• Pen Pal Project to Write Away Isolation: An IRB-approved Project Aimed at Decreasing Isolation During a Global Pandemic

      Barfield, Kailey; de la Cruz, Jennifer; Lepp, Erin F. (2021)
      As the COVID-19 pandemic radically upended the daily lives and routines of many people, those considered vulnerable faced increased physical isolation due to efforts of increased protection. While interventions such as social distancing have been appropriate to maintain physical health, mental health has taken the brunt of the pandemic. To create connections while maintaining safe physical distance, a letter writing project was created between Mercer Physician Assistant Students and volunteers in the community. This project was created for the Paul Ambrose Scholars Program in which students in medical professions are selected to design a community health project focusing on one of the Leading Health Indicators (LHI) of Healthy People 2020. Suicide was the LHI chosen for this project. As depression increases among elderly, isolated individuals during the pandemic, the risk of suicide increases as well. Letter writing is a cheap, easy way to maintain emotional connections with others despite social distancing guidelines. This project has been IRB approved and included nineteen Mercer Physician Assistant (PA) students and nineteen volunteer letter recipients throughout the United States. A screening tool was used to assess depression levels of volunteer letter recipients both prior to and after receiving letters from PA students over the course of 4-5 months. This poster is a summary of the research project.
    • Perceptions, Attitudes, and Beliefs of Young, Underrepresented Minorities in Clinical Trials

      Ross, Allison; Wong, U.; Nguyen, J. (2021)
      Introduction:This study is designed to ask Millennials (1981-1996) and early Generation Zers (1997-2002) about their perceptions of clinical trials. This will provide insight to identify reasons for the lack of diversity in age, ethnicity, and background for the advancement of future medicine. Methods:The data provided evaluated Millennials and Generation Zers using a survey. Participants were recruited via convenience sampling. Questions included personal demographics, knowledge of clinical trials, willingness to participate in clinical trials. Results:A chi-square test was performed to examine potential associations between individual demographics and responses(N=172, Minority=126, Male=37.7%). For the likelihood of participating in vaccine-focused clinical trials, 62.4% of the respondents reported that it would be unlikely for them to participate in a study; 76.9% Millennials versus Gen Z (N=125, p=0.009). When analyzing gender, women were found to be 69.5% more likely than men to deny participating in a clinical trial for vaccines (N=81, p=0.0005). Discussion:In regard to participating in a clinical trial with a focus on vaccinations, Millennials were less likely to indicate participation than Gen Zers. Between both generations, females were most opposed to the concept. Increased representation in gender and minority-based ethnicity (significantly in the Hispanic and/or Asian community) will allow more comprehensive insight for future implementation and analysis.
    • 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.
    • 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.
    • 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
    • Recovery and Discovery: Developing a trauma-sensitive theology model which informs wholistic pastoral care for African American Women

      Stubbs, Tiffany (2021)
      Abstract: This research study seeks to examine the experience and responses of trauma within the realms of intersectionality and trauma informed care for African American women. The criticality of examining the duality of trauma and theology is filtered through a literature review and theological discourse. There is evidence of a correlation between the StrongBlackWoman schema and intergenerational epigenetic trauma. The trauma of living through the intersectional lanes of what it means to be an African American woman has consequently imbued African American Women with an obligation to bear the burden of strength and resiliency. This obligation has had detrimental effects on African American women’s physical, emotional and spiritual well-being. In order to provide space for transformative healing, I have suggested a construct of pastoral care model that encompasses a trauma-sensitive theological approach as a pathway to transformative healing. The goal of the pastoral care model is to provide strategies of recovery from trauma and discover ways to cope.
    • 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.
    • Return to Golf Post Subscapularis Repair: Consideration of Regional Interdependence

      Williams, Katelyn; Ebert, Jeffrey G. (2021)
      Return to golf post subscapularis repair Background Isolated subscapularis tears are uncommon in relation to the frequency of rotator cuff (RTC) pathology. However, in specific populations such as golfers, the subscapularis is the second most torn RTC muscle. Purpose The purpose of this case is to encourage clinicians to consider regional interdependence between a subscapularis tear/repair and a history of low back pain in a recreational golfer. Standard rehabilitation specific to the shoulder post subscapularis repair achieved full functional use of the upper extremity, but limitations persisted specific to golf. This case report highlights the importance of assessing golf mechanics with regional interdependence in mind in order to assist a patient in returning to functional golf performance. Case description A 42-year-old male, recreational golfer since age 14, presented to the clinic post subscapularis RTC repair with a goal of returning to golf. Golf swing analyses were performed pre and post treatment and test retest treatment methods assessed patient�s lingering pain complaints during golf. Outcomes The FOTO and numeric pain rating scale were used to measure improvement along with the patient�s subjective report and golf swing analysis with video footage. The patient�s FOTO score improved by 50 points over 6 months of rehabilitation indicating return to functional use of the UE. Patient�s pain decreased to 0/10 during golf game.
    • School-Based Health Centers and Mental Health Access among Minority and Low-Socioeconomic Adolescents

