Life Sciences Commons^™

The Validity And Reliability Of Assessments Through Telemedicine: An Evidence-To-Practice Review, Connor L. Givens, Gabrielle A. Griffin, Matthew D. Johnson, Zachary K. Winkelmann

Clinical Practice in Athletic Training

The validity and reliability of telemedicine assessments has been explored through numerous studies. Telemedicine is a diagnostic tool that combines visual technology, audio technology, and tools for assessment. The assessment of musculoskeletal disorders is a key portion in the field of athletic training. The development of telemedicine assessment tools has improved over time but has not yet been perfected. Data was collected via four databases that included articles examining validity, inter- and intra- rater reliability, and telemedicine assessment for musculoskeletal tests. The reviews of the systematic review used Quality Assessment of Diagnostic Accuracy Studies (QUADAS) and quality appraisal tool for …

Return-To-Tennis Considerations And An Elusive Diagnosis For A Cuboid Avulsion Fracture: A Disablement Model Case Study, Grant G. Yee, Zachary K. Winkelmann, Zoe J. Foster

Clinical Practice in Athletic Training

This disablement-model case study is focused on a 23-year-old NCAA Division I men’s tennis player that sustained an injury in a competitive singles tennis match. Upon initial examination, the athletic trainer diagnosed the individual with an anterior talofibular ligament sprain and treated conservatively. The patient experienced significant disruptions to his activities of daily living due to his difficulties with ambulation during the early stages of his recovery. Interestingly, the patient was eventually diagnosed with a cuboid avulsion fracture. Midfoot fractures are uncommonly experienced in the general population, and are particularly uncommon in tennis athletes, making them difficult to recognize. Clinical …

Burnout In Sport Specializers Versus Samplers: An Evidence-To-Practice Review, Katherine Godfrey, Justin Disanti, Tamara Valovich Mcleod

Clinical Practice in Athletic Training

The prevalence of sport specialization is a common concern in contemporary youth sports and has been linked to potential negative physical and psychological effects for developing athletes. While the evidence regarding negative physical effects, such as overuse injury, are consistent in the literature, the psychosocial outcomes are unclear due to the lack of published studies on the topic. Specialization is thought to lead to added stress, which may affect an athlete’s mental health, whereas athletes who sample multiple sports are believed to have a healthier psychosocial experience. Burnout is characterized as physical and emotional exhaustion, sport devaluation and a reduced …

Review Of Diagnostic Accuracy Of The Ottawa Knee Rules In Adult Acute Knee Injuries, Sean L. Glover, Amy M. Loveless, Sara A. Posson, Zachary K. Winkelmann

Clinical Practice in Athletic Training

Acute knee injuries are commonly found in athletic populations. The wide range of knee injuries can present a challenge deciding which injuries require imaging. Currently, radiography is considered the gold standard of imaging for knee fractures. However, imaging is often costly not only for the patient, but also for the healthcare system. Since imaging is expensive, it is critical that clinicians decipher which patients require such testing. The Ottawa Knee Rules (OKR) is a predictor tool created by Stiell et al in 1995 to help clinicians accurately distinguish potential knee fractures from non-fractures for imaging purposes. The OKR guidelines state …

Anterior Cruciate Ligament Reconstruction Of A College Student With A Prosthetic Limb: A Disablement Model Case Study, Sara A. Zilvetti, Amanda Y. Young, Jeff Stein, Scott E. Lawrance

Clinical Practice in Athletic Training

This case examines a 19-year-old male college student with a left anterior cruciate ligament reconstruction (ACLR) secondary to a motor vehicle accident (MVA). The accident caused numerous severe injuries to both lower limbs including untreatable right lower leg injuries, leading to a right below knee amputation, and a left ACL tear. Before the accident, the patient was a varsity cross country and track athlete expecting to continue in college. Six weeks following surgical reconstruction, the patient reported to the rehabilitation clinic for standard ACLR rehabilitation practices including lower leg and proximal hip strengthening, attaining full knee ROM, and balance exercises. …

