Medicine and Health Sciences Commons^™

Early Versus Delayed Rehabilitation After Arthroscopic Rotator Cuff Repair, Abigail Chang, Jessica Dennis

Physician Assistant Capstones, 2016 to 2019

Objective: To determine how the timing of rehabilitation, early versus delayed, affects clinical results and tendon healing rates after arthroscopic rotator cuff repair. Design: Systematic literature review. Methods: Searches were done in PubMed, utilizing the terms arthroscopic rotator cuff repair, rehabilitation, early, and delayed. In PubMed the following filters and terms were used: published in the last 10 years, humans, randomized controlled trial, free full-text articles, and English. Results: The Keener et al study was included because it evaluated clinical results and tendon healing rates after arthroscopic repair using two distinct rehabilitation protocols, early versus delayed …

The Effect Of Staphylococcus Aureus On Stiffness Of Cortical Bone, Ariel N. Kunde

Graduate Theses

Osteomyelitis, a term for bone infection, is a common cause of hospitalization in the United States. Infection leading to osteomyelitis is almost always a product of bacterial origin. Although polymicrobial presence is seen at infection sites of osteomyelitis, Staphylococcus aureus is most commonly isolated and found to be the cause of more than 95% of bone infection in adults. This organism is a common commensal of humans that is carried by an estimated 60% of the US population. S. aureus is transferred by infected asymptomatic individuals, and its ability to proliferate under a variety of environmental conditions contributes to the …

Relationship Between Breakfast And Basketball Shooting Accuracy, Dimitrije Cabarkapa

Masters Theses, 2010-2019

Purpose: The purpose of this study was to determine if collegiate and recreational basketball players shooting accuracy improved after consumption of breakfast (BF) compared to no-breakfast (No-BF).

Methods: 24 male and female collegiate and recreational basketball players completed a three-week intervention study with a crossover design. Subjects were randomly assigned to a four-day BF or No-BF treatment starting on Monday and completed testing that included a free-throw drill and timed 2-point and 3-point drills on day four. Treatment switched the following Monday. Food intake records were collected during each treatment phase.

Results: There was no difference between BF and No-BF …

Effects Of Glucosamine Versus Chondroitin Sulfate In Reducing Joint Space Narrowing In Knee Osteoarthritis, Caroline Horton, Ashani Andrews

Physician Assistant Capstones, 2016 to 2019

Objective: To determine if over the counter supplements, chondroitin sulfate and glucosamine, in combination or alone, are effective in the treatment of joint space narrowing (JSN) in knee osteoarthritis.

Design: Systematic Literature Review

Methods: Database search of PubMed and MEDLINE using the search terms “glucosamine”, “chondroitin sulfate”, “osteoarthritis”, and joint space narrowing. Filters were implemented to include articles that only dealt with human subjects, that were published in 2000 or later, and were full-text. Articles were excluded if they were cohort studies, reviews, non-English papers, or had pain as the only outcome.

Results: Sawitzke et al.primary outcomes revealed no …

Application Of D-Dimer To Aid In Diagnosis Of Acute Aortic Dissection, Hannah Scarboro, Julia Starkey

Physician Assistant Capstones, 2016 to 2019

Introduction: Acute aortic dissection (AAD) is an emergent, relatively uncommon condition that typically presents with sudden onset severe chest or back pain.1 Advanced imaging, such as computerized tomography, is currently the gold standard to diagnose AAD; this can be expensive and unavailable at all health care centers. D-dimer is a blood test that has been shown in recent studies to be elevated in acute aortic dissection. This may be a more cost-effective way to help the clinician “rule-out” an acute aortic dissection.1

Objective: The purpose of this research was to determine if there is significant data regarding the sensitivity and …

Methadone Versus Buprenorphine-Naloxone As A Treatment For Opiod Dependent Individuals, Danielle T. Billings, Ashley Tromblay

Physician Assistant Capstones, 2016 to 2019

Objective: To investigate if buprenorphine/naloxone compared to methadone improves treatment retention and effectiveness among opioid dependent individuals. Design: Systematic literature review. Methods: Searches were conducted in PubMed and Scopus using the terms methadone, buprenorphine-naloxone and opioid dependence. In PubMed the following filters were applied: humans, English, randomized controlled trials and meta-analysis. Studies that had opioid dependent subjects, treatments comparing buprenorphine-naloxone and methadone and outcomes measures of treatment retention and efficacy were included. Results: Otiashvili et al. found that daily observed doses of methadone and buprenorphine-naloxone were effective in reducing illicit buprenorphine and other illicit opioid use. Kamien et al. found …

Age-Adjusted Vs Conventional D-Dimer Thresholds In The Diagnosis Of Venous Thromboembolism, Kirsten Zimmerman, Nikki Caldwell

Physician Assistant Capstones, 2016 to 2019

Context: D-dimer measurements are vital in the diagnosis and exclusion of venous thromboembolism (VTE). D-dimer levels increase with age, causing many older individuals to be subject to unnecessary imaging in the diagnostic process. The implementation of an age-adjusted D-dimer may help to improve specificity of the test, therefore, preventing further imaging.

