Medicine and Health Sciences Commons^™

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 …

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 …

Identifying The Molecular Pathways That Drive Retinal Degeneration In The Childhood Neurodegenerative Disease: Mucolipidosis Type Iv, Michael Pamonag

Masters Theses, 2020-current

Humans, like many other vertebrates, possess five Aristotelian senses (vision, olfaction, hearing, taste, and touch) which we use to experience and navigate our environment. Our visual system is the only source of light detection and light signaling in our bodies. This makes our visual system essential for detecting movement, distance, time of day, and seasonal changes in the length of days within our environment. The visual systems of most animals are designed to capture photons of visible light and convert that energy into a neurological signal (visual signal) to be transmitted to brain regions responsible for visual perception1 . This …

Stereo Hearing With Unilateral Bone Conduction Amplification, Megan Crouse

Dissertations, 2020-current

Abstract

Conductive hearing loss results when the neural integrity of the auditory system is healthy, but sound is prevented from reaching the cochlea in its entirety. Unilateral Congenital Aural Atresia (UCAA) is a birth defect in which there is no external ear canal, resulting in the reduction of sound able to reach the middle ear. Two primary options for correcting this conductive hearing loss are canalplasty or a bone anchored hearing device (BAHD). We want to compare the benefit level from these options, specifically in two conditions: sound localization and the ability to detect speech from one ear while there …

Alcohol Use In Women: Resources And Recommendations For Counselors, Samantha Haling

Educational Specialist, 2020-current

The research shows that alcohol use is rising rapidly among women, resulting in devastating consequences that have not been sufficiently explored in counselor education and training. This paper aims to address this by providing a review of the literature which shows that women are more vulnerable to many of the physical and mental health consequences of alcohol use than men, and that they have unique treatment needs and face gender-specific risk factors and barriers to treatment. The review examines the interaction between gender and alcohol use, summarizes the existing research on the physical and behavioral health consequences of alcohol use …

Relation Between Academic Advisor And Cohort Support With Well-Being In Graduate Students, Morgan Delong

Masters Theses, 2020-current

Well-being issues like the limitations of typical treatment protocols and common mitigating factors for mental health problems for graduate students, specifically the importance of therapeutic lifestyle changes (TLCs) were explored. The current study aims to determine if TLCs, individual engagement in the TLCs as well as support of them by mentors and peers, predict overall well-being, satisfaction with the graduate program, and job stress in masters’ students. This study was conducted during COVID-19 which is a limitation.

Pediatric Health Literacy, Morgan E. Sapper, Grace G. Lloyd

Senior Honors Projects, 2020-current

Abstract

Background: Unless you are a healthcare provider or licensed healthcare professional, understanding the United States healthcare system and its accompanying medical jargon can be confusing and overwhelming to try to navigate. Even more difficult is comprehending what resources are available to specific populations and how to gain the most benefit from these offered resources. Limited health literacy skills have been identified as the largest barrier in identifying an individual’s health outcomes. Health affects every stage of life. The purpose of this paper is to analyze what health literacy implementations look like as well as the age and developmental stage …

Alzheimer’S And Patient Caregiver Burnout: A Comprehensive Review Of The Literature, Madeline J. Hekeler

Senior Honors Projects, 2020-current

The term ‘silent epidemic’ has become fitting for Alzheimer’s disease, as it is now the sixth leading cause of death in the US. Caring for AD patients at home in the US costs billions of dollars each year. The current comprehensive literature review discusses the background/history of AD, pathology and modes of transmission of AD, behavioral and natural risk factors, prevention and treatment options, and how the aforementioned factors contribute to caregiver burnout and subsequently affect the AD patient. The extensive examination of the literature determined several gaps to be addressed. More specifically, burnout among AD caregivers has become an …

Integrating Ethics And The Opioid Crisis Via Simulation: An Ethical Debriefing For Nursing Students, Raigan A. J. Shackelford

Senior Honors Projects, 2020-current

Over the past three decades, opioid medication misuse and abuse has skyrocketed. The increase in improper use has created the need for more frequent exercise of ethical reasoning skills in practice. This study was designed to determine the effect of an ethics-centered debriefing exercise following a standardized simulation scenario concerning opioid misuse/abuse on nursing students’ value of and perceived confidence in ethical reasoning skills. 18 senior level BSN students at James Madison University in Harrisonburg, VA, participated in an ethics- focused debriefing exercise following the simulated scenario. The debriefing was constructed using the ANA Code of Ethics and James Madison …

Academic Stressors, Perceived Stress, And Coping Strategies Among Undergraduate Students, Danielle J. Levin

