• Student involvement in curriculum development enhances medical education

      Griffeth, Jacline; Sawyer, Alexandra; Johnson, Nolan; Hashmi, Osama; Gupta, Neha; Swartz, Sarah; Martin, Kathryn; Augusta University (Georgia Public Health Association, 2017)
      Background: During the 2014 annual review of the curriculum for first year medical students at the Medical College of Georgia, the public health module was noted as an area that needed improvement. To address this concern, a Public Health Curriculum Workgroup was formed for the purpose of identifying specific areas to improve and developing a more robust and integrative curriculum. A small cohort of medical students with public health backgrounds were invited to be members of this workgroup and participate in the development and delivery of public health content to the next cohort of first year medical students. We hypothesized that having this type of student participation results in a more clinically relevant and engaging curriculum. Methods: The curriculum workgroup met weekly to establish learning objectives, prioritize topics, and design interactive activities. The student members contributed to both curricular planning and content delivery. First year medical students completed course evaluations following the public health curriculum. These evaluations included five Likert scale questions and three narrative feedback response questions. Evaluation data before and after student involvement in the curriculum was examined. Results: Student evaluations of the overall quality of the public health curriculum increased 38% from 2014-2016. The measure of how well the content contributed to development as a future physician increased 36%. There was a 33% increase in how well the instructional materials aided understanding of topics. Theming of narrative evaluation comments showed that student involvement in the curriculum was well received. In 2016, 28.4% of narrative comments cited student presentations as the most valuable aspect of their public health experience. Conclusions: Involving medical students with public health backgrounds in curriculum development and content delivery of a public health module for first year medical students led to improvements in overall quality, clinical relevance, and instructional materials.
    • A Study of Human Skin Color, a Natural Sunscreen: Physiology, Molecular Evolution, Public Health, and Student Learning

      Ayala, Juan; Biological Sciences (Augusta University Libraries, 2020-05-05)
      This item presents the abstract for a poster presentation at the 21st Annual Phi Kappa Phi Student Research and Fine Arts Conference.
    • Studying Gene Expression in Whole Embryos by in situ Hybridization: A Peer-to-Peer Laboratory Guide

      Kalra, Aarushi; Xia, Di; Department of Biological Sciences (Augusta University Libraries, 2017-05-11)
      The extracellular matrix (ECM) plays an important role in cell to cell signaling pathways. Our goal is to provide a full laboratory guide for students to study gene expression in zebrafish embryos by in situ hybridization. Prior to our study, the laboratory had observed disorganized and shortened cilia in cells that are important for cell signaling in the pronephric duct and neural tube floor plate of the zebrafish embryo. Ciliogenesis depends on a master transcriptional regulator, foxj1a, whose mRNA expression can be monitored through in situ hybridization and microscopic imaging. Knockdown morpholino-injected, control mismatched morpholino-injected, and uninjected embryos were fixed to determine if foxj1a transcription is qualitatively affected by ECM gene knockdown. Our results showed that the knockdown embryos portrayed an inconsistent foxj1a signal strength along the length of the pronephric duct, when compared to analysis of control mismatched and wild-type uninjected embryos. We created this manuscript for other students to observe how ECM gene knockdown can affect foxj1a mRNA expression, but also to give them a guide to the tools they would need to explore their own genes of interest, in zebrafish or in many other organisms and tissues.
    • Substance use-related brief interventions with emergency department patients reduce mental health co-morbidities

