Medicine and Health Sciences Commons^™

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; …

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 …

A Rapid Review Of The Literature: Cardiovascular Disease Preventive Practices And Rural Black Women, Modjadji M. Choshi, Maria Devalpine

Virginia Journal of Public Health

Cardiovascular disease (CVD) is the leading cause of death among Black/African American women. Rural Black women have the highest CVD prevalence and are more likely to have modifiable risk factors such as high blood pressure, diabetes, and obesity than any other race. Accessible evidence-based culture-appropriate self-care programs for risk reduction and CVD prevention can address these disparities. This rapid review aims to provide a comprehensive collection of such programs. Methods. Searches were performed in PubMed, CINAHL, Web of Science, Psychinfo-Embase, and Scopus for studies reporting CVD prevention programs for rural Black women. Three articles met the inclusion criteria, with …

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 …

The Covid-19 Pandemic And International Students: A Mixed-Methods Approach To Relationships Between Social Media Use, Social Support, And Mental Health, Hyunjin Seo, Yuchen Liu, Husain Ebrahim, Muhammad Ittefaq, Donghwa Chung

School of Communication Studies - Faculty Scholarship

The COVID-19 pandemic and international students: A mixed-methods approach to relationships between social media use, social support, and mental healthThe COVID-19 pandemic has added significant stress to international students in the U.S. who already facemyriad challenges in adjusting to their host country. We used a mixed-method approach combining surveyand interview research involving international students enrolled in undergraduate or graduate programs at aU.S. university to analyze how their social media use and perceived social support and social adjustmentare associated with their sense of mental well-being when taking into account demographic and socialpsychological characteristics. Our findings show that international students spent an …

A Systematic Literature Review Of Research From 2010 To 2020 Addressing User-Generated Online Comments Related To Health Issues And Recommendations For Future Research, Muhammad Ittefaq, Mauryne Abwao, Ioana A. Coman, Waqas Ejaz

School of Communication Studies - Faculty Scholarship

This systematic literature review was conducted to provide insights into how online readers’ comments have been studied in the context of health over a 10-year span. About 593 studies published between 2010 and 2020; of these, 34 met the research criteria for inclusion. Our findings reveal that 60% of the studies focused on the United States, and a qualitative method was used in 74.3% of these studies. About 23.5% of the studies explored vaccine-related issues. Our results reveal that among the selected studies, 76.5% and 20.6% had female and male first authors, respectively. Textual analysis of abstracts shows that the …

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 …

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, …

The Use Of Autologous Prp Gel For The Treatment Of Diabetic Foot Ulcers, Erin Klein, Dominic E. Paoletti

Physician Assistant Capstones, 2020-current

The purpose of this systematic literature review is to examine the efficacy of platelet rich-plasma (PRP) gel as a therapy for diabetic foot ulcers (DFUs). Infections in patients with diabetes, especially diabetic foot ulcers, are challenging to treat due to neurovascular compromise. Searches were done in PubMed utilizing the terms “diabetic foot ulcer”, “platelet rich plasma” and “autologous”. In PubMed, the following limits and terms were used: randomized control trial (RCTs), sample size greater than 30 participants, foot ulcers, and English. A meta-analysis revealed three studies meeting inclusion/exclusion criteria: Li et al, Gude et al, and Ahmed et al. The …

The Impact Of Oral Health On Low-Income Pregnant Women Living In The United States, Jill Diss, Olivia Ward

Virginia Journal of Public Health

Abstract

Introduction: Oral health has a significant impact on pregnancy outcomes. Interprofessional collaboration can assist in bridging the gap between oral and systemic health and assist in optimizing the health of low-income pregnant women, infants, and children.

Methods: A literature review was used to ascertain the impact of oral health on adverse pregnancy outcomes. Research sources used in this literature review were gathered from the U.S. National Library of Medicine at the National Institutes of Health, PubMed, The Centers for Disease Control and Prevention (CDC), Elsevier, Department of Medical Assistance Services (DMAS), the Office of the Surgeon General, and Google …

Alzheimer's And Patient Caregiver Burnout: A Review Of The Literature, Madeline Hekeler

James Madison Undergraduate Research Journal (JMURJ)

The term “silent epidemic” is fitting for Alzheimer’s disease (AD), as its negative impact is widely felt but rarely discussed. Burnout among AD caregivers has become an epidemic of its own as caregivers experience an increase in health risks, stress, and financial burden. This literature review focuses on caregiver burnout and how imperative it is that caregivers are better supported in their role. Researchers have developed instruments to assess and intervene in caregiver burnout that have shown effectiveness among caregivers and their families.Nevertheless, further longitudinal research is warranted regarding more effective interventions, including stress management and social support mechanisms.

