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 …

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 …

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 …

The Directional Effect Of Target Position On Spatial Selective Auditory Attention, Heesung Park

Dissertations, 2020-current

Spatial selective auditory attention plays a crucial role in listening in a mixture of competing speech sounds. Previous neuroimaging studies have reported alpha band neural activity modulated by auditory attention, along with the alpha lateralization corresponding to attentional focus. A greater cortical representation of the attended speech envelope compared to the ignored speech envelope was also found, a phenomenon known as 'neural speech tracking’. However, little is known about the neural activities when attentional focus is directed on speech sounds from behind the listener, even though understanding speech from behind is a common and essential aspect of daily life. The …

Terror Management And The News: An Exploration Into The Effects Of Framing On Mortality Salience, Peter Montwill

Masters Theses, 2020-current

The present study explores the link between Terror Management Theory and the use of its principles within news media. Political news media in the digital age undergoes a variety of framing effects, more specifically episodic and thematic frames of stories. To induce mortality salience, college-aged participants were presented with stories framed from the perspective of an individual’s experience or a general theme of experiences regarding the controversial pro-life topic and a non-controversial hiking topic. These stories are presented in the style of Instagram posts to mirror how college-aged people consume news media. The stories also contain wording designed to induce …

Effects Of Age On Amplitude-Modulated Cvemp Temporal Modulation Transfer Function, Raghav H. Jha

Dissertations, 2020-current

With the aging population on the rise, the need for effective assessment tools to identify risk factors for falls among the elderly is paramount. One independent risk factor for falls is vestibular impairment, but the available vestibular diagnostic tests have limitations. A promising new methodology: amplitude-modulated tones to elicit a vestibular-evoked myogenic potential (AMcVEMP), offers a more detailed examination of vestibular (sacculo-collic reflex) functions. This method assesses non-linearities, synchrony, and magnitude, providing a more thorough evaluation compared to the conventional transient cVEMP. So far, AMcVEMP has only been utilized in young adults.

The current study aimed to investigate the impact …

Medical Interpreters' Work Impact On Their Lives: Understanding Medical Interpreters' Work Experience, Nicholas M. Herrarte Smith

Senior Honors Projects, 2020-current

Medical interpreters in the US are crucial health workers that specialize in facilitating communication between non-English-speaking patients and English medical professionals. Although much research has been done regarding the positive impact of professional medical interpreters on LEP (limited English proficient) patients' health, it is less known how medical interpreters’ lives are impacted in this line of work. Thus, this study was aimed at gaining a better understanding on the impact that this line of work has on the lives of medical interpreters. For this study, a survey was created with questions regarding demographics, interpretation’s certification process, interpreter’s satisfaction/experience, and mental …

Age-Related Decline In Neural Synchrony And The Ffr, Haley Szabo

Dissertations, 2020-current

It is a known phenomenon that speech understanding in background noise declines with advancing age. Although there is ample evidence of behavioral measures declining with age, there is less physiologic evidence. This study hypothesizes that the FFR will be degraded with advancing age, consistent with poorer phase locking. This is hypothesized to be present even in people with audiograms within normal limits. A second hypothesis is that middle-aged adults will have degraded neural representation as frequency increases, compared to a younger normal hearing group which will have better high frequency neural representation than the middle-aged group. Subjects were divided into …

The Impact Of Sleep Quality Combined With Physical Activity On Autonomic Function (24-Hour Hrv) In College Students, Meghan Peterson, Trent Hargens, Elizabeth Edwards, Christopher Womack

Masters Theses, 2020-current

Long-term poor sleep quality is associated with health outcomes that can lead to autonomic nervous system dysfunction. Both cardiorespiratory fitness and physical activity (PA) are associated with improvements in autonomic function and heart rate variability (HRV). Markers of fitness and sleep were explored to determine the degree of contribution to autonomic dysfunction. A total of 15 subjects, (age = 20.6±0.5; BMI = 23.9±1.0) completed 7 days of physical activity and sleep assessment via accelerometry. Participants then completed a graded exercise test to determine cardiorespiratory fitness (VO_2max), followed by a 24-H HRV measurement. HRV through LF:HF ratio was negatively …