      Johnson, J. Aaron; Abraham, Amanda J.; Georgia Regents University; University of Georgia (Georgia Public Health Association, 2015)
      Background: Research on screening and brief interventions (SBIs) has shown that, in addition to reducing alcohol use, interventions delivered in healthcare settings can reduce trauma readmissions, hospitalization days, driving offenses, and future healthcare utilization and costs. Mental health co-morbidities often accompany unhealthy alcohol and drug use, but few studies have examined the impact of SBIs on the mental health of patients. The present study determined if SBIs focused on reducing alcohol or drug use affected the mental health status of patients at a six-month follow-up. Methods: Participants (N=1152) were randomly sampled from patients receiving SBIs for at-risk alcohol or drug use after presenting to one of two urban emergency departments (EDs) in Georgia. Telephone follow-up interviews were completed with 698 of the original participants at six months after the intervention. Mental health co-morbidities were measured at both time points using the Global Assessment of Individual Needs Short Screener (GAIN-SS) and the SF-12. Analyses were conducted using paired samples t-tests. Results: Analyses found significant reductions in the percentage of patients reporting feelings of anxiety (45% to 33%, p<0.001), depression (52% to 37%, p<0.001), and suicidal ideation (13% to 8%, p<0.001) as well as improvements in global mental health measures (SF12 mental health score and internalizing and externalizing subscales of the GAIN-SS). Conclusions: Six months after receiving SBIs for alcohol and drug use in EDs, several measures of the mental health of participants showed significant improvements. Widespread implementation of SBIs in Georgia's EDs may affect a broad array of public health concerns, including mental health.
    • Suite for Piano – Blending Styles and Discovering Creative Process

      Kenison, Aurora; Department of Music (Augusta University Libraries, 2021-05-18)
      This item presents the abstract for a presentation at the 2021 Annual Phi Kappa Phi Student Research and Fine Arts Conference at Augusta University.
    • Superconductivity and Magnetism in the A15 Phase of Alkali-Doped Fullerides

      Kieu, Khang; De Silva, Theja; Department of Chemistry and Physics (Augusta University Libraries, 2021-05-18)
      This item presents the abstract for a presentation at the 2021 Annual Phi Kappa Phi Student Research and Fine Arts Conference at Augusta University.
    • Surveillance, Epidemiology, and End Results (SEER) data for monitoring cancer trends

      Yoo, Wonsuk; Coughlin, Steven S; Augusta University (Georgia Public Health Association, 2019)
      Background: Monitoring cancer trends allows evaluation of the effectiveness of cancer screening or detection methods and determination of priorities in cancer control programs. Government officials and policy makers also use information on cancer trends to allocate resources for cancer research and prevention. Although data from the Surveillance, Epidemiology, and End results (SEER)-affiliated cancer registry are accessible to the public, there is a shortage of published research describing cancer incidence rates for White, Black, and other residents in Georgia. The objective of this research is to provide an overview of how to use SEER data through analysis of the incidence rate for cervical cancer. Methods: Cervical cancer cases (ICD-O-3/WHO 2008 =’Cervix Uteri’, corresponding to C530-C539) were obtained from the SEER18 database. It includes the largest geographic coverage compared to SEER 9 and SEER 13 data. The incidence and incidence rates for cervical cancer were obtained, stratified by year (2000-2012), sex, race/ethnic groups, and region (Georgia and US). Age-adjusted incidence and incidence rates (to the 2000 US standard population) were calculated using SEER*Stat software, which is available, free of charge, on the SEER Web site: http://seer.cancer.gov. Results: Age-adjusted incidences and incidence rates in Georgia and the US from SEER 18 data were created by SEER*Stat. The incidence rates were stratified by age variable (5-year category), sex, race/ethnicity, and other socio-demographic variables. Annual percent changes (APC) and 95% CI were also obtained to characterize trends in cancer rates over time. The trends for age-adjusted incidence rates for regions (Georgia and the US) and race (white, black, others) were compared using APC. Furthermore, age-specific incidence and incidence rates for cervical cancer for Georgia and US for recent five years (2008-2012) were reported. Conclusions: The Surveillance, Epidemiology, and End results (SEER) program provides cancer researchers a convenient and intuitive system for viewing individual cancer records and producing statistics useful in studying the impact of cancer on a population.
    • Surviving HIV and dying for a smoke: Implications for tobacco use among people living with HIV

