• Coworker Support Amplifies Reactions to the COVID-19 Pandemic for Working Parents

      Donnelly, Lilah; O'Brien, Kimberly; Shepard, Agnieszka (2021)
      The COVID-19 pandemic directly threatened our health and safety, while contradictory scientific and media reports generated uncertainty. Employees likely relied on their coworkers for emotional support and to make sense of the confusion. In this study, we evaluate the role of coworker support, which has been shown in the past to have either ameliorative (as a resource) or exacerbating (as social information) results. We use data, collected from a heterogeneous sample of working parents in May of 2020 (when most states were getting ready to lift their stay-at-home orders), to illustrate the path from resilient personal resources (measured as optimism, generalized self-efficacy, and internal locus of control) to fear of COVID-19 to workplace outcomes in a multiphasic study design. Employees with more optimism, generalized self-efficacy, and internal locus of control reported less fear of COVID-19, and in turn, less decrement to their workplace outcomes. This mediation is moderated by coworker support, such that the indirect effect is amplified by coworker support. This is consistent with previous research, which shows that coworker support can unintentionally corroborate and amplify employee stress perceptions. We therefore recommend that, when faced with significant adversity, organizations provide communication training oriented toward increasing positive coworker interactions and guiding social information.
    • Platelet-Rich Plasma for Chronic Plantar Fasciitis

      Shimada, Yoichiro; Heard, Henry (2021)
      Platelet-rich plasma (PRP), also referred to as autologous platelet gel, has been increasingly used for musculoskeletal injuries, including Achilles tendonitis, shoulder impingement, rotator cuff tear, lateral epicondylitis, patellar tendinopathy, and plantar fasciitis. Chronic plantar fasciitis is defined as degenerative irritation of the plantar fascia that has failed to respond to conservative therapy, and it presents with non-inflammatory, fibroblastic hypertrophy and dysfunctional vasculature. With the chronic degenerative changes of the tissue along with zones of avascularity, chronic plantar fasciitis is difficult to treat, and the recurrence is common even after prolonged rest. Current treatments for chronic plantar fasciitis include corticosteroid injection, extracorporeal shock wave therapy, and surgery. Corticosteroid injections are common treatments for chronic plantar fasciitis; however, there are potential disabling complications associated with corticosteroid injections. PRP has been proposed as an effective, safer alternative treatment option for chronic plantar fasciitis. Due to the hypovascularity and hypocellularity nature of the injury, directly introducing growth factors and cytokines found in PRP to the fascia is believed to promote tissue heal. The purpose of this review is to examine current literature on PRP treatment for chronic plantar fasciitis.
    • Current Treatment for Hepatitis C Patients: A Review

      Purcell, Anna Lydia; Heard, Henry (2021)
      Hepatitis C is an RNA virus that affects millions in the United States and globally, but with recent pharmacological achievements, the cure rate of hepatitis C has increased greatly. Hepatitis C is transmitted by blood, with the main infections in the US being cause by IV drug use and blood transfusions prior to 1992. Hepatitis C has six genotypes, but the overwhelming majority of cases in America are genotypes 1, 2, and 3. Diagnosis of hepatitis C is difficult due to the lack of symptoms on presentation. Screening in high risk populations has shown to be efficacious in diagnosing the disease. Previous treatment norms consisted of interferon, but cure rates were very low. In 2011, direct-acting antivirals were introduced and revolutionized the treatment of hepatitis C. Response rates have increased exponentially to over 95%, and the medications are much more tolerable.
    • Emerging Migraine Treatment Monoclonal Antibodies: Pathophysiology, Efficacy, and Recommendations

      Oliver, Hannah; Salmon, Arlene (2021)
      Migraines cause immobilizing headaches and are amongst the top causes of disability worldwide. In the past, migraines were understood as a vascular disorder, but in recent years researchers have attributed the cause of migraines to be a series of neurovascular events. This cascade of events causes a release of peptides, most notably, calcitonin gene-related peptide (CGRP) which triggers pain signals to be released from the trigeminal neurons in the brain. This development in comprehension has led to the production of a new treatment, monoclonal antibodies targeting CGRP, to treat migraines. Since 2018, four new drugs of monoclonal antibodies have been approved by the FDA and each drug has shown significant decrease in monthly migraine days when compared to placebo in people who suffer from episodic and chronic migraines. Today these medications are recommended in patients with migraines who have failed simple abortive therapy.
    • Catheter Directed Thrombolytics: Best Therapy for Pulmonary Emboli?

