Analytical, Diagnostic and Therapeutic Techniques and Equipment 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; …

Focused Assessment With Sonography Exams Vs Ct Scan, Anne Kresge, Charlotte Mueller, Briar Tures

Physician Assistant Capstones, 2020-current

Blunt trauma is a common reason patients present to the emergency department. Providers must evaluate these patients quickly to get them the correct treatment, especially for intra-abdominal bleeding. Focused assessment with sonography for trauma (FAST) exams are growing in use to evaluate trauma patients for free fluid in the abdomen. To be valuable to emergency providers, it must be known how FAST exams compare to the gold standard evaluation, computed tomography (CT) scans. Searches were done on Pubmed and Scopus databases using terms “focused assessment with sonography for trauma” and “FAST exam CT blunt abdominal trauma.” Limits were added to …

Injuries In Manual And Mechanical Cpr, Macon Spruill, Malik Bangura

Physician Assistant Capstones, 2020-current

Objective: To compare the rate of injuries during cardiopulmonary resuscitation (CPR) using manual versus mechanical chest compressions with the Lund University Cardiopulmonary Assist System (LUCAS™).

Design: Systematic literature review

Methods: We investigated the use of 2 different CPR methods, manual and mechanical, in order to determine if one was more likely to cause injury in individuals during a cardiac arrest. PubMed searches were conducted using the terms “cardiopulmonary resuscitation,” “adverse effect,” “classification,” “method,” “mortality,” “statistical and numerical data,” “trends,” “complication,” “epidemiology,” and “etiology.” Studies were excluded if they took place before the year 2000, included individuals under 18 …

Are Polypills A Viable Option To Improve Health Outcomes In Those With Cardiovascular Disease?, Alexander Voytovich, Cara Mckee

Physician Assistant Capstones, 2020-current

Objective: Does the use of polypill therapy improve systolic blood pressure and low-density lipoprotein cholesterol (LDL-C) levels more than usual care in adults with established cardiovascular disease (CVD) or with 10-year atherosclerotic cardiovascular disease risk >10%. Design: Systematic literature review. Methods: Searches were performed in PubMed and UpToDate using the following search terms polypill and cardiovascular. Other limits included: randomized control trials, adults, published in the last 10 years, LDL-C and systolic blood pressure. Results: Analysis of articles to ensure similar design, intervention and fit with the other inclusion/exclusion criteria yielded three studies: Labefer et al, Muñoz et al, and …

Ketamine As A Treatment Modality For Treatment-Resistant Depression, Tracy Wulff, Shen Cao

Physician Assistant Capstones, 2020-current

Many recent studies have demonstrated the ability of ketamine, an NMDA receptor antagonist, to produce antidepressant effects that may be effective in helping reduce treatment-resistant major depression. In particular, three double-blinded randomized control trials have been conducted to assess the viability and effectiveness of this medication for treatment. This systematic literature review will analyze these studies and determine if the overall research indicates that ketamine is useful in improving depression as measured by the Montgomery–Asberg Depression Rating Scale (MADRS)¹.

Objective: Assess the effectiveness of IV Ketamine in reducing treatment-resistant major depressive disorder as measured by the Montgomery–Asberg …

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 …

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 …

The Use Of Life-Like Robotic Animals In The Acute Care Setting To Assist In The Care Of Patients With Dementia, Abby Denby

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

The purpose of this pilot project was to describe the effect of life-like robotic animals on the nurses’ ability to provide care, patients’ level of agitation, use of antipsychotic medications, restraint and sitter use for patients with dementia in an acute care setting. Nurses report challenges and feelings of helplessness while caring for patients with dementia. Dementia may cause depression, agitation, aggression (physical or verbal) and a decrease quality of life. Animal Assisted Therapy (ATT) is a growing therapy in many healthcare settings but there is a lack of literature specifically related to the use of AAT in the acute …

Angiotensin Ii In The Treatment Of Distributive Shock, An Old Theory Revitalized, Jennifer D. Leach, Daniel P. Curran

Physician Assistant Capstones, 2020-current

Objective: To assess whether or not angiotensin II in combination with current treatment has a favorable outcome in the treatment of distributive shock in terms of decreasing duration of vasopressor usage, increasing mean arterial pressure (MAP) above 65 mmHg, and improving mortality.

