Medical Specialties Commons^™

Observed And Reported Outcomes Following Experiential Cultural Capability And Clinical Yarning Training For Clinicians Treating Aboriginal And Torres Strait Islander People With Persistent Pain, Stuart Ekberg, Renata F. I Meuter, Ivan Lin, Roslyn Rowen, Angela Kinnell, Eva Malacova, Tania Waring, Kushla Houkamau, Marayah Taylor, Matthew Bryant, Jermaine Isua, Andrew Claus, Paul Gray, Joseph Kluver, Christina M. Bernardes, Greg Pratt

Journal of the Australian Indigenous HealthInfoNet

Communication is recognised as crucial to culturally safe healthcare, and poor communication remains a major reason that Aboriginal and Torres Strait Islander people do not access healthcare. This pragmatic, pre-post comparison study employed mixed methods to evaluate cultural capability and clinical yarning training delivered to 57 clinicians supporting Aboriginal and Torres Strait Islander people at three persistent pain management services in Queensland, Australia. Observable outcomes of the training were evaluated by video recording clinicians’ training experiences and seven consultations with patients that occurred either pre- or post-training. Reported outcomes were evaluated by using a modified Cultural Safety Survey (CSS), which …

A Description Of Mental Health Policies In Ohio Secondary Schools, Laura L. Harris, Molly Rowe

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

OBJECTIVE To compare secondary school mental health policies implemented for the student body with those implemented for student athletes.

Athletic Trainers Confidence In Evaluating And Treating Emergent Conditions, Andrea Cripps, Jenny Toonstra, Sara Stiltner

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

OBJECTIVE The profession of Athletic Training (AT) has undergone a substantial educational overhaul in the last decade, adding more advanced knowledge and skills than ever before. With more than 50% of the profession having obtained their certification more than 10 years prior,¹ it is essential that we understand the varying levels of confidence in evaluating and managing these new skills, so that appropriate continuing education opportunities can be developed to bridge any gaps that may be identified. The purpose of this study to examine self-reported confidence in evaluating and managing acute care skills.

Sternocleidomastoid Syndrome In A Collegiate Basketball Athlete: A Case Study, Sara Stiltner, Rob Whitehurst, Eric Avers

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

BACKGROUND
20-year-old male basketball athlete with recurring upper and lower extremity instability injuries presented fall 2021 with shoulder and ankle instability. A past medical history of thermal capsulorrhaphy from high school with surgical intervention May 2021 (college first year). October 2021 athlete began experiencing rotator cuff strains in both shoulders. November 2021, December 2021, January 2022 athlete experiences recurrent right ankle sprains. Each ankle sprain resulted in two weeks of lost participation, followed by one week of active participation. The third ankle sprain associated with increased swelling and pain over medial ankle. Upon referral and MRI a deltoid ligament sprain …

Causes Of Athletic Trainer Attrition: A Critically Appraised Topic, Mckenna E. Tuttle, Klevione D. Brown, Elizabeth A. Starns

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

Athletic Training (AT) attrition has been a persistent issue within the profession for years^1,2. By identifying the factors contributing to the attrition rates among Athletic Trainers, targeted interventions can be developed to mitigate turnover and decrease attrition within the profession.

Kinematic Analysis Of Lower Extremity Movement Patterns During Functional Tests In Collegiate Track And Field Runners To Predict Injury Incidence, Maddie Hoyt, Brooke Parker, Bailey Weise, Andrew Busch

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

OBJECTIVE
Lower extremity overuse injuries are becoming increasingly more prevalent in endurance-based running sports^1,2,3,4,5,6. These injuries negatively impact an athlete’s sports performance and increase the risk of additional injuries^3,4. The purpose of this study was to first examine kinematic and kinetic variables within distance runners and compare those with previous lower extremity injuries to those without reported injuries; and second to understand if such variables predicted future injuries sustained throughout a track season.

Injury Epidemiology In Collegiate Marching Band, Morgan Davis, Jinghzen Yang, Matthew Brancaleone

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

OBJECTIVE
Marching bands have become more popular and physically demanding, with performers taking up to 16,174 steps on game days, which may increase their risk of musculoskeletal injuries. However, research on these performers remains limited. The purpose of this study was to describe the incidence of reported injury and pain and soreness experienced by marching artists within a collegiate marching band.

