Medicine and Health Sciences Commons^™

Delayed Umbilical Cord Clamping: A State Of The Science, Landynn E. Ouellette

Senior Honors Projects, 2010-2019

The purpose of this paper is to explore the state of the science related to delayed versus early umbilical cord clamping. This interprofessional change in practice and protocol needs to take place within obstetric practice, which can be made up of obstetricians, midwives, nurse practitioners, and nurses. Patients must be educated by their providers so that they can better understand the care being performed. A search of the literature published through PubMed was conducted using the key phrases delayed umbilical cord clamping (DUCC), benefits of delayed cord clamping, and umbilical cord protocols. The search yielded 133 titles, which was limited …

The Hemostatic Effects Of Acute Exposure To Colored Cornstarch Powder During A 5k Run, Robert C. Allsbrook

Senior Honors Projects, 2010-2019

PURPOSE: To examine the acute hemostatic effects of particulate matter (PM) in the form of colored corn starch powder during a 5 kilometer race. METHODS: 10 recreationally active adults completed two 5k runs, one with color and one without color. 10 mL blood samples were taken 6 hours prior to the trial and immediately following the trial. PAI-1 activity, FVIII antigen, and tPA activity were measured using an ELISA. RESULTS: No significant main effects or interaction effects (P<0.05) were observed among any of the variables although a trend (P = 0.082) was observed for increased PAI-1 activity during exercise in the color condition. CONCLUSIONS: There is a trend towards increased PAI-1 activity levels during exercise during color runs that could be due to increased inflammation. Furthermore, the lack of increased FVIII:ag and tPA activity suggests that the intensity of the exercise may not have been adequate and further research should be conducted in this area.

Using Community Health Workers In Collaboration With Nurse Case Managers In Effecting Change In Quality Of Life For Heart Failure Patients, Patra Hull Reed

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

This project was designed to evaluate the effectiveness in improving the quality of life among heart failure patients with the addition of the role of Community Health Worker (CHW) to a current continuum case management model. The study also addressed the increased need for more appropriate and cost-effective chronic care management for heart failure patients. Hospitals and healthcare systems are being challenged to find innovative ways to decrease readmissions, decrease unnecessary emergency room visits, increase patient adherence, and manage chronic disease, all improving the patient’s overall quality of life. Studies show that approximately 76% of heart failure patients have a …

Procedural Sedation: Policy, Practice & Knowledge, Jennifer A. Martin

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Diagnostic and invasive procedures performed outside of the operating room with nurse- administered procedural sedation are increasing. As procedural sedation practice national guidelines are evolving, there are inconsistent state regulations and a great deal of variability in staff training. These challenges lead to potential knowledge gaps and practice variation that create unsafe patient environments. A local hospital has continued to experience near miss events when procedural sedation is administered. In an attempt to investigate this issue and create improved practice, an organizational policy analysis was conducted. The aims of this project were to: 1) analyze current hospital policy content compared …

Shared Decision Making For The Appropriate Use Of Antibiotics For Respiratory Tract Infections, Kristina Blyer

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Objective- Determine the effectiveness of shared decision making to 1) increase decisional comfort with the appropriate use of antibiotics for respiratory tract infections and 2) maintain antibiotic prescribing rates at current levels.

Participants- English speaking college students age 18 and over diagnosed with a respiratory tract infection in the general medical clinic of a university health center from August 31, 2015-May 6, 2016.

Methods- Pre- and post-intervention surveys used to measure decisional conflict of students. Intervention included staff training in shared decision making and the use of a decision aid in clinical practice.

Results- Students who received routine care …

Implementing Post-Hospital Interprofessional Care Team Visits To Improve Transitions Of Care And Decrease Hospital Readmission Rates, Stacy M. Baldwin

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Background: Today’s healthcare climate is comprised of a population of patients who are more complex, presenting with multiple comorbidities, and requiring frequent hospitalizations. It is imperative for acute care and primary care landscapes to bridge silos and form collaborative relationships to ensure safe and effective transitions of care from hospital to home. An interprofessional, post hospital follow-up clinic is one approach that can be utilized to improve transitions of care and decrease preventable hospital readmissions.