Objective: To assess whether the application of age-adjusted cutoff values (age x 10 μg/L) compared to a conventional cutoff value (500 μg/L) improves diagnostic accuracy of the D-dimer test in older individuals (>50 years) with suspected venous thromboembolism (VTE) without compromising safety.

Methods: A PubMed search was conducted …

Arthroscopic Partial Meniscectomy Versus Nonoperative Therapy In The Treatment Of Degenerative Meniscus Tears, Kelly Mulhern, Jillian Robideaux

Physician Assistant Capstones, 2016 to 2019

Objective: To determine the efficacy of arthroscopic partial meniscectomy versus nonoperative therapies in the treatment of degenerative meniscus tears in adults 35 years of age and older.

Design: Systematic literature review.

Methods: Primary searches were done in PubMed and New England Journal of Medicine, using key search terms including meniscectomy, degenerative meniscus tears, conservative, physical therapy, and long term outcomes. Within both search engines the following limits were set: humans, English, publication within past 5 years, full text, randomized control trials, adults: >35 years.

Results: The Yim et al. study was included due to its examination of both meniscectomy and …

How Much Atrial Fibrillation Is Too Much? The Net Clinical Benefit Of Anticoagulation Therapy In Atrial Fibrillation Patients With An Intermediate Cha2ds2-Vasc Score, Rebekah Stovall, Ashley Carter, Lynsey Deudne

Physician Assistant Capstones, 2016 to 2019

Background: Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia seen in medical practice, affecting 33.5 million people worldwide. Arterial thromboembolism, particularly ischemic stroke (IS), is a significant complication of AF. The most widely recommended tool used to evaluate AF patient’s risk of IS is the CHA₂DS₂-VASc score, which assigns a numerical value to predetermined IS risk factors and allows an overall estimation of the patient’s risk by adding these individual numerical values together. Current guidelines offer varying recommendations regarding oral anticoagulation (OAC) therapy use in patients with varying CHA₂DS₂-VASc scores, …

Effects Of Individualized Health Coaching In Patients With Type 2 Diabetes, Stephanie Gill, Emily Nilson

Physician Assistant Capstones, 2016 to 2019

Objective: To conduct an analysis of literature that examined the effects of individualized health coaching on hemoglobin A1c in adults with type 2 diabetes. Methods: A literature search of the PubMed database using the terms “goal setting” AND type 2 diabetes OR “individual counseling” was performed. Only randomized controlled trials and meta-analysis were included. Results: All three studies reported a statistically significant difference in lowering hemoglobin A1c levels with individualized health coaching interventions compared to the standard diabetes interventions. Conclusion: Health coaching should be further studied for longer amounts of time to determine the true clinical significance of lowering …

Virtual And Authentic Tennis: Similarities And Differences Of Three Common Tennis Strokes, Kristy M. Noble

Graduate Theses

The purpose of this mixed-methods multi-phase study was to compare the similarities and differences of three common tennis strokes performed by National Collegiate Athletic Association Division I tennis players in an authentic and motion-based video game (MBVG) environment. Moreover, the perceived effectiveness of using MBVGs as a pedagogical tool was also examined. Statistical analyses revealed that the forehand, backhand, and serve were performed significantly different in the authentic and MBVG environments. However, the participants perceived that the MBVG forehand and serve were similar to the authentic environment. In addition, the participants perceived several positives and negatives of utilizing MBVGs when …

Perceptions Of Ncaa Division I Baseball Pitchers On Treatment Modalities For Pitching Arm Health, Thomas Williams

Graduate Theses

Throwing athletes of all sports have similarities, even if the sport itself is very different. Throwing an object creates a great amount of stress on the body, particularly at the shoulder and the elbow. A baseball pitcher should train and compete in all three planes of movement-sagittal, frontal and transverse. Training for throwing athletes has two main goals: to increase throwing power and to reduce throwing injuries. Analyzing training habits of a throwing athlete includes an understanding of the modalities they perform in order to prevent potential injuries from occurring. Baseball pitchers are extremely susceptible to throwing injuries, and must …

