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This sub-community contains the Department of Health Informatics Faculty Papers, the Department of Physical Therapy Faculty Papers, and the Doctor of Physical Therapy Student Papers collections

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  • ADIPOSE HDAC9 DELETION PROTECT AGAINST DIET INDUCED OBESITY IN MICE THROUGH REGULATING ENERGY EXPENDITURE

    Hassan, Nazeera; Zarzour, Abdalrahman; Department of Biological Sciences; Department of Medicine; College of Allied Health Sciences; Kim, Ha Won; Weintraub, Neal; Augusta University (2019-02-13)
    Our group has previously identified histone deacetylase 9 (HDAC9) as a regulator of adipocyte differentiation, and its expression levels were elevated in diet induced obese (DIO) mice.� We also reported that global HDAC9 deletion protected mice against DIO through promoting beige adipogenesis. Here, we hypothesized that adipose HDAC9 correlate with human obesity similar to murine models, and its deletion is sufficient to protect against DIO. To test this hypothesis we crossed HDAC9 floxed mice with adiponectin-cre mice to generate adipose-specific HDAC9 knockout mice (AdipCre-HDAC9), which exhibited 30% less weight gain when fed high fat diet compared to control despite increased food intake, in association with increased energy combustion & O2 consumption, improved insulin sensitivity and glucose tolerance. However, unlike global HDAC9 deletion, this was not associated with increased beige adipogenesis nor increase in brown adipose tissue function. Interestingly, AdipoCre-HDAC9 mice fed normal chow diet didn�t exhibit altered energy expenditure nor weight differences when compared to littermate controls. These finding suggest that adipose HDAC9 regulate energy expenditure in response to high fat diet and can be a promising therapeutic target to combat obesity.
  • EFFECTS OF CHRONIC ALOHOL AND GLUCOSE EXPOSURE ON VIABILITY OF ALVEOLAR MACROPHAGES

    Keller, Elizabeth; College of Science and Mathematics; College of Allied Health; Curry-McCoy, Tiana; Thomas, Amanda; Augusta University (2019-02-13)
    The adverse health risks associated with alcohol abuse and obesity are widely known by the general population. Although lesser known, studies have presented the lungs as secondary organs affected by such lifestyle factors. Healthy lungs are protected against infection and harmful airborne particles by macrophages, the working entities of the immune system which fight potential sources of infection. When these immune-responsive cells are compromised and unable to perform their functions, lung health may deteriorate. Therefore, a healthy pulmonary alveolar macrophage population is vital for adequate lung function. Chronic alcohol abuse and obesity have been shown to suppress alveolar macrophage function, thus lowering the lungs� first line of defense. The objective of this study is to determine the effects of exogenous ethanol and increased glucose concentration on macrophage size and viability via an�in vitro�study on NR8383 rat alveolar macrophages. The study measures macrophage viability under treatment conditions.
  • 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.
  • 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.
  • 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).
  • Online Teaching

    Barefield, Amanda; Department of Health Management and Informatics (2016-10-24)
    "Have you ever wandered what it would be like to teach online, or do you cringe at the sound of the words? In this session, Dr. Barefield will share insights from her 15+ years of teaching in an online environment. Topics of discussion will include learning in the 21st century, planning an online course, developing the online course, and teaching the online course. Whether you are a newby or old pro, there will be something for everyone to discuss." Ms. Barefield has 20 years experience teaching in hybrid and online environments. She received her EdD in Instructional Technology and Distance Education from Nova Southeastern University. Her research includes evaluating student support services in online environments and comparisons of student performance in traditional and online environments. She currently teaches in both traditional and online formats for the Health Information Administration and Master of Public Health Programs.
  • Creating a Culture of Mentoring Within our Diverse University

    Chatto, Charlotte; Quinn, Molly; Department of Physical Therapy; Department of Teacher Education (2016-09)
    The presenters will share the path they took to create an evidenced-based pilot mentor training program designed to serve our faculty in liberal arts and health science colleges. During their year as Faculty Development Fellows, they created and delivered a pilot program that consisted of three weekly, two-hour workshops with six faculty from the College of Nursing. The audience will engage in several of the engaging activities that were used in the program. Results from participant surveys and self-assessments will be reported, as well as literature illuminating the benefits of mentoring and characteristics of effective mentors. Dr. Charlotte Chatto and Dr. Molly Quinn were the 2015-2016 Faculty Development Fellows in the Office of Faculty Development and Teaching Excellence (OFTDE). They have been working on a major initiative that involves piloting a research-based mentor program in each of their respective colleges, as well as, developing a university-wide mentor training program.
  • Managing clinical knowledge for health care improvement

    Balas, E. Andrew; Boren, Suzanne A.; Office of the Dean of the 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.
  • Pulmonary Stress in the Alcoholic and Obese Lung

    Thomas, Amanda Blair; Department Of Undergraduate Health Professions (Augusta University, 2015-05)
    In the United States today, alcoholism and obesity are increasingly becoming issues for a vast age group from young children to geriatric adults. Alcoholism and obesity have been extensively studied as separate entities that have been proven to change metabolism and cause over-lapping health issues, which prompted us to study them in conjunction with one another, especially in the lungs. One major link between these two alarmingly common problems is Krüppel-Like Factor 4 (KLF4), a cell regulatory protein crucial to cellular normality and monocyte differentiation. This particular study highlights the effects alcoholism and obesity have on the lung, specifically epithelial cells (L2) and macrophages (AM). The goal of this project is to measure the KLF4 expression in the L2 and AM cells subjected to high ethanol (EtOH) consumption, high glucose consumption, high EtOH and glucose consumption, as well as a healthy control lung in to explain the mechanism behind decreased immune function in these patients.
  • Rehabilitation of a 38 year old male following an Arthroscopic Repair of a Type II Superior Labral Anterior Posterior (SLAP) Lesion