Design: Systematic Literature Review

Methods:Searches were conducted in PubMed, Google Scholar, and the James Madison University Library Database for the key terms angiotensin II, shock, septic shock, vasodilatory shock, distributive shock, blood pressure, double-blind, humans, and vasoconstrictor agents. Search results were filtered by year, for animal trials, irrelevant therapies, meta-analysis, retrospective studies, and case studies. Only original …

Diagnostic Accuracy Of Mcmurry’S Test In The Diagnosis Of Meniscal Tears, Jessica Smyth, Hartwell Rainey

Physician Assistant Capstones, 2020-current

No abstract provided.

Galcanezumab As A Treatment For The Prevention Of Migraines, Jacob Brown, Chelsea Weedon

Physician Assistant Capstones, 2020-current

Objective: To determine the effectiveness of subcutaneous galcanezumab as a preventative treatment for chronic migraines via a systematic review. Methods: JAMA and PubMed databases were searched using the terms galcanezumab and migraines in order to survey resulting patient clinical trials. Results: The 3 studies reviewed here all showed a statistically significant decrease in migraine headache days (MHDs) per month when using galcanezumab. Stauffer, et al. showed a mean decrease in MHDs of 4.7 and 4.6 for the 120mg and 240 mg doses of galcanezumab vs. 2.8 for placebo⁹ . Rosen, et al. showed a mean monthly 100% response rate …

Therapeutic Potential Of A Ketogenic Diet In The Treatment Of Major Depressive Disorder, Jordan A. Murrin

Masters Theses, 2020-current

Major depressive disorder (MDD) is the second most common mental health condition and a leading cause of disability in the world. It is theorized that MDD develops from a combination of biological, psychological, and social stressors. The condition is typically treated using pharmaceuticals and psychotherapy. However, not all individuals with MDD have access to or choose to use these treatments, or may prefer to incorporate therapeutic lifestyle changes such as exercise, sleep, and healthy eating. Even with treatment, MDD can alter brain structure and function, leading to the development of comorbid mental health and chronic metabolic conditions like obesity, cardiovascular …

Chlorhexidine Gluconate Vs Povidone-Iodine In The Prevention Of Clean-Contaminated Surgical Site Infections, Erin Layne, Abigail Stone

Physician Assistant Capstones, 2016 to 2019

Abstract

Background:

A patient’s skin is the major source of pathogens that can cause post-operative complications such as surgical site infections (SSIs). Optimization of pre-operative skin antisepsis is obtained with chlorhexidine gluconate (CG) and povidone-iodine (PI). These two solutions are the most widely used antiseptics for pre-operative purposes.

Objective:

Among surgical patients greater than 18 years of age undergoing clean-contaminated surgery, which antiseptic, iodophors or chlorhexidine gluconate, is more effective at reducing postoperative surgical site infections?

Methods:

A search was done in PubMed utilizing the terms chlorhexidine, infection control, iodophors, and surgical site infection. The limits applied included randomized …

Bout Vs. Non-Bout Physical Activity Minutes As Predictors Of Waist Circumference In College Students, Valerie Olijar, Matt Scott, Brooke Ferraro, Elizabeth Edwards, Trent Hargens

Showcase of Graduate Student Scholarship and Creative Activities

Physical activity recommendations to reduce all cause mortality consist of 10 minute bouts of a moderate-vigorous intensity, for a total of 150 min/week. This study investigates if those 10 minute bouts really matter. We found that step count was the best predictor of waist circumference. This finding supports many new technological devices that use step counts as a form of measuring activity. It provides support that the more steps you take, the likelier you will have a small waist.

Innovative Care Of Individuals In The Athletic Training Room: A Case Series, Kathryn E. Young

Senior Honors Projects, 2010-2019

This work follows three unique cases of athletic injuries and/or injuries in patients. These cases were selected because of the innovative nature of the rehabilitation process conducted by the sports medicine team via the athletic training room or the unique nature of the injury/case.

The first is a concussion sustained from a motor vehicle accident in a collegiate female thrower. This is unique because it’s a non-sport related concussion handled as an athletic trainer would handle a sports related concussion. It also demonstrates a new unique protocol for concussion management.

The second case is a patient with two complete anterior …

Long Term Outcomes Of On-Pump Cabg Versus Off-Pump Cabg, Christopher Fetrow, Jessalyn Dickerson

Physician Assistant Capstones, 2016 to 2019

Objective: Assess the long-term outcomes including mortality, revascularization and myocardial infarction events to determine whether off-pump CABG is more effective for patients compared to on-pump CABG procedures.

