Event: Health Sciences Research Conference 2020 eProgram

Poster #1
Presentation 5pm
Mech Ventilation

A Bench Study Evaluation of the Amount of Auto-PEEP when Ventilating an Electronic Lung Model Simulated to Represent Normal, ARDS and COPD Conditions

Kathleen A. Davis (Boise State University), Heather P. Peterson (Boise State University), Alex R. Sanders (St. Luke’s Meridian Medical Center)

Faculty Mentor: Lonny Ashworth MEd RRT FAARC; Dept. of Respiratory Care (Boise State University)

Background: The purpose of this study was to evaluate the occurrence of Auto-PEEP in VC A/C when ventilating normal, ARDS and COPD lung models on the Servo-i, Drager V500, PB 980 and Avea. Methods: This study was completed using an IngMar Medical ASL 5000 electronic lung simulator (ASL 5000) setup to simulate normal, ARDS and COPD conditions. Normal lung: Cst 54 mL/cm H2O, inspiratory resistance (Rin) 13 cm H2O/L/s, expiratory resistance (Rout) 12 cm H2O/L/s; ARDS: Cst 39 mL/cm H2O, Rin 12 cm H2O/L/s, Rout 14 cm H2O/L/s; COPD: Cst 59 mL/cm H2O, Rin 22 cm H2O/L/s, Rout 18 cm H2OL/s. VC A/C parameters were set using 70 kg PBW and a tidal volume of 6 mL/kg. Respiratory rates of 15, 20 and 25 breaths/min with a tidal volume of 420 mL were chosen to achieve a minute ventilation of 90 mL/min/kg, 120 mL/min/kg, and 150 mL/min/kg. PEEP was set at 5 cm H2O throughout the study. Peak flow and I-time were adjusted to maintain an I:E ratio of 1:3 for normal and ARDS conditions. An I:E ratio of 1:4 was used for COPD conditions. A decelerating flow waveform was used, when available. The same circuit was used for each ventilator. The y-piece of the ventilator circuit was attached to the ASL 5000 using a 7023 Hans Rudolph 22 mm adapter. With each change in minute ventilation, the conditions were stabilized for one minute before data collection. Data were collected on each ventilator for each minute ventilation and lung condition for two minutes.

Results: As respiratory rate increased, an increase mean pressure, Auto-PEEP and total PEEP were observed in each ventilator. Conclusions: A reduction in expiratory time causes an increase in mean pressure, Auto-PEEP, and total PEEP in all conditions with all ventilators. The Servo-i showed the lowest amount of Auto-PEEP with the Avea yielding the highest amount of Auto-PEEP in all patient conditions. Due to the possible physiological consequences of Auto-PEEP in critically ill patients, further research is needed to evaluate the presence of Auto-PEEP in the clinical setting with mechanically ventilated patients.

Poster #2
Presentation 5pm
Mech Ventilation

APRV: A Comparison of APRV/BiLevel, PC-APRV, BiLevel and BiVent

Camille Hinchcliff (Boise State University), Megan West (Boise State University), Morgan McEwan (Boise State University), et. all

Faculty Mentor: Lonny Ashworth MEd RRT FAARC, Respiratory Care (Boise State University)

Background: Airway Pressure Release Ventilation (APRV) is a pressure controlled mode of ventilation that ventilates the patient with a long Time High (Thigh) and short Time Low (Tlow) to intentionally create Auto-PEEP. APRV may improve oxygenation and increase alveolar lung recruitment. The purpose of this bench study was to evaluate APRV on the Carefusion Avea (Avea) in APRV/BiLevel, Drager V500 (V500) in PC-APRV, Medtronics PB 980 (PB 980) in BiLevel, and Maquet Servo-i (Servo-i) in BiVent using the IngMar Medical ASL 5000 (ASL) electronic lung simulator set at three levels of static compliance (Cst) to simulate three severities of ARDS. Methods: An extended self-test was performed on each ventilator using oxygen and air. ASL settings: Cst 40 ml/cmH2O (mild), 30 ml/cmH2O (moderate), and 20 ml/cmH2O (severe); inspiratory resistance 12 cmH2O/L/s, expiratory resistance 14 cmH2O/L/s, and Pmus 0 cmH2O (apneic). The ASL was connected directly to the ventilator y-piece with a 22 mm adapter. Ventilator settings: Pressure High (Phigh) 17 and 22 cmH2O, Thigh 6 seconds, Pressure Low (Plow) 0 cmH2O, Tlow was adjusted to achieve a release point at 75% of Peak Expiratory Flow Rate (PEFR), Pressure Support 0 cmH2O, and Tube Compensation off. PEFR was measured directly from the ventilator flow waveforms. The ASL was ventilated for one minute to stabilize and one minute for data collection, first ventilating at Phigh 17 then 22 cmH2O. Data were recorded directly by the ASL and the parameters evaluated include: PEFR, peak inspiratory pressure (Ppeak), mean airway pressure (Pmean), total PEEP (PEEPtot), and expiratory tidal volume (exp Vt). Results: Phigh 22 cmH2O resulted in an increase of all evaluated parameters. As Cst decreased, exp Vt decreased. In severe ARDS, the Avea and the V500 exhibited the greatest exp Vt. In severe ARDS the V500 and the Servo-i exhibited the greatest PEFR. Overall pressures (Ppeak and Pmean) were highest on the Avea. The Avea exhibited the highest level of PEEPtot while the V500 exhibited the lowest.

Conclusion: This study demonstrated that all ventilators provided an increase in PEEPtot, exp Vt, Pmean, PEFR, and Ppeak at Phigh of 22 cmH2O. The ventilators provided a different level of PEFR and PEEPtot at 75% PEFR. Further research is needed to compare APRV in patients to determine the amount of Auto-PEEP remaining in the lung at 75% PEFR in order to prevent derecruitment of the lung.