      Hill, Jonathan; Baeten, Robert (2021)
      Pulmonary emboli are blood clots in the pulmonary arterial vasculature that can lead to right ventricular strain, obstructive shock, and even death. Current treatment options for pulmonary emboli include anticoagulants, systemic thrombolytics, and/or surgical embolectomy. Although these therapies are usually effective, they are associated with side effects such as increased risk of bleeding, surgical site infections, and intracranial hemorrhages. Additionally, there are contraindications to these treatments that limit which patients are eligible. In the past 10 years, the use of catheter directed thrombolytics has emerged and appears to be a promising alternative to traditional therapies. This therapy has been shown to have similar efficacy to anticoagulation or systemic thrombolytics with a much lower risk of severe complications.
    • Dry needling with electrical stimulation in the post-ACL reconstruction management of a female basketball athlete with persistent quadriceps palsy: A case report

      Pyle, Rebecca; Lucado, Ann (2021)
      Background and Purpose: Anterior Cruciate Ligament (ACL) injury is common in sports.1 Well-developed protocols on post-surgical management do not address all potential complications. Our purpose is to determine the effectiveness of dry needling with electrical stimulation (DNES) to address persistent quadriceps palsy (PQP) post ACL reconstruction (ACLR). Methods: A 16-year-old female basketball athlete post-ACLR with quadriceps tendon graft followed the Baylor ACLR Accelerated Protocol with appropriate modifications. DNES to the quadriceps began at post-op week 15 for PQP. Findings: The Lower Extremity Functional Scale (LEFS), knee ROM, MMTs, and circumferential measurements were tracked. All surpassed significant values. Clinical Relevance: When neuromuscular electrical stimulation (NMES) is ineffective for PQP, DNES offers an alternative intervention strategy for increasing maximal voluntary contraction. Conclusion: Data suggest improvement in outcome measures and may promote voluntary muscle contraction of the quadriceps. Further research is required for optimal protocols. Keywords: Neuromuscular control, voluntary contraction
    • Analyzing propensity of hospital readmissions of diabetic customers to reduce medical expenditure

      Bandi, Ravi; Pokhriyal, Shitanshu; Khan, Shakeel A. (2021)
      Background: A large portion of hospital inpatient management expenditure is due to high readmission rates. Diabetes is one of the leading causes of re admissions for chronically ill patients. Analyzing readmission patterns helps proactively manage and reduce readmission, thus resulting in reduced medical expenditure. Objective of the study is to find factors that lead to readmission of Diabetic patients and identify key influencers impacting readmission rates. Study Design Methods: The data originated from Cerner EMR systems with instances for over 70,000 patients and has information on Inpatient admission, diabetes type, length of stay, Lab tests performed, and medications administered across 130 US hospitals We used Logistic Regression, Na�ve Bayes and Classification tree methods and Data visualization by using key influencers to identify the key factors. Results & Findings: Using the above data mining and visualization techniques, the study had key findings as below: - Outpatient Diabetics above age 40 with HBA1c level more than 8 are more likely to readmit. - Inpatient diabetic patients with higher number of prescribed medications and number of procedures are less likely to get readmitted. - Serum level analysis shows that with High glucose serum levels, the readmission rates are higher. - Higher HbA1c in patients has a direct relationship with re admissions. - Lab Procedures show high correlation with medications, diagnosis, and time in Hospital.
    • Reliability of Low-Cost Thermometers for Monitoring Foot Temperature

      Doolittle, Kristen M.; Wendland, Deborah M. (2021)
      Diabetes prevalence is high and often burdens the economically disadvantaged. With the risk for foot complications in those with diabetes, foot temperature monitoring can help lessen ulcer risk. Higher cost thermometers have been validated. Validation of lower cost thermometers could improve access for the underserved. Purpose: To assess device repeatability, reliability, and ease of use. Methods: 3 inexpensive infrared thermometers were compared against a reference thermometer for repeatability. Rater reliability was assessed by 2 raters using 3 trials at 3 sites across 25 subjects. Feasibility was assessed by subjects ranking the thermometers after testing them. Data Analysis: Descriptive statistics were used for device repeatability. Intra-class correlation coefficient was used to assess rater reliability. Results: Device repeatability: single day coefficients of variation (CV) ranged from 0.20%-0.91%; all days CVs ranged from 3.32%-4.69%. Rater reliability: 25 subjects (49.6�15.8 years). Intra-rater ICC was >0.99 for researchers and thermometers. Inter-rater ICC was 0.965 - 0.975. Thermometers were ranked based on comfort, handling, size, and the light presence. Discussion: Reliability and repeatability of thermometers were good and measurements correlated strongly with the reference. The subjects had little difficulty using the devices. Conclusions: Inexpensive, commercially available infrared thermometers can be a reliable/valid way to assess local skin temperature.
    • The Efficacy Found within the Adlerian Theory

