Medical Specialties Commons^™

Medical-Legal Partnership Effects On Mental Health, Health Care Use, And Quality Of Life In Primary Care: A Randomized Clinical Trial, Winston Liaw, Thomas F Northrup, Angela L Stotts, Christine Bakos-Block, Robert Suchting, Alvin Chen, Abigail Hernandez, Lisandra Finzetto, Charles Green, Thomas Murphy

Faculty, Staff and Student Publications

Purpose: To determine whether an immediate referral to a medical-legal partnership (MLP), compared with a 6-month waitlist control, improved mental health, health care use, and quality of life.

Methods: This trial randomly assigned individuals to an immediate referral or a wait-list control. The MLP involved a collaboration between the primary care clinic and a legal services organization. The primary outcome was stress (6 months) as measured by the Perceived Stress Scale (PSS). Secondary measures included the Center for Epidemiologic Studies Depression Scale; Generalized Anxiety Disorder scale (GAD-7); Patient-Reported Outcomes Measurement Information System (PROMIS); and emergency department (ED), urgent care, and …

Immune Checkpoint Therapy Combinations In Adult Advanced Mit Family Translocation Renal Cell Carcinomas, Omar Alhalabi, Jonathan Thouvenin, Sylvie Négrier, Yann-Alexandre Vano, Luca Campedel, Elshad Hasanov, Ziad Bakouny, Andrew W Hahn, Mehmet Asim Bilen, Pavlos Msaouel, Toni K Choueiri, Srinivas R Viswanathan, Kanishka Sircar, Laurence Albiges, Gabriel G Malouf, Nizar M Tannir

Faculty, Staff and Student Publications

Background: There remains a paucity of data regarding the efficacy of immune checkpoint therapy (ICT) combinations ± vascular endothelial growth factor (VEGF) targeted therapy (TT) in translocation renal cell carcinoma (tRCC).

Methods: This is a retrospective study of patients with advanced tRCC treated with ICT combinations at 11 centers in the US, France, and Belgium. Only cases with confirmed fluorescence in situ hybridization (FISH) were included. Objective response rates (ORR) and progression-free survival (PFS) were assessed by RECIST, and overall survival (OS) was estimated by Kaplan-Meier methods.

Results: There were 29 patients identified with median age of 38 (21-70) years, …

Delayed Presentation Of Biopsy-Proven Eosinophilic Myocarditis Following Covid-19 Mrna Vaccine, Chaitra Janga, Tirth Patel, Hussam Al Hennawi, Sarin Atam, Shreeja Shah Shah, Ifrah Naeem, Rahat Memon, Donald C. Haas

Abington Jefferson Health Papers

Myopericarditis associated with COVID-19 mRNA vaccines has been recognized as an uncommon adverse reaction, especially among young, healthy adult males. Eosinophilic myocarditis is a rare form of inflammation reflecting a hypersensitivity reaction following an inciting event commonly caused by drugs including vaccines. Eosinophilic myocarditis, a subtype of myocarditis, is characterized by eosinophilic myocardial infiltrates. It is usually accompanied by systemic eosinophilia in the form of a drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome and is rarely associated with myocyte fibrosis and/or necrosis. In this report, we present a case of biopsy-proven eosinophilic myocarditis in a 24-year-old male patient, …

Tfeb And Tfe3 Drive Kidney Cystogenesis And Tumorigenesis, Chiara Di Malta, Angela Zampelli, Letizia Granieri, Claudia Vilardo, Rossella De Cegli, Laura Cinque, Edoardo Nusco, Salvatore Pece, Daniela Tosoni, Francesca Sanguedolce, Nicolina Cristina Sorrentino, Maria J Merino, Deborah Nielsen, Ramaprasad Srinivasan, Mark W Ball, Christopher J Ricketts, Cathy D Vocke, Martin Lang, Baktiar Karim, Luisa Lanfrancone, Laura S Schmidt, W Marston Linehan, Andrea Ballabio