Purpose: The purpose of the project's discharge clinic was to improve transitions of care and decrease thirty day hospital readmission rates. The primary objective of …

Segregation Or Integration: Exploring The Interprofessional Collaboration Of The Sexual Assault Response Team-A Pilot Study, Phyllis E. Adams

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The Sexual Assault Response Team (SART) has been functioning since the early 1970’s with little research on the dynamics of the members’ interprofessional collaboration practice. A current gap in the literature is research specific to the assimilation of the disciplines within the SART and the collaborative practice of the SART. The purpose of this project study is to clarify the 12 subscales of Interprofessional Collaborative Practice (motivation, role expectations, personality style, professional power, group leadership, communication, coping, social support, organizational culture, organizational aims, organizational domain, and organizational environment) and explore how each profession perceives these subscales. The sample participants were …

A Systematic Review Of Complimentary Therapies To Treat Symptoms Of Post-Traumatic Stress Disorder In The Aftermath Of Domestic Abuse, Jordan A. Meeks, Saida Byrami

Senior Honors Projects, 2010-2019

Objectives: Explore the impact of intimate partner violence (IPV) on the health of female survivors. Identify complementary therapies that alleviate symptoms of psychological health impacts of IPV on women’s health.

Method: An exhaustive search of published, peer reviewed literature on complementary therapies and IPV was conducted. Databases included PubMed and CINAHL. Each article reviewed was published between the years of 2002 and 2016. The initial search produced 112 articles, abstracts of all studies were reviewed and studies were included if they addressed; a) complementary and alternative therapies, b) post-traumatic stress disorder, anxiety, and depression and, c) the impact of IPV …

Caffeine Mouth Rinsing In The Fed State Does Not Enhance 3-Km Cycling Performance In The Morning Or Evening, Kayla Sweeney

Senior Honors Projects, 2010-2019

PURPOSE: To assess the effect of a caffeine mouth rinse on performance at different times of day. METHODS: 12 recreational cyclists completed a simulated 3-km time trial and 4 sets of 5 leg extension repetitions, twice in the morning and twice in the evening. 25 ml of 1.14% caffeine, or placebo solution was mouth rinsed before sets 3 and 4 of the leg extension and before the time trial. Treatments include: caffeine + morning, placebo + morning, caffeine + evening, and placebo + evening. RESULTS: The caffeine rinse had a negative impact on time trial performance in both the morning …

Improving Provider Compliance Of The Naepp 2007 Asthma Guidelines Through The Electronic Health Record (Ehr) In A Pediatric Primary Care Practice, Tiffany L. Kidd

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The Expert Panel Report -3 (EPR3) NAEPP 2007 evidence-based clinical asthma guidelines were developed to provide evidence-based high-quality patient care that leads to improved outcomes. A literature review showed that healthcare providers do not routinely follow the asthma guidelines. The purpose of this project was to develop and implement an evidence-based asthma electronic health record (EHR) template in a pediatric office to improve provider compliance to the guidelines resulting in improved outcomes for children with asthma. The study was conducted over a period of four months from January - April 2016. An EHR asthma protocol template and training for providers …

Examining The Implementation Of The Patient-Centered Recovery Model In Psychiatric Nursing, Nicole K. Rossi

Senior Honors Projects, 2010-2019

The Recovery Care Model is the recommended evidence-based model for delivering holistic, patient-centered care for mental health clients. The model is a more therapeutic approach than the traditional medical model and upholds the ideas that psychiatric clients are more than just their illness, should be respected as unique individuals, and provided with hope and empowerment in their care while being given the opportunity for informed and autonomous decision-making. Although research has shown support for the Recovery Care Model, its implementation has not been fully accomplished in all psychiatric facilities. Of all of the members of the health care team, nurses …

Hemostatic Responses To Exercise In A Polycythemia Vera Patient, Allison M. Huschke

Senior Honors Projects, 2010-2019

PURPOSE: To assess the hemostatic responses to exercise in a patient with Polycythemia Vera (PV). METHODS: Six female runners (≥15 miles/week) completed a maximal treadmill test. One subject had PV while the other five subjects made up the comparison group. Blood samples were taken before and within two minutes after exercise. VO2max was also recorded. RESULTS: Pre-exercise Factor VIII and tPA-antigen were similar in the PV subject and comparison group. Factor VIII and tPA-antigen increased dramatically in the PV subject (+100%, +1000%) in relation to the comparison group (+22.9 ± 8.7%, +108 ± 78%) after exercise. Pre-exercise PAI-1 was lower …