      Culbreth, Rachel; Kelly, Jane; Maggio, David; Wortley, Pascale; Drenzek, Cherie; Georgia Department of Public Health HIV/AIDS Epidemiology Section; Georgia State University; Georgia Department of Public Health (Georgia Public Health Association, 2015)
      Background: Since the advent of highly active antiretroviral therapy in the mid-nineties, deaths among persons living with HIV (PLWH) have declined nationally. Now a controllable condition, HIV has become a chronic disease, highlighting the importance of tobacco cessation in lowering morbidity and premature mortality. Current smoking is approximately twice as high among PLWH compared with the general population. PLWH who smoke experience higher rates of cardiovascular disease, AIDS-defining illnesses, and cancer than PLWH who do not smoke. Loss of life-years associated with smoking among PLWH is greater than life-years lost from HIV. Methods: Data on current smoking, derived from the 2009-12 Georgia Medical Monitoring Project (MMP) were analyzed. Smoking rates were calculated by demographic characteristics, and results were compared to those from the 2011 Georgia Behavioral Risk Factor Surveillance System (BRFSS), a population-based telephone survey. Results: The prevalence of current smoking among PLWH was 36.1%, compared with 21.2% among the general population in Georgia. Smoking prevalence for PLWH generally varied by demographic characteristics according to the same pattern as for the general population, but prevalence was consistently higher among PLWH. Conclusions: The prevalence of current smoking among PLWH in Georgia is high. Clinical and public health interventions must address smoking cessation as part of HIV care to prevent disease, improve quality of life, and reduce mortality. HIV-infected smokers have more barriers to quitting (alcohol, depression, drug dependence, and inaccurate risk perception) and a lower quit rate than non-HIV-infected smokers. Efficacy studies of behavioral and pharmacological interventions for smoking cessation specific to PLWH are needed.
    • Syphilis in Georgia, 2009-2014

      Moore, Kathryn; Parker, Leonardo; Wells, Joy; Georgia Department of Health (Georgia Public Health Association, 2016)
      Background: In the period of 2002-2014, Georgia has ranked among the top three states in the United States for rates of primary and secondary syphilis cases, creating a continuing need to analyze the data and to plan and implement disease prevention efforts. Methods: The present effort involved analysis of data from Georgia’s electronic disease reporting system, State Electronic Disease Surveillance System (SendSS), including demographic characteristics by year for the period of 2009-2014 and behavioral data obtained from interviews with communicable disease specialists. Results: In Georgia, from 2009-2014, primary and secondary syphilis, the infectious stages of the disease, were seen most commonly among black, non-Hispanic (77%) males (91%) between the ages of 20-29 (45%); 52% were males who have sex with other males. Conclusions: Analysis of the data provides a better understanding of the populations affected by syphilis. It can enhance discussions about disease surveillance, prevention, and strategies to decrease the burden of this disease.
    • A systematic review of lifestyle interventions for chronic diseases in rural communities

      Smith, A Selina; Ansa, Benjamin; Augusta University (Georgia Public Health Association, 2016)
      Background: Rural Americans suffer disproportionately from lifestyle-related chronic diseases (e.g., obesity, diabetes, hypertension, cardiovascular disease, and breast cancer). Interventions that consider the distinctive characteristics of rural communities (e.g., access to healthcare, income, and education) are needed. As an initial step in planning future research, we completed a systematic review of dietary intake and physical activity interventions targeting rural populations. Methods: Manuscripts focused on dietary intake and physical activity and published through March 15, 2016, were identified by use of PubMed and CINAHL databases and MeSH terms and keyword searches. Results: A total of 18 studies met the inclusion criteria. Six involved randomized controlled trials; 7 used quasi-experimental designs; 4 had a pre-/post-design; and 1 was an observational study. Eight studies were multi-site (or multi-county), and 3 focused on churches. Primary emphasis by racial/ethnic group included: African Americans (6); Whites (2); Hispanics (3); and two or more groups (7). Most studies (17) sampled adults; one included children. Two studies targeted families. Conclusions: Additional lifestyle intervention research is needed to identify effective approaches promoting healthy diet and exercise and chronic disease prevention in rural communities. Studies that include rigorous designs, adequate sample sizes, and generalizable results are needed to overcome the limitations of published studies.
    • Tailoring a hybrid program for reducing health and education disparities in Georgia communities: Outcomes of listening sessions

