• Adjuvant Chemotherapy for Patients with Stage III Colon Cancer: Results from a CDC-NPCR Patterns of Care Study.

      Cress, Rosemary D; Sabatino, Susan A; Wu, Xiao-Cheng; Schymura, Maria J; Rycroft, Randi; Stuckart, Erik; Fulton, John; Shen, Tiefu; Department of Health Management and Informatics (2010-08-06)
      OBJECTIVE: To evaluate adjuvant chemotherapy use for Stage III colon cancer. METHODS: This analysis included 973 patients with surgically treated stage III colon cancer. Socioeconomic information from the 2000 census was linked to patients' residential census tracts. Vital status through 12/31/02 was obtained from medical records and linkage to state vital statistics files and the National Death Index. RESULTS: Adjuvant chemotherapy was received by 67%. Treatment varied by state of residence, with Colorado, Rhode Island and New York residents more likely to receive chemotherapy than Louisiana residents. Older age, increasing comorbidities, divorced/widowed marital status, and residence in lower education areas or non-working class neighborhoods were associated with lower chemotherapy use. Survival varied by state but after adjustment for sex, sociodemographic and health factors, was significantly higher only for California and Rhode Island. Older age and lower educational attainment were associated with lower survival. Chemotherapy was protective for all comorbidity groups. CONCLUSION: Although adjuvant chemotherapy for Stage III colon cancer improves survival, some patients did not receive standard of care, demonstrating the need for cancer treatment surveillance. Interstate differences likely resulted from differences in local practice patterns, acceptance of treatment, and access.
    • Assessments Evaluating the Relationship Between Psychosocial Factors and Upper Extremity Trauma: A Scoping Review

      Coleman, Isabelle; Glaze, Morgan; Griffin, Caroline; Holbrooks, Sarah Beth; Moore, Kristen; Department of Occupational Therapy (Augusta University, 2021-09)
      Objectives of Presentation: At the conclusion of this presentation, attendees will: ● Identify 3 current assessments available that evaluate the psychosocial components of upper extremity (UE) recovery after trauma. ● Discuss 3 of the most common types of psychosocial challenges often experienced by individuals with UE trauma. Clinical/Research Question: What assessments are available for examining the relationships between psychosocial factors and UE trauma during rehabilitation of adults with UE trauma?
    • Benefits and Challenges in the Development and Implementation of a Doctor of Physical Therapy Consortium

      Keskula, Douglas R; Mishoe, SC; Wark, ET; Department of Physical Therapy (Georgia Regents University, 2013-05-23)
      Educational consortiums provide an opportunity to improve the quality of the educational programs involved through an increase in resources, collaboration, and expertise, both administrative and faculty. This paper addresses the benefits along with the major challenges encountered in the development and implementation of a consortium involving multiple universities within a state system of higher education. The Board of Regents of the University System of Georgia approved the Doctor of Physical Therapy Consortium in 2005. The consortium created a partnership between three existing and successful physical therapy programs. One program was housed in a research university, and two were located in state universities. The primary goal of the consortium was to create an educational alliance within Georgia, which enabled the two state university physical therapy programs to offer doctoral level education to their students. The state university programs were unable to award the doctoral degree due to their institutional missions at that point in time. Forming a collaborative relationship between the state programs built on the excellence of the existing programs, helped to meet the demands of incoming students seeking a degree in physical therapy, produced a steady number of physical therapy graduates, and helped to meet the increasing expectations for practice into the future. The consortium was created to allow each partner to retain their unique mission, curriculum and identity while offering a doctoral degree in physical therapy to all students. Although there were several successful outcomes directly related to the consortium, there were also a variety of challenges that we believe limited the sustainability of the partnership. These challenges included costs relative to benefits, managing ambiguity, the perceived lack of faculty control, and issues related to effective and assertive conflict management.
    • Benefits of International Fieldwork for Occupational Therapy Students