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

Physician Assistant Capstones, 2020-current

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

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 …

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 Danger Of Apathy: College Students' Receipt Of Mumps Vaccine During An Outbreak, Laura A. Keane

James Madison Undergraduate Research Journal (JMURJ)

A mumps outbreak occurred on the James Madison University campus in Harrisonburg, Virginia, during the Spring 2018 semester. For many of the students, it was probably the first time they had to decide on their own whether or not to receive a vaccine. This study examined the relationships between students’ general vaccine acceptance; measles, mumps, and rubella (MMR) vaccine acceptance; vaccine knowledge; and intent to receive/receipt of the MMR booster. An explanatory, cross-sectional study was distributed in Fall 2019 to students in two health courses (n = 243). For students who were enrolled during the Spring 2018 semester, the …

Pulling Heart Strings: Quality Improvement Algorithm For Temporary Epicardial Pacing Wire Removal Post Cardiac Surgery, Jessica Norman

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

The placement of temporary epicardial pacing wires (TEPW) is considered standard practice post cardiac surgery and is dependent on the patient’s cardiac function intra-operatively and their electrophysiologic profile after weaning from cardiopulmonary bypass (Reade, 2007; Elmistekawy et al, 2016). Complications associated with TEPW removal include myocardial damage, infection, perforation, tamponade, disruption of anastomoses, ventricular arrythmias, and death (Bojar, 2009; Carroll et al, 1998;Timothy & Rodeman, 2004). Currently there is no standard practice on the removal of TEPW and there is wide variation in removal practices involving patients who are routinely on medications such as dual antiplatelet therapies and systemic anticoagulation. …

Efficacy Of Fecal Microbiota Transplant In Conjunction With Oral Vancomycin For The Treatment Of Recurrent Clostridium Difficile, Abigayle Afflick, Jackson Laboue

Physician Assistant Capstones, 2020-current

Objective: To determine the effectiveness of fecal microbiota transplant in addition to traditional therapy of oral vancomycin for the treatment of recurrent Clostridium difficile infections. Methods: Google Scholar was searched to identify randomized control trials using the terms vancomycin, fecal transplant, c. diff, and recurrent. Results: Three studies met inclusion criteria and two found a statistically significant benefit to the addition of fecal microbiota transplant to vancomycin therapy. Cammarota, et al. reported a 90% cure rate when administering fecal microbiota transplant in addition to vancomycin as opposed to a 26% cure rate with vancomycin alone with a P value …

Evaluation Of Hyperhomocysteinemia In The Progression Of Parkinson's Disease, Marisa A. Ducach, Pritpal S. Saggu

Physician Assistant Capstones, 2020-current

Abstract:

Objective:To assess the prevalence of hyperhomocysteinemia in Parkinson’s Disease (PD) and if this elevated serum level can be used as a predictive biomarker in risk assessment for the progression of cognitive decline in PD.

Design:Systematic Literature Review

Methods:A literature search was conducted through Google Scholar and Pubmed using phrases such as, “Parkinson's Disease”, and “homocysteine”, “Parkinson’s progression. Three articles, measuring serum homocysteine levels and cognitive functioning in PD patients, were selected, analyzed, and compared to assess for a relationship between homocysteine levels and cognitive decline in PD.

Results: Elevated homocysteine levels are associated with worse cognitive …

Efficacy Of Pulmonary Ultrasound Compared To N-Terminal Prohormone Brain Natriuretic Peptide As A Diagnostic Tool For Congestive Heart Failure In Patients Presenting With Acute Dyspnea In The Emergency Setting, Leah Krohn, Michael Burns

Physician Assistant Capstones, 2020-current

Objective: To determine the efficacy of using pulmonary ultrasound as a diagnostic tool in acute dyspnea of undetermined cause compared to the use of serum N-Terminal prohormone Brain Natriuretic Peptide (NT-proBNP) in the diagnosis of heart failure.

Design: Systematic literature review

Methods: Searches were conducted in PubMed and Scopus using the terms pulmonary ultrasound and congestive heart failure and studies within the last 10 years. Studies that used pulmonary ultrasound compared to BNP as a marker for the diagnosis of heart failure were included.