Atypical Anterior Tibial Stress Fracture Leading To Acute Fracture And Intermedullary Rodding, Emily Mulkey Swisher, Chad Cochran, Raymond Duffett

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

OBJECTIVE
This case highlights an unusual stress fracture progressing to an acute tibial fracture requiring intermedullary rodding.

The Athletic Trainer's Responsibility In Disability Exercise Adherence, Elizabeth Starns, Stephanie M. Kubiak, Rebecca J. Wehler

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

OBJECTIVE
This study examined exercise adherence to aerobic and strength training exercise guidelines in individuals with disabilities, highlighting the implications for athletic training (AT). Because disabilities impact over 25% of the U.S. population¹, an understanding of the varied exercise adherence patterns can inform inclusive AT best practices and assist in promoting exercise and sport participation.

Emergency Action Planning In Collegiate Athletics: An Evaluation Of The Current Adoption Of Best Practice Recommendations, Kyler Conn, Ken Blood, Genna Fusco

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

OBJECTIVE
The primary objective of this study was to assess the current adoption of the National Athletic Trainers’ Association’s (NATA) best practice recommendations regarding emergency planning, outlined in the NATA Position Statement: Emergency Planning in Athletics, at the collegiate level.

Effect Of Hearing Status On Modified Balance Error Scoring System Performance, Matthew Brancaleone, Claire Akard, Jaclyn Caccese

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

OBJECTIVE
Concussion assessments typically include evaluations of self-reported symptoms, neurocognitive function, and postural control. Specifically, postural control is often assessed using the modified Balance Error Scoring System (mBESS). Although normative mBESS data exist, they may not be appropriate for all athletes, such as those who are deaf or hard-of-hearing (D/HoH). Given the relationship between the cochlea and the vestibular system, athletes who are D/HoH may exhibit differences in postural control due to potential vestibular dysfunction. Therefore, the objective of this study was to compare mBESS performance between athletes who are D/HoH and athletes who are hearing.

Spontaneous Pneumothorax In A Male High School Wrestler, Laura Breese, Sara Stiltner

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

OBJECTIVE/BACKGROUND
A pneumothorax is the presence of air in the pleural space, it is a life threatening condition and can be classified as spontaneous, acquired, or by pathophysiology. (1)(2) This specific case presents the incident of a spontaneous pneumothorax in an adolescent population.

Novel Rpl30 Variant In Diamond Blackfan Anemia Demonstrates Early Impact On Erythroid Differentiation With Downregulated Gata1-Hsp70, Alexandra Prosser-Dombrowski, Irina Pushel, Jacqelyn Nemechek, Priyanka Kumar, Jay L. Vivian, Jennifer Gerton, John M. Perry

Research Days

Background: Diamond Blackfan anemia (DBA) is an inherited bone marrow failure syndrome caused by ribosomal protein gene mutations leading to apoptosis of erythroid progenitors. We identified a novel heterozygous variant (c.167+769C>T) in the noncoding region of RPL30 in a patient diagnosed with DBA.

Objectives/Goal: We hypothesized that this variant stunts erythroid differentiation at the proerythroblast stage and is pathogenic for DBA.

Methods/Design: We developed an induced pluripotent stem cell (iPSC) model with a wild type (WT) and three CRISPR-Cas9 edited RPL30 mutant clones. iPSCs were differentiated into hematopoietic stem cells, which were assessed by flow cytometry and single cell …

Duration Of Labor And Umbilical Artery Acidosis In Critical Congenital Heart Disease, Sarah Gwazdacz Md, Teresa Nguyen Bs, Mary Donofrio Md, Faap, Facc, Fase, Timothy Bennett Md, Amanda Mcintosh Md, Faap, Facc.

Research Days

Standard delivery protocols for most prenatally diagnosed CCHD is induction of labor at 39 weeks with aims of a vaginal delivery (VD) near a tertiary care center. There is no benefit to planned Cesarean delivery (CD) over VD for most infants with CCHD. However, longer durations of labor (DOL) in CCHD have been described as a risk factor for umbilical artery (UA) acidosis. We aim to describe the relationship between DOL and UA pH and neonatal outcomes in those with prenatally diagnosed CCHD.