Poster #3
Presentation 6pm
Mech Ventilation

A Comparison Of Two Ventilators Using Volume Guarantee Modes for Ventilation of the Neonate Using a Lung Model

Kelly Reilly (Boise State University), Ashley Ross (Boise State University), Celine Brown (Boise State University), et. all

Faculty Mentor: Ryan Forbush Department of Respiratory Care (Boise State University)

Background Volume guarantee modes (VG) are used with increasing frequency for the neonatal population in an attempt to minimize lung injury and hypocarbia due to unintentional hyperventilation. Ventilator manufacturers utilize different proximal flow sensor technology and software to achieve VG, and investigation of the behavior of each ventilator is useful. This ex- vivo experimental design evaluated the Vti, Vte, and PIP delivered during VG modes with the Vyasis Avea (Avea) and Drager VN500 Babylog (VN500) using the IngMar Medical ASL 5000 electronic lung simulator (ASL 5000). Methods The ASL 5000 was programmed to model a 1-3 kg body weight neonate with normal to moderately affected lungs. ASL 5000 settings: Cst 1.5 mL/cm H2O, Raw 70 cm H2O/L/s, Pmus 0 cm H2O (passive), f zero. The EST on the Avea, and circuit check on the VN500, were completed prior to testing; the proximal flow sensors were zeroed on each ventilator. Trials were conducted at ambient temperature and humidity. Constant settings on the Avea: 30 breaths/min, PEEP 6 cm H2O, flow trigger 0.5 L/min, FIO2 0.21, Rise 5. Constant settings on the VN500: 30 breaths/min, PEEP 6 cm H2O, FIO2 0.21, slope 0.20 seconds, Pmax 50 cm H2O. Variable settings on each ventilator were: inspiratory time 0.25, 0.30 and 0.35 seconds and tidal volume to simulate an 800 g, 1 kg, 2 kg and 3 kg infant at 5 mL/kg (4, 5, 10 and 15 mL). Each ventilator was tested with each variable setting for a total of two minutes using the ASL 5000. After a stabilization period of 15 breaths, delivered Vti, Vte, and PIP were recorded continuously by the ASL 5000. The results for each parameter were then averaged over a 1 minute period, and the standard deviation was calculated for each measurement. Results The Avea and VN500 delivered similar volumes and pressures as recorded by the ASL 5000. The Avea demonstrated wider standard deviation due to periodic spikes in Vti and PIP. The VN500 consistently delivered lower tidal volumes as measured by the ASL 5000 compared to the Avea, usually at lower measured PIP. This delta varied with each breath.

Conclusions: The VN500 and Avea deliver consistent Vti, Vte, and PIP in a passive model. Measured values were higher than set VG on both ventilators; the lower Vti and Vte on the VN500 may be due to variances in how each ventilator deals with the compressible volume of the breathing circuit, as well as the temperature and saturation of the inspired gas.

Poster #4
Presentation 5pm
Mech Ventilation

Evaluation of Three Sizes of Nasal Cannula Interface to Deliver NIV to Neonates Using a Lung Simulator

Lynae Johnston (Boise State University), Tiffany Silvestri (Boise State University), Jori Dudgeon (Boise State University), Jill Sherlock (Boise State University), Jeremy Gibbs (Boise State University), et. all

Faculty Mentor: Ryan Forbush, Respiratory Care (Boise State University)

Background: Noninvasive ventilation (NIV) is a commonly used mode of ventilation to provide respiratory support after planned extubation of the neonate. Further investigation of the various interfaces and ventilators utilized to administer NIV is needed in order to optimize the support delivered to the infant. Some centers use the NeoTech RAM Cannula as the interface for delivery of NIV in conjunction with several different ventilators. This ex vivo experimental design evaluated the PIP, PEEP, and MAP delivered during NIV with the Vyasis Avea (Avea) ventilator in conjunction with three sizes of RAM Cannula using the IngMar Medical ASL 5000 electronic lung simulator (ASL 5000). Methods: The simulator was programmed to model a neonate (1-3kg body weight) with normal to moderately affected lungs. ASL 5000 settings: Cst 1.5 mL/cm H2O, Raw 70 cm H2O/L/s, Pmus Maximum, f zero (passive model). A 3D printed interface was created for each size RAM cannula (outer prong sizes: 3.5, 3.0 and 3.0 mm) with openings approximately 20% larger than the outer dimensions of the RAM prongs; the interface connected directly to the neonatal adapter on the ASL 5000. Simulated nares sizes were: Micro Preemie 3.6 cm, Preemie 3.6 cm, Neonate 4.2 cm. The EST was completed on the Avea, and the interface calibration was completed for each size RAM prior to testing. Each size cannula was then evaluated in Nasal CPAP/IMV mode at the following settings: 1) rate 20 breaths/min, 2) inspiratory time 0.25, 0.30 and 0.35 seconds, 3) PIP 10, 20 and 30 cm H2O, 4) rise of 9, 5) PEEP 5, 8 and 10 cm H2O, 6) FIO2 at 0.21. The ASL 5000 recorded data, including the delivered PIP, PEEP and MAP, for one minute at each combination of settings, and each size RAM Cannula. Results: The delivered PIP, as measured by the ASL 5000, approximated the set value on the ventilator only when the set PIP was 10 cm H2O. The data show that the PEEP recorded from the ASL 5000 was consistently lower than the PEEP level set on the Avea. With an increase in inspiratory time, there was a slight increase in both delivered PIP and PEEP. The delivered PIP and PEEP decreased as the RAM Cannula was sized down.

Conclusions: When properly sized to the nasal diameter, the NeoTech RAM Cannula interface results in the delivery of lower pressures than set on the Avea. Based on the results of this bench study, pressure attenuation to lower than set pressure is likely when utilizing the RAM Cannula for NIV with the Avea.

Poster #5
Presentation 6pm
Mech Ventilation

Evaluating the Change in Thickness of the Diaphragm and Work of Breathing while Normal Subjects are Exercising

Camille Stover, MET, RRT (Boise State University), Lonny Ashworth MEd, RRT, FAARC (Boise State University), Joie Burns MS, RT(R)(S), RDMS, RVT (Boise State University), et. all

Student work involved: Jeremy Gibbs (Boise State University), Katie McLaughlin (Boise State University), et. all

Background: Exercising patients in the ICU receiving mechanical ventilation has shown to have positive outcomes; however, there is limited evidence on mode of ventilation to use during exercise. The purpose of this study was to evaluate the change in diaphragm thickness between expiration and inspiration (ΔDTE-I) during exercise in four modes of ventilation in normal subjects. The goal was to determine which mode had the smallest ΔDTE-I, indicating the lowest WOB. Method: Following IRB approval, 16 subjects (8 male, 8 female) were ventilated with the PB 980 in VC A/C, VC+ A/C, PC A/C and CPAP with PSV. Ventilator settings: PEEP 0 cm H2O in all modes, VT 8 mL/kg in VC A/C and VC+ A/C, PSV 5 cm H2O in CPAP, PIP 5 cm H2O in PC A/C. While sitting on an exercise bike, subjects breathed on one of the four randomly-assigned modes of ventilation for two minutes. At the end of two minutes, the diaphragm thickness was measured at end-expiration (DTE) and end-inspiration (DTI) on three breaths, when possible, by an experienced sonographer using a 9L3 linear transducer at 8 MHz. Heart rate (HR), SpO2, PEEP and Borg rating were recorded. Subjects remained in the same mode and started to pedal 50 RPM. At two minutes, subjects stopped pedaling, but continued to breathe on that mode while data were gathered. After the subject’s HR and SpO2 returned to baseline, the next randomly-assigned mode was selected and the process was repeated until the subject breathed on all four modes. Results: VC A/C had the highest, and CPAP with PSV had the lowest Borg rating during exercise, 6.25 and 1.94, respectively. During exercise, VC A/C had the most negative PEEP (-15.5 cmH2O), while PEEP in CPAP with PSV was least affected (-0.28 cmH2O). There was no statistically significant difference in DTI, DTE or ΔDTE-I when comparing VC A/C, VC+ A/C and PC A/C to CPAP with PSV during exercise.