      Vickman, Hannah; Carter, Krissy; Dittmer, Chandler; Nettles, Taylor; Wang, Caroline; McCarley, Trinity; Department of Occupational Therapy (Augusta University, 2020-09-01)
      At the conclusion of this presentation, attendees will: 1) Identify the perceived benefits for international fieldwork ascertained from the research and how that relates to professional and personal development, and 2) Identify the key clinical experience differences between OT students participating in international and domestic fieldwork, as established from the presented research.
    • Development and Characterization of a Closed-Head Mild Traumatic Brain Injury Model

      Alverson, Katelyn; Clinical Laboratory Sciences (Augusta University, 2020-12)
      Traumatic brain injury (TBI) is a leading cause of death and disability worldwide and places an enormous economic burden on both families and health care systems that provide support for survivors. The majority of TBI cases are deemed mild (mTBI) and go undetected due to the less discernable signs and symptoms. However, there is increasing evidence that mTBI can lead to detrimental chronic consequences. Unfortunately, the mTBI research field is still in its infancy. We set out to develop a model of closed-head mTBI that recapitulated mTBI in the clinic. Using a murine controlled cortical impact model, we show no structural damage, increased edema, behavioral deficits, cell death and decreased synapses in the acute time after the mTBI. We also evaluated the chronic behavioral changes from two weeks to three months post TBI. All in all, our mTBI model showed significant cellular changes, but did not give robust chronic behavioral results. A secondary outcome of our study was the evaluation of a potential therapeutic: remote ischemic conditioning (RIC). Acutely, RIC improved edema, behavioral outcomes, cell death, and synapse loss. Overall, our study does identify key areas that should be recapitulated in further development of the model: no structural damage, little to no edema, cell death and decreased synapses, and behavioral changes. This model also requires further investigation into the chronic consequences of mTBI as well as the use of RIC.
    • Disparities in Autism Educational Classification in the United States: A Summary of Public-School Data in Three States in Autism Educational Classification in the United States: A Summary of Public-School Data in Three States

      Bevil, Bailey; Breitmann, Shelby; Dyals, Bethany; Franke, Catherine; Hassett, Anna; Padgett, Gracie; Benevides, Teal; Department of Occupational Therapy (Augusta University, 2021-09)
      • Problem: Limited research exists to describe and understand disparities in autism spectrum disorder (ASD) classification across counties in the United States. A classification of ASD is valuable as it provides the child with greater access and provision of resources both within and outside of the school system. • Research has shown that definitions and evaluation procedures vary among states (Pennington et al, 2014). • Some individuals who have autism spectrum disorder do not obtain a diagnosis of ASD until they are into their adolescence or adulthood (Centers of Disease Control and Prevention [CDC], 2020). • Early intervention for autism spectrum disorder can increase positive outcomes (CDC, 2020). • Only 58% of children who meet the criteria for a diagnosis of autism spectrum disorder have it documented in their education or health records (Mandell et al, 2009). • Purpose Statement: This study sought to collect data demonstrating ASD disparities in three states, Massachusetts, Louisiana, and New York, in the United States as it relates to classification and accessibility to school-based services.
    • The Effects of Interprofessional Education on Occupational Therapy Student Practitioner Outcomes: A Systematic Review

      Adams, Emma; Carlto, Meg; Kali, Todd; Department of Occupational Therapy (Augusta University, 2020-09-01)
      Objectives of Presentation: 1) Understand and communicate the effects that various evidence based interprofessional education interventions have on occupational therapy student outcomes. and 2) Discuss the gaps in the literature, indicated by this systematic review, as they relate to interprofessional education and its effects.
    • Enabling Assessments to Better Inform Goal Setting and Treatment Planning for Patients with Elbow, Wrist, and Hand Impairments

