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EFFECTS OF SODIUM BICARBONATE ON GLUCOSE HOMEOSTASIS AND BLOOD PRESSURE IN CHRONIC KIDNEY DISEASESodium bicarbonate (NaHCO3) is a therapeutic used in chronic kidney disease (CKD). NaHCO3 is typically used to treat metabolic acidosis, but clinical studies have indicated that NaHCO3 supplementation may slow CKD progression. As such, NaHCO3 is now given to patients with CKD to slow the decline of glomerular filtration rate. However, the consequences of chronic NaHCO3 supplementation in CKD remain unclear. Acidosis has been associated with insulin resistance, and correction of acidosis with NaHCO3 was reported to improve insulin sensitivity. Our goal in Aim 1 was to determine whether acid and alkali loading would promote loss of acid-base homeostasis and consequently decrease insulin sensitivity. We determined that the blood glucose response to insulin is enhanced following renal mass reduction, and that this response is not reversed by an acidosis. Additionally, the development of an alkalosis did not impair the blood glucose response to insulin. Alkali can promote potassium (K+) wasting, and an association between K+ wasting and insulin resistance has been identified in clinical and basic science research. Our goal in Aim 2 was to identify whether chronic NaHCO3 treatment may promote loss of insulin sensitivity through effects on K+ status. We determined that chronic NaHCO3 treatment impairs insulin sensitivity when combined with other K+ wasting stimuli. K+ deprivation alone also impaired the blood glucose response to insulin, however these impairments in insulin sensitivity were not directly related to decreases in intracellular [K+]. Salt-sensitivity increases as functional renal mass declines, and chronic sodium (Na+) loading with NaHCO3 may contribute to hypertension in patients with CKD. Our goal in Aim 3 was to investigate whether NaHCO3 loading promotes similar levels of Na+ and volume retention, and hypertension as sodium chloride (NaCl) loading does in a rat model of CKD. We found that NaHCO3 was pro-hypertensive, but to a lesser degree than NaCl, despite similar amounts of Na+ and volume retention. From these studies we concluded that NaHCO3 does not improve insulin sensitivity through its effects on acid-base status. Further, access to dietary K+ may improve insulin sensitivity with chronic NaHCO3 treatment. Finally, NaHCO3 can promote hypertension in CKD.
Evidence to Support Environmental and Contextual Modifications to Improve Participation in Community Events for Children with Disabilities• 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.
Evidence Related to Setting, Structure, and Outcomes of Occupational Therapy Nontraditional Level II Fieldwork: A Scoping ReviewDefinition: 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.
Assessments Evaluating the Relationship Between Psychosocial Factors and Upper Extremity Trauma: A Scoping ReviewObjectives 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?
A Scoping Review of International Interprofessional Education and Collaborative Evidence• Gap in literature: Best practices for allied health international interprofessional collaboration and education • Collaboration better coordinates interprofessional care for best patient centered focus. • Interprofessional education improves health outcomes, sets foundation for future health care professionals, and provides basis for communication, collaboration, and patient care. • Allied Health Professions: Those which require practitioners to attend a higher level institution, obtain a certificate, and work collaboratively with other healthcare professionals to provide care to individuals suffering from acute and chronic diseases, rehabilitation services, and dietary and nutrition services in several settings. Research Question: Among allied health science disciplines, what is the evidence supporting outcomes as related to international interprofessional education and collaborative experiences?