Conclusion: VC A/C was shown to have the highest work of breathing via the Borg rating, the decrease in SpO2 and the decrease in PEEP. It is very difficult to measure the change in diaphragm thickness in a normal subject while exercising because of the chest movement and variation in VT causing the excursion of the diaphragm to move out of the range of the ultrasound transducer. There was no significant difference between DTI, DTE, ΔDTE-I between modes, during rest or exercise. Factors such as negative PEEP, SpO2 changes and the patient’s perceived WOB should be used to evaluate WOB during early mobility.

Poster #6
Presentation 5pm
Phthalate exposure

Neonatal Exposure to di-2ethyhexyl (DEHP) in Respiratory Therapy Equipment

Ryan Forbush, BS, RRT-NPS (Boise State University), Dr. Randall Jenkins M.D. OHSU (St. Luke’s Children’s Nephrology and Hypertension), et. all

An association between phthalate exposure and neonatal hypertension was reported in 2019, including a linear relationship between intravenous (IV) phthalate exposure and systolic blood pressure. The same phthalate is present in common respiratory therapy equipment utilized to treat neonates. We created a bench model to approximate DEHP exposure in infants receiving respiratory therapy. Heated and humidified circuits for high flow nasal cannula, CPAP, conventional invasive ventilation, and high-frequency oscillatory ventilation were set up to run into Erlenmeyer flasks at flow rates approximating those used in patients. Air samples were collected from the flasks by drawing 2lpm of flow from the flask through OVS-Tenax sampling tubes for a specific length of time and analyzed via gas chromatography for the presence of DEHP. Condensed water vapor from the flasks was also collected and analyzed via gas chromatography/mass spectrometry for the presence of DEHP. The presence of DEHP varied widely depending upon the specific circuit. The amount of DEHP contamination in air samples was consistently lower than the level of DEHP contamination in condensed water vapor. The high-frequency oscillator showed the highest level of DEHP contamination. The results support the potential for neonatal exposure to DEHP from respiratory therapy equipment. Further investigation is necessary to determine the level of exposure and the potential role of DEHP in pulmonary or other hypertension in neonates.

Poster #7
Presentation 6pm
Ventilation and radiation

Occupational Radiation Exposure of Respiratory Therapists During Manual Ventilation in the Neonatal Intensive Care Unit

Samantha Davis, MS, RRT-NPS, AE-C (Boise State University), et. all

Radiation exposure and associated cancer risk have been studied since the mid-1900’s. Cancer risk and increased mortality are well-documented in the literature throughout a variety of professions. Respiratory Therapists (RTs) commonly provide manual ventilation to neonates during imaging following surfactant administration or endotracheal tube placement / manipulation. Providers are encouraged to wear protective lead whenever risk of occupational exposure is present. Dose used for neonatal images is significantly less than adults, which may provide a false sense of security to providers leading them to forego protective wear. This bench study measured radiation exposure using a phantom model to simulate the provider’s hand, thyroid, and chest using standard dose and distance measurements. Though this is a relatively small exposure in a single episode, it’s not unusual for the NICU RT to be exposed to an average of 10 images per week which, over the period of one year, would total 160 mR to the provider’s hand. This is not an insignificant overall exposure and requires further study. For added perspective, a single lumbar spine CT scan provides a dose of approximately 150 mR. Repeated doses to RTs choosing not to wear protective apparel can be harmful over time. Without adequate protection, RTs who provide manual ventilation during imaging may significantly increase their radiation exposure and potential cancer risk, even when the dose may seem insignificant.

Poster #8
Presentation 5pm
Gonadal Shielding

Gonadal Contact Shielding: Serves Negligible Benefit with Modern Technology

Aline Bates (Boise State University),Micheal Johnson (Boise State University), Chelsea Clower (Boise State University), Madison Wirth (Boise State University), Madison Koster (Boise State University), et. all

Faculty Mentor: Natalie Mourant MHS, RT(R)(CI), Radiologic Sciences (Boise State University)

Background: The American College of Radiology (ACR) has endorsed a position statement from the American Association of Physicists in Medicine (AAPM) indicating that the legacy practice of gonadal shielding during diagnostic imaging should be discontinued. Research on this topic demonstrates that gonadal shielding can increase dose, is ineffective in female patients and that radio-sensitivity to gonads is not as high or consequential as previously believed. Objective: To assess the current research indicating the effects of gonadal shielding in diagnostic imaging and to contribute to current literature by testing the Null Hypothesis:56 There is a significant difference in exposure to radiosensitive tissues when contact shielding is used, while holding other variables constant. Methods: DR technology was used to obtain diagnostic images of foot, abdomen and chest phantoms while recording dose with a dosimeter placed at the level of the ovaries during each exposure. For each phantom, both a shielded and without shield series was imaged three different times. The average of exposures for shielded and the average of without shield exposures were recorded for comparison. Results: For all radiographs taken of the foot phantom, an undetectable dose was recorded for both shielded and unshielded series for all exposures. The average dose recorded for the abdomen shielded series was 0.1365 mSv. Without shield average dose for the abdomen series was recorded to be .322 mSv. The average dose recorded for the chest shielded series was 0.00 mSv. Without shield average dose for chest series was recorded to be 0.00061 mSv.