      Hughes, Jason; Department of Occupational Therapy (11/7/2018)
      Musculoskeletal disorders, including elbow, wrist, and hand impairments, are the second most common disability worldwide and place a large burden on the health care system. Due to this prevalence and cost, accurate and precise assessment is critical to ensure that patient treatment is optimal (i.e. efficient and productive). Our first objective was to examine the item-level characteristics of the Elbow, Wrist, and Hand Computer Adaptive Test (EWH CAT) using Rasch analysis, including item difficulty measures, person ability measures, item fit, and item-person match. A unique feature of Rasch analysis is its ability to plot person ability and item difficulty on the same continuum. Awareness of this relationship helped us discern that while our items matched our sample relatively well (i.e. sample mean .13 logits above the item mean) there were slight ceiling and floor effects indicating that the addition of some harder and easier items might increase the breadth of abilities in our sample that could be accurately measured. After identifying the item-level properties of the EWH CAT, our second objective was to develop a data collection form to assist clinicians in goal setting and treatment planning. Using the Winsteps Rasch analysis program, a keyform was generated. Based on this keyform, a data collection form was created that could be used to illustrate how patient responses to specific items (i.e. difficulty indicated) differ from admission and discharge, thus helping to guide clinicians in goal setting and treatment planning. Our third objective was to identify factors that increase the probability of favorable outcomes for patients with elbow, wrist, and hand diagnoses. Seven variables were found to be associated with the likelihood of a poorer outcome: being female, having greater than three comorbidities, having a history of surgery, acuity of > 22 days, exercising less than 3 times a week, no medication use, and payer source. Four variables were significantly associated with a greater probability of a good outcome: no history of surgery, no medication use, shorter acuity, and payer source. This knowledge might indicate when a treatment approach different from traditional rehabilitation may be required and/or additional consults may be necessary.
    • Evidence Related to Setting, Structure, and Outcomes of Occupational Therapy Nontraditional Level II Fieldwork: A Scoping Review

      Graham, Maggie; Hartman, Kylee; LeMasters, MacKenzie; Moore, Brette; Reed, Lilly; Thrysoe, Gitte; Vera, Laurie; Kearney, Pamalyn; Department of Occupational Therapy (Augusta University, 2021-09)
      Definition: Nontraditional Fieldwork (NTFW): Site where OT services may be unavailable prior to implementation • May be supervised by an employee of organization1 or an OT • ACOTE: full time FW hours for 24 weeks graduation eligibility2 Gaps in the literature include: • Definition of NTFW • Amount of supervision • Sample size variations between traditional FW and NTFW • How students engage with patients in NTFW settings • Information to support and inform all stakeholders about difficulties in NTFW settings • Results on student educational success in NTFW Purpose: to address the gap in the literature by looking at widely available sources to provide relevant insight into nontraditional Level II Fieldwork for the interested audience.
    • Evidence supporting interventions within the scope of occupational therapy for addressing

      Arnold, Jackie; Cyr, Emily; Garner, Kathryn; Long, Tori; Robles, Alexis; Department of Occupational Therapy (Augusta University, 2020-08-26)
      At the conclusion of this presentation, attendees will: a) List three effective interventions to address cognitive and psychological factors in chronic pain based on the presented scoping review of the literature, and b) Articulate the importance of cognitive/psychosocial factors in relation to chronic pain.
    • Evidence to Support Environmental and Contextual Modifications to Improve Participation in Community Events for Children with Disabilities

      Howell, Alexis; Priest, Teri; Sandy, Emily; Williams, Meghan; Kearney, Pamalyn; Rosche, Mallory; Department of Occupational Therapy (Augusta University, 2021-09)
      • Current literature has shown that children with disabilities participate less often and are not as engaged when participating compared to children without disabilities • This lack of participation might occur due to the interaction between environmental, attitudinal, and social barriers at home, at work, and during play • Participation allows children to learn about societal expectations, appropriate communication with others, develop friendships and skills they need to become successful at home, in communities, and in life • Participation is regarded as an essential aspect of child health and well being • This study aims to determine what evidence is available to support modifications to environments and contexts to improve participation in community events for children with disabilities under the age of 18.
    • Human vs Machine: A Systematic Review of Automated Bead-Based Multiplex Immunoassay Performance

