• 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.
    • 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.
    • 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 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.
    • 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.
    • 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.
    • 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.
    • 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.
    • 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.
    • Outcomes of Music, Dance, & Movement Interventions for Children with Autism Spectrum Disorder Within the Scope of Occupational Therapy: Scoping Review

      Bankson, Baylee; Cox, Ashlyn; Fulmer, Haley; Hausman, Lydia; Longfellow, Danielle; Department of Occupational Therapy (Augusta University, 2020-08-31)
      At the conclusion of this, attendees will: 1) Identify frequently measured outcomes of using music, dance, and movement-based interventions with individuals with autism spectrum disorder, as identified through a scoping review of the literature and 2) List specific music, dance, or movement-based interventions that are available to OT practitioners working with individuals with autism spectrum disorder (ASD), as identified through a scoping review of the literature.
    • Psychosocial Factors as Predictors for Patient Outcomes in Rehabilitation of Upper Extremity Injury Caused by Trauma:

      Holley, Ashlyn; Saren, Madison; Wygle, Sarah; Deese, Abigail; Payne, Regan; Department of Occupational Therapy (Augusta University, 2020-08-26)
      At the conclusion of this presentation, attendees will be able to: 1) Explain three ways in which psychosocial factors have the ability to alter rehabilitation outcomes in individuals who have sustained a traumatic upper extremity injury, 2) Discuss two gaps in the literature regarding the impact of psychosocial factors on rehabilitation outcomes in individuals recovering from traumatic upper extremity injuries, 3) Identify two methods, strategies, or assessments to be implemented in practice in order to evaluate and address psychosocial factors as a component affecting functional outcomes of clients with traumatic UE injuries.
    • 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.
    • Telehealth Interventions to Address Chronic Disease Self-Management Interventions within the Scope of Occupational Therapy: A Scoping Review

      Albritton, Liz; Fish, joJo; Henkel, Jeff; Lee, Shelby; Luttrel, Rachel; Rackleff, Layne; Department of Occupational Therapy (Augusta University, 2020-09-02)
      At the conclusion of this presentation, attendees will: 1) Distinguish between the types of telehealth interventions for chronic disease self-management within the scope of occupational therapy and 2) Describe the outcomes of using telehealth for chronic disease self-management based on the presented results of a scoping review of the literature.