Senior Honors Projects, 2020-current

Stress is common among college students and is a predominant factor interfering with academic performance. This study evaluated how college students perceive their level of stress, the coping strategies used, and the use of resources to offset stress offered by the university. This study showed that overall, undergraduate students at JMU experienced moderate levels of stress. Pressure to succeed, balancing coursework, and lack of motivation were the most prevalent academic stressors experienced by students. This study provides evidence that perceptions of stress greatly impact student behavior and use of coping strategies. Variation in coping strategies among students highlights the importance …

Objective Detection Of Vestibular Evoked Myogenic Potentials, Daniel J. Romero

Dissertations, 2020-current

Cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs, respectfully) are considered objective tests of vestibular function measured using surface electromyography (EMG). In addition, VEMPs are visually detected by an examiner, often requiring a high level of stimulation to the ear to easily visualize a waveform plotted across time. However, a high level of stimulation, like those used during routine VEMP testing, is problematic since it has been shown to be unsafe in children when compared to adults. Visual interpretation can also vary between examiners in cases of reduced vestibular function or when the level of required muscle contraction …

Fucoxanthin: A Review Of Potential Benefits Relative To Human Health, Michael R. White

Masters Theses, 2020-current

Fucoxanthin is a carotenoid sourced and extracted mainly from dark orange and brown seaweeds found in the pacific ocean, such as the wakame algae. The allenic bonds and unique oxygen groups give fucoxanthin its unique structure and are thought to be part of the reason fucoxanthin has unique physiological functions. Fucoxanthin has potentially numerous effects on the physiology of human health, ranging from skin health to metabolic health, which have been demonstrated in animal model research. The goal of this review is to examine current literature to discuss fucoxanthin’s potential application as a nutraceutical, treatment for obesity, type 2 diabetes, …

The Influence Of Side-Lying Position On Oropharyngeal Swallow Function In At-Risk Infants: An Exploratory Study, Julian White

Dissertations, 2020-current

Speech-Language Pathologists (SLP) are the primary healthcare providers responsible for the evaluation and treatment of infant feeding and swallowing disorders. At-risk infants, such as those born prematurely or with certain medical conditions, are more prone to swallowing impairments (i.e., dysphagia). Dysphagia in at-risk infants can have severe consequences such as chronic respiratory symptoms, pneumonia, progressive lung disease, undernutrition, and death. Therefore, it is important to have methods of examining an infant’s swallow functioning that are both safe and accurate. A leading method of evaluating infant swallowing is the Modified Barium Swallow Study (MBS). The works contained within this dissertation document …

Influence Of Musicianship, Socioeconomic Status, And Working Memory On Children’S Speech Recognition In Noise, Victoria H. Whitney

Dissertations, 2020-current

Superior speech recognition in the presence of background noise has been repeatedly observed among musicians. For children whose auditory skills are immature or delayed, improved speech-in-noise understanding via musical training could have significant clinical implications. The present study considered the impact socioeconomic status (SES) and working memory have on musicians’ greater skill during such tasks in order to better understand the mediating factors of the proposed musician advantage, as well as provide additional evidence of its existence. Participants were recruited by the Laboratory for Auditory Perception in Children and Adults at James Madison University. Ultimately, twenty-five normal-hearing children between the …

Physical Activity In A University Community Before And After A Covid-19 Shutdown, Brynn Hudgins

Masters Theses, 2020-current

Reaching recommended levels of physical activity (PA) is important for achieving and maintaining health, however there are many potential barriers which may impact an individual’s ability to engage in PA. The COVID-19 pandemic resulted in the transition to remote teaching and learning, shut-downs of places to engage in PA, and changes to the daily work routine of university staff. Therefore, overall PA levels were likely impacted. The purpose of this study was to assess whether a significant change in PA occurred before and after one university transitioned to remote learning and working due to COVID-19 shutdowns. Subjects were recruited from …

Fucoxanthin: A Review Of Potential Benefits Relative To Human Health, Michael R. White

Masters Theses, 2020-current

Fucoxanthin is a carotenoid sourced and extracted mainly from dark orange and brown seaweeds found in the pacific ocean, such as the wakame algae. The allenic bonds and unique oxygen groups give fucoxanthin its unique structure and are thought to be part of the reason fucoxanthin has unique physiological functions. Fucoxanthin has potentially numerous effects on the physiology of human health, ranging from skin health to metabolic health, which have been demonstrated in animal model research. The goal of this review is to examine current literature to discuss fucoxanthin’s potential application as a nutraceutical, treatment for obesity, type 2 diabetes, …