      Charles, Mosa; Gao, Jie; Jiang, Jingyuan; Cannon, Joseph; Sloan, Gloria; Stuart, Ansley; Weintraub, MJ; College of Allied Health Sciences - Clinical Laboratory Sciences (2017-03-10)
      Autoimmune diseases are important contributors to morbidity and mortality in the United States. Researchers have identified more than 20 subtypes of antinuclear antibodies (ANAs), which are the hallmark of autoimmune diseases (1). Reliable, rapid ANA tests with acceptable sensitivity and specificity are in high demand for the timely diagnosis and treatment of autoimmune diseases (2,3). The gold standard for ANA detection is manual indirect immunofluorescence (IIF) with Hep-2 cells. This method is highly sensitive but has several flaws. It relies heavily on highly skilled morphologists which may lead to reader bias, and increased inter-laboratory variation (2,4). This study is a systematic review of the currently available multiplexed systems (i.e., Bioplex 2200, AtheNA Multi-Lyte ANA and FIDIS Connective 10) that might serve as alternative methods for detection of ANAs in the diagnosis of autoimmune diseases (5).
    • In Vivo Pilot Study: Effect of Dehydration/Rehydration on Upper Anterior Tooth Color Change

      Britton, Eduardo; Nappi, A; Cao, T; Shepherd, K; Department of General Dentistry, Dental Hygiene, Department of Restorative Sciences (Augusta University Libraries, 2019)
      Isolation of tooth structure during fabrication of a bonded, direct, resin-based restoration is essential to optimizing its potential for long-term clinical success. Failure to protect etched enamel and bonding agents from contamination by saliva results in inadequate and unpredictable interfacial bonding of the restorative composite, potentially leading to marginal discoloration, open margins, recurrent decay, or ultimately to restoration loss or failure. A consequence of tooth isolation during placement of direct, esthetic restorative resins is the dehydration of enamel surfaces that will not be coated with saliva, and will, over time, lose water that has penetrated into the outer enamel layers (will dehydrate). The longer the tooth isolation time, the greater will be the subsequent loss of water from enamel. Presence of this water in enamel helps to provide for a stable tooth color. In teeth, the observed tooth color is the result of internal light penetration and interaction with tissues below the surface. Enamel is a translucent material, passing a great majority of transmitted light to fall on the more opaque and yellow-colored tissue underneath of it: dentin. In the hydrated state, enamel is more translucent than in its dehydrated state. The white opaque appearance of dehydrated enamel can be of great clinical concern, once a rubber dam has been removed, and the treated teeth with newly placed restorations are observed. Usually, because of the opaque, white nature of recently dehydrated enamel, there is an initial mismatch between an esthetic restoration just placed and its surrounding, remaining enamel. Patients are normally forwarded of this consequence, and are advised that a period of time needs to pass before the surrounding enamel becomes rehydrated, and more translucent (less opaque), before its pre-isolated color returns to a natural state. It is hoped that, at that time, the new restoration will perfectly match the color characteristics of the remaining enamel, and the recent replacement will not be visible at all, but will instead optically blend in without notice. However, prior to that time, there are definitely distinct color differences between a recently placed resin restoration and its surrounding tooth structure. To date, little-to-no information is available on the rate at which a clinician or patient can expect isolated enamel to return to its pre-isolated color, and when to expect this esthetic blending to occur.
    • INDICATORS OF IMPROVING LIFE SCIENCES RESEARCH PERFORMANCE AT US ACADEMIC INSTITUTIONS