    Gonsalves, Vincent; Keskula, Douglas R; Department of Physical Therapy (Shenandoah University, 2013-06-25)
    Postoperative rehabilitation following arthroscopic repair of the Type II superior labral anterior posterior (SLAP) biceps lesions presents a challenge to the physical therapist due to limited evidence-based reviews available within the literature. This case report describes the postoperative rehabilitation of an arthroscopic Type II SLAP repair utilizing suture anchors. The interventions and the postoperative precautions are outlined and related to the emerging evidence. The patient described was a 38 year old male electrician who sustained a work-related SLAP lesion and was referred to physical therapy for postoperative rehabilitation. Following participation in a supervised structured plan of care, the patient developed adequate strength and range of motion required for job functions and ADLs. He achieved a score of 95% on the American Shoulder and Elbow Surgeons (ASES) functional test. Patient goals were met and he was released to full duty without restrictions at 5 months post-surgery.
  • 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.
  • 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.
  • Witchcraft and Physical Therapy Management: Application of the Inquiry-Based Model to Physical Therapy Education

    Keskula, Douglas R; Wark, ET; Department of Physical Therapy; Department of Physical Therapy (Georgia Health Sciences University, 2013-01-08)
    The purpose of this case report is to describe the inquiry-based model of instruction and its use in an entry-level physical therapy educational setting. Educators facilitate the acquisition of critical thinking skills through their choice and application of various instructional strategies and methodologies. The inquiry model is designed to help students problem solve by facilitating the acquisition of both analytical and process skills. Practice and mastery of these skills are beneficial to students in the health professions, as they will need to transfer these abilities to the complex clinical setting. This is particularly true of physical therapists, who practice in an increasingly autonomous manner. The use of the inquiry model as an instructional method complements a learner centered environment. The learning activity described below is used as a bridge to the examination, evaluation and diagnostic process the physical therapy students will need to master in subsequent didactic and clinical educational experiences. The selection of the problem used in the inquiry process is a key consideration to the success of the activity. The problem chosen must be interesting, intriguing and hold the attention of the students. A general problem such as the witchcraft example discussed in this paper is suitable for most disciplines, as specific clinical skills or content knowledge is not necessary for students to participate and be successful in this activity. The key element of the inquiry method is the debriefing session that concludes the activity. In the debriefing, faculty lead a guided discussion regarding the processes used by the learners to reach a viable solution to the problem. Areas examined include why certain hypotheses were formed, what information was sought and utilized by the learners to try to prove or disprove the hypotheses, and how the learners classified or grouped information together. The debriefing discussion highlights not the outcome of the problem but rather the critical reasoning process utilized by the learners to reach a conclusion, which is the primary goal of this learning activity. Students consistently respond favorably to this activity as evidenced by their active participation and positive course feedback. The faculty and students of the entry-level physical therapy program have found this activity to be a very pertinent precursor to the critical reasoning required for the clinical diagnostic process. Practical guidelines for the organization and implementation of the inquiry model as a type of instructional strategy are presented.
  • The National Physical Therapist Assistant Examination's First Time Pass Rates and Their Relationships to Education Program Faculty Attributes

    Novak, MK; Brown-Cross, Dawn; Echternach, John; Department of Physical Therapy (Nova Southeastern University, 2011-10)
    Background and Purpose. There is a paucity of published literature regarding the correlation between faculty attributes and education program pass rates on the National Physical Therapy Examination (NPTE) particularly regarding the physical therapist assistant (PTA). The purpose of this study was to 1) determine if there is a relationship between faculty attributes in PTA educational programs and program outcomes on the NPTE for Physical Therapist Assistants (NPTE-PTA) and 2) construct a prediction model for PTA program outcomes based on faculty attributes. Subjects. The 233 United States’ PTA programs accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE) in 2006 were studied. Methods. Using a retrospective design, data were obtained regarding the PTA programs from the dataset of CAPTE’s PTA annual accreditation report and the Federation of State Boards of Physical Therapy’s pass rate database. Selected faculty attributes (designation of highest degree conferred, years of teaching experience, employment status, license designation [physical therapist or physical therapist assistant] and clinical specialization) were correlated to first time program pass rates. Backward deletion regression was used to predict the first time pass rate on the NPTE-PTA. Results. Based on data from 190/233 PTA programs, seven attributes had a statistically significant relationship to the outcomes on the NPTE-PTA. They were the number of: 1) full-time faculty; 2) adjunct faculty with an associate’s degree; 3) full-time faculty with a terminal degree; 4) core faculty with a terminal degree; 5) all faculty with a terminal degree 6) years of teaching experience of the full-time faculty; 7) years of teaching experience of the core faculty. Backward deletion regression analyses demonstrated an overall model of two combined predictor factors (full-time faculty years of teaching and full-time faculty terminal degree) that significantly predicted the first time pass rate on the NPTE-PTA accounting for 6.5% of the variance. Discussion and Conclusion. Faculty attributes of the institutions providing PTA programs are associated with first time pass rates of their graduates. This study provides a foundation for future studies by identifying some of the faculty attributes that relate to NPTE-PTA outcomes.
  • 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.