Discussion: The practice of gonadal shielding would be better discontinued due to its negligible benefits and the associated risks that paradoxically can lead to increased patient dose due to its incompatibility with advanced technology, positioning errors and loss of diagnostic efficacy

Poster #9
Presentation 6pm
Radiation Dose

Factors That Affect Dose To The Eyes Of The Operator Of A C-Arm Guided Procedure

Paige Tilden (Boise State University), Abby Dunton (Boise State University), Darby Lyon (Boise State University), Rachel Christensen (Boise State University), et. all

Faculty Mentor: Natalie Mourant, MHS, RT(R)(CI), Radiologic Sciences (Boise State University)

The purpose of this research was to determine if there is a significant difference in dose to the eyes of the operator when imaging anatomy of different sizes and manipulating collimation in c-arm-guided procedures. Although fluoroscopy plays an important role in the diagnosis and treatment of diseases in patients, it exposes the staff assisting in the procedure to higher amounts of occupational dose. As a result, radiosensitive tissues such as the lens of the eyes, are more susceptible to damage and can result in the formation of cataracts. The research conducted in this experiment identifies the amount of radiation a radiologic technologist could be exposed to when imaging body parts of different tissue thickness in fluoroscopic procedures. It also evaluates the difference in dose received to the lens of the eyes of the operator when collimating to only the anatomy of interest.

Poster #10
Presentation 5pm
Radiation Dose

The Study of X-ray Penetration Through Various Barriers

Carey Hammer (Boise State University) , et. all

Faculty Mentor: Natalie Mourant, MHS, RT(R)(CI), Radiologic Sciences (Boise State University)

The purpose of this research is to determine if there is significant dose exposure due to scatter radiation penetrating non-shielded building materials. The motivation behind this experiment was generated by the speculation that some medical locations have not been properly constructed with protective barriers to provide adequate radiation protection within their facilities. The research group tested the hypothesis by radiating through non-leaded walls and adjacent doors in order to actuate how much dose was able to penetrate through each barrier. Many variables were used to determine differences in absorbed radiation. Those variables included exposing torso and hand phantoms, altering source-to-image distances (SID), and exposure technique changes to determine the amount of dose that penetrated through the material. After the experiment was concluded, it was determined that a significant amount of scatter radiation penetrated non-leaded walls. This can negatively impact patients in neighboring rooms and conflicts with ALARA (As Low as Reasonably Achievable) practices of radiation safety.

Poster #11
Presentation 5pm
Positioning

Relating Scoliosis Positioning to Breast Tissue Exposure

Shaylynn Giroir (Boise State University), Kendal Sweet (Boise State University), Diana Stelmakh (Boise State University), Lauren Mattaini (Boise State University), et. all

Faculty Mentor: Natalie Mourant, MHS, RT(R)(CI), Radiologic Sciences (Boise State University)

The purpose of this research paper is to present the data collected on patient breast dose related to full spine radiography. A dosimeter was secured to the left and right breast of a phantom patient to calculate the total absorbed breast dose that would be received by a physical patient. The phantom patient was exposed in both anteroposterior (AP) and posteroanterior (PA) positions. Based on the data gathered from the experiment, this paper recommends the use of a compensating filter in combination with PA positioning to reduce breast dose in both male and female patients. The primary goal of this research is to educate radiographers and to equip them with the necessary information to acquire diagnostic images and make decisions that benefit patients.

Poster #12
Presentation 6pm
Collimation

How Collimation Effects Dose

Dylan Mogensen (Boise State University), Almira Mujic (Boise State University), Katelyn Bolam (Boise State University), et. all

Faculty Mentor: Natalie Mourant, MHS, RT(R)(CI), Radiologic Sciences (Boise State University)

The goal of this research is to demonstrate the relationship between dose and collimation. The experiment was conducted using three different x-ray phantoms and a dosimeter to measure the amount of dose that was received with a collimated light field and a non-collimated light field against a 14″ x 17″ digital imaging plate.

Poster #13
Presentation 5pm
Health Facility Care

Effectiveness of Cleaning Protocols in Radiology Departments

Kate Maryon (Boise State University), Nathan Drussel (Boise State University), Zach Williams (Boise State University), Moises Lazo (Boise State University), et. all

Faculty Mentor: Natalie Mourant, MHS, RT(R)(CI), Radiologic Sciences, (Boise State University)

The effectiveness of cleaning, which includes the several steps taken to help reduce the spread of disease or bacteria, is a critical task that all professionals in the medical field should know and follow. While wiping down surfaces with disinfectant is an important step in the removal of bacteria or other infectious agents, several factors such as not using the correct type of disinfectant or not using enough wipes can have an effect on how well the area is cleaned. This paper evaluates the cleaning protocols among five different areas within four hospital and clinic sites and how effectively these protocols are being followed To test the effectiveness of the cleaning protocols, swabs were taken at each site from some of the most frequently touched and used areas throughout the radiology department. Samples were collected using multiple trypticase soy agar (TSA) plates, sterile swabs, and distilled water. Photos from five different hospital and clinical settings in the Pacific Northwest provided evidence that while protocols are put in place, professionals in the healthcare field are not doing an effective enough job of disinfecting equipment. Improving how radiology departments follow cleaning protocols could have a dramatic effect on helping to lower hospital acquired infections. Through continuing this research, the authors will be testing three different types of wipes that are used throughout the Pacific Northwest and determine if one is more effective than the others. We will use a similar format to test the effectiveness of the wipes as our original experiment.

Poster #14
Presentation 6pm
Patient experiences

Patients’ expectations for and experiences with primary healthcare services received from a patient centered medical home

Dr. Janet Reis (Boise State University), et. all

Objective: Expectations for and experiences with healthcare services are summarized for 1143 patients receiving care in a statewide demonstration of Patient Centered Medical Homes (PCMH). Methods: Patients were recruited from 91 primary care clinics for semi-structured interviews to determine what patients expect, what they plan to do and how they intend to execute their plans in partnership with their healthcare team. Results: The majority (78%) of patients defined the patient-team partnership as a collaborative and problem-solving effort. Overall, 68% defined responsibility for own health as a personal responsibility; 55% defined listening to patient’s concerns and answering questions as a responsibility of their healthcare team. Diet and exercise came up most frequently whether as a personal responsibility, issues for receiving additional help from their clinic, or plans for personal change. Conclusion: Patients’ preferred a collaborative, problem-solving healthcare team partnership but also had boundaries for what additional services they wanted from this team. Practice Implications: Patients’ expectations for a collaborative partnership, acceptance of personal responsibility and interest in diet and exercise expands opportunities for patient education and teamwork. Clinics’ engagement with broader resources would be needed to address patients’ many and varied challenges to taking care of their health.