      Ejikeme, Chinwe; Georgia Department of Public Health (Georgia Public Health Association, 2017)
      Background: Minorities in Georgia experience increased rates of chronic disease and poor health and education outcomes. In the general population in 2013, about 35% of adolescents were either overweight or obese and approximately 13% of children 2-4 years old were obese, with minorities accounting for higher rates. In 2010, 23% of students from low-income families, comprising a higher proportion of minorities, scored at or above proficient level for reading at the end of third grade. Targeting children 0-5 years, Georgia Department of Public Health developed an integrated curriculum to train Early Childcare Educators (ECEs) to increase their knowledge and skills to model food, activity and language nutrition in their classrooms and to coach families. We conducted listening sessions to understand attitudes and knowledge around nutrition in 3 communities with significant racial and ethnic populations. Methods: Listening sessions with ECEs and families were conducted separately in each community. Participants engaged in guided one-hour discussions around food, activity and language nutrition and completed a post-listening session survey to assess their nutrition practices with the children in their care or homes. Results: 70 ECEs and families participated in the sessions and post session surveys. With an over 80% satisfaction rate with sessions, results showed that although baseline understanding of and challenges to modelling nutrition differed in different communities, many strategies used to support nutrition were common across communities. Participants also demonstrated a need for support in increasing access to resources to improve nutrition. Conclusions: This study suggested that multiple issues hinder optimal engagement of children 0-5 years in improved nutrition. Addressing the factors specific to targeted communities is essential to reducing disparities. Thus, integrating these findings in the development of the curriculum and training strategy has the potential to produce more knowledgeable and skilled ECEs as coaches for improving nutrition.
    • Tapping the “town and gown” potential for correctional health research collaborations

      Gates, Madison L.; Staples-Horne, Michelle; Webb, Nancy C.; Braithwaite, Ronald; Hastings, Beverly (Georgia Public Health Association, 2015)
      Background: Collaborations between juvenile justice systems (town) and academia (gown) promise to significantly enhance what we understand about high rates of sexually transmitted infections (STIs) found among detained populations, particularly African American young women. However, research related to the sexual health of adolescent detainees has not occurred in proportion to the magnitude of issues found in the population. While there are many challenges to conducting research with this population, there are also lessons learned and best practices from other studies that may provide guidance. Methods: In 2015, we implemented a pilot project with young women in a detention center to understand the association between STIs and relationship dynamics. Using a formative assessment-based approach, the team periodically compared expectations to actual milestones and outcomes. This approach has provided feedback, guidance and lessons learned that we will use to adjust our pilot project. Results: Three challenges emerged from our review: concerns related to different agendas, bureaucratic difficulties and human protection. In addressing these challenges, we identified study procedures to revise and to incorporate into future works. Conclusions: Juvenile justice and academic partnerships require extensive pre-research work to account for the many challenges to implementing and conducting projects with this population. However, “town and gown” approaches to understanding and improving the sexual health of detainees can result in a more complete assessment of these issues compared to either a solely academic or juvenile justice investigation.
    • TEACH Kitchen: A Chronological Review of Accomplishments