      Barfield, Kailey; Martinelli, LeAnne (2021)
      School-Based Health Centers (SBHCs) are comprehensive health clinics that provide a myriad of services to the students that they serve. SBHCs are meant to overcome barriers students face when it comes to accessing healthcare such as transportation, limited clinic hours, and parent work schedules. However, many of the most vulnerable populations - like those living in poverty and those that identify as racial/ethnic minorities - may still encounter barriers when it comes to accessing mental healthcare. A review of previous studies was done, and suggestions were provided for improved access to mental health services through SBHCs to even the most vulnerable populations.
    • Social Determinants of Health That Affected Covid-19 Outcomes

      Carter, Angelique; Couch, Valerie; Mullinax, Jonathan; Willis, Steffenie; Walthall, Sabrina (2021)
      The covid-19 pandemic has exposed the longstanding structural drivers of health inequities, such as race, economic disparities, and housing insecurities. These important determinants of health have interlinked with other factors during covid-19 to exacerbate existing social vulnerabilities in society. People from racial and ethnic minority groups are disproportionately affected by lack of access to quality health care which leads to inequities in treatment. People from lower incomes, experience challenges that make managing expenses, paying medical bills, accessing nutritious food, and reliable childcare difficult. Some groups are disproportionately affected by difficulties finding affordable and quality housing. This may limit their housing options to neighborhoods and residences with crowded conditions. These conditions are often time family members of many generations living in one household which can lead to exposure of older adults to illnesses and diseases. This research discusses how these determinants may increase risk of COVID-19 exposure, leading to hospitalization, long-term health issues, social consequences, and death.
    • Spaciotemporal analysis of COVID-19 to study impact of mobility on infection rate

      Hamza, Syed Ali; Bukhari, Syeda Sydra; Chandio, Sara Khan; Khan, Shakeel (2021)
      Background: COVID-19’s asymptomatic nature in some people makes it undetectable in initial days of contact and results in spread of the infection. Some countries have contained its spread, whereas some are still experiencing increasing cases. This study includes spaciotemporal analysis of COVID-19 and mobility data to provide insights in how the infection spreads while comparing the public mobility between the best and worst performing countries. Study Design/Method: The data about cases, recoveries, and deaths from Jan ’20 to Feb ’21 from John Hopkins-CSE is integrated with mobility data from Google. It is then analyzed at global level with further drilldowns into continent, countries, and states in US. Study includes comparative analysis between US and New Zealand to show which mobility parameters influenced the spread. Locations such as transit stations, retail, grocery, workspaces, residential areas, and parks were studied to find their impact. Findings: The analysis indicates that there was a short-term drop in mobility around workplaces, retail and grocery stores, and transit stores in United States along with a spike in the mobility across parks during the initial period. On the other hand, mobility has been under control in New Zealand. The study highlights that the areas with higher public activity shows higher infection rate, thus controlling the public movement around retail and grocery places has positive influence than complete shutdown of the workplaces.
    • Stress in Cancer Patients

      McLean-Clark, Stephanie (2021)
      o A major insurance company that employees over 70,000 persons and provides healthcare coverage to approximately 180 million people in more than 30 countries across the world. Every year they receive thousands of prior authorization requests related to tests for cancer patients. Currently, providers must submit these requests through a designated electronic system and these requests may take up to seven business days for processing. During this waiting period, Cancer patients experience stress upon learning that they may have cancer. Additional stress can be added when they are forced to wait for approval from the insurance company to have additional testing performed. The goal of this proposal is to decrease the wait time for cancer patients by providing an approval or denial by reconfiguring the system to move these requests to the top of the processing list.
    • 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.
    • Technology Implementation: How it Reduces the Transmission of HIV/AIDs in Low-income/Rural Communities

      Walker, Brittany (2021)
      Sexuality, race, age, education, and socioeconomic status are all actors in HIV transmission. In a sense, socioeconomic status encompasses all factors which directly affect the quality of life and privileges offered to people. The lack of resources in low-income communities is directly linked to risk behavior; people who lack resources are more likely to participate in drug use and high-risk sexual behaviors. Also, individuals who experience homelessness are more likely to engage in sexual behaviors in exchange for money, housing, and food are also at a higher risk of contracting/transmitting HIV; this is also the case for people who lack nutritional resources. Though it cannot be said that poverty causes HIV, poverty is highly correlated with HIV infection rates. Implementing technology utilization in clinics within impoverished communities can positively impact subjects at a higher risk of contracting and transmitting the disease. By combining technology and education, access to health care and other resources are accessible to at-risk subjects.
    • 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.
    • The Bridge to Better Health