Poster #15
Presentation 5pm
Health facility Care

Hand Hygiene in the Hospital Setting

Katelyn McAllister (Boise State University), et. all

Faculty Mentor: Natalie Mourant, MHS, RT(R)(CI), Radiologic Sciences (Boise State University)

The purpose of this research paper was to discover if there is a significant difference in bacteria on technologist hands when they sanitize them between patient exams. A broad consensus exists that hand washing is imperative to keep nosocomial infections low, but how many technologists actually follow the protocol of hand sanitation after each exam? Good hand hygiene practices of technologists are especially vital due to the high volume of patients from all areas of the hospital that come in to have procedures done in the radiology department. Although there have been studies conducted on hand hygiene in the past, many do not specifically focus their attention onto radiologic technologists. To conduct this research, a group of radiologic technologists in a medium sized hospital were asked to provide a sample swab of their hands after completing various x-ray exams within their department. Limitations in this research included the low number of technologists who were swabbed for this experiment due to the short time frame given to collect data. However, the evidence gathered suggests that if radiologic technologists follow hand sanitation guidelines than there will be a reduction in bacterial growth that could prove harmful to immunocompromised patients. It is hoped that this study will be a continuous reminder that the small act of hand hygiene is still important between each exam to eliminate the risk of disease for the patients entrusted to radiologic technologists for their imaging procedures.

Poster #16
Presentation 5pm
Injury

Use of cold-water immersion for post-exercise pain and function in active adults

Terisa Zimmerman (Boise State University), et. all

Faculty Mentor: Dave Hammons, Ed.D, ATC, PES, Kinesiology (Boise State University)

Introduction: Post exercise recovery methods are used to help control the healing process after high intensity exercise in order to avoid negative symptoms (delayed onset muscle soreness (DOMS) and muscular weakness) that often accompany the recovery process. Cold-water immersion therapy is a commonly used method among athletes to achieve these goals. However, research fails to agree on if this practice is beneficial for the athlete, or if it causes more harm than good. Purpose: To determine the effectiveness of cold-water immersion on post exercise muscle function and DOMS when tested against a control group of passive recovery treatment. Hypothesis: It is hypothesized that in the first 24 hours after receiving immersion treatment, pain will decrease, and function will increase. 48-72 hours after treatment, participants will show the reverse effects of increased pain and decreased function.

Methods: 6 adults ages 18-26 years, who report being non-injured, able-bodied, self-proclaimed physically active individuals, will be recruited to complete a high intensity lower extremity exercise routine. This routine is designed to stimulate microtrauma that cause decreased post exercise muscle function and stimulates DOMS. The participants will then be randomly divided into two equal groups. The treatment group will submerge fatigued extremities for 15-minutes, in water set at 8 degrees C or 46 degrees F. The control group will practice passive recovery. Subjects will be tested at baseline, 24, 48, and 72 hours for function and pain. This will be done by using the Lower Extremity Functional Scale, and a 1-10 numeric rating scale.

Poster #17
Presentation 5pm
Loading/injury

Foot Progression Angle Predicts Knee Adduction during Load Running

Matthew McDonald (Boise State University), Alay Parikh (Idaho College of Osteopathic Medicine), et. all

Faculty Mentor: Tyler Brown, COBR (Center for Orthopaedic & Biomechanics Research), (Boise State University)

Increasing toe out (i.e., foot progression angle) reportedly increases knee adduction and risk of premature knee osteoarthritis (OA) that is prevalent in military personnel. Yet, it is currently unknown if the body borne load military personnel routinely carry during operational exercises, such as running, increases either foot progression or knee adduction. This study examined the effect of body borne load on foot progression angle and knee adduction biomechanics, and whether it differs between sexes. Twenty male and 16 female participants had lower limb biomechanics quantified while running (4.0 m/s) with four body borne loads (20, 25, 30 and 35 kg). Foot progression at initial contact (FPA), and peak stance knee adduction angle (KAA) and moment (KAM) were submitted to a linear model with load (20, 25, 30 and 35 kg) and sex (male, female) as fixed effects. FPA was considered a covariate for KAA and KAM. Males exhibited greater FPA (p=0.046) and KAM (p=0.013), but not KAA (p=0.681) than females. Load increased KAM (p=0.037), but not FPA (p=0.261) or KAA (p=0.111). FPA was a significant covariate for both PS KAM (p=0.003) and KAA (p<0.001), and each 1 degree increase in FPA predicted 0.01 Nm/kgm greater KAM and 0.2 degree greater KAA, knee biomechanics thought to increase OA risk. Males may be at greater risk of knee OA, as they exhibited 3.5 degrees greater FPA and 0.16 Nm/kgm greater KAM than females. But, the military may decrease risk of knee OA, particularly for males, by modifying foot progression during training programs.

Poster #18
Presentation 6pm
Injury

Trend Symmetry of Dominant Limb during Prolonged Load Carriage

Fred Christensen (Center for Orthopaedic and Biomechanics Research) (Boise State University), Micah Drew (Center for Orthopaedic and Biomechanics Research) (Boise State University), Samantha Krammer (Center for Orthopaedic and Biomechanics Research) (Boise State University), et. all

Faculty Mentor: Tyler Brown, COBR (Center for Orthopaedic & Biomechanics Research), (Boise State University)

Musculoskeletal injuries are a common, costly military problem that may result from asymmetrical lower limb biomechanics during routine training exercises, such as prolonged walking with body borne load. But, it is currently unknown if military body borne load or duration of walking increase asymmetry of lower limb biomechanics. Fifteen (10 male, 5 female) participants had trend symmetry of the dominant limb quantified while walking at 3.0 m/s for 60 minutes with three body borne loads (0, 15, and 30 kg). Specifically, trend symmetry, including raw symmetry, phase shift, range amplitude, and range offset, were calculated for hip, knee, ankle motions and submitted to a linear model to test the main and interaction effects of time (0, 30, 60 minutes) and load (0, 15, 30 kg). Time, but not load impacted raw symmetry. Specifically, duration of walking had a significant effect on raw symmetry of hip adduction (p=0.035) and ankle internal rotation (p0.05). Load impacted the range offset of ankle inversion motion (p=0.021), but no hip or knee motion (p>0.05). Both load and time impacted range amplitude. Specifically, load had a significant effect on range amplitude of knee (p=0.049) and ankle flexion (p=0.030) motions, while duration of walking had a significant effect on range amplitude of hip internal rotation motion (p=0.001). Body borne load and duration of walking may elevate injury risk by increasing asymmetry and altering lower limb motions during routine military training exercises.