      Chea, Jung Hee; Ansa, Benjamin E.; Smith, Selina A.; Augusta University (Georgia Public Health Association, 2017)
      Background: The Eating and Cooking Healthy (TEACH) Kitchen was founded at the Medical College of Georgia in 2015 as a nutrition-based intervention to combat the high prevalence of obesity and obesity-related chronic diseases in the area of Augusta, Georgia. Despite the importance of diet in the management of chronic diseases, inadequate nutrition education among patients and healthcare providers presents a barrier. The purpose of TEACH Kitchen is to address this gap. Methods: TEACH Kitchen is as a student-led initiative that promotes healthy cooking among medical students and patients with chronic diseases. Healthy nutrition and cooking classes are held during the academic year. Participants spend four weeks on each of four modules: obesity, hypertension, hyperlipidemia, and diabetes mellitus. Data collection, which began in January 2017, is currently on going. TEACH Kitchen has collaborated with Augusta University, Sodexo, and Kohl’s. Results: Currently, TEACH Kitchen has enrolled 14 patients and 6 children. Anticipated results include measurements of preand post-intervention changes in knowledge, attitudes, beliefs, and competence in nutrition, as well as differences in clinical indicators, including body mass index, blood pressure, lipid profile, and HbA1c. Conclusions: TEACH Kitchen is the first medical school-based nutrition/cooking education initiative in Augusta, Georgia. It provides patients and medical students with hands-on healthy nutrition/cooking experience with the goal of decreasing the prevalence and improving the outcome of obesity-related diseases.
    • Techniques Used to Establish the First Person Narrator and Perspective in Double Indemnity and Murder, My Sweet

      Walton, Breana; Department of English and Foreign Languages (Augusta University Libraries, 2017-05-11)
      Directed by Billy Wilder and Edward Dmytryk respectively, the films noir Double Indemnity (1944) and Murder, My Sweet (1944) each have a storyline that unfolds from a first person perspective as told by a narrator. The techniques used in the films establish this first person perspective through which the films are understood. Both films include voice over as a technique, which determines who the narrator is and the amount of information withheld or disclosed to the audience. Establishing the visual perspective of the narrator is portrayed through differently for each film. While, Double Indemnity utilizes camera angle, Murder, My Sweet uses camera filters and special effects. Lastly, to achieve the first person narration, the character narrating in each film must be present in every scene or give explanation of events that occur in his absence. The various techniques used in each film function cohesively to establish the narrator and achieve his perspective through which the plot is understood by the audience.
    • Telehealth in Assisted Reproductive Technology to Improve Disparities in Access to Care in Rural Georgia

      Smith, Hannah; Mikael, Sasha; Gaidis, Anna; Gavrilova-Jordan, Larisa; College of Education; Department of Obstetrics and Gynecology (Augusta University Libraries, 2021-05-18)
      This item presents the abstract for a presentation at the 2021 Annual Phi Kappa Phi Student Research and Fine Arts Conference at Augusta University.
    • Trends in cancer incidence rates in Georgia, 1982-2011

      Yoo, Wonsuk; Coughlin, Steven S.; Lillard, James; Georgia Regents University; Emory University; Morehouse College (Georgia Public Health Association, 2015)
      Background: Although data from the Surveillance, Epidemiology, and End results (SEER)-affiliated cancer registry are accessible to the public, there is a shortage of published research describing cancer incidences for White, Black, and other residents in Georgia. The objective of this research is to provide an overview of the trends in incidence of cancer in Georgia. Methods: Incidence data were obtained from the Surveillance, Epidemiology, and End Results (SEER) 9 program, supported by the National Cancer Institute, spanning the years 1982 to 2011. To assess trends over time, age-adjusted cancer incidence rates relative to the 2000 Standard US population and annual percent changes (APCs) were calculated using SEER*Stat software. Results: In Georgia, cancer incidence rates for women increased from 365.1 per 100,000 in 1982 to 404.2 per 100,000 in 2011, with an overall APC of 0.3% (95% confidence interval: 0.2 to 0.4), but, for men, cancer incidence rates showed a slight decline from 528.0 per 100,000 in 1982 to 513.7 per 100,000 in 2011 (APC of 0.2%, 95% CI: -0.6 to 0.1). For Black, White, and Other (Asian/Pacific Islanders/American Indians) females, there were increases in incidence in this period, with APC values of 0.6, 0.4, and 0.3, respectively. For all males and for Black and White males, there were overall decreases in incidence, with APC values of -0.2. For Other males, however, the APC value was -0.9. Conclusions: In Georgia, increases in cancer incidence rates occurred during 1982-2011 among the female population and within various racial groups in this population, but there was relative stability in incidence rates among the male population, except for Other males.
    • Trends in HIV testing among adults in Georgia: Analysis of the 2011-2015 BRFSS data