Rationale For Participation In Jmu Worksite Wellness Programs, Rebecca Mathien

Masters Theses, 2020-current

Effective employee wellness programs require an adequate understanding of the needs of employees. An employee wellness needs assessment was created to target the understanding of specific topics of interest, incentives and barriers to participation, and general health status of university employees. The majority (74.1%) of the 639 survey respondents (15.3% response rate) were female (age 45.7 ± 11.7 years), full-time employees. Employees were most interested in participating in programs involving physical activity, nutrition, and lifestyle wellness. Stages of change related to these topics include physical activity (pre-action: 42.3% and action: 44.7%), nutrition (pre-action: 37.4% and action: 42.2%), and work/life balance …

How College Men Describe Their Understanding Of Sexual Assault, Sarah Anolik

Dissertations, 2020-current

Despite the proliferation of many vital bystander intervention programs across the country, approximately one in four college women will experience sexual violence. Though it was once believed that a small minority of men were responsible for the vast majority of sexual violence, an estimated 12%-25% of college men report having used sexual violence as an undergraduate student. Research across disciplines suggests several factors associated with the perpetration of sexual violence. While numerous studies have explored these constructs quantitatively on and off college campuses, there have been far fewer qualitative studies that provide insight into how men who have perpetrated violence …

Language Sampling With Older School-Aged Children: Examination Of Analyses And Sampling Contexts, Michelle Lenhart

Dissertations, 2020-current

Purpose: Conversation, narrative, and expository language sampling contexts are recommended for school-aged children (Pezold et al., 2020), and multiple ways to analyze these samples have been promoted in the clinical literature. This dissertation addressed two gaps in the literature related to analyses and sampling contexts. The purpose of study one was to examine differences in two commonly-used language sample analysis methods, Sampling Utterances Grammatical Analysis Revised (SUGAR) and Systematic Analysis of Language Transcripts (SALT). The purpose of study two was to examine the presence of age-related changes in conversation, narrative, and expository contexts for older school-aged children.

Method: Conversational, narrative, …

Dual Task Study Of Cognitive And Postural Interference: Development Of A Methodology For Use In Vestibular Disorders, Valerie Beacham

Dissertations, 2020-current

For patients with vestibular impairments, postural stability alone can be demanding but is more taxing when an individual’s attention is focused on both maintaining balance and a secondary/cognitive task simultaneously. Thus, dual task paradigms where balance must be maintained while performing postural and cognitive tasks concurrently provides an assessment on one’s attentional resources available for balance. Previous studies show varying levels of dual task effects in patients with vestibular loss with little consistency between studies regarding choice of balance and cognitive tasks. The purpose of this study was to assess the feasibility of a dual task paradigm using portable instrumentation …

Assessing Word Recognition Through Head Turn Preference In Infants With Chronic Otitis Media, Allison E. Schmidt

Dissertations, 2020-current

Previous studies across a variety of different languages have shown that eleven-month-olds tested via the head-turn preference paradigm show a preference for familiar words over unfamiliar words, as demonstrated by longer look times. This study examined the effect of chronic otitis media on the preference for familiar over unfamiliar words. Nine eleven-month-old children (mean age 342 days, SD = 9.61) with chronic ear infections, defined as three or more diagnoses before the test date, were tested using wordlists adapted from a study performed by Vihman et al. (2004). Children with a history of chronic otitis media did not show a …

Effect Of A Small Change In Auricle Projection On Sound Localization, Elizabeth N. Surface

Dissertations, 2020-current

Pinnae assist in sound localization, and changes in auricle shape, position, or projection can theoretically alter the perceived position of a sound. The minimal displacement required to affect perceived sound location is undefined. This study quantified the error in horizontal sound localization when auricle projection is slightly decreased. The study was conducted at two sites by different experimenters, using different (though similar) systems, over a year apart. There were 21 normal-hearing participants: 11 at the University of Virginia (UVA) and 10 at James Madison University (JMU). Both UVA and JMU protocols involved a normal listening condition and a second condition …

Weight And The Therapeutic Relationship: Implications For Counselors, Emily Shank

Educational Specialist, 2020-current

Central to the healthcare system in the United States is the belief that weight is an accurate measure of health. This belief, which is the foundation of the Weight Centered Health Paradigm (WCHP), is linked to the proliferation of diets, weight cycling, and weight stigma. However, a growing body of research indicates that higher weight is not necessarily linked to negative health outcomes and that the impact of weight cycling and weight stigma pose far greater risks to health. Counselors and other mental health professionals function within the weight-normative healthcare system in the United States and are faced with the …