Methods: Studies were found using PubMed with the search term, “on and off pump CABG” which yielded 1736 studies. After assessing for records within 5 years the search was narrowed to 370 articles and then down to 353 because some articles were not available in full-text. Our search was then divided into first looking at randomized control trials and meta-analysis availability from the 353 articles meeting our criteria. After narrowing our search for …

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 …

Design Of A Homeopathic Solution For Chronic Cough, Jacob Ziemke

Senior Honors Projects, 2010-2019

Chronic cough is most commonly defined as a cough that persists for more than eight weeks and is estimated to affect more than 30 million people in the United States at any given time. Diseases contributing to the onset of chronic cough include asthma, pulmonary fibrosis, lung cancer, postnasal drip, gastroesophageal reflux disease (GERD), and bronchitis, and may include lifestyle choices such as smoking. For those who seek medical advice, pharmaceuticals and speech therapy are two common methods of combating chronic cough but serve to mask the symptoms rather than treat the problem; frequently, chronic cough is misdiagnosed or cannot …

Validity And Reliability Of The Ymca Submaximal Cycle Test Using An Electrically Braked Ergometer, Justin Kidd

Senior Honors Projects, 2010-2019

Purpose: To test the effect of using an electrically braked ergometer on the validity and reliability of the YMCA submaximal cycle test.

Methods: 22 male and 13 female subjects ages 19 to 31 completed one maximal treadmill test and four submaximal cycle tests to measure and estimate VO_2max, respectively. The maximal tests involved recording heart rate and VO₂ during graded exercise until volitional fatigue; an actual max was verified when two out of the following criteria: respiratory Exchange Ratio > 1.1, VO₂ plateau (< 150 ml/min increase in VO₂ during final stage), and achievement of 90% age-predicted HR max (or completed …

Transitioning To The Role Of A Professional Physical Therapist Through Community Engagement, Brittany L. Wentzel

VA Engage Journal

This article recounts the author's experiences observing and interning with physical therapists in a variety of settings.The hands-on experiences the author describes allowed the author to learn the specific procedures and requirements in a typical day as a Physical Therapist, and to gain knowledge on the protocol for different injuries, the muscles that each exercise strengthens, and how to properly perform exercises to prevent further injuries. The author also explores how these experiences fostered observational and interpersonal skills and solidified the decision to pursue Physical Therapy as a career.

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 …

Manual Vs. Mechanical Chest Compressions In Out-Of-Hospital Cardiac Arrest, Ellie J. Tansey, Jesse B. Kalhorn, Abigail Hubble

Physician Assistant Capstones, 2016 to 2019

Objective: The objective was to conduct an analysis of literature that examined whether the use of mechanical vs. manual chest compressions results in outcomes (e.g. quality of CPR, return of spontaneous circulation (ROSC), neurologic outcome, survival) that are significantly increased or decreased in adults that experienced out of hospital cardiac arrest (OHCA). Methods: Systematic searches were conducted through the James Madison University Library. The inclusion criteria included human adults that experienced out of hospital cardiac arrest that were treated by Emergency Medical Services (EMS) with and/or without a mechanical chest compression device. Results: A statistically significant difference was not found …

A Study Into The Diagnosis Of Obesity In Infants Less Than Two Years Old In The State Of Virginia, Lindsay Ann Bruno

Senior Honors Projects, 2010-2019

In 2007, the CDC reported approximately 12.5 million children and adolescents in the U.S. were obese. Among 24-month old clinically obese children, only 23% were diagnosed as obese. The most concerning is the prevalence of obesity in 6-month olds; 16% of 6-month old infants in the U.S. are obese, of which only 14% are diagnosed as being obese. Previous research concentrates on the factors that influence infant obesity, but does not address the prevalence of diagnosing obesity in children, particularly those under two years of age. The purpose of this project was to pioneer a survey exploring the prevalence of …

Adaptive Technology Catalog, Cisr

CISR Studies and Reports

By design, the purpose of this Adaptive Technology Catalog is to provide a resource for governments, survivor-assistance and other agencies to help victims of landmines and other explosive remnants of war (ERW) and other disabled workers get back to self-sufficiency and paid work.

Landmine and ERW injuries have a devastating impact on the economic security of individuals, families and communities. Most often, these circumstances exist in countries that lack the basic social welfare infrastructure that might otherwise keep this at-risk population from poverty.

Designing, developing and identifying simple and inexpensive tools and programs that assist with survivor work reintegration is …