Superficial Peroneal Nerve Entrapment In Female Collegiate Tennis Athlete: A Disablement Model Case Study, Sarah Branning, Neeru Jayanthi, Zachary K. Winkelmann

Clinical Practice in Athletic Training

A 19-year-old female, NCAA Division I collegiate tennis player presented with a burning and aching sensation halfway up the lateral portion of her right calf following an extensive period spent in a squatting position. This discomfort began distal to the fibular head, then ran along her lateral calf, reached into her ankle, and wrapped behind the lateral malleolus. Initially, the patient only noticed this discomfort during long durations of physical activity. However, she began to report symptoms with activities of daily living (ADLs) and following workouts. The patient first received a working diagnosis of a stress reaction along the mid …

Concussion Clinical Pathway: Headache And Cervical Assessment Framework, Nicholas Hattrup, Nicholas Pfeifer, Tamara Valovich Mcleod

Clinical Practice in Athletic Training

The prevalence of sport specialization is a common concern in contemporary youth sports and has been linked to potential negative physical and psychological effects for developing athletes. While the evidence regarding negative physical effects, such as overuse injury, are consistent in the literature, the psychosocial outcomes are unclear due to the lack of published studies on the topic. Specialization is thought to lead to added stress, which may affect an athlete’s mental health, whereas athletes who sample multiple sports are believed to have a healthier psychosocial experience. Burnout is characterized as physical and emotional exhaustion, sport devaluation and a reduced …

Strategies To Improve Healthcare Communication With Non-Native English Speakers: An Evidence To Practice Review, Skylar B. Hudgens-Wallace, Kaitlyn M. Pierce, Madison P. Whitesell, Nancy A. Uriegas, Zachary K. Winkelmann

Clinical Practice in Athletic Training

As the number of non-native English speakers in the United States rises, the degree to which some patients understand their healthcare communication is decreasing. It is essential to recognize the areas of limited health literacy to ensure proper patient communication and education are achieved. The guiding systematic review aimed to examine different communication interventions and the reported patient experiences from those interactions. The main forms of healthcare communication interventions used in the study included in-person, telephone, and video call interpreters. Patients have been shown to respond best to in-person interpreters, but using interpreters via telephone or video call was also …

Effects Of Social Determinants Of Health And Diabetes On A Lower Extremity Workplace Injury: A Disablement Model Case Study, Bridget L. Davidson, Richelle M. Williams, Sean M. Rogers

Clinical Practice in Athletic Training

This clinical case study involves a 36-year-old male patient who injured his right lower leg while working in the kitchen at a county correctional institution. The mechanism of injury involved the patient getting his foot caught under a wooden pallet, losing his balance, and then catching himself on his right leg in a twisting motion. The injury led to the patient seeking care in the emergency department and was diagnosed with a nonspecific strain of the right triceps surae muscle group. Upon discharge, the patient was referred to outpatient athletic training services within the hospital system. Follow-up care provided by …

Prioritizing Patient-Centered Care When Integrating Athletic Training Students Into Clinical Practice, Amber Kingsley, Amy L. Fraley, Krista M. Richards, Matthew J. Drescher, Zachary K. Winkelmann

Clinical Practice in Athletic Training

Athletic trainers are responsible for the patient care of student-athletes but also can be responsible for the education and mentorship of athletic training (AT) students through the role of preceptor. ATSs require extensive first-hand clinical experiences to prepare them for autonomous practice but must first feel comfortable with the skills they have learned to apply them in clinical practice. The unique clinical experience these ATSs experienced was the combined experience of a graduate assistant athletic trainer preceptor who also assisted as a teaching assistant in the classroom. This allowed the preceptor to help the ATSs expand on the information provided …

Rhabdomyolysis And Hypothyroidism In A Collegiate Hammer Thrower: A Disablement Model Case Study, S. Andrew Cage, Robert Michael Galbraith, Rebecca Peebles, Payton Williams, Brandon Warner