The Effects Of Age On The Perception Of Frequency In Noise, Mary E. Scherer

Dissertations, 2014-2019

Difficulty understanding speech in the presence of background noise is one of the most common complaints of older adults, both with and without hearing loss. One possible contributing factor is an age-related decline in neural synchrony (e.g., phase locking). Tones-in-noise were used in an attempt to disrupt rate-place coding of frequency and to encourage participants to use phase-locked, temporal representations of frequency during a behavioral frequency discrimination task. Fourteen adults participated in the study (five younger, aged 21-29; four middle aged, 41-50; and five older, aged 61-80). Participants had clinically normal hearing sensitivity (≤ 25 dB HL at octave frequencies …

Effect Of Age On Abrs In Mice With Epha4 Mutations, Melissa M. Teller

Dissertations, 2014-2019

It is known that EphA4 can influence the establishment of tonotopic pathways in the auditory system. This can be measured by an increase in thresholds on the auditory brainstem response test (ABR) in mice. It is also known that the aging population in humans tends to have poorer thresholds in the high frequency sounds as they age, termed presbycusis or age-related hearing loss. The C57BL/6J background strain of mice that is known to experience a presbycusis-like process, although it is not specified when this process begins and how it progresses through their life span. The goal of this study was …

The Neural Representation Of Frequency In Quiet And Noise Across The Adult Life Span, Alexandra Bove

Dissertations, 2014-2019

The purpose of the present study was to examine why older adults have trouble with speech-in-noise understanding. Difficulty with speech-in-noise comprehension has been associated with age-related degradation in frequency processing. Our study sought to investigate this relationship by examining the neural representation of frequency in quiet and in noise across the adult-life span. In order to do this, one behavioral correlate of frequency processing, frequency difference limens (FDLs), and one electrophysiological correlate, the frequency following response (FFR), was utilized. In the present study, we specifically focus on the electrophysiological measures of frequency processing across the adult life span. It was …

Physiological Differences In Cardiovascular Hemodynamics Across Treadmill And Cycle Exercise As Assessed Through Impedance Cardiography, Daniel S. Valcicak

Masters Theses, 2010-2019

Impedance cardiography (IC) measures cardiovascular hemodynamics non-invasively during exercise. However, IC measurements assessing physiological differences across treadmill (TM) and cycle (CYC) exercise has not been investigated. The purpose of this study is to investigate whether hemodynamic measurements assessed via IC are consistent between TM and CYC exercise at two absolute exercise intensities. Twenty-one men (age = 21.4 ± 0.5 y; BMI = 24.4 ± 0.5) completed four exercise tests, two TM and two CYC. Within each test, two, five-minute, steady-state stages were completed with targeted intensities of 5 (MODex) and 7 (VIGex) metabolic equivalents (METs). Oxygen consumption (VO₂) …

The Effects Of Coffee Ingestion On The Acute Testosterone Response To Exercise, Taylor Landry

Masters Theses, 2010-2019

Abstract

This study investigated the effects of coffee ingestion (COF) on serum testosterone responses to exercise in recreationally weight-trained males. Subjects ingested either 12 ounces of 6mg/kg caffeinated coffee (COF), decaffeinated coffee (DEC), or water (PLA) one hour prior to exercise in a randomized, within-subject, crossover design. The exercise session consisted of 21 minutes of high intensity interval cycling (alternating intensities corresponding to two minutes at power outputs associated with 2.0 mmol/L lactate and 4.0 mmol/L lactate) followed by resistance exercise (7 exercises, 3 sets of 10 repetitions, 65% 1RM, 1-minute rest periods). Subjects also completed repetitions to fatigue tests …

Mouth Exposure To Carbohydrate Prior To Exercise Possibly Impairs The Efficacy Of Carbohydrate Mouth Rinsing During Exercise, Kevin Decker

Masters Theses, 2010-2019

Decker K. P., M. J. Saunders, N. D. Luden, C. J. Womack, and N. J. Hladick. Mouth Exposure to Carbohydrate Prior to Exercise Possibly Impairs the Efficacy of Carbohydrate Mouth Rinsing during Exercise. Purpose: Carbohydrate mouth-rinsing (CHO-MR) during intense endurance exercise has been associated with improved cycling performance, due to neurological influences. However, prior studies have reported the efficacy of CHO-MR is attenuated following a pre-exercise meal. To determine if this outcome is related to desensitization of CHO receptors (rather than metabolic effects following digestion), this study will investigate whether CHO-MR prior to exercise influences cycling performance when CHO-MR …