Duncan NRI Faculty and Staff Publications

Birt-Hogg-Dubé (BHD) syndrome is an inherited familial cancer syndrome characterized by the development of cutaneous lesions, pulmonary cysts, renal tumors and cysts and caused by loss-of-function pathogenic variants in the gene encoding the tumor-suppressor protein folliculin (FLCN). FLCN acts as a negative regulator of TFEB and TFE3 transcription factors, master controllers of lysosomal biogenesis and autophagy, by enabling their phosphorylation by the mechanistic Target Of Rapamycin Complex 1 (mTORC1). We have previously shown that deletion of Tfeb rescued the renal cystic phenotype of kidney-specific Flcn KO mice. Using Flcn/Tfeb/Tfe3 double and triple KO mice, we now show that both Tfeb …

Advantages Of Whole Genome Sequencing In Mitigating The Helicobacter Pylori Antimicrobial Resistance Problem, Kartika Afrida Fauzia, Ricky Indra Alfaray, Yoshio Yamaoka

Faculty, Staff and Students Publications

Helicobacter pylori antimicrobial resistance is a critical public health issue. Typically, antimicrobial resistance epidemiology reports include only the antimicrobial susceptibility test results for H. pylori. However, this phenotypic approach is less capable of answering queries related to resistance mechanisms and specific mutations found in particular global regions. Whole genome sequencing can help address these two questions while still offering quality control and is routinely validated against AST standards. A comprehensive understanding of the mechanisms of resistance should improve H. pylori eradication efforts and prevent gastric cancer.

Perspectives On Non-Prescription Antibiotic Use Among Hispanic Patients In The Houston Metroplex, Lindsey Laytner, Patricia Chen, Susan Nash, Michael K Paasche-Orlow, Richard Street, Roger Zoorob, Barbara Trautner, Larissa Grigoryan

Faculty, Staff and Students Publications

BACKGROUND: Non-prescription antibiotic use includes taking an antibiotic without medical guidance (e.g., leftovers, from friends/relatives, or purchased without a prescription). Non-prescription use contributes to antimicrobial resistance, adverse drug reactions, interactions, superinfection, and microbiome imbalance. Qualitative studies exploring perspectives regarding non-prescription use among Hispanic patients are lacking. We used the Kilbourne Framework for Advancing Health Disparities Research to identify factors influencing patients' non-prescription use and organize our findings.

METHODS: Our study includes Hispanic primary care clinic patients with different types of health insurance coverage in the Houston metroplex who endorsed non-prescription use in a previous survey. Semistructured interviews explored the factors …

Dna Supercoiling-Induced Shapes Alter Minicircle Hydrodynamic Properties, Radost Waszkiewicz, Maduni Ranasinghe, Jonathan M Fogg, Daniel J Catanese, Maria L Ekiel-Jeżewska, Maciej Lisicki, Borries Demeler, Lynn Zechiedrich, Piotr Szymczak

Faculty, Staff and Students Publications

DNA in cells is organized in negatively supercoiled loops. The resulting torsional and bending strain allows DNA to adopt a surprisingly wide variety of 3-D shapes. This interplay between negative supercoiling, looping, and shape influences how DNA is stored, replicated, transcribed, repaired, and likely every other aspect of DNA activity. To understand the consequences of negative supercoiling and curvature on the hydrodynamic properties of DNA, we submitted 336 bp and 672 bp DNA minicircles to analytical ultracentrifugation (AUC). We found that the diffusion coefficient, sedimentation coefficient, and the DNA hydrodynamic radius strongly depended on circularity, loop length, and degree of …

Impact Of Early Relapse Within 24 Months After First-Line Systemic Therapy (Pod24) On Outcomes In Patients With Marginal Zone Lymphoma: A Us Multisite Study, Narendranath Epperla, Rina Li Welkie, Pallawi Torka, Geoffrey Shouse, Reem Karmali, Lauren Shea, Andrea Anampa-Guzmán, Timothy S Oh, Heather Reaves, Montreh Tavakkoli, Kathryn Lindsey, Irl Brian Greenwell, Emily Hansinger, Colin Thomas, Sayan Mullick Chowdhury, Kaitlin Annunzio, Beth Christian, Stefan K Barta, Praveen Ramakrishnan Geethakumari, Nancy L Bartlett, Alex F Herrera, Natalie S Grover, Adam J Olszewski