Retrospective chart review of prenatally diagnosed with CCHD born at Children’s Mercy from 2012 – 2023. Inclusion …

The Impact Of Cultures On Treating Abscesses Associated With Appendicitis, Cory Nonnemacher, Seth Saylors, Meredith Elman, Tolulope A. Oyetunji Md Mph, Shawn D. St Peter

Research Days

Background/Purpose

Perforated appendicitis is associated with elevated risk of post-operative intra-abdominal abscess (PIAA) formation. Small PIAAs can be successfully treated without drainage, while larger ones warrant Interventional Radiology drainage. Routine culture of drained abscesses occurs at most institutions, with some prior studies showing resistance rates of 40-50%, prompting change of post-drainage antibiotics. The purpose of our study is to evaluate if culture results impact the antimicrobial therapy chosen for patients with PIAA, with our hypothesis being that routine culture does not have a significant impact on patient outcomes.

Methods

Patients < 18 years of age who were treated for perforated appendicitis at a standalone tertiary children’s hospital from 2011 to 2024 were retrospectively evaluated for abscess formation and extracted those who underwent drainage procedures with abscess cultures to assess the need for antibiotic adjustments from the standard of care based on culture results.

Results

A total of 1736 patients treated for perforated appendicitis …

Opportunities For Solid Organ Donation In The Neonatal Intensive Care Unit, Sarah Pippin, Jotishna Sharma, Ashley Sherman, Julie Weiner

Research Days

This study aims to characterize the theoretical eligibility of neonates undergoing withdrawal of care in the NICU for donation after circulatory determination of death (DCDD), with a focus on warm ischemic time (WIT) ≤ 90 minutes.

Abusive Head Trauma (Aht) Diagnoses: The Influence Of Clinical Presentation And Evidence Of Impact, Ruairi Smith-Dewey, Angela N. Bachim, Colleen Bressler, Kristine Campbell, Lori Frasier, Christopher Greeley, Danielle Horton, Nicole Johnson, Jan Leonard, Megan Letson, Daniel M. Lindberg, Caitlin Mcnamara, Shalon Nienow, Ashley K. Sherman, Joanne Wood, James Anderst

Research Days

Background: In cases where Child Abuse Pediatricians (CAPs) diagnose abusive head trauma (AHT) in young children, some factors surrounding the diagnosis have been challenged including causative shaking, necessity of external signs of impact, or concomitant suspicious injuries. Evaluation of CAP diagnoses in children with subdural hemorrhage (SDH) can give insight into factors related to the frequency of abusive head trauma (AHT) diagnoses. Additionally, characterization of those with SDH+CSI without evidence of impact may inform controversies around AHT diagnoses.

Objectives/Goal: We aim to compare CAP diagnoses in subjects with SDH across clinical presentations and in the context of evidence of head …

In Search Of The Unknown Mimic Of Abusive Head Trauma., Ruairi Smith-Dewey, Angela N. Bachim, Colleen Bressler, Kristine Campbell, Lori Frasier, Danielle Horton, Nicole Johnson, Jan Leonard, Megan Letson, Caitlin Mcnamara, Shalon Nienow, Ashley K. Sherman, Stuart Sommers, Joanne Wood, James Anderst

Research Days

Background:

Some claim that Child Abuse Pediatricians (CAPs) are misdiagnosing a yet-to-be-identified mimic as abusive head trauma (AHT), particularly in ill children with isolated subdural hemorrhage (SDH). Though not diagnostic criteria, specific social stressors have been identified as AHT risk factors. If a yet-to-be-identified mimic is meaningfully present within a group being evaluated for AHT, that group should have fewer AHT risk factors than children with actual AHT. The existence of such a mimic can be assessed by comparing the prevalence of AHT risk factors across groups: CAP-identified mimics, non-ill SDH only, ill SDH only, and SDH plus concomitant suspicious …

Engineering A Novel Treg Population To Control Autoimmune Diabetes, Sofia Colon Guzman, Elly Puckett, Mary A. Markiewicz, Ryan T. Fischer

Research Days

We created a model to test the immunosuppressive capacity of Helios+FOXP3+ eTregs compared to nTregs against islet-specific autoreactive T cells. We also showed that nTregs decrease the response of these cytotoxic T cells when co-cultured with BetaLox5 cells.