      Varner-Kirkland, Yvonne (2021)
      The purpose of this literature review poster is to present the significance of the Adlerian Theory and its effectiveness as a counseling tool. As a current graduate counseling student with exposure to a plethora of theories, Adlerian Theory closely resonates with me and my personal values. My theoretical orientation paper, written for my Counseling Theory course, demonstrates just how Adlerian Theory resonates with me. Research shows how Alfred Adler�s individual psychology, known as Adlerian Counseling, since its origin in 1912, has risen to be one of the most comprehensive humanistic counseling approaches. Adlerian Counseling is applied to various therapies, e.g. Adventure Therapy (AT), and Adlerian Theory allow for the integration of neuroscience principles into the counseling profession (Miller & Dillman Taylor, 2015). The review showed a limited number of studies on Adlerian Theory (AT) and Adlerian Play Therapy (AdPT); however, the evidence gathered from the literature review supported the efficacy of Adlerian Theory as evidenced by the use of Adlerian Individual Psychology (Adlerian Counseling), Adlerian Therapy (AT), and Adlerian Play Therapy (AdPT).
    • Are Virtual Visits A Viable Alternative to In-Person Visits from a Healthcare Professional Perspective?

      Scott, Tashaleta M. (2021)
      The COVID Pandemic has changed the way that various parts of healthcare perform interactions and business with patients. This is very true for Orthopaedics. It seemed to be a difficult process to think of when stating a virtual visit for Orthopaedic injuries. It is important that wounds are evaluated, radiographs are taken, etc. to ensure that the correct care is given. It is also important to ensure that the virtual information and process can be easily understood by patient, staff, and physicians. Virtual visits require the use of an application that can call and/or provide video. There must also be access to an EMR/EHR to document the visit and provide the necessary information to setup the virtual visit. The most important issue to determine when looking at the implementation of virtual visits is to understand how the physicians and staff feel about the procedural change. The users are an important aspect of understanding the issues, concerns, as well as the favorable aspects of a system. If the users are not satisfied with the virtual visits, the system could be less used which would result in a decrease in revenue. These factors will allow organizations to focus on reducing and/or eliminating issues that could cause the virtual visit to be unsuccessful and/or misuse of valuable resources. The best way to assess this is to pose various questions that will look at productivity, time management, satisfaction, advantages, and disadvantages of the virtual program. The results from polling and providing questionnaires to physicians and staff can assist with choosing a system or process that better serves the patients and those who utilize the system. Virtual visits are about convenience as well as providing an alternative of care that can be as beneficial as in person visits. Overall, the opinions and insight from the physicians and staff who utilize the virtual visit program will be beneficial to ensuring that virtual visits are a viable alternative to in-person visits, user friendly, and accomplishes the goal of providing superb patient care.
    • Clinical Reasoning in the Management of a Patient with Low Back Pain in Multiple Classification Categories: A Case Report

      Orton, Nicholas; Moran, Kristen Doolittle; Lucado, Ann (2021)
      Low back pain is one of the most common reasons for individuals to seek physical therapy. While prevalent, low back pain can be difficult to classify and treat. Multiple evidence-based classification systems exist with varying approaches to treatment. Case Description: This case report explores the clinical reasoning in the treatment of a patient falling into multiple low back pain classification categories based on the impairment/functional-based classification system. The patient is an otherwise healthy female presenting to physical therapy with a chief complaint of an acute flare-up of persistent low back pain. The rationale behind the sequence in which classification categories were addressed, the decisions behind when to change categories based on emerging data, and the intervention strategies implemented to successfully manage this patient are illustrated. Outcomes: The patient was seen for a total of 13 visits over a span of two months. At discharge, the Revised Oswestry Disability Index for low back pain and the numeric pain rating scale demonstrated improvement with achievement of all patient goals, return of function, and ability to manage symptoms independently. Conclusion: Use of the impairment/functional-based classification system approach to low back pain management proved beneficial and effective. This classification-based approach may assist in clinical decision making when treating individuals with acute flare-ups of persistent low back pain.
    • Cultural Responsiveness in Counseling and Counselor Education