Impact Of Diabetes Mellitus On Vestibular Function: A Scoping Review, Ellen M. Jones

Dissertations, 2020-current

Diabetes mellitus (DM) encompasses a group of metabolic diseases that result in high blood sugar (i.e., hyperglycemia). By 2030, it is anticipated that 578 million adults worldwide will have DM, with this number growing at a faster rate in developed areas of the world.^[27] If left uncontrolled, DM can cause considerable damage to several areas of the body, including the heart, kidneys, nerves, and ears. When focusing exclusively on the ears, there has been markedly less research on the vestibular system when compared to the auditory system, even though DM is a known risk factor for falling. The purpose …

Assessing Word Recognition In Infants With A History Of Chronic Otitis Media, Sarah Wright

Dissertations, 2020-current

Otitis media (OM) is a common ear-related disorder diagnosed in children that can cause a temporary conductive hearing loss. The fluctuating hearing loss may alter auditory processing which may interfere with language development while impacting quality of life for infants and their caregivers (Homøe et al., 2019). In several languages, eleven-month-old infants have shown a preference for familiar words over unfamiliar words using the head-turn preference paradigm. This study examines the effect of chronic OM on the preference for familiar or unfamiliar words in eleven-month-old infants. Fourteen eleven-month-old infants (mean age 344 days) with three or more diagnosed ear infections …

Reality Of Counseling In Pediatric Audiology Clinical Practice, Lara Leggio

Dissertations, 2020-current

The overwhelming nature of hearing loss identification often causes families to experience grief and confusion. Children as young as nine months old with severe hearing loss have the option to undergo cochlear implantation (CI) surgery with the hopes of restoring normal hearing. Pediatric audiologists accompany families through the identification of hearing loss and the learning process that coincides with this surgery. Despite knowledge that parents of children with communication disabilities will experience a sense of loss and have moderate to severe cyclic emotional reactions, little is known about how audiologists manage the emotional needs of families, if they feel prepared …

Magnitude Estimates Of Angular Motion: Perception Of Speed And Spatial Orientation Across Visual And Vestibular Modalities, Erin Hernon

Dissertations, 2020-current

Both the vestibular system and optokinetic system generate conjugate eye movements in response to either movement of the head or movement of the visual surround. Both systems help to maintain gaze stability. While the VOR is most sensitive to input frequencies above .2 Hz, the optokinetic system helps maintain gaze stability at lower frequencies. Previous research on perceptual thresholds across the two sensory modalities shows that there are frequency-dependent differences between vestibular and visual perception. The purpose of this study is to extend previous vestibular psychophysics work by 1) comparing magnitude estimates from vestibular stimulation to visual stimulation across multiple …

Role Of Emg Monitoring On Cvemp Testing In Preschool Age Children, Brenna Murray

Dissertations, 2020-current

While cervical vestibular evoked myogenic potential (cVEMP) testing has largely been studied and practiced on the adult population, less is known about the best practices for performing cVEMPs on a pediatric population, especially in young children under the age of 5 years. Further, very young children (i.e., 2-3 years) often prefer to sit with their caregiver during the testing, yet there is very little data on how much electromyographic (EMG) activity a child generates if in a seated position as opposed to a supine position. The purpose of this study was to assess the role of EMG on cVEMP recordings …

Exploring Barriers To Rural Mental Health Practice: A Pilot Study, Caitlin Vu

Educational Specialist, 2020-current

There is a shortage of mental health professionals in rural areas around the world. Current literature on barriers to healthcare professionals choosing to practice in rural areas mainly focuses on medical professionals, with few studies examining the barriers to rural practice for mental health professionals. Along with examining the perceived barriers and enablers to rural mental health practice, researchers wanted to further examine the reliability of the revised Barriers to Rural Mental Health Practice instrument. Researchers distributed the survey to mental health professionals across the United States. Preliminary findings support high internal reliability for the total scale and three of …