The Effect Of Menstrual Phase And Oral Contraceptive Steroids On Caffeine During Cycling Performance, Annette M. Lemanski

Masters Theses, 2010-2019

PURPOSE: There is evidence that female sex hormones impact caffeine metabolism, with decreased CYP1A2 activity and diminished caffeine clearance in women with higher estrogen levels. Therefore, the objectives of this project were to determine the effects of oral contraceptives and menstrual cycle on the benefits of caffeine supplementation for cycling performance. METHODS: Sixteen recreationally trained female cyclists, oral contraceptive steroid (OCS) users (n=8, age = 21.4 ± 1.4 years, height = 168.4 ± 3.6 cm, weight = 63.6 ± 7.2kg, VO_2max = 48.0 ± 4.0 ml/kg/min), and non-users (n=8, age = 20.9 ± 2.1 years, height = 161.0 ± …

The Impact Of Freedson Bout Vs. Non-Freedson Bout Physical Activity On Metabolic Syndrome Risk In College Students, Valerie Olijar

Masters Theses, 2010-2019

Purpose The aim of this study is to examine moderate to vigorous physical activity in Freedson bouts compared to non-Freedson bouts and their association with Metabolic Syndrome risk factors in college students.

Methods 72 subjects aged 18-26 were recruited from James Madison University. Subjects height, weight, waist circumference, blood pressure, and body composition were assessed on visit 1. Blood pressure, fasted blood glucose, and lipid profile were assessed on visit 2. Subjects wore an Actigraph GT3X+ accelerometer, which measured physical activity and sleep for 7 days and nights. Univariate Pearson correlation analyses were performed to determine the relationship physical activity …

Caffeine Intake Helps Maintain 3-Km Cycling Performance The Morning Following Sleep Restriction, Erin E. Horil

Masters Theses, 2010-2019

Abstract

Introduction: Although a full understanding of the role of sleep is debated, it is widely accepted that sleep is important for recovery from heavy exercise. Recent research suggests that sleep restriction (SR) may negatively impact recovery and subsequent performance. It is unknown if caffeine supplementation mitigates this performance decrement. Our objective was to investigate the effect of caffeine supplementation on exercise performance following one night of SR in trained cyclists.

Methods: Subjects (n=10) completed a 3-km time trial (TT) and an exhaustive bout of exercise in the evening (EX1), then returned to repeat the TT the following …

Organizational Factors Associated With Quality Perinatal Care, Lisa H. Akers

Dissertations, 2014-2019

Provisions for perinatal care are an integral part of quality healthcare and are increasingly moving to the forefront of quality care measures in the healthcare setting (Agency for Healthcare Research and Quality, 2012; National Quality Forum, 2012; & The Joint Commission, 2010). Previous literature specifically focused attention to general quality of care, but recently there has been a call for a more comprehensive approach to measuring quality in the perinatal care setting, which necessitates the need for a better understanding of what is currently being offered (Collins & Draycott, 2015). Until now the literature has remained limited on the association …

Coordinated Pluralism As A Means To Facilitate Integrative Taxonomies Of Cognition, Jacqueline Anne Sullivan

Brain and Mind Institute Researchers' Publications

© 2017 Informa UK Limited, trading as Taylor & Francis Group. The past decade has witnessed a growing awareness of conceptual and methodological hurdles within psychology and neuroscience that must be addressed for taxonomic and explanatory progress in understanding psychological functions to be possible. In this paper, I evaluate several recent knowledge-building initiatives aimed at overcoming these obstacles. I argue that while each initiative offers important insights about how to facilitate taxonomic and explanatory progress in psychology and neuroscience, only a “coordinated pluralism” that incorporates positive aspects of each initiative will have the potential for success.