      Vernon, Marlo; Department of Interdisciplinary Studies (8/3/2018)
      The academic research institution has long been recognized as a source of innovation and scientific advancement. The goal of this study is to determine how external and internal influences on university research can best contribute to and benefit society through science, economics, and public health. A systematic review of university ranking systems first outlines the current metrics used to evaluate the productivity of research and their validity for assessing research quality and translation of ideas. A total of 24 ranking systems were identified and 13 eligible ranking systems were evaluated. Ranking systems rely on singular indicators, reputation surveys, and tend to be non-replicable. Rankings influence academic choice yet research performance measures are the most weighted indicators. A new multi-dimensional framework of indicators for evaluation of academic research is then proposed across three factors: contributions to science, public health, and economics is then proposed. Data on faculty size, research expenditure, publications, citations, intellectual property outcomes, clinical trials registration and results, and contributions to clinical practice guidelines were included. National benchmarks are reported for the top ten percentile averages of each indicator. One of the proposed public health indicators utilizes clinical trials reporting. At 167 universities, 16,787 clinical trials were evaluated for planning, execution, and overall quality between 2001 and 2016. Over time, significant quality improvement was observed, however execution quality was much lower than planning quality. For completed intervention trials after 2007, only 21% (95%CI: 20%, 21%) had uploaded results – this is required under certain conditions within one year of completion. NIH funded trials had significantly better quality scores than all others (p<0.001). Finally, latent profile analysis (LPA) identified three university profiles determined by the proposed indicators, which significantly predicted research expenditure and income generated from licensure. The profiles were also linearly associated with the 2015 Carnegie Classification, providing convergent validity. Considering the large ratio of non-reproducible research, and the increasing societal pressure to demonstrate value, broader and more practical indicators for evaluation, as proposed, may better support improvement and attract public trust in research.
    • Insulin-like Growth Factor-1 Receptor as a Prognostic Factor for Breast Cancer: A Systematic Review and Meta-Analysis

      Du, Helen; Koranteng, Patience; Stuart, Ansley; Sloan, Gloria; Weintraub, MJ; Cannon, Joseph; College of Allied Health Sciences - Clinical Laboratory Sciences (2017-03-10)
      Breast cancer is the “malignant proliferation of epithelial cell lining the ducts or lobules of the breast” (1). Breast cancer is the most common form of cancer affecting women and the second leading cause of cancer death among women. Insulin-like growth factors are potent mitogens that have a role in cell proliferation, differentiation, and apoptosis. Overexpression of IGF-1R is thought to cause an increased risk in tumor metastasis and tumorigenesis. The aim of this project is to conduct a systematic review of IGF-1R expression in breast cancer and its relationship to patient survival. Our hypothesis is that increased insulin-like growth factor-1 receptor expression leads to poor prognosis in breast cancer patients.
    • Intraprofessional Educational Activities Implemented by Occupational Therapy Programs in the United States

      Eller, Sydney; Morris, Emma; Parker, Olivia; Ruble, Charlotte; Speciale, Natalie; Usry, Jenna; Watford, Patricia; Department of Occupational Therapy (Augusta University, 2021-09)
      ● Intraprofessional collaboration has been shown to increase:2. 3 ○Confidence ○Patient care ○Ethical compliance ○Cost-effective care ●The accrediting body for occupational therapy education, ACOTE, requires that OT and OTA programs address: ○Intraprofessionalcollaboration ○How to engage in the consultative process, evaluation process, and treatment process with their intraprofessionalcolleagues.1 ●An unpublished survey from 2019 found that 68% of programs included intraprofessional collaboration in their curriculum4despite requirements from ACOTE.1 ●Our research questions are: What is the prevalence of intraprofessional collaboration in occupational therapy education programs and what strategies are used to implement intraprofessional activities?
    • Managing clinical knowledge for health care improvement