Registered Nurse-Led Annual Wellness Visits In Rural Health Clinics: A Program Evaluation Of A New Role, Tina Switzer

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

The passage of the Patient Portability and Affordable Care Act had a goal of increasing access for preventive care. The Medicare Annual Wellness Visit (AWV) has been a free yearly, comprehensive preventive care opportunity for most Medicare beneficiaries since 2011. Because of the time intensive nature of these visits, the overall national completion rate for them has been low as providers often perceive time and resource constraints. Registered Nurses (RNs) have the skill set to complete these visits with minimal provider involvement. Rural residents often face health care access barriers and outcome disparities, and Rural Health Clinics (RHCs) are a …

Improving Glycemic Control During The Covid-19 Pandemic: A Quality Improvement Project, Megan Henderson

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

Diabetes is a costly, chronic health condition. The COVID-19 pandemic has significantly impacted the delivery of health care and exacerbated chronic health conditions, such as diabetes. Diabetes is one of the most significant comorbid conditions associated with poor COVID-19 outcomes (Cariou et al., 2020). Control of blood glucose levels during the COVID-19 pandemic has proved challenging to maintain. The purpose of this quality improvement project is to identify gaps in diabetic self-care and then implement a diabetic toolkit to improve self-efficacy of diabetes self-management. According to the American Diabetes Association (2022), self-management of diabetes, education, and support from providers is …

Developing A Quality Improvement Process: Impacting Patient Outcomes And Achieving Ambulatory Accreditation, Colleen E. Nappi

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

Colon cancer is the second leading cause of cancer deaths in the United States (US) and colonoscopy is the best method for screening and detecting cancer before symptoms are present. A colonoscopies' ability to detect precancerous lesions or identify colorectal cancer (CRC) relies on patients having a high-quality bowel preparation. The US Multi Society Task Force (USMSTF) on colorectal cancer set quality standards for colonoscopy including bowel preparation quality, adenoma detection, and cecal intubation times. As a private gastroenterology practice in Northern Virginia was preparing for re-accreditation with the Accreditation Association for Ambulatory Health Care (AAAHC) it was determined that …

Improving Access For Medicare Inpatient Psychiatric Patients: A Health Policy Analysis, Malinda B. Whitfield

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

The Medicare Inpatient Psychiatric Services (IPS) policy, originally developed in the 1960s and without any significant or meaningful updates since the 1980’s, is physician specific, does not reflect the current model of care for psychiatric inpatients, and is restrictive for psychiatric mental health nurse practitioner (PMHNP) practice. The policy is complex, consists of outdated regulations, and results in millions of dollars in compliance costs for Inpatient Psychiatric Facilities (IPFs) annually (NABH, 2019). Although clearly an important part of the inpatient psychiatric services team, PMHNPs are not identified or defined in the policy (Center for Medicare and Medicaid Services [CMS], 2019). …

Implementing Routine Depression Screening In An Urgent Care Setting: An Implementation Science Project, Lori Conyers

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

Identifying patients with depression is essential, and early detection of depression leads to early intervention. Routine screening of patients for depression is the responsibility of the primary care provider, but many patients have not had a primary care visit in the recent past. Those patients without a primary care provider are likely not being screened for depression. Urgent care (UC) may be the best opportunity to screen patients who do not have a medical home. However, the dynamic nature of the urgent care setting may dissuade staff from engaging in routine screening. As a quality improvement (QI) effort, regular PHQ …

Postoperative Atrial Fibrillation Prevention: A Quality Improvement Project, Emily O. Schneiderman