Clinical Practice in Athletic Training

The purpose of this disablement model case report was to detail the case of a patient suffering from rhabdomyolysis and hypothyroidism. Despite swelling, cramping, and loss of range of motion at the wrists, hands, and fingers, the patient did not seek physician evaluation until their athletic trainer encouraged them. While hypothyroidism is a relatively common condition, there has been little literature published that associate hypothyroidism with rhabdomyolysis. In this case, the patient reported to the athletic training staff reporting swelling, cramping, and loss of range of motion at the wrists, hands, and fingers. After evaluation by the team physician and …

Knowledge Of And Attitudes Toward Native American And First Nations People Among Ncaa Division I Athletic Trainers, L E. Trail, L K. Warner, B J. Warner, M Decker, S A. Cage

Clinical Practice in Athletic Training

Introduction: Current literature shows that Native Americans people experience more health care disparities relative to other ethnic and racial groups. Previous research has also shown that these healthcare disparities are present in pediatric and young adult Native American populations. As healthcare professionals who will potentially treat these populations, it is important to understand the knowledge of and attitudes toward Native Americans people among athletic trainers. The purpose of this pilot study was to describe the knowledge of, and attitudes and opinions of National Collegiate Athletics Association (NCAA) Division I athletic trainers toward Native Americans. Methods: An electronic survey (Table 1) …

The Effects Of Dry Cupping Therapy On Touch Pressure Threshold In Collegiate Baseball Players., S A. Cage, R L. Peebles, J D. Volpi, L E. Trail, B J. Warner

Clinical Practice in Athletic Training

Introduction: Cupping therapy is a therapeutic modality that uses negative pressures to achieve therapeutic benefits. Various published studies report that cupping therapy decreases pain, increases range of motion, and improves blood flow. Previous studies also report an effect on tissue tenderness. However, there do not appear to be any studies assessing the effects of cupping therapy on touch pressure threshold, which measures skin sensitivity. Changes in touch pressure threshold may provide more information on the neurological effect cupping therapy has on treated tissues. The purpose of this study was to compare the effects of cupping therapy on touch pressure threshold …

Acute Management Of An Abdominal Cavity Perforation In A Collegiate Baseball Pitcher: A Case Report., D M. Gallegos, A P. Jacobsen, R M. Galbraith, R L. Peebles, B J. Warner, S A. Cage

Clinical Practice in Athletic Training

Background: A 21-year-old male collegiate baseball player was performing warm up exercises when he tripped backwards onto one of the team’s pitching machines that had been laid on its side. Upon falling backward, the patient sustained a puncture wound through the left buttock from one of the machine’s handles. Unaware of the injury, the patient’s teammates lifted him off of the machine and retrieved the athletic trainer. Evaluation revealed a deep wound with visible adipose tissue and musculature. At this time, the patient was immediately transported to the emergency department of the local hospital, and team physicians were informed to …

Twelfth Rib Avulsion Fracture In A Collegiate Baseball Pitcher: A Case Report., L K. Warner, A P. Jacobsen, R M. Galbraith, C Hodges, B J. Warner, S A. Cage

Clinical Practice in Athletic Training

Background: A 21-year-old male collegiate baseball player reported to the athletic training staff after experiencing acute pain in his left side following throwing a pitch. The patient experienced immediate difficulty with active lateral flexion and trunk rotation. Palpation revealed spasm and tenderness along the internal and external oblique muscle. The patient reported having subluxed a rib on a previous occasion. While the pain experienced was similar, the patient stated that there was more pain along the muscle bellies of the internal and external oblique muscles compared to the previous injury. No difficulties with breathing, bowel movements, or urination were reported. …

The Diagnosis, Rehabilitation, And Treatment Of Posterior Impingement In A High School Baseball Pitcher, K Tisdale