Growth Hormone Deficiency In Childhood Cancer Survivors: Response To Growth Hormone Therapy And Aromatase Inhibitors Compared To Growth Hormone Therapy Alone., Haya Azouz, Sarah Tsai, Keith August, Jennifer W. Boyd

Research Days

With evolving technologies leading to better cancer cure rate, the number of childhood cancer survivors has increased. There has been increasing reports of later endocrine effects including growth hormone deficiency (GHD). Our aim is to investigate the influence of adding aromatase inhibitors (AI) to growth hormone (GH) therapy in childhood cancer survivors with growth hormone deficiency (GHD). A retrospective chart review was performed looking at children between ages 0 and 18 years with history of malignancy and subsequent diagnosis of GHD at our institution. Fifty-nine children were included in this study. Participants were classified into 3 groups: (1) the target …

Improving Adherence To Evidence Based Sti Care For Patients Who Tested Positive At Ed Index Visit Qi Project, Noelle Tran, Melissa Miller, Kim Barbee, Julie Jost, Christopher Kaberline, M Smith

Research Days

Problem Statement/Question:

Previous work improved clinician sexually transmitted infection (STI) testing behaviors, but overlooked treatment interventions needed to facilitate risk reduction, HIV and syphilis (RPR) testing, and STI retesting at three months—critical components that reduce morbidity and disease spread. We are not adhering to evidence-based STI care for adolescents who tested positive for STIs at the ED index visit.

Background/Project Intent (Aim Statement):

According to the Centers for Disease Control and Prevention (CDC), in 2023, over 2.4 million cases of RPR, gonorrhea (GC), and chlamydia (CT) were diagnosed; about half of reported cases were among adolescents and young adults aged …

Characterizing Attendance At Faculty Education Sessions From A Diversity, Equity, & Inclusion Perspective, Mauro D. Rodriguez, Do, Kimberly A. Randell, Md, Msc, Emilie Keeton, Msod, Myles Chandler, Ms, Ashley K. . Sherman, Ma, Jacqueline Hill, Phd, Mph, Frances Turcotte Benedict, Md, Mph

Research Days

The impact of Diversity, Equity, and Inclusion (DEI) education for faculty is largely unknown. This retrospective analysis tracked CMH faculty participation over three years to determine attendance by gender, race/ethnicity, academic rank, and department at DEI and non-DEI education sessions. Ultimately, further studies are needed to understand participation barriers to DEI education.

Food Insecurity In Adolescent Athletes, Andrew Donaldson, Shannon Margherio, Jay Roberson, Kevin Latz

Research Days

Background: The prevalence of food insecurity among children in the United States is estimated at 21%. Food insecurity during childhood leads to worse school performance, more emotional and behavioral health concerns, and increased suicide attempts. Further, food insecurity has been noted to have multiple deleterious effects on the collegiate student athlete, including lower GPA, disordered eating, and substance use.

Hypothesis: Food insecurity is prevalent in the adolescent athlete population and exists across demographics.

Methods: Voluntary surveys were distributed to parents at all sports medicine clinics at our institution. Demographic data was collected including athlete age, race, school and school district, …

Shilla Growth Guidance System (Sggs) Instrumentation With Pelvic Foundation (Sggs) For Severe Neuromuscular Spine Deformity. Does It Work?, Hannah Geoffroy, Richard Schwend

Research Days

This study evaluates the use of the Shilla Growth Guidance System (SGGS) with a pelvic foundation for treating severe neuromuscular scoliosis in young children. The primary outcomes include revision surgery and complication rates. In a 21-patient cohort (mean age 5.3 years, follow-up 10 years), 57% required only one surgery, while 43% needed revisions. The complication rate was 38%, with a 29% deep infection rate. The procedure improved spinal alignment and growth but carried significant risks. SGGS with pelvic fixation may reduce the need for repeated surgeries in this complex patient population.

Identifying Prior Concerning Injuries In Children With Abusive Fractures, Noelle Tran, Maria Antonucci, Angela Bachim, Colleen Bressler, Kristine Campbell, Nara Cho, Kristin Crichton, Lori Frasier, Nancy Harper, Sara Kilbride, Natalie Laub, Jan Leonard, Daniel Lindberg, Ashley Sherman, Joanne Wood, James Anderst

Research Days

Background-

Existing data characterizes the relationship between prior concerning injuries (PCI) in infants preceding abusive head trauma (AHT). Little data exists on the relationship between PCI and other abusive injuries, in particular fractures. As AHT and abusive fractures differ in epidemiology and inciting events, it is possible that the frequency, type, and age of occurrence of PCI preceding abusive fractures may differ.

Objectives/Goals-

We aim to compare the frequency and number of PCI known to a Child Abuse Pediatrician (CAP) at the time of evaluation between children with abusive and non-abusive fractures.