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

Postoperative atrial fibrillation remains one of the most common complications after cardiac surgery despite surgical and medical advances in the field. While generally transient, postoperative atrial fibrillation increases long-term morbidity and mortality, hospital length of stay, and financial obligation. The postoperative heart's unique chemical and physical properties make tactics for preventing and treating postoperative atrial fibrillation differ from classic atrial fibrillation management. This quality improvement project utilizes a care bundle for non-pharmacologic measures and early beta-blockade administration to reduce the incidence of postoperative atrial fibrillation. Implementation of this care bundle establishes a standard of care, increases clinician knowledge and accountability, …

Narrative Review: Food Image Use For Machine Learnings’ Function In Dietary Assessment And Real Time Nutrition Feedback And Education, Jason Fee

Masters Theses, 2020-current

Technology has played a key role in advancing the health and agriculture sectors to improve obesity rates, diseasecontrol, food waste, and overall health disparities. However, these health and lifestyle determinants continue to plague theUnited States population. While new technologies have been and are currently being developed to address these concerns, they may not be practical for the general population. Utilizing machine learning advancement in food recognition using smartphone technology may be a means to improve the dietary component of nutrition assessments while providing valuable nutrition feedback. This narrative review was conducted to assess the current state of the literature on …

The Rationale For The Utilization Of Under Desk Bikes In Office Settings, Danielle Little

Masters Theses, 2020-current

Inactivity and sedentary behavior are major health concerns, exacerbated by the amount of time individuals spend at work. Purpose: To examine if 30-60 minutes of daily under-the-desk bicycle (UDB) use while working for 8 weeks helped sedentary and physically inactive adults reach the U.S. physical activity guidelines (PAG) and improve perceptions of wellness and job satisfaction. Methods: Subjects (n=22, average age=45.3 yrs, average BMI=30.2 kg/m2) cycled for 30-60 minutes on workdays for 8-weeks at a self-selected intensity level of 2 or 3 out of 8 total levels. Participants were advised not to engage in additional physical activity outside the study …

Dynamic Measures Of Referential Communication Reveal Hidden Pragmatic Strengths For Adolescents With Autism Spectrum Disorder, Mariana Schreuders

Senior Honors Projects, 2020-current

The ability to communicate effectively and efficiently while maintaining mutual understanding is a fundamental aspect of human-to-human interaction. Studies have shown that individuals with autism spectrum disorder (ASD) face challenges in areas of social communication skills, such as aspects of referential communication; or the ability to refer to things in such a way that a listener will know what the speaker is describing. The current study used data from a preexisting Barrier study to compare the referential communication abilities of school-aged children with ASD to those of neurotypical children (NT). Referential communication was observed during a barrier task, where participants …

Pre-Pulse Inhibition In Mutated Mice: Studying Compromised Microglial Cells To Discover New Genetic Connections To Autism, Bailey R. Kramarik

Senior Honors Projects, 2020-current

Microglial cells “play a pivotal role in refining neural networks during early critical periods” (Gabriele & Gray, 2020, p. 1). A disturbance in the functioning of these microglial cells contribute to specific characteristics of some neurodevelopmental disorders- including autism spectrum disorder. In this study, we used a mouse model to study disruptions in cell activity, as understanding the biological and genetic background of autism spectrum disorder could help us provide better treatment and therapy options to those diagnosed.

The mutated mice in this experiment have microglial cells with “compromised fractalkine signaling” (Gabriele & Gray, 2020, p. 4-5). We studied multimodal …

Intercorrelations Between Essentialist Beliefs And The Social Identities Of Religion, Political Affiliation, And Nationality, Truman Deree

Senior Honors Projects, 2020-current

In this study, I investigated the relationships between political identity, religious identity, and national identity, as well as related attitudes about essentialism. I hypothesized that having essentialist attitudes about one identity group will correlate with having essentialist attitudes about other identities. I also predicted that the more important an identity is to one’s sense of self, the more likely they will be to hold essentialist attitudes about that identity. Finally, I predicted that having a Republican identity positively correlates with essentialist views of one’s national identity. In this paper, I discuss the theoretical basis, as well as the method, sampling …