Clinical Practice in Athletic Training

Introduction: Posterior impingement, also known as internal impingement, is a type of secondary impingement that is caused by overuse and repetitive movements of the shoulder overhead during motions such as throwing, spiking, etc. A combination of shoulder abduction and external rotation produces impingement of the infraspinatus and/or of the supraspinatus against the posterior-superior glenoid. Posterior impingement is common in overhead athletes, and this mechanism is usually seen during the cocking phase of throwing. Someone suffering from posterior impingement may complain of posterior shoulder pain, posterior stiffness and decline in performance. Patient Information: In this case study, a 15- year-old male …

The Impact Of Bracing On Kinesiophobia And Recovery In Acl Reconstruction Patients: A Case Study, N Valdecanas, K Neelon, K Braunreiter

Clinical Practice in Athletic Training

Introduction: With 100,000 to 200,000 cases reported in the U.S. yearly, the anterior cruciate ligament (ACL) is a commonly torn structure in the knee among contact and non-contact sports. As medical research on ACL injuries grows, ACL reconstruction (ACLR) continues to be the preferred surgical intervention. Due to extensive rehabilitation timeline requirements, ACLR patients may face physical and psychosocial circumstances affecting their overall recovery. At any point in rehabilitation the patient may experience kinesiophobia, or an irrational fear relating to further injury from participation in physical movement, especially with return to running, jumping, and sports-specific programs. Functional bracing has been …

Use Of Blood Flow Restriction Training With A Collegiate Baseball Player Following Hook Of The Hamate Excision, J P. Goza, R M. Galbraith, A P. Jacobsen, B J. Warner, S A. Cage

Clinical Practice in Athletic Training

Background: A 21-year-old male collegiate baseball player underwent successful excision of the hook of hamate of the left hand. Following two weeks in a padded splint to allow for appropriate scar healing, the patient’s sutures were removed and rehabilitation was initiated. Initial rehabilitation consisted of passive range of motion exercises progressing to active range of motion exercises. After one week of range of motion exercises and improvement of range of motion, resistance training with blood flow restriction was initiated. Differential Diagnosis: Hook of the hamate excision. Treatment: Week 3: Prior to beginning resistance training with blood flow restriction, grip strength …

Hook Of The Hamate Fracture In A Collegiate Baseball Player Preceded By A Hamate Stress Fracture, H N. Parker, R M. Galbraith, A P. Jacobsen, C Hodges, B J. Warner, S A. Cage

Clinical Practice in Athletic Training

Background: A 21-year-old male collegiate baseball player reported to the athletic training staff complaining of pain along the hypothenar eminence of the left hand. The patient’s pain was intensified when swinging a bat but remained constant even at rest. The patient reported symptoms beginning approximately three weeks prior to being evaluated by the athletic training staff, but delaying reporting symptoms in order to continue playing. Physical exam revealed tenderness over the hook of the hamate and hypothenar eminence, decreased active wrist extension, decreased grip strength, and pain with resisted pronation and supination. At this time, the patient was removed from …

A Case Report Of The Evaluation And Management Of Low Back Pain In A High School Basketball Player, K Leveston, K Neelon, E Ephran

Clinical Practice in Athletic Training

Background: Low back pain can be a tough injury to endure, especially in the growing high school athlete.3 LBP in a high school athlete can be caused by various factors, such as structural deformities, mobility deficits, and so much more. The majority of LBP in adolescents is nonspecific LBP, which is defined as LBP that does not cause systemic or structural changes.5 Nonspecific LBP is often a result of other etiologies such as hypermobile or hypomobile segments of the spine, hip mobility deficits, gait, sleeping positions, or improper weightlifting form. Differential Diagnoses: Other possible diagnoses of LBP in adolescents could …

Figure-8-Reconstruction Of Posterior Sternoclavicular Joint Dislocation 18 Days Post Initial Injury, M Suri, S Bunemann

Clinical Practice in Athletic Training

Introduction: Traumatic sternoclavicular joint injuries account for less than 3% of all traumatic joint injuries1. Although rare, posterior dislocation of the sternoclavicular joint has the potential to be life-threatening due to the proximity of vital structures posterior to the manubrium. This injury typically requires a high-energy force applied through the joint2. SC dislocations become increasingly difficult to reduce after 24 hours, so timely diagnosis and treatment are important. Glass et al. found mediastinal compression occurred 30% of the time with posterior dislocations. If left untreated, prolonged pressure on the superior mediastinum can cause erosion of the great vessels, tracheoesophageal fistula, …