      Ansa, Benjamin; Augusta University (Georgia Public Health Association, 2017)
      Background: Georgia is ranked fifth highest among states for rates of HIV diagnosis. About 4% of persons living with HIV infection in the United States reside in Georgia, and almost 19% of these people do not know their HIV status. The present study examined the trends and associated factors of HIV testing among adults in Georgia between 2011 and 2015. Methods: The 2011-2015 Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed. Results: A total of 31,094 persons aged ≥18 years were identified who responded to the question “Have you ever been tested for HIV?” Overall, there were 11,286 (44.2%) respondents who had been tested for HIV, with a slight decrease in percentage from 45.6% in 2011 to 43.7% in 2015 (APC= -0.98, not significant). Factors associated with HIV testing were being female (p=0.004), black (p<0.001), younger than 55 years (p<0.001), single (p<0.001), attaining education level above high school (p<0.001), and earning annual income of $50,000 or less (p=0.028). Conclusions: Overall in Georgia, there has been a slight decline in the temporal trend of HIV testing, and more than half of adults have never been tested for HIV.
    • Triple-negative breast cancer in Georgia: Burden, disparities, and connections to Georgia’s Breast Cancer Genomics Project

      Berzen, Alissa; Bayakly, Rana (Georgia Public Health Association, 2017)
      Background: Triple negative breast cancer (TNBC) is typically aggressive and unresponsive to traditional cancer treatment, and disproportionately affects young and Black women. Approximately 60%-80% of breast cancers in women with the breast cancer gene (BRCA) mutation are TNBC, and children of a parent with a BRCA mutation have a 50% chance of inheriting it. Current guidelines recommend women diagnosed with TNBC receive genetic testing and counseling. Georgia’s Breast and Cervical Cancer Program (BCCP) routinely screens clients for increased risk of genetic mutation via an online screening tool. Methods: Using data from the Georgia Comprehensive Cancer Registry (GCCR) for 2010-2013, we calculated TNBC percentages/rates, diagnosis stage, and case fatality rate based on vital status. By using TNBC data as a proxy for BRCA gene mutation prevalence, we assessed the burden of TNBC and racial/age disparities to inform Georgia’s genomics efforts. Results: The percentage of invasive breast cancers, versus in-situ, was the same for Georgia Black and White women; however, Black women had almost double the percentage of TNBC as compared to White women. Black women under 40 had a 20% higher breast cancer incidence rate than similarly aged White women, but had almost double the TNBC rate. Georgia TNBC cases were about twice as likely as non-TNBC cases to be deceased, and Black TNBC cases had higher fatality rates than White cases (almost twice as high in women under 40). Conclusions: Georgia’s genomics program began screening in 2012, and participating counties offer screening to all women’s health clients. Awareness of hormone receptor status (and furthermore, possible presence of genetic mutation) for women diagnosed with breast cancer can guide the proper course of treatment. Additionally, family members of women diagnosed with TNBC in Georgia may take advantage of the screening for risk of genetic mutation through the genomics program prior to a cancer diagnosis, and receive counseling where appropriate.
    • The two Georgias: Disparities in rural health and healthcare

      Nelson, D Gary; Healthcare Georgia Foundation (Georgia Public Health Association, 2016)
    • Unconsciously in the Closet: Repressed Queerness in Another Country

      O’Keefe, Alison; English and Foreign Languages (Augusta University Libraries, 2020-05-05)
      This item presents the abstract for an oral presentation at the 21st Annual Phi Kappa Phi Student Research and Fine Arts Conference.