Comparing Nebivolol And Spironolactone In The Treatment Of Heart Failure With A Preserved Ejection Fraction, Caroline Joseph, Alison Fenter

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the efficacy of improving diastolic dysfunction with the use of nebivolol, a selective beta-1 adrenergic receptor antagonist, as compared to spironolactone, a mineralocorticoid receptor antagonist, in the treatment of diastolic heart failure. To assess whether or not these medications have a favorable outcome in terms of improving exercise capacity in patients with Heart Failure with Preserved Ejection Fraction (HFpEF). Design: Systematic Literature Review. Methods: Searches in PubMed and the JMU online library database using mesh terms that included “diastolic heart failure”, “nebivolol”, and “spironolactone”. In order to narrow down relevant articles, filter terms included “humans”, …

Bupivacaine Vs. Ropivacaine: Looking At The Chondrotoxic Effects Of Intraarticular Anesthetics In Osteoarthritic Joints, Sarah Burke, Lauren Price

Physician Assistant Capstones, 2016 to 2019

Objectives: Intraarticular injections of corticosteroids used in combination with local anesthetics are commonly used in orthopedic practice for osteoarthritic pain relief. Many orthopedists question whether these anesthetics have chondrotoxic effects on human articular cartilage. The purpose of this meta- analysis is to examine the chondrotoxic effects of local anesthetics on osteoarthritic human articular cartilage and to determine whether ropivacaine has fewer chondrotoxic effects than bupivacaine.

Methods: Studies were found using PubMed with the search terms, “Ropivacaine,” “Bupivacaine,” and “Chondrocytes.” Initially 20 studies were found. Several studies were eliminated using the following excluding factors: human studies, published in last 10 years, …

Cranberry Juice Vs. Placebo As Prophylaxis For Recurrent Urinary Tract Infection In Adult Women: A Systematic Review, Donald S. Trawick, Hinda Mezaache

Physician Assistant Capstones, 2016 to 2019

Objective: To determine the effectiveness of cranberry juice consumption as prophylaxis for urinary tract infection (UTI) in women with a history of recurrent UTI. Methods: Systematic literature review using Google Scholar with search terms “cranberry juice prophylaxis.” Results: Our search resulted in three randomized-control trials (RCTs), two of which demonstrated no benefit of cranberry juice in preventing recurrent UTI. Conclusion: Because of the significant heterogeneity among published studies, there is no definitive proof that cranberry juice is effective or useless as UTI prophylaxis.

"How Do International Collegiate Athletes Perceive The Impact Of Dietary Acculturation On Current Eating Patterns?", Cailey Ryan

Masters Theses, 2010-2019

This qualitative research study examined perceptions of international collegiate athletes on the impact of dietary acculturation on current eating patterns. Twenty-two international collegiate student athletes participated in one of three focus group sessions. Focus groups explored participant dietary patterns in the context of acculturation. Thematic analysis of data, using a grounded theory approach, implicated that participants faced challenges as they adapt to the American culture. Emergent themes of challenges included cultural differences compared to home, demand of their sport and dining on campus. Topics related to dietary acculturation were discussed including food differences and quality, availability of fast food, family …

Pediatric Intrafalcine Empyema From A Sinogenic Origin: A Case Report., Kyle Mueller, John Myseros

Neurological Surgery Faculty Publications

Sinusitis and otitis are common within the pediatric population. If left untreated, these can extend intracranially and lead to the development of infections in the various intracranial compartments resulting in a high rate of morbidity and mortality. We report the first case of an intrafalcine empyema, absent subdural purulence, in a patient with the likely spread from a sinogenic origin. This case illustrates the novelty of this as a pathological entity as well as the surgical considerations for intrafalcine purulence in the absence of expected subdural collections.

A Study Of Cultural Competence And Implicit Bias Amongst Healthcare Students, Jerry Strklja, Natalia Dembowska, Zoya Vinokur, Elaine Leinung

Publications and Research

Cultural competence is defined as the ability of providers and organizations to effectively deliver equitable and unbiased health care that meet the social, cultural, and linguistic needs of a culturally diverse patient body. By 2050, minority populations will increase to 48 percent of the U.S. population and Hispanics will represent 24.4 percent of the total population (U.S. Census, 2010). This demographic shift brings challenges and opportunities to universities and organizations alike to create policies and curriculums that foster quality health care amongst students, while also contributing to the eradication of implicit biases that may unwittingly perpetuate healthcare disparities amongst racial …

The Role Of Simulation In Mixed-Methods Research: A Framework & Application To Patient Safety, Jeanne-Marie Guise, Matthew Hansen, William E. Lambert, Kerth O'Brien

Psychology Faculty Publications and Presentations

Background: Research in patient safety is an important area of health services research and is a national priority. It is challenging to investigate rare occurrences, explore potential causes, and account for the complex, dynamic context of healthcare - yet all are required in patient safety research. Simulation technologies have become widely accepted as education and clinical tools, but have yet to become a standard tool for research.

Methods: We developed a framework for research that integrates accepted patient safety models with mixed- methods research approaches and describe the performance of the framework in a working example of a large …