Poster #19
Presentation 5pm
Injury

Effects of prolonged load carriage on angular jerk of frontal and sagittal knee motion

Samantha Krammer (Center for Orthopaedic and Biomechanics Research) (Boise State University), Fred Christensen (Center for Orthopaedic and Biomechanics Research) (Boise State University), Micah Drew (Center for Orthopaedic and Biomechanics Research) (Boise State University), et. all

Faculty Mentor: Tyler Brown, COBR (Center for Orthopaedic & Biomechanics Research), (Boise State University)

Smoothness of knee motion, quantified as angular jerk, may be an important measure of knee musculoskeletal injury risk during load carriage. However, it is currently unknown if either body borne load or duration of load carriage increase angular knee jerk. This study sought to quantify sagittal and frontal plane angular knee jerk during a prolonged load carriage task. Sixteen participants had knee biomechanics quantified while walking at 1.3 m/s for 60 minutes with three body borne loads (0, 15, or 30 kg). At minute 0 and every 15 minutes thereafter, peak and cost of angular jerk for sagittal and frontal plane knee motion were quantified and submitted to a RM ANOVA to test the main effect and interaction of load (0, 15, and 30 kg) and duration (0, 15, 30, 45, and 60 min.). Body borne load increased peak angular jerk in the sagittal plane (p=0.025), and jerk cost of sagittal (p=0.025) and frontal (p=0.019) plane knee motion. However, after correcting type I error, there was only a significant increase in jerk cost in sagittal (p=0.006) and frontal plane (p=0.033) knee motion with the 30 compared to 0 kg load. Additionally, duration had a significant effect on peak (p=0.009) and cost (p=0.003) of frontal plane knee angular jerk. After correcting for Type I error, only jerk cost of frontal plane knee motion significantly increased at minutes 45 (p=0.044) and 60 (p=0.012) compared to minute 0. Prolonged load carriage may lead to musculoskeletal injury risk by increasing “jerky” knee motions.

Poster #20
Presentation 5pm
Injury

The Effect of Prolonged Load Carriage on Knee Adduction Biomechanics

Micah Drew (Center for Orthopaedic and Biomechanics Research) (Boise State University), Samantha Krammer (Center for Orthopaedic and Biomechanics Research) (Boise State University), Fred Christensen (Center for Orthopaedic and Biomechanics Research) (Boise State University), et. all

Faculty Mentor: Tyler Brown, COBR (Center for Orthopaedic & Biomechanics Research), (Boise State University)

Knee osteoarthritis (OA) is increasingly prevalent for military personnel and may stem from biomechanics adopted when walking with heavy body borne loads. Yet, it is unknown if knee adduction, biomechanics related to OA risk increases during prolonged load carriage. This study sought to quantify the effect of body borne load and duration of walking on magnitude and variability of knee adduction. Sixteen participants had knee biomechanics quantified while walking 3.0 mph for 60-minutes with three body borne loads. Starting at minute 0 and every 15 minutes thereafter, peak and range of knee adduction angle (KAA), peak knee adduction moment (KAM), and within subject variability of KAA and KAM (calculated as coefficient of variation) were calculated, and submitted to a RM ANOVA to determine the effect of body borne load (0, 15 and 30 kg) and time (0 – 60 min). Load had a significant effect on KAA range (p=0.045) and peak KAM (p<0.001). Specifically, KAA range increased 36% with 30 (p=0.035) compared to 0 kg, while peak KAM increased 35% and 13% with 30 (p<.001) and 15 (p<0.013) compared to 0 kg load. Time had a significant effect on peak (p=0.003) and KAA range (p=0.030). Specifically, peak KAA significantly increased at minutes 15 through 60 compared to minute 0 (p0.05). Body borne load and walking duration increased knee adduction biomechanics and potential risk of OA.

Poster #21
Presentation 6pm
Knee Biomechanics

Knee Biomechanics Increase with Load and Locomotion Speed, but Vary Across Terrain

Elijah M. Walker (Boise State University), Gaervyn J. Salverda (Boise State University), Miranda Nelson (Boise State University), et. all

Faculty Mentor: Tyler Brown, COBR (Center for Orthopaedic & Biomechanics Research), (Boise State University)

Military personnel are required to traverse complex terrains at varying speeds with heavy body borne loads. Although heavy body borne loads produce biomechanical adaptations that increase injury risk, particularly at the knee, it is unknown if terrain or speed of locomotion further exasperate knee biomechanics related to injury risk. This study examined the effect of body borne load, speed, and terrain of locomotion on knee biomechanics. Up to 40 participants (20 male/20 female) will walk (1.3 m/s), jog (3.0 m/s) and run (4.5 m/s) over normal, slick, and uneven surfaces with three body borne loads (0, 15 and 30 kg). Knee biomechanics related to musculoskeletal injury, including peak knee adduction angle and moment, jerk cost of knee adduction, and joint stiffness, will be submitted to RM ANOVA to compare main and interaction effects of load (0, 15 and 30 kg), speed (1.3, 3.0 and 4.5 m/s) and terrain (normal, slick and uneven). It is expected that each incremental addition of body borne load and speed will significantly increase peak knee adduction biomechanics and joint stiffness. Although it is expected that knee adduction will vary across terrain, we anticipate a slick surface will produce the largest increase in joint stiffness and uneven surface the greatest increase in knee jerk. Further study is warranted to determine whether the type of knee musculoskeletal injury, such as stress fracture or soft-tissue rupture, depends on terrain commonly traversed during locomotor activities.

Poster #26
Presentation 6pm
Injury

Static Knee Malalignment Predicts Knee Adduction During Body Borne Load

Gaervyn J. Salverda (Boise State University), Elijah M. Walker (Boise State University), Miranda Nelson (Boise State University), et. all

Faculty Mentor: Tyler Brown, COBR (Center for Orthopaedic & Biomechanics Research), (Boise State University)

Static lower limb alignment reportedly contributes to knee biomechanics that increase the likelihood of musculoskeletal disorder development at the joint. Military personnel, when compared to civilians, are 6 to 8 times more likely to develop a musculoskeletal disorder, such as knee osteoarthritis. Currently it is unknown if static lower limb malalignment (varus) of the predisposes certain military personnel to hazardous knee biomechanics during training. This study examined the relationship between static knee alignment and biomechanics associated with musculoskeletal disorder, and determined whether body borne load or locomotion speed further increased hazardous knee biomechanics. Up to 40 participants (20 male/ 20 female), will walk (1.3 m/s), jog (3.0 m/s), and run (4.5 m/s) with three body borne loads (0, 15, and 30kgs). Static knee alignment calculated from participant’s anatomical position and peak knee adduction biomechanics calculated during stance phase of locomotion will be submitted to statistical analysis. Specifically, peak knee adduction angle and moment will be submitted to a RM ANOVA to compare the main interaction effects of load (0, 15, 30kg) and speed (1.3, 3.0, 4.5 m/s), with static knee alignment as a covariate. It is expected that both knee adduction angle and moment will increase with load and speed of locomotion, and static knee alignment (i.e., varus) will predict significant increases in peak knee adduction angle and moment. Participants with varus static alignment may be predisposed to knee adduction biomechanics and greater likelihood of musculoskeletal disorder.