      McDonald, C. Peeper; Burch, Shakenya; Davis, Dazzmen (2021)
      Given the continued and steady growth of diversity within the United States population (Tran et al., 2016; Vespa et al., 2020) and the discourse around social injustice in all it's forms, it is more important than ever that the strengths-based approaches to counseling be infused with cultural responsiveness. As a result, cultural responsive approaches will be discussed as it relates to counseling and teaching to create social change. In this way, this presentation will not only educate the general public about how professional counselors and educators are utilizing best practices for serving traditionally minoritized and under-represented groups, it will illuminate advocacy action efforts perpetuated through cultural responsiveness.
    • Preference and Perception of Mobile Health Applications Educating African American Women on Sexual and Reproductive Health

      Griswold, Allison McKenzie; Ramadan, Awatef A. Ben (2021)
      The Preference and Perception of Mobile Health Applications Educating African American Women on Sexual and Reproductive Health First author: Allison Griswold Co-author: Awatef Ben Ramadan Abstract Background: Previous studies have found that African American women are affected by sexually transmitted diseases and reproductive health issues at a higher rate than any other race. Study Aims: To increase awareness of cultural barriers, and to explore the need for medically accurate sexual and reproductive health information through mobile health applications. Methods: The Institutional Review Board approved an anonymous online survey using convenience sampling of African American women between the ages of 18-50. Respondents answered questions regarding past sexual education course experience, use of women�s health applications, interest in health messages, the importance of health information, personal knowledge satisfaction, and preference for receiving information. The study results presented as graphs, which were generated through excel spreadsheets. Results: Of the 159 respondents that completed the survey, 38.5% currently use any form of women�s mobile health application very frequently. However, 65.8% are interested in receiving information on sexual and reproductive health through women�s health applications. Of the 159 respondents, only 27% were very satisfied with their current sexual and reproductive health knowledge. Conclusion: This study proves that African American women are open to learning and gaining sexual and reproductive facts through mobile applications. Keywords: African American women, period trackers, mobile health applications, sexual health, reproductive health
    • A Pain in the Face: When Insurers Sucker Punch Their Subscriber's Teeth In

      Lancaster, Kimberly D. (2021)
      There is a crisis in American healthcare. This very crisis involves insurers whether those insurers be medical, dental, or property and casualty insurers not covering surgical and non-surgical treatments for craniomandibular and temporomandibular disorders that include accompanying commodities that become multi-system overall health dysfunctions. In many jurisdictions, these subscriber denials are in direct violation of state statue. The states that experience some of the highest denial rates leaving patients receiving shocking sucker punches to their oral health, joint health, multi-system health, wallets, and functional capacities including performing daily ADLs (activities of daily leaving) are the biggest offenders. These disorders, thanks to the insurance carriers' relentless arguments whether this is dental or medical has left many patients between the ages of thirty and forty chronically disabled with many being forced to live in poverty on social security and receive further sub-par medical management on state plans. Thus, to shed light on the necessity for legislative and healthcare overalls that address this forgotten medical population, I have followed the personal stories of two patients and their families from Tennessee and Illinois that have laws mandating coverage (Tmjjoints.org, n.d.). The aim of this research is being used to become a national and global catalyst for permanent and effective access to coverage and care change. The goal is academic and personal.
    • Drug Use In The LGBT Community

      Cleary, Drew (2021)
      Drug use in the LGBT community is a large problem. Rates of drug use in the community is higher than in the heterosexual community. There are several factors that contribute to the high rates that are unique to the LGBT community. One way to conceptualize these unique factors is to use the minority stress model. There are a few therapeutic options as well as directions for future research.
    • A Knee Blowout Complicated by Fibular Nerve Damage and the COVID-19 Pandemic: A Case Report