Results: All three studies found that the use of pulmonary ultrasound was a more specific …

Lipoprotein Associated Phospholipase A2 In Individuals With Obstructive Sleep Apnea, Kendall G. Clark

Masters Theses, 2020-current

Abstract

Introduction: Lipoprotein-associated Phospholipase A₂ (Lp-PLA₂) is a protein produced by inflammatory cells in circulation and is associated with cardiovascular disease (CVD) risk. Prior research demonstrates that obstructive sleep apnea (OSA) leads to increased inflammation and is also related to CVD. Physical activity is known to reduce inflammation and risk for both CVD and OSA. However, Lp-PLA₂ has yet to be examined in individuals with OSA who do not have any other pre-existing conditions nor has it been associated with chronic physical activity. The purpose of this study was to examine if there is a relationship …

Effects Of Stem Cell Therapy On 6-Minute Walk Test Distance And Left Ventricular Ejection Fraction In Patients With Nonischemic Cardiomyopathy, Kayleigh Hunt, Alexa Maziuk

Physician Assistant Capstones, 2016 to 2019

Objective

To assess the efficacy of stem cells in the improvement of functional capacity and quality of life in the setting of nonischemic dilated cardiomyopathy.

Design

Systematic literature review

Methods

A literature search of PubMed was conducted utilizing the following search terms: “stem,” “cell,” “nonischemic,” and “cardiomyopathy.” The following limits were used: “2015-2018,” nonischemic cardiomyopathy, results of LVEF and 6MWT, randomized controlled trials, pilot studies, and sample size >22.

Results

Butler et al. found that within the itMSC group, 6MWD increased by an average of 27.40 m (95% CI 0.28–54.52; P=0.05), but it decreased by an average of 10.83 m …

Subanesthetic Iv Ketamine Reduces Acute Suicidal Ideation In Patients With Mood Disorders, Kimberly Jenko, Jack Anzilotti

Physician Assistant Capstones, 2016 to 2019

Background. Depression and suicide are common in the United States and present a significant problem in the healthcare landscape. Currently, there are few options that can rapidly reduce suicidal ideation in patients with depression. Ketamine, a glutamate N-methyl-D-aspartate (NMDA) receptor antagonist, has been shown to reduce acute suicidality in patients with depression. Previous studies have a reduction of suicidal ideation compared to saline placebo, but few studies have shown a significant effect compared to a similar psychoactive drug such as midazolam.

Method. A search of PubMed and PsychNET was performed in September 2018 using the terms “ketamine,” “suicide,” …

Effect Of Postpartum Protocols On Maternal Outcomes, Kelsey Grimm, Emily Harnish

Physician Assistant Capstones, 2016 to 2019

Objective: To determine whether postpartum hemorrhage (PPH) protocols lead to decreases in maternal morbidity and mortality.

Design: Systemic literature review.

Methods: The clinical question investigated is whether the implementation of PPH protocols has measurable impact on maternal morbidity and mortality. Searches were done through PubMed using the keywords: “maternal hemorrhage postpartum protocol.” Studies were eliminated if they were more than 10 years old, conducted outside the United States, published in a non-English language, used other animal subjects besides humans, used non-female subjects, if they did not answer the clinical question, or were review articles. Eventually, three cohort …

El Vph Y El Cáncer Cervical En El Perú: Diferencias De Accesibilidad Entre Las Mujeres De Las Zonas Rurales Y Urbanas / Hpv And Cervical Cancer In Peru: The Differences In Accessibility For Rural And Urban Women, Jemma Stratton

James Madison Undergraduate Research Journal (JMURJ)

Este informe examina el estado actual del tratamiento y prevención del VPH en el Perú, y pone énfasis con problemas específicas que han contribuido al riesgo alto de cáncer cervical entre las mujeres rurales. Perú ha tomado grandes pasos en las décadas últimas para establecer programas que se dirigen al VPH y la salud de las mujeres. Sin embargo, las mujeres peruanas tienen una población más probable para contraer cáncer cervical en el mundo. Este informe compara los esfuerzos de prevención del VPH entre las poblaciones rurales y urbanas en el Perú y identificar las barreras que causando esta crisis …

Investigating The Role Of Integrin Beta 3 In Dendritic Arborization In The Supragranular Developing Cerebral Cortex, Zachary Logan Holley