Poster #23
Presentation 5pm
Injury

Impact of Body Borne Load and Locomotor Speed on Tibial Compressive Force

Miranda Nelson (Boise State University), Gaervyn J. Salverda (Boise State University), Elijah M. Walker (Boise State University), et. all

Faculty Mentor: Tyler Brown, COBR (Center for Orthopaedic & Biomechanics Research), (Boise State University)

Tibial stress fractures are a common occupational injury suffered by military personnel. Yet, it is unknown if the body borne load military personnel commonly carry during operational activities increases tibial compression and risk of stress fracture. This study sought to examine how tibial compression is affected by body borne load and speed of locomotion. Up to 16 participants will have tibial compression force quantified while they walk (1.3 m/s), jog (3.0 m/s), and run (4.5 m/s) with three body borne loads (0, 15 and 30 kg). Tibial compressive force will be quantified with custom Matlab code and submitted to RM ANOVA to test main and interaction effects of load (0, 15, and 30 kg) and speed (1.3, 3.0 and 4.5 m/s). Peak tibial compression is expected to significantly increase with each incremental increase of locomotion speed and body borne load. Understanding how tibial compressive force changes during common military operational activities will produce the military the knowledge to decrease the number of tibial stress fractures suffered by military personnel.

Poster #24
Presentation 6pm
Injury

Do Guardian Caps Reduce Concussion Incidence, Severity, or Time to Return to Play in High School Football Players?

Morgan Fowler (Boise State University), et. all

Faculty Mentor: Dr. Philip Ford, PhD, LAT, ATC, PES, CES, Kinesiology (Boise State University)

Introduction: Approximately two million high school age youth participate in football every year. Among the highest injuries found in the sport are concussions. Helmets and rules have changed to help prevent these brain injuries, but it has not been enough. Recently, the Guardian CapTM was developed and marketed to consumers claiming to help prevent trauma to the head, thus decreasing the amount of concussions. Purpose: The purpose of this study is to determine whether Guardian CapsTM are useful in preventing concussions, decreasing concussion severity, and decreasing the amount of time for return to play in high school football players by conducting a meta-analysis of current research. Hypothesis: Research will indicate that concussion incidence, severity, and return to play time will only be marginally decreased with the use of the Guardian CapTM, based on previous research conducted on similar devices or situations. Methods: A meta-analysis will be conducted to determine if Guardian CapsTM are decreasing incidence of concussion, concussion severity, or time to return to play.

Expected Outcomes: Concussion incidence, symptom score, and time for return to play will all decrease slightly. Research indicates that some padding can help disperse and absorb traumatic blows, however concussions mainly occur due to rotational forces in which there is no direct blow to the head. The Guardian caps are likely going to be best to try to decrease the severity of concussions rather than expecting the device to prevent them completely due to the mechanical protection provided compared to the mechanism of injury.

Poster #25
Presentation 5pm
Concussion recovery

Supporting Teens’ Concussion Recovery: Parents’ Advice for Schools, Health Care Providers and Sport Teams

Dr. Laura Petranek, Dr. Shelley Lucas, et. all

The purpose of this study was to better understand the experiences parents and guardians have during their teenagers’ recovery from a sport-related concussion. Parents and guardians expressed a need to learn how to navigate various systems and settings (e.g., school, sport-team, medical care, family and friends) and a need to advocate for their teenager in these settings. The current study reflects a multidisciplinary approach to examine the complexities of sociological and environmental factors that interact with developmental issues unique to teenagers during recovery from a concussion. We interviewed twelve parents and guardians of teenagers, 14-17 years of age, who had been diagnosed with a sport-related concussion from a variety of sport settings; in some instances, these teens had suffered more than one concussion. This presentation will focus on the advice and recommendations these parents and guardians had for school personnel, sport-team coaches and trainers, and health care providers. Specifically, we will highlight two areas that emerged from their experiences that impacted their teenagers’ recovery process: concussion education training and care and support for their teen. These experiences illustrate the role parents and guardians play mediating between their teen, health care providers, school personnel and coaches. Parents and guardians want help in knowing how to support their teens through the recovery process.

Poster #26
Presentation 6pm
Aging

Effects of Physical Activity on Cognition Functions among Chinese Older and Young Adults across Gender

Jing Jin (School of Psychology, Shanghai University of Sport, Dr. Yong Gao (Dept. of Kinesiology, Boise State University); Dept. of Kinesiology, Boise State University), Yingying Wang (School of Psychology, Shanghai University of Sport), Qichen Zhou (School of Psychology, Shanghai University of Sport), Chenglin Zhou (School of Psychology, Shanghai University of Sport), et. all

Objective: Aging is often associated with declines in certain cognitive functions. Physical activity (PA) may reduce the risk of cognitive decline in older adults, but its effects are not well known. It is also not clear if males respond to PA differently than females if a PA effect on cognitive functions does exist. The purpose of this study was to a) examine the effects of PA on cognitive functions among Chinese adults; b) determine if the effects of PA on cognitive functions differed between young and older adults across gender. Methods: Fifty-four participants (22 young adults aged 18-30 years; 31 older adults aged 59-69 years) participated in this study. Cognitive functions were accessed using the Chinese version of Montreal Cognitive Assessment-Basic (MoCA) test and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Participants’ PA levels were assessed using the International Physical Activity Questionnaire-Short Version (IPAQ-S), where the low-moderate PA level was defined as participants engaged in a minimum of 600 metabolic equivalent minutes (METs) of physical activities per week, and the high PA level a minimum of 3000 METs·min·wk-1. A three-way (age group by PA level by gender) MANOVA was conducted to examine the differences in cognitive scores between PA levels across age and gender groups. Statistical significance level was set at 0.05. Results. Forty-two participants, where 21 were young participants (12 males/9 females, 23.0 ± 2.1 yrs., 171.9 ± 7.4 cm, 65.5 ± 11.2 kg, 16.5 ± 1.5 yrs. of education, 10 in low-moderate PA level and 11 in high PA level); and 21 were older adults (12 males/9 females, 63.2 ± 2.3 yrs., 167.7 ± 6.7 cm, 72.6 ± 9.9 kg, 11.1 ± 1.9 yrs. of education, 8 in low-moderate PA level and 13 in high PA level), completed this study. The older adult group had significantly lower scores than the young adult group in almost all cognitive function measures assessed by MoCA (p values ranged from <0.0005 to p=0.035) and RBANS (p<0.0005), except MoCA scores in orientation (p = 0.122), calculation (p = 0.155), naming (p = 0.224) and attention (p = 0.295). MoCA score in fluency was significant lower in the low-moderate PA level than the high PA level (p = 0.016). A significant age group by PA level by gender interaction was observed on the MoCA total score (p = 0.046), RBANS total score (p = 0.034) and RBANS score in attention (p = 0.005). Older male adults had much lower MoCA and RBANS total scores and RBANS score in attention at the high PA level compared to those at the low-moderate PA level, but such differences disappeared or were narrowed down for the young adult male group; however, while there was no difference in MoCA and RBANS total scores and RBANS score in attention between low PA and high PA levels among older female adults, young female adults at the low-moderate PA level had much greater MoCA and RBANS total scores and RBANS score in attention than those at high PA level. Conclusions. The findings of this study indicate that PA level affect cognitive functions differently between young and older adult groups across gender. Participating in low-moderate level of PA appears to be more beneficial for certain cognitive functions among older male adults.