      Balas, E. Andrew; Boren, Suzanne A.; College of Allied Health Sciences (2000)
      The authors assess the growth in clinical research studies coupled with a slow rate of adoption, often taking an average of 17 years for new evidence-based findings to reach clinical practice. Some issues discussed include the need for a more efficient information infrastructure to better connect front-line professionals with the research community, difficulties in translating research into practice, and an inadequate system to help health care clinicians evaluate the strength of new study findings.
    • Manual Physical Therapy for a Patient Following Total Knee Arthroplasty (TKA)

      Petosky, Teressa; Keskula, Douglas R; Akinwuntan, Abiodun; Wilson, Diane; Department of Physical Therapy (Georgia Regents University, 2013-06-07)
      A 66-year-old woman was referred to outpatient physical therapy 3 weeks following primary unilateral TKA for severe osteoarthritis. Upon initial examination, the patient had significant post-operative pain, impaired gait, and decreased range of motion (ROM),strength, and functional mobility. Additionally, the patient presented with adherent scar tissue along the length of her surgical incision and diffuse soft tissue restrictions in the quadriceps and tensor fascia latae. Treatment consisted of all the components of conventional physical therapy in addition to manual physical therapy. Components of traditional physical therapy included strengthening exercises, aerobic exercises, stretching, and training in performance of everyday activities, such as navigating stairs. Manual therapy techniques included joint mobilization, scar tissue massage, soft tissue mobilization, and therapist-assisted manual stretching. Active knee flexion ROM, the Timed Up and Go (TUG), the 6 Minute Walk Test (6MW), and the 36-Item Short Form Health Questionnaire (SF-36) were completed at initial examination and again 5 weeks later at discharge.
    • Micronutrient and Macronutrient Composition of Breastmilk from Women Delivering Prematurely

      Gates, Amy; Department of Interdisciplinary Health Sciences (Augusta University, 2020-07)
      Objective: The objective of this study was to measure the macronutrient and micronutrient composition of breastmilk expressed by mothers, including African-American women, delivering preterm infants < 33 weeks gestational age. Our second objective was to use mother’s milk data to determine if preterm breastmilk (lactation day 7 and 28), and donor breastmilk fortified with four commonly available human milk fortifiers met the minimum recommended range of nutrients for the preterm infants. Methods: We collected breastmilk samples from mothers of preterm infants admitted to the NICU at Augusta University Medical Center (AUMC) from January-November 2019. Mother’s milk samples were collected on post-partum days 7, 14, 21, and 28 and analyzed for macronutrients and micronutrients. Using the nutrient data (means) in preterm breastmilk at lactation days 7 and 28, we calculated the nutrient composition of the fortified preterm breastmilk and donor breastmilk after the addition of four commercially available fortifiers; Enfamil® Human Milk Fortifier High Protein Liquid (EHP) (Evansville, IN), Enfamil® Human Milk Fortifier Standard Protein Liquid (ESP) (Evansville, IN), Similac® Human Milk Fortifier Hydrolyzed Protein Liquid Concentrate (SLP) (Columbus, OH), Prolacta +4 H2HMF® (PRO4) (City of Industry, CA). Results: Thirty-eight mothers, average age 27 ± 5.1 years and majority African-American (66%) provided milk for the study. The average EGA and birthweight was 28.2 ± 2.8 weeks and 1098 ± 347 grams respectively, with 42% of infants in the cohort delivering prior to the 28th week of pregnancy. Differences in protein, sodium, potassium, calcium, phosphorus, and zinc concentration based on race, day, and milk volume were identified. Dilution effects for protein, sodium, and chloride, and vitamin D concentration over time were identified. Recommended levels of energy, calcium, phosphorus, and potassium were met with the addition of all four fortifiers. Sodium, chloride, magnesium, Vitamin D, and zinc failed to meet recommendations for mature milk or donor milk and additional supplementation of these nutrients may be warranted Conclusion: Nutrient concentration in preterm breastmilk depends on numerous factors including race, volume of milk produced, lactation stage, and gestational age. These factors should be considered when developing feeding plans for preterm infants.