Department of Medicine Faculty Papers

Progression of disease within 24 months (POD24) from diagnosis in marginal zone lymphoma (MZL) was shown to portend poor outcomes in prior studies. However, many patients with MZL do not require immediate therapy, and the time from diagnosis-to-treatment interval can be highly variable with no universal criteria to initiate systemic therapy. Hence, we sought to evaluate the prognostic relevance of early relapse or progression within 24 months from systemic therapy initiation in a large US cohort. The primary objective was to evaluate the overall survival (OS) in the two groups. The secondary objective included the evaluation of factors predictive of …

Elucidating The Impact Of Sos-Response Timing In On Escherichia Coli Survival Following Treatment With Fluoroquinolone Topoisomerase Inhibitors, Stephanie Schofield

Honors Scholar Theses

Antibiotic treatment failure is a public health crisis, with a 2019 report stating that roughly 35,000 deaths occur in the United States yearly due to bacterial infections that are unresponsive to antibiotics (1). One complication in the treatment of bacterial infection is antibiotic persistence which further compromises our battle to effectively treat infection. Bacterial persisters can exist in clonal bacterial cultures and can tolerate antibiotic treatment by undergoing reversible phenotypic changes. They can survive drug concentrations that their genetically identical kin cannot. Some persisters remain in a slow growing state and are difficult to target with current antibiotics. A specific …

Telehealth And Its Impact On The Management Of Type 2 Diabetes Mellitus, Melissa N. Toulios

Evidence-Based Practice Project Reports

Diabetes mellitus type 2 (T2DM) is a growing epidemic that affects millions of people throughout the world. The recent COVID-19 pandemic has created many new challenges, including access to health care for treatment of chronic diseases, such as diabetes (Robson & Hosseinzadeh, 2021). Telehealth has offered a promising approach to improve the management of diabetes(Bellman, 2021). People with diabetes are less likely to manage their diabetes through the usual care because of risk of contracting COVID-19 (CDC, 2022). The purpose of this EBP project was to evaluate the effectiveness of T2DM management through a telehealth approach. This project has addressed …

Evaluating Nurse Use And Satisfaction With Video-Based Discharge Education For Adults With Heart Failure, Krystyna Simon Rn, Bsn, Molly Hendrickson Rn, Bsn, Windy Alonso Phd, Rn, Fhfsa

Doctor of Nursing Practice Projects: College of Nursing

Background

Heart failure (HF) readmission rates are high and influenced by self-care practices and self-efficacy for managing chronic disease. Using digital education via tablet can help improve the discharge education process and may increase self-care knowledge.

Objective

The purpose of the study is to assess the current discharge processes implemented for HF patients in cardiovascular units at a Midwestern academic medical center.

Methods

Participants for this two-phase study were recruited from two inpatient cardiovascular units within a 700-bed, Midwestern academic medical center. Phase one used a pre-post quasiexperimental design to evaluate a discharge educational intervention using the teach-back method in …

Chest Wall Injury Pain With Movement, Lindsey Cavlovic

Theses & Dissertations

Rib fractures are the most common injury in patients who sustain trauma to the chest wall. These patients often report exacerbated pain severity with deep breathing, coughing, and performing movements of the upper body. Clinical experience in treating these patients shows that patients usually avoid movement due to increased pain severity. Most pain scores from patients with chest wall injuries are assessed while the patient lies comfortably in bed. Although pain is the primary complaint of patients with chest wall injury, the assessment of this pain is likely under-represented, given that these patients remain inactive due to the pain that …

Use Of Pre-Transplant Cmi To Predict Infection And Mortality Post-Cardiac Transplantmortality Post-Cardiac Transplant, Chetaj A. Mahabir