The Effect Of Chronic Obstructive Pulmonary Disease On Swallowing, Jessica R. Torres

Senior Honors Projects, 2010-2019

This work is composed of a literature review, research review, and self-reflective essay. The anatomy and physiology of normal swallowing and respiration are reviewed. Additionally, the effect of chronic obstructive pulmonary disease (COPD) on these processes is discussed. The research goal was to determine how lung volume changes adapt the physiology of swallowing in individuals with COPD. The research project was designed and conducted by Teresa Drulia, M.S., CCC-SLP. COPD participants (n=9, mean age=72, 6 male) were compared to older healthy individuals (n=10, mean age= 59, 3 male). Participants completed swallows of 20cc of water at four lung volume conditions: …

The Effects Of Lung Volume On Swallowing In Chronic Obstructive Pulmonary Disease, Teresa C. Drulia

Dissertations, 2014-2019

Chronic Obstructive Pulmonary Disease (COPD), a respiratory disease that leads to reduced airflow, may result in difficulty swallowing with disease progression. The coordination between the respiratory and swallowing systems decouple and they may experience increased risk of aspiration. This study aimed to determine the effects of lung volume on swallowing in individuals with COPD compared with older healthy. Specifically, the study examined if altering lung volume at the time of the swallow changed swallowing timing, specifically pharyngeal swallow duration, and impacted the respiratory-swallow pattern in individuals with COPD. Measurement of estimated lung volume (ELV), pharyngeal swallow duration, and respiratory-swallow patterning …

Cancer Perceptions And Health Behaviors In Tazewell County, Virginia, Sarah E. Waddle

Senior Honors Projects, 2010-2019

Tazewell County is a community the citizens feel is plagued by cancer. This concern was so great the county officials requested a study be done by a local university, Virginia Polytechnic Institute and State University (Virginia Tech), to explore potential external factors causing these perceived high rates of cancer within the community. The results of the Virginia Tech study found the rates of cancer were no higher in Tazewell County than elsewhere in the state of Virginia. The purpose of the current study was to explore the idea of perceptions and the effect they may have on the health behaviors …

The Effect Of Depression On Bone Mineral Density In College-Aged Females, Caitlin A. Cadematori

Senior Honors Projects, 2010-2019

Research regarding the relationship between depression and bone mineral density (BMD) has produced very inconsistent and limited results, especially in younger females. The purpose of this study was to examine the relationship between depression scores and BMD in college-aged female students. Forty-six participants, ages 18-24 (+/-1.0368) completed a 24-hour dietary recall, medical history, Beck’s Depression Inventory and the Depression, Anxiety, and Stress Scale (DASS) and had their femur and sacral vertebrae BMD, z-score, and t-score measured in the Dual X-Ray Absorptiometry (DXA) machine. Participant demographics were analyzed with descriptive statistics and potential variable correlations were analyzed by partial and bipartial …

The Effect Of Simulations On Nursing Students’ Ethical Reasoning Confidence In Disasters: A Pilot Study, Sara E. Greco

Senior Honors Projects, 2010-2019

This study measured the effect of a disaster nursing simulation and debriefing session on senior BSN students’ perceived ethical reasoning confidence and their belief in the importance of ethical reasoning. Using a quasi-experimental design, this study compared participants’ responses before and after the interventional activities using the Survey of Ethical Reasoning. Post-test results demonstrated an increase in students’ perceived ethical reasoning confidence, perceived importance of ethical reasoning, and utilization of James Madison University’s Eight Key Questions Ethical Reasoning Framework.

Type And Location Of Speech Disruptions In Adolescents With And Without Specific Language Impairment, Katherine E. Davies

Senior Honors Projects, 2010-2019

This research project analyzed the types and locations of speech disruptions in adolescents with and without Specific Language Impairment (SLI). The narrative samples of 12 adolescents with SLI and 12 typically developing (TD) adolescents were analyzed. Using Schwalbe’s (2012) classification system, the speech disruptions in the 24 narratives were coded for the type and reason for disruption. The broad category of speech disruptions were classified under revisions, repetitions, filled pauses and orphans, and silent pauses. The reason for the disruption was coded as the part of speech of the word that was determined to have caused the disruption. Comparisons were …