Methods/Design-

This was a retrospective, case-control study using …

Improving Guideline-Based Prep Management In A Philadelphia-Based Academic Family Medicine Office, Brittany Macdonald, Md, Marshall Miller, Md, Nwando Ekezie, Md, Maia Mandel, Md, Christina Boras, Md, Eunice Choe, Md, Meghan Swyryn, Md, Meg Broderick, Md, Pascaline Karanja, Md, Julia Beatini, Md, Julie Jones

Health Equity and Quality Improvement (HEQI) Summit

Background

Pre-Exposure Prophylaxis (PrEP) significantly reduces the risk of contracting HIV:

• Reduces risk from sexual contact by 99%
• Reduces risk from injection drug use by at least 74%

Despite its effectiveness, PrEP is underutilized in the USA.

• In 2019, an estimated 224,000 Americans received a prescription for PrEP despite 1.1 million people having indications for PrEP.
• Lack of provider knowledge surrounding PrEP clinical guidelines is a common reason for underutilization.

Screening And Diagnosis Of Gestational Diabetes, And Perinatal Outcomes In Patients With Bariatric Surgery History, Silpa Annavarapu, Bs, Charlette Williams, Md, Rodney Mclaren, Jr., Md, Sarah Boudova, Md, Phd

Health Equity and Quality Improvement (HEQI) Summit

Background

- ~1 in 5 women of reproductive age are obese, with bariatric surgery increasing in popularity as an intervention

- Gestational diabetes mellitus (GDM) is associated with shoulder dystocia, polyhydramnios, weight >4500g, hypoglycemia, hyperbilirubinemia, NICU admission, respiratory distress, cesarean delivery, gestational hypertension (HTN), and Preeclampsia

- Adverse outcomes of GDM can be mitigated with early diagnosis and blood glucose management

- The glucose tolerance test (GTT) is the current gold standard for diagnosing gestational diabetes (GDM)

• Individuals with a history of bariatric surgery may not tolerate the sugar load or volume of the GTT
• The GTT may not accurately …

Identifying Unnecessary And Excessive Use Of Intravenous Heparin For The Treatment Of Intermediate-Risk Pulmonary Embolism, Youssef Elfatatry, Ryan Gardner, Chukwuemezie Kamanu, Ruben Rhoades

Health Equity and Quality Improvement (HEQI) Summit

Problem Statement

- Intermediate-risk pulmonary embolism (PE) is a diagnosis with heterogenous presentations and mortality rates ranging from 2% to 15%.

- European Society of Cardiology (ESC) guidelines recommend low-molecular weight heparin (LMWH) as first line therapy in most patients. Despite this, the use of IV heparin in intermediate-risk PE remains widespread, due to uncertainty regarding patients receiving further procedures and mitigation of bleeding risk.

Project AIM:

- We aim to (1) identify prescribing patterns and outcomes of anticoagulant therapy on admission, and (2) propose and implement a "PE Care Pathway" in EPIC to address uncertainty in risk-stratifying and treating …

Post-Operative Management Of Chronic Subdural Hematomas, Steven R. Glener, Md

Health Equity and Quality Improvement (HEQI) Summit

Primary Objective & Outcome Measures

Objective: Identify standard of care for post-operative subacute to chronic subdural hematomas (cSDH) that undergo burr hole evacuation

Primary outcomes:

• Rate of SDH recurrence requiring re-evacuation or MMA embolization

Secondary outcomes:

• LOS
• Readmission for a medical problem related to chronic subdural evacuation

Future Of Transplant Centers: Leveraging Integration Of Transplant Institutes To Mitigate The Impact Of Transplant Professional Shortages And Enhance Patient Outcomes, Kiran Goli, Prashamsa Shenoy, Paula Martinez-Cantarin, Maitreyee Gupta, Rakesh Gulati, Pooja Singh

Health Equity and Quality Improvement (HEQI) Summit

Background

The Increasing Organ Transplant Access (IOTA) Model introduced by the Centers for Medicare & Medicaid Services (CMS) emphasizes increasing transplant volumes, reducing disparities, and enhancing care efficiency. Transplant centers face unique challenges, including workforce shortages, growing demand for organ transplants, care delivery inefficiencies, and the need to align with the achievement, efficiency, and quality domains of the IOTA model while fostering health equity. Integration, whether through mergers, acquisitions, or strategic alliances, offers transplant centers a competitive advantage in optimizing resources, expanding access, and meeting CMS metrics.