      Gould, Chelsea; Washington, Kayla; Thomas, Joy; Lepp, Erin; May, Stephanie (2021)
      Nutrition education is important for all individuals but most people do not have this knowledge. The lack of nutritional knowledge is a growing problem that contributes to the growth of obesity in Dekalb county. In Dekalb county, approximately 30% of adults and 13% of high school students are obese. Even more people in Dekalb county (73.4% of adults and 79% of youth) do not consume the recommended amount of fruits and vegetables per day(CDC, 2013). Objectives: Increasing knowledge of healthy foods Increasing understanding of nutritional value Ability to participate in healthier eating habits Increasing community support for a healthier well-being Identifying barriers to healthy eating Methods: Mercer University College of Health Professions, Department of Public Health, and the professional program in Physician Assistant Studies program partnered with the Bridge at Austin Community Center's leaders, Dr. Stephanie May and Ms. Bernita Reese. Interactive and educational sessions are held online using Zoom. They are open to both males and females of all ages in Dekalb county. Participants filled out a registration form which included information on their name, children�s names, phone number, address, email, race/ethnicity, ages of household members, and what they are looking to learn from the sessions. This intervention is still currently in progress. The goal of the intervention was to help improve health and wellness for participants.
    • 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).
    • The positive impacts on the adoption and advancement of patient portals within a healthcare facility.

      Kamra, Navneet; Baskaran, Vikraman (2021)
      The intention of this research study is to encourage clinical facilities that do not have a patient portal system, to encourage them to adapt one for their facility or to upgrade outdated patient portal when necessary. Patient portal systems, now more than ever, are a powerful tool for patients to be able to keep track of their health. Despite the many reasons to adopt a patient portal system, many practices are still reluctant to provide a patient portal system for their patients, in fear that they may be making the right investment or may be jeopardizing their provider-patient relationship. The question this research will answer is, Is patient turnout and satisfaction positively impacted based on the adoption of a patient portal within a healthcare facility? In order to answer this questions, It is important to research what patients want out of a patient portal and how patient portals can increase patient satisfaction. Ultimately patient satisfaction is correlated to an increased number of patients/new patients.An increased number of patients generally means a potential increase in revenue. To do this research Lifeline Primary Care Clinic was chosen which is a clinic that has switched through three patient portals over the years; e-clinicalworks, Healow app (after merging with eclinicalworks in 2014) and AthenaHealth. The clinic has also expanded into other locations as well. Thus making this clinic an ideal facility for the proposed research. Another factor of choosing this clinic was due to the vast data the clinic has produced that is relevant to this research and health IT overall. In order to start the research process, a literature review was conducted in regards to the patient portal, as well as how they were perceived by both patients and healthcare providers. Upon reviewing the relevant articles on the topic, a methodology was mapped out to be able to collect patient data from each portal implementation and transition to be able to detect whether or not each transition had increased number of current and new patients due to the potential decrease in phone times by the staff with the portals having appointment and messaging systems. The data from these findings would then be compiled in an excel spreadsheet to show upward or stagnant trends in a line graph. Along with this, survey questions were generated through surveymonkey.com to be able to assess patient satisfaction by the current and by past patient portals based on preferences. Another survey was also created for the medical staff as well, in order to see the staff�s perception on patient portals and if the patient portals have impacted their workload in a positive manner or not.
    • The Progression From My ePortfolio To My Writing Major

      Cantrell, April (2021)
      Developing an ePortfolio purposefully walks you through the process of understanding and conceptualizing your general education and major courses with your specific path followed to develop and explain your major. Simply knowing that I wanted to write or be a writer wasn't necessarily specific enough. Why did I want to be a writer? Did I have a purpose? The ePortifolio was a light to the path that helped me understand that I want to write to heal others as they read and to self-heal the writers emotional struggles. Narrowing the broad concept of a major in writing to the narrow concept of writing with the intention to heal others and myself through writing is the result of my ePortfolio.
    • The Use of Metformin in Breast Cancer Treatment in Non-Diabetic Women

      Weintraub, Taylor; Mattingly, Jill (2021)
      Breast cancer is the second leading cause of death of women in the United States, with approximately 245,000 new cases being diagnosed each year. The current primary treatment is lumpectomy or total mastectomy, radiation therapy, along with adjuvant hormone and chemotherapy as indicated for metastatic disease. While each of these invasive treatments are effective at killing cancer cells, they are extremely toxic to every cell in the patient�s body. Metformin, a biguanide, is the most commonly prescribed drug for diabetes mellitus type 2. It�s mechanism of action works by decreasing the amount of glucose synthesized in the liver and increasing insulin sensitivity in muscle cells. Studies have already shown that diabetic patients taking metformin have a decreased risk of developing breast cancer, in addition to a better prognosis in those diagnosed with breast cancer. However, there has been no conclusion about the benefit of metformin in non-diabetic patients with breast cancer. This review presentation describes the numerous proposed anti-tumor mechanisms of metformin, such as its ability to enhance the effects chemotherapy, and inhibit cancer cell growth before and after it has begun. Metformin is a well-tolerated, inexpensive and safe medication. If its effectiveness is proven as an adjuvant treatment, breast cancer patients could reach remission with less harmful radiation and chemotherapy.