Clinical Study Of Canine Tear Lacritin As A Treatment For Dry Eye, Katherine E. Kelly

Senior Honors Projects, 2010-2019

Keratoconjunctivitis sicca (KCS), the deficiency of tears also known as dry eye, is a prevalent disease that affects both humans and canines. The current treatment for dye eye, cyclosporine (Restatis®), only provides temporary relief, is often associated with discomfort and is inconsistently effective. Lacritin is a naturally occurring tear glycoprotein secreted from the human and canine lacrimal glands. It has been shown that lacritin stimulates basal tearing in rabbits when applied topically. This study characterized the amount and form of lacritin found in the tears of dogs with healthy and dry eyes—information which may be applied to the development of …

Applying The Social Cognitive Theory To The Hookup Culture Embodied In The Undergraduate Students Of James Madison University, Jacqueline M. Crawford

Senior Honors Projects, 2010-2019

The hookup culture on college campuses is creating a social shift away from traditional dating. The social influence of this culture could potentially be explained through the use of the Social Cognitive Theory (SCT). The SCT examines the effects of peer influence, environmental influence, and personal beliefs on individual behavior. The current study applied the SCT to the hookup culture embodied in the undergraduate student body at James Madison University. Research found that many students may be influenced by their peers and environment to participate in this culture and students misperceive the hookup behavior of their peers. These results can …

Role Of Interleukin-3 In An Experimental Model Of Mouse Cerebral Malaria Caused By Plasmodium Berghei Anka, Brendon R. Perry

Senior Honors Projects, 2010-2019

Malaria is a life-threatening mosquito-borne disease caused by parasites of the genus Plasmodium, with about 200 million new cases reported each year. In rodent models of malaria, a variety of immune proteins called cytokines have been noted to either promote or suppress protective immunity. While the cytokine interleukin-3 (IL-3) clearly promotes host defense against some intestinal nematode parasites, few studies have reported a similar function for IL-3 in the pathophysiology of malaria. In this study, we investigated the role of IL-3 in a mouse model of cerebral malaria caused by Plasmodium berghei ANKA. We infected wild-type (WT) and IL-3 …

Reflection: Effect Of Age On Auditory Brainstem Responses In Mice With Epha4 Mutations, Erica L. Hoogerland

Senior Honors Projects, 2010-2019

Presbycusis, or age-related hearing loss is a condition that affects approximately 40% of the population over 65 years of age (Gates & Mills, 2005). Studying the effects of EphA4 mutations (wild type, heterozygous, and homozygous) mice is fundamental in understanding the relationship between onset of age-related hearing loss, in both the mammalian population and the human population. In order to further understanding of age-related hearing loss, the researchers evaluated thirty-six mice in a preliminary study from two months to nine months of age. Following data analysis, the researchers confirmed the results by continuing a second round of testing. The hearing …

Parents Of Children With Arthritis-Related Diseases: An Examination Of Knowledge Of And Participation In Select Support Programs And Services Offered By The Arthritis Foundation, Margo B. Deihl

Senior Honors Projects, 2010-2019

The purpose of this pilot study was to identify the knowledge of and participation in select Arthritis Foundation support programs and services among parents of children with arthritis-related diseases. Parents attending the 2014 Juvenile Arthritis National Conference in Keystone, Colorado completed an online survey that asked about their knowledge of and participation in these programs. The data collected for the study was quantitative and qualitative. Respondents were given the opportunity to add comments to some survey items, and these items were analyzed by grouping them according to common themes. Results indicated that the parents were more knowledgeable about the Juvenile …

Macronutrient Supplementation For Endurance Athletes, Jonathan B. Hurst

Senior Honors Projects, 2010-2019

Purpose: The present study addressed two questions related to macronutrient supplementation during endurance exercise. Firstly, the effects of carbohydrate and protein co-ingestion on time trial (TT) performance were compared to carbohydrate alone. Secondly, the effects of isolated protein ingestion on TT performance were compared to a placebo.