Clinical Athletic Trainers Decrease Orthopedic Physician Clinical Burden, A Barloon, K Meadows, A Pennuto, K Petrachaianan, N Glass, M Hogue

Clinical Practice in Athletic Training

Introduction/Context: More than half of physicians in the United States are reporting symptoms of burnout. These symptoms lead to increased risk to patient safety and overall physician health. The use of Certified Athletic Trainers (ATCs) is increasing in popularity, especially in Orthopedic clinics. ATCs in the clinical setting have been shown to allow physicians to focus on patient care and less on clerical and documentation tasks. The goal of this study is to assess if ATCs in the physician practice setting influence physician work-life integration, burnout, and work engagement. Methods/Intervention: Approval obtained by IRB at University of Iowa. An observational, …

Enhanced Structural Control Of Soft-Templated Mesoporous Inorganic Thin Films By Inert Processing Conditions, Maximilliano Jesus Jara Fornerod, Alberto Alvarez-Fernandez, Eric R. Williams, Miximillian W.A. Skoda, Beatriz Prieto-Simon, Nicolas H. Voelcker, Morgan Stefik, Marc-Oliver Coppens, Stefan Guldin

Faculty Publications

Mesoporous thin films are widely used for applications in need of high surface area and efficient mass and charge transport properties. A well-established fabrication process involves the supramolecular assembly of organic molecules (e.g., block copolymers and surfactants) with inorganic materials obtained by sol-gel chemistry. Typically, subsequent calcination in air removes the organic template and reveals the porous inorganic network. A significant challenge for such coatings is the anisotropic shrinkage due to the volume contraction related to solvent evaporation, inorganic condensation, and template removal, affecting the final porosity as well as pore shape, size, arrangement, and accessibility. Here, we show that …

Covid-19 Mitigation Strategies: A Natural Experiment Highlighting The Importance Of Structure In The Prevention And Treatment Of Childhood Obesity, Keith Brazendale, Michael Beets, Robert Weaver Med, Phd, Bridget Armstrong, Ethan T. Hunt

Faculty Publications

Societal restrictions due to the Coronavirus Disease 2019 (COVID-19), such as the closure of schools, childcare centers, and community programs, were implemented to prevent the spread of the disease and to protect the health and well-being of the population. These mitigation efforts drastically interrupted the day-to-day environments of children and adolescents and influenced how they spent the majority of their waking hours. Evidence shows on days when children and adolescents are in “structured” settings, such as school or other extracurricular programs or day camps, their obesogenic behaviors (i.e., sleep, physical activity, diet, and screen/media time) are more favorable than on …

Epidemic Time Series Similarity Is Related To Geographic Distance And Age Structure, Tad Dallas, Grant Foster, Robert L. Richards, Bret D. Elderd

Faculty Publications

Objective

More similar locations may have similar infectious disease dynamics. There is clear overlap in putative causes for epidemic similarity, such as geographic distance, age structure, and population size. We compare the effects of these potential drivers on epidemic similarity compared to a baseline assumption that differences in the basic reproductive number (R₀) will translate to differences in epidemic trajectories.

Methods

Using COVID-19 case counts from United States counties, we explore the importance of geographic distance, population size differences, and age structure dissimilarity on resulting epidemic similarity.

Results

We find clear effects of geographic space, age structure, …

Potential Use Of Engineered Nanoparticles In Ocean Fertilization For Large-Scale Atmospheric Carbon Dioxide Removal, Peyman Babakhani, Tanapon Phenrat, Mohammed Baalousha M.Sc, Ph.D., Kullapa Soratana, Caroline L. Peacock, Benjamin S. Twining, Michael F. Hochella Jr.