Poster #27
Presentation 5pm
Injury

Female’s Postural Stability following a six week off-season training cycle in Division I Collegiate Soccer

Jo Wang (Boise State University), Jeff Wilkins (Boise State University), et. all

Faculty Mentor: Tyler Brown, COBR (Center for Orthopaedic & Biomechanics Research), (Boise State University)

Female athletes have 4 to 6 times greater incidence of non-contact ACL injury than males. Decreased dynamic postural control from acute neuromuscular fatigue is purportedly a predictor for ACL injury. Injury rates tend to be higher with prolonged training, yet, it is unknown if the cumulative fatigue of high intensity off-season training decreases dynamic postural control. PURPOSE: This study examined the effect of a six-week off-season training program on postural stability in female athletes, and whether stability differed between limbs.

METHODS: 27 female NCAA Division I soccer players performed a series of forward single-leg hops immediately prior to and following their off-season training. Participants performed 5 successful single-leg hops with each limb over a 17 cm box and landing with either dominant (D) and non-dominant (ND) limb on the force platform. During landing, time to stabilization (TTS) and dynamic postural stability index (DPSI) were calculated. A Two-Way ANOVA tested main effect and interaction of training and limb, while a paired T-Test compared limb asymmetry.

RESULTS: Neither training, nor limb had a significant effect on TTS (p=0.199, p=0.528) or DPSI (p=0.098, p=0.193). Additionally, limb asymmetry was not significantly different for TTS (p=0.830) or DPSI (p=0.291) following training.

CONCLUSION: Cumulative fatigue of high-intensity training did not significantly alter dynamic postural stability for female athletes. D and ND limbs, however, exhibited directionally similar changes in dynamic postural stability following high-intensity off-season training. Additionally, athletes exhibited no significant asymmetry between limbs.

Poster #28
Presentation 5pm
Biomechanics of Training

Starting collegiate female soccer athletes exhibit increased force production following a competitive season

Jeff Wilkins (Boise State University), Jo Wang (Boise State University), et. all

Faculty Mentor: Tyler Brown, COBR (Center for Orthopaedic & Biomechanics Research), (Boise State University)

Starters on a female soccer team reportedly exhibit reduced muscular power following a competitive season compared to non-starters, emphasizing the importance for workload management throughout the season. Twenty-two (9 starters, 13 non-starters) division 1 female soccer athletes had vertical ground reaction forces (vGRF) quantified during five maximal effort countermovement jumps immediately prior to offseason training and the competitive season, and immediately following the competitive season. For each jump, peak force (N) and power (W) were calculated from vGRF during CMJ takeoff phase, and submitted to a RM ANOVA to test the main effect and interaction between time (pre-training, pre-season, post-season) and playing status (starter vs. non-starter). A significant time by playing status interaction was evident for peak force production (p = 0.039). Specifically, starters exhibited significant 6.69% and 6.71% increases in peak force production at post-season compared to pre-training (p < 0.001) and pre-season (p 0.05). Starters exhibited at 5.11% and 4.51% increase in peak power at the post-season compared to pre-training and pre-season time points; whereas, non-starters exhibited 2.08% and 1.15% increase in peak power following the competitive season. Current starters did not exhibit muscular force and power reductions following the competitive season, and further study is warranted to determine the precise workloads that lead to decrements in muscular strength and power for competitive female athletes.

Poster #29
Presentation 6pm
HIIT

Measures of competency over six-weeks of training: Does it pay to commit to HIIT?

Emily R. Dunston (Eastern Washington University), Alan J. Coelho (Eastern Washington University), Katie Taylor (Eastern Washington University)

Faculty Mentor: Dr. Katie Taylor, Exercise Science (Eastern Washington University)

Purpose: To determine the effect of 6 weeks of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on measures of psychological and physiological competence. METHODS: Physically inactive adults (n=11; 21.5±1.9 years) were randomized to the HIIT or MICT training group. Before and after the intervention, all participants completed an incremental exercise test. Participants completed a total of 18 training sessions over 6 weeks, with the first 3 weeks of training supervised and the latter 3 unsupervised. Perceived competence, autonomy, and self-efficacy were measured after the first, ninth, and eighteenth training sessions. Differences were analyzed using 2 (group) x 3 (time) repeated measures ANOVAs for psychological variables and 2 (group) x 2 (time) repeated measures ANOVAs for physiological variables. RESULTS: There were no significant differences in perceived competence (p=0.13), autonomy (p=0.22), or self-efficacy (p=0.99) due to time. However, MICT (96.5±4.3) had significantly higher self-efficacy scores than HIIT (84.0±3.2; p=0.04). There were no group differences in competence (p=0.13) or autonomy (p=0.36). Peak oxygen uptake (p<0.01) and peak power output (Pre: 225.1±20.7 watts; Post: 239.4±27.4 watts; p0.05).

Conclusions: Physiological measures of competency improved across the intervention irrespective of training group; although, there were no differences in psychological competency due to time. Our findings suggest that both HIIT and MICT may improve physiological competency over 6 weeks in previously inactive, adults. However, psychological competency may change at a different rate and could be more sensitive to training intensity.

Poster #30
Presentation 5pm
Nutrition

BroncoFamily Table: Psychosocial and Nutritional Impact of Family-style Meals for University Students

Marlee Harris (Boise State University), et. all