      Dieckmann, Ansley; Ebert, Jeffrey (2021)
      While an anterior cruciate ligament (ACL) injury is the most common knee injury, it typically does not occur in isolation. Increased age and contact injuries have been associated with a higher incidence of concomitant damage. The impact of traumatic nerve injury on rehabilitation of the knee is not widely discussed in current literature and optimal timing of ACL reconstruction surgery is not largely agreed upon. Prehabilitation and rehabilitation are provided for patients who undergo knee reconstructive surgery. The purpose of this study is to examine the rehabilitation of a patient status post knee reconstruction when complicated by COVID-19 and fibular nerve damage. This study examines the rehabilitation of a 23-year-old male s/p ACL and LCL reconstruction. The patient presented to a physical therapy (PT) clinic following surgery and revealed that the initial injury occurred 3 months prior, but intervention was delayed due to the COVID-19 pandemic. The nerve damage and delay in intervention altered his rehabilitation and current functional ability. Outcome measures used include the Lower Extremity Functional Scale, ranges of motion of involved joints, and manual muscle testing. This report details a case complicated by fibular nerve damage and delayed intervention after a severe knee injury. The complications led to impaired safety and function prior to surgery and interfered with PT. The patient may have had minimal difficulties when recovering without these complications.
    • Teledermatology: Preventing and Diagnosing Skin Cancer in the Rural United States

      Benedit, Veronica; Aycock, Mallory (2021)
      In the United States, skin cancer is a prevalent and sometimes preventable form of cancer that causes a significant disease burden on both rural and urban communities. Studies have shown, however, that rural communities bear a unique burden in that rural residents are less likely to engage in primary prevention behaviors against skin cancer. Additionally, skin cancer incidence and mortality are higher among rural residents. Teledermatology can be used to address disparities in both skin cancer diagnosis and health education to improve dermatology outcomes in rural communities. Teledermatology is the use of technological advancements in both image acquisition and communication to improve access to dermatology care. This poster reviews teledermatology formats, barriers, and benefits to encourage integration of teledermatology modalities into regular physician assistant practice. Both family practice as well as dermatology physician assistants can utilize teledermatology to improve access to dermatology care, especially for patients living in rural areas.
    • Physical Therapy Evaluation and Management of a Patient with Acute Anterior Cruciate Ligament and Meniscal Tears Complicated by Hereditary Multiple Osteochondromas in the Occupational Health Setting: A Case Report

      Pendergrast, Sarah; Ebert, Jeffrey (2021)
      Background: Hereditary Multiple Osteochondromas (HMO) is a disease that primarily affects the musculoskeletal system. Sequelae of the disease are often treated via outpatient orthopedic physical therapy. There is a lack of literature on HMO in physical therapy. The purpose of this report is to discuss management of a man with HMO and an acute orthopedic injury. Description: A 44-year-old male with HMO and acute knee injury presented with instability and structural abnormalities as well as impaired range of motion, gait, and muscle performance. MRI confirmed anterior cruciate ligament rupture, meniscal tear, and nondisplaced fibular fracture. The examination and plan of care for this patient included special considerations due to the presence of HMO and nuances of the occupational health setting and insurance. Outcomes: The lower extremity functional scale was used to assess the patient�s functional abilities related to his injury, and objective tests and measures were used to assess the impairments. Discussion: Clinicians should treat within the individual context of each patient, including all comorbidities and patient specific findings in order to make effective clinical decisions. Evaluating and treating a patient in the occupational health setting with HMO that has sustained an acute orthopedic injury requires a combination of disease knowledge, clinical reasoning, collaboration with other healthcare providers, and diagnostic imaging.
    • Subcutaneous CGRP Antagonist Injections: A Novel Approach to the Treatment of Chronic Migraines

      Burrows, Caroline; Sadowski, Catherine (2021)
      Nearly 4 million Americans suffer from chronic migraines. These patients have severe headaches that occur for 15 or more days a month, leading to a diminished quality of life. Current recommended therapy is not conducive to all patients, as one study shows 68% of these patients experience at least one medication treatment failure. Within the last few years, the FDA has approved new medications, known as CGRP antagonists, that are proving to be efficacious in the treatment of chronic migraine.
    • How to save a life: Esketamine as a potential rapid pharmacological suicide intervention

      Montgomery, Kevin; Bedoya, Damian (2021)
      Suicide prevention and intervention efforts have been launched with hopeful results; however, research rarely focuses on pharmacological treatment for the acutely suicidal patient. Correlation between mental health diagnosis and suicide drives recommendations to tailor treatment to the mental health diagnosis rather than the acute life-threatening symptom. This article proposes treatment for the acutely suicidal patient should be intentionally directed at the suicidal ideation instead of the mental health diagnosis. Esketamine has been approved by the FDA, and randomized controlled trials show some evidence that this treatment is worth continued study as a method to rapidly reduce suicidal thoughts in at-risk patients.