Methods: Six trained cyclists (Age: 22 ± 1 years; Height: 167 ± 12 cm; Weight: 60 ± 10 kg; VO_2max: 62 ± 7 ml/kg/min) completed four experimental trials, consisting of constant-load cycling for two hours (55% W_max) immediately followed by a 30-km simulated time trial. During the trials, subjects …

Effective Communication Of School Health Screening Information: A Pilot Study Evaluating The Effect Of Electronic Communication Of Bmi Screening Information In Elementary Schools, Kara Elizabeth Carter

Senior Honors Projects, 2010-2019

Obesity is a growing concern surrounding today’s youth. School-based health screenings are promoted as a public health strategy to identify obese children and those at high risk for becoming obese. Despite numerous programs, data is lacking in effective school to parent communication of health related information. The purpose of this research is to determine the effect of electronic communication of health screening outcomes, including parents’ understanding of screening information, utilization of informational resources, and decision to seek physician follow-up. Screenings for body mass index, acanthosis nigricans and blood pressure were conducted during school hours among children in kindergarten and third …

The Impact Of Mild Traumatic Brain Injury On Romantic Relationships, Rylie K. Power

Senior Honors Projects, 2010-2019

Well-documented symptoms of traumatic brain injury (TBI) include acute symptoms such as headaches, dizziness, blurred vision, nausea, and memory loss. However, many TBI survivors also experience changes in cognition, behavior, personality, and mood that challenge interpersonal relationships. These invisible, neurobehavioral symptoms are uniquely challenging for survivors and caregivers of mild TBIs that lack physical, daily reminders that can accompany more severe injuries. The present study focused on the effects of survivors’ mild TBIs on their romantic relationships and the potential for a deteriorating support system. A convergent parallel mixed methods approach quantitatively assessed the environment of romantic relationships after …

Brain Derived Neurotrophic Factor Response During Endurance Cycle Training: Impact Of Carbohydrate And Protein Supplementation, Jordan L. Parker

Senior Honors Projects, 2010-2019

Purpose: Brain Derived Neurotrophic Factor (BDNF) is part of the superfamily of neurotrophins including: nerve growth factor (NGF), neurotrophin-3 (NT-3) and neurotrophin-4 (NT-4). Recent evidence suggests that aerobic activity can increase BDNF levels both during and following exercise. Likewise, dietary habits have been shown to alter BDNF levels. However, nothing is known about the effect of BDNF levels during aerobic activity under specific dietary interventions. The purpose of this study was to examine the effects of specific macronutrient supplementation on BDNF levels during aerobic exercise. Methods: We had the opportunity to determine BDNF levels in blood samples obtained from two …

Examination Of The Effects Of Language And Cultural Barriers On Spanish-Speaking Patients In Health Settings As Observed By Medical Spanish Interpreters, Sarah J. Kraska

Senior Honors Projects, 2010-2019

This study aimed to investigate how the Spanish language and culture affects treatment, access to healthcare and perceptions of medical visits within the Hispanic population. This was examined through the viewpoint of medical Spanish interpreters in the Harrisonburg community. Quantitative data served to provide descriptive statistics regarding these interpreters, while qualitative data was used to gather data about themes and subthemes that were developed regarding this topic. Language was found to not be a significant barrier, but culture did have a significant affect. It was found that these barriers affected access to care because of lack of information, education levels …

Assessing Understanding Of Sexual Assault Resources And Response Among Health Sciences Students, Michelle M. Pappalardo

Senior Honors Projects, 2010-2019

Background: The widely published statistic of 1 in 5 represents the number of women on college campuses who have been sexually assaulted (White House Office of the Press Secretary, 2014). Many colleges and universities have been attempting to address the sensitive topic of sexual assault for quite some time; however, sexual violence still remains prevalent on campuses throughout the United States (Allen, Ridgeway, & Swan, 2015). Many of the roadblocks an institution faces in its efforts may stem from a lack of understanding of the true nature of student attitudes surrounding the topic of sexual assault. The specific needs of …

The Effect Of Stress On Bone Mineral Density In College Aged Females, Grace C. Berardini

Senior Honors Projects, 2010-2019

The relationship between psychological variables and bone mineral density (BMD) has been increasingly studied in the past few years, with research suggesting that decreased mood may play a role in decreased BMD. The purpose of this study was to determine if stress in college aged females on the James Madison University campus was related to decreased BMD. This study included 46 females between the ages of 18-24, who were currently enrolled in the Fall of 2015. All participants completed a medical questionnaire, 24-hour dietary recall, the Perceived Stress Scale (PSS), and the Depression, Anxiety, and Stress Scale (DASS). Participants’ BMD …