conclude that addressing social determinants of health, especially stigma, is an important measure of HIV/AIDS control …

Perceptions Of Diversity, Equity, And Inclusion Within Undergraduate Curriculum And University: A Qualitative Study, Suzanne Grossman, Raihan Khan, Theresa Enyeart Smith

Department of Health Sciences - Faculty Scholarship

Objective

Diversity, equity, and inclusion (DEI) efforts are important at university campuses, especially preparing students for the workforce. This study aimed to identify perceptions of DEI among seniors related to their major curriculum and at the university.

Participants

In Spring 2021, 101 graduating seniors, who are future health professionals, completed an online survey.

Methods

Open-ended and multiple-choice survey items were analyzed. Thematic coding for open-ended questions and SPSS was used for the quantitative analysis.

Results

Analyses revealed the university kept students informed of DEI activities; however, more could be done. In the department, participants reported that classes focused on DEI …

Chronic Disease And The Inflammatory Body Burden: Social And Environmental Factors And Implications For Longevity, Catherine L. Zeman, Junu Shrestha, Raihan Khan, Ashley N. Oginz Wilson, Lisa A. Beltz

Department of Health Sciences - Faculty Scholarship

Everyday our body’s immune and detoxification systems are working to protect us from pathogens, cancerous cells, foreign substances, and chemical exposures. Declining trends in per capita longevity in the US suggest that these systems are being stressed beyond their natural resiliency. Several of these trends are discussed in light of funding for preventive vs. illness care. The authors then use a systems and interdisciplinary approach to introduce the immunobiological and biotransformation systems, and the concept of the exposome for those unfamiliar. The science of the immune and detoxification systems is explored considering the idea of chronic low-level inflammation. Additionally, new …