Senior Honors Projects, 2010-2019

Integrin subunits have been implicated in axonal and dendritic outgrowth. In particular, a strong positive association has been found between mutations in integrin beta 3 (Itgb3) and autism spectrum disorder, but little is known about neuronal Itgb3 function in vivo. Many forms of autism spectrum disorder are thought to arise from dysfunctional dendritic arborization and synaptic pruning. Global knockout of Itgb3 in mice leads to autistic-like behaviors. Itgb3^-/- mice also have reduced callosal volume, a key neuroanatomical correlate of autism. Here, we test the hypothesis that Itgb3 is required for normal dendritic arborization in layer II/III pyramidal …

Does Acute Preprandial Exercise Modify Postprandial Inflammation After A High Fat Meal In Young And Older Adults?, William Wisseman

Masters Theses, 2010-2019

A single high-fat meal (HFM) can increase systemic inflammation (postprandial inflammation; PPI) and may be attenuated by recent exercise. However, the effect of preprandial exercise on PPI in older adults (OA) is not clear. Purpose: To determine if preprandial exercise attenuates PPI in YA and OA. Methods: 12 YA (23.3±3.9 years n= 5 M/7 F) and 12 OA (67.7±6 years, n= 8 M/4 F) completed two HFM challenges in a randomized order. During HFM alone, participants abstained from exercise 48 hours prior to the HFM session (except for the exercise session) and adhered to a 12 hour overnight …

Implementing A Discharge Navigator Reducing 30-Day Readmissions For Heart Failure And Sepsis Populations, Karen Weeks

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

A national focus for healthcare reform is preventing hospital readmissions. Thirty-day unplanned hospital readmissions impact patient outcomes and are costly to the healthcare system. This project explored the impact between the discharge navigator and 30-day unplanned readmissions for heart failure and sepsis populations in a 238-bed community hospital located in central Virginia. The primary aim of this discharge navigator project was to reduce 30-day readmissions for the heart failure and sepsis populations to meet the goals of the top quartile for like hospitals and the evaluation of cost avoidance for these readmissions. Heart failure and sepsis populations are high risks …

Community-Acquired Pneumonia In Adults: Diagnostic Reliability Of Physical Examination Techniques And Their Teaching In Academia, Amber Tordoff, Lauren A. Williams

Physician Assistant Capstones, 2016 to 2019

Background: Chest physical examination techniques are taught in academia, but their usefulness in the evaluation and diagnosis of patients in the clinical setting is controversial. Objective: To investigate the accuracy of physical examination techniques and their reliability in diagnosing community acquired pneumonia (CAP) and suggest a modified teaching approach to be used in academia. Design: Systematic Literature Review. Methods: Database search of PubMed and Google Scholar using the search terms “prediction of pneumonia in adults” and “prediction rule for pulmonary infiltrates.” Filters were implemented to include articles that only dealt with human subjects and were full text. Articles …

Characterization Of Isolates And Whole Samples From Turkeys Infected With Bordetellosis, Alexandra Lovrinic

Senior Honors Projects, 2010-2019

Bordetellosis is a disease in turkeys attributed to the Gram-negative bacterium, Bordetella avium. The closely related species, B. hinzii, is known to colonize in turkeys as well but was not thought to cause disease. However, over the past few years, B. hinzii has been isolated from turkeys diagnosed with bordetellosis. The presumed identification of isolates obtained from Butterball farms in different locations was conducted through standard identification tests, including hemagglutination, PCR of B. avium specific genes, 16s rDNA PCR, carbohydrate utilization tests, and complete genome sequencing of a few strains. Out of ~100 isolates tested, 14 yielded contradictory …

Development Of A Survey To Examine The Association Between Relationship Status And Human Papillomavirus Vaccination Behavior, Ansley Waters

Senior Honors Projects, 2010-2019

Literature: HPV is the most prevalent STI in the United States. Although a vaccine to prevent HPV infection exists, only 49.5% of females were up-to-date on the recommended vaccination HPV vaccination series in 2016. Though recommended for younger individuals, there is a catch-up period for females ages 18-26, which shows consistent under-participation. One potential risk factor for non-vaccination may be relationship status. Unlike other sexual health issues where monogamous, long-term relationships serve as a protective factor, such relationships may negatively impact HPV infection risk perception. Building from previous qualitative research, this study examined the quantitative association between relationship status and …