Faculty Publications

Artificial ocean fertilization (AOF) aims to safely stimulate phytoplankton growth in the ocean and enhance carbon sequestration. AOF carbon sequestration efficiency appears lower than natural ocean fertilization processes due mainly to the low bioavailability of added nutrients, along with low export rates of AOF-produced biomass to the deep ocean. Here we explore the potential application of engineered nanoparticles (ENPs) to overcome these issues. Data from 123 studies show that some ENPs may enhance phytoplankton growth at concentrations below those likely to be toxic in marine ecosystems. ENPs may also increase bloom lifetime, boost phytoplankton aggregation and carbon export, and address …

Subchronic Oral Cylindrospermopsin Exposure Alters The Host Gut Microbiome And Is Associated With Progressive Hepatic Inflammation, Stellate Cell Activation, And Mild Fibrosis In A Preclinical Study, Punnag Saha, Macayla Upright, Dipro Bose, Subhajit Roy, Ayushi Trivedi, Madhura More, Geoff Scott Ph.D., Bryan W. Brooks, Saurabh Chatterjee

Faculty Publications

Epidemiological studies have reported a strong association between liver injury and incidences of hepatocellular carcinoma in sections of humans globally. Several preclinical studies have shown a strong link between cyanotoxin exposure and the development of nonalcoholic steatohepatitis, a precursor of hepatocellular carcinoma. Among the emerging threats from cyanotoxins, new evidence shows cylindrospermopsin release in freshwater lakes. A known hepatotoxin in higher concentrations, we examined the possible role of cylindrospermopsin in causing host gut dysbiosis and its association with liver pathology in a mouse model of toxico-pharmacokinetics and hepatic pathology. The results showed that oral exposure to cylindrospermopsin caused decreased diversity …

Insectdisease: Programmatic Access To The Ecological Database Of The World’S Insect Pathogens, Tad Dallas, Colin J. Carlson, Patrick R. Stephens, Sadie J. Ryan, David W. Onstad

Faculty Publications

Curated databases of species interactions are instrumental to exploring and understanding the spatial distribution of species and their biotic interactions. In the process of conducting such projects, data development and curation efforts may give rise to a data product with utility beyond the scope of the original work, but which becomes inaccessible over time. Data describing insect host–pathogen interactions are fairly rare, and should thus be preserved and curated with appropriate metadata. Here, we introduce the insectDisease R package, a mechanism for curating, updating and distributing data from the Ecological Database of the World's Insect Pathogens, a database of insect …

An Assessment Of Future Tidal Marsh Resilience In The San Francisco Estuary Through Modeling And Quantifiable Metrics Of Sustainability, James T. Morris, Judith Z. Drexler, Lydia J.S. Vaughn, April H. Robinson

Faculty Publications

Quantitative, broadly applicable metrics of resilience are needed to effectively manage tidal marshes into the future. Here we quantified three metrics of temporal marsh resilience: time to marsh drowning, time to marsh tipping point, and the probability of a regime shift, defined as the conditional probability of a transition to an alternative super-optimal, suboptimal, or drowned state. We used organic matter content (loss on ignition, LOI) and peat age combined with the Coastal Wetland Equilibrium Model (CWEM) to track wetland development and resilience under different sea-level rise scenarios in the Sacramento-San Joaquin Delta (Delta) of California. A 100-year hindcast of …

Validation Of A Script To Facilitate Social Determinant Of Health Conversations With Adolescent Patients, Emily M. Giorgi, Matthew J. Drescher, Zachary K. Winkelmann, Lindsey E. Eberman

Faculty Publications

Current social determinants of health (SDOH) tools exist to assess patient exposure; however, healthcare providers for the adolescent population are unsure of how to integrate SDOH knowledge into clinical practice. The purpose of this study was to validate a focused history script designed to facilitate SDOH conversations between clinicians and adolescents through the use of the Delphi method. Six individuals (1 clinician, 5 educators/researchers) participated as expert panelists. Panelists provided critical feedback on the script for rounds 1 and 2. For rounds 3–7, panelists received an electronic questionnaire asking them to indicate agreement on a 6-point Likert scale (1 = …