Theses & Dissertations

This paper discusses a study investigating the relationship between the cell-mediated immunity (CMI) level before cardiac transplant and the incidence of infection and mortality after the transplant. CMI is an important measure of a person's immune system. The study included 126 patients who underwent cardiac transplants between September 2011 and January 2020. Out of these, 21 patients had a low CMI level (<225), and 105 had a high CMI level (≥ 225) before transplant. The mean CMI level in the low CMI group was 175.3, while in the high CMI group, it was 479.9. The two groups were similar except for the lower white cell count and cardiac output in the CMI< 225 groups and the higher Caucasian demographic in the CMI≥ 225 groups. The study concludes that patients with lower CMI levels before cardiac transplant have a higher risk of infection (p=0.052) and mortality (p=0.005) one year after the transplant. The risk of dying for patients with CMI <225 is 12.9 times the risk of dying for patients with CMI ≥ 225 after adjusting for the other covariates in the model. However, this study has some limitations including its retrospective nature, small sample size, and single-center design. Further studies are needed to replicate these findings and investigate the optimal immunosuppressive regimens based on baseline CMI levels.

Oxidative Damage Together With Post-Occlusive Re-Oxygenation Kinetics, In Calf Muscle, Implicate Microvessels In The Myopathy Of Peripheral Artery Disease, Molly Schieber

Theses & Dissertations

Background:Peripheral Artery Disease (PAD) is characterized by calf muscle fibrosis and myofiber oxidative damage (OxD). Our laboratory has demonstrated architectural changes of calf-muscle microvessels (

Methods:Gastrocnemius biopsies were collected from controls, patients with Stage II PAD, and Stage IV patients with limb-threatening ischemia. Carbonyl adducts (CA; oxidative damage), and Heme Oxygenase-1 (HO-1; anti-OxD in microvessels) were quantified in microvessels (

Results: Post-occlusive re-oxygenation of calf muscle was slowed in Stage II patients versus controls. Kinetic parameters correlated poorly with Ankle-Brachial Index. Microvessel CA was increased in pre- and post-exercise Stage II patients and in Stage IV patients versus …

Center Based Cardiac Rehabilitation Outcomes Associated With Covid-19 Pandemic: A Retrospective Comparative Cohort Study, Haley Williams, Kayla Woodworth

Doctor of Nursing Practice Projects: College of Nursing

Background: Traditional cardiac rehabilitation (CR) is a multidisciplinary, multifaceted program for cardiac patients. Throughout the Covid-19 pandemic, health care, including center-based CR (CBCR) programs, were closed to in-person sessions. Even with the return to CBCR participation, patient outcomes may have been affected by this disruption in care. The goal of this study was to determine if CR participation outcomes differed before and after CBCR program closure due to Covid-19.

Methods: A retrospective comparative cohort design was used to examine CR participant outcome data before and after the Covid-19 pandemic. Convenience sampling of CR participants at a large, urban …

Interpretive Phenomenological Analysis [Ipa]: Examining The Impact Of Sleep Disturbances On Lived Experiences Of Persons With Parkinson’S Disease (Pwpd), Adriana Ornelas, Angela Blackwell, Karen Aranha

Spring 2023 Virtual OTD Capstone Symposium

Introduction: This investigation aimed to examine the lived experiences of PwPD who suffer from insomnia. Sleep disturbance affects up to 96% of individuals with PD. The non-motor symptom (NMS) significantly reduces HR-QOL, positively correlates with disease severity and duration, and increases the disease burden of care. Due to the nature of the disease, typical sleep hygiene protocols may not be the most effective intervention for this population. Understanding their challenges is vital to developing a sleep hygiene protocol tailored to their needs.

Methodology: A pilot qualitative study using an interpretive phenomenological analysis (IPA) with PwPD (N=12). The study received IRB …

Evaluating The Impact Of Routine Enteral Iron Fortification On Gastrointestinal Dysbiosis In Premature Infants, Matthew Van Ormer

Theses & Dissertations

The gastrointestinal microbiome in preterm infants bears significant influence on optimal outcomes – dysbiosis is shown to substantially increase the risk of the life-threatening necrotizing enterocolitis, whereas optimal microbiome composition improves nutrient digestion and immune function. Iron is a vital nutrient especially during the perinatal window of rapid hemoglobin production, tissue growth, and foundational neurological development. However, excess colonic iron exhibits potent oxidation capacity and alters the competitive environment of microbes – potentially facilitating the proliferation of pathological bacterial strains in the gut. Of note, breastfed preterm infants routinely receive iron fortification starting at 14 days of life and are …

Targeting The Cxcr1/2 Axis In Pancreatic Ductal Adenocarcinoma, Caitlin Molczyk

Theses & Dissertations

Pancreatic ductal adenocarcinoma (PDAC) is notoriously challenging to diagnose and treat. This tumor has an aggressive phenotype and benign clinical features until severe disease dissemination, which makes it too late to eradicate. Although it is only the 10th most common cancer in the United States, it is the fourth leading cause of cancer-related deaths. The treatment options are complicated further due to tumor heterogeneity, meaning not all tumor cells are in the same state phenotypically or epigenetically. They also express cytokines, chemokines, and receptors differently. Here we explore the usage of CXCR1 and CXCR2 and their ligands in PDAC tumor …

Impact Of The Covid-19 Pandemic On The Management Of Risk Factors In Patients With Stable Atherosclerotic Vascular Disease, Dean Karalis, Patrick Moeller, Albert Crawford, Maria Janelli, Scott Hessen

Division of Cardiology Faculty Papers

Background

Effective control of risk factors in patients with ASCVD is important to reduce recurrent cardiovascular events. However, many ASCVD patients do not have their risk factors controlled, and this may have worsened during the COVID-19 pandemic.

Methods

We retrospectively evaluated risk factor control among 24,760 ASCVD patients who had at least 1 outpatient encounter both pre-pandemic and during the first year of the pandemic. Risk factors were uncontrolled if the blood pressure (BP) ≥ 130/80 mm Hg, LDL-C ≥ 70 mg/dL, HgbA1c ≥ 7 for diabetic patients, and patients were current smokers.

Results

During the pandemic, many patients had …

Higher Dose Corticosteroids In Patients Admitted To Hospital With Covid-19 Who Are Hypoxic But Not Requiring Ventilatory Support (Recovery): A Randomised, Controlled, Open-Label, Platform Trial, Recovery Collaborative Group

Faculty, Staff and Student Publications

BACKGROUND: Low-dose corticosteroids have been shown to reduce mortality for patients with COVID-19 requiring oxygen or ventilatory support (non-invasive mechanical ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation). We evaluated the use of a higher dose of corticosteroids in this patient group.

METHODS: This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing multiple possible treatments in patients hospitalised for COVID-19. Eligible and consenting adult patients with clinical evidence of hypoxia (ie, receiving oxygen or with oxygen saturation

FINDINGS: Between May 25, 2021, and May 13, 2022, 1272 patients with COVID-19 and hypoxia receiving no oxygen …

Higher Dose Corticosteroids In Patients Admitted To Hospital With Covid-19 Who Are Hypoxic But Not Requiring Ventilatory Support (Recovery): A Randomised, Controlled, Open-Label, Platform Trial, Recovery Collaborative Group

Faculty, Staff and Student Publications

BACKGROUND: Low-dose corticosteroids have been shown to reduce mortality for patients with COVID-19 requiring oxygen or ventilatory support (non-invasive mechanical ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation). We evaluated the use of a higher dose of corticosteroids in this patient group.

METHODS: This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing multiple possible treatments in patients hospitalised for COVID-19. Eligible and consenting adult patients with clinical evidence of hypoxia (ie, receiving oxygen or with oxygen saturation

FINDINGS: Between May 25, 2021, and May 13, 2022, 1272 patients with COVID-19 and hypoxia receiving no oxygen …

Development Of Combination Therapy Strategies To Treat Cancer Using Dihydroorotate Dehydrogenase Inhibitors, Nicholas Mullen

Theses & Dissertations

Cancer cells require supraphysiologic levels of nucleotide triphosphates to fuel their malignant behaviors, including uncontrolled proliferation, immune evasion, metastasis, and therapy resistance. This requirement is met by hyperactive flux through the de novo pyrimidine and de novo purine pathways. Dihydroorotate dehydrogenase (DHODH) is an essential enzyme in the de novo pyrimidine pathway that can be targeted by FDA approved and experimental drug compounds. A robust body of preclinical evidence, encompassing hundreds of independent studies over several decades, demonstrates impressive activity of DHODH inhibitors in animal models of cancer. Paradoxically, however, all clinical trials to date have failed to demonstrate efficacy …

Letter From The Editor: Oata Special Issue 2023, Sara Stiltner

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Letter from the Editor

Thank you for viewing the OATA Annual Meeting Special Issue of the

Journal of Sports Medicine and Allied Health Sciences:

The Official Journal of the OATA.

This is our 9^th year working in conjunction with the

OATA Annual Meeting to open a new volume of the JSMAHS.

This special issue would not be possible without the Managing Editor, Cole Dearing and the OATA Research and Grant Subcommittee Members who spend time and pour in effort to provide highly critiqued blinded peer review of the OATA Free Communication Abstracts. Those members include: Stacey Busser, Akron University, …

Perceptions Among Athletic Trainers’ Education In Treating Athletes With Attention Deficit Hyperactivity And Autism Disorders, Juliette Mueller, Audrey Wagstaff, Jennifer Walker

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

The purpose of this study was to investigate the education and preparedness of athletic trainers when caring for athletes with Attention.Deficit.Hyperactivity.Disorder (ADHD) and or Autism Spectrum Disorder (ASD).

Athletic Trainers Knowledge And Practices For Sudden Cardiac Death, Brent Mcclure, Chyrsten Gessel, Brittany Peppel

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

Sudden cardiac death (SCD) is one of the leading causes of death in athletics, despite athletic trainers working as first responders for athletic events. The purpose of this study was to assess athletic trainers’ knowledge of SCD, and to analyze perceptions regarding evidence-based practice. This study aimed to answer how the NATA position statement has impacted athletic trainers practice, and to identify potential limitations in implementing best practice.

Unreported Concussions Within Law Enforcement Officers, Bailee Faulkner, Jennifer Walker, Audrey Wagstaff

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

Understand the degree to which concussions go unreported among members of the Law Enforcement community.

Perceived Knowledge And Confidence Of Social Determinants Of Health In College And Secondary School Athletic Trainers, Lauren Redfern, Chyrsten Gessel, Elena Robinson

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

For most athletes, their athletic trainer is the healthcare provider with whom they interact the most while for others, ATs are the only health care professionals they interact with. It is crucial that ATs can assess and implement strategies that account for SDH in athletes. The purpose of this study was to explore the relationship between the number of years certified as an athletic trainer in the college and secondary school settings and perceived knowledge of factors and confidence in the implementation of interventions to address social determinants of health (SDH) when treating patients.

Usage And Influence Of Dietary Supplementation Amongst Adolescent Athletes, Allison Harlow, Jennifer Walker, Aubrey Wagstaff

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE The purpose of this study was to investigate the use of dietary supplements or ergogenic aids amongst high school athletes.

The Effect Of Instrument Assisted Soft Tissue Mobilization On Improving Joint Range Of Motion In Active Individuals: A Critically Appraised Topic, Cole E. Dearing, Andrea Cripps, Jenny Toonstra

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

CLINICAL SCENARIO

In all activities that require physical movement, whether in athletics or in other daily tasks, it is important for joints to have adequate range of motion and flexibility. Soft tissue restrictions are very common pathologies in healthcare. Although a decrease in myofascial range of motion can arise from a variety of reasons such as biomechanical deformities, autoimmune diseases, or age, it is often caused by overtraining or musculoskeletal injuries in active populations. Instrument assisted soft tissue mobilization techniques are gaining popularity to assist in treating various soft tissue injuries and musculoskeletal pathologies. The belief is that by applying …

Rates Of Burnout Among Collegiate Athletic Trainers During The Covid-19 Pandemic, Lauren Linn, Jennifer Walker, Audrey Wagstaff

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

The purpose of this study was to investigate the effects of COVID-19 related tasks on the rates of burnout in athletic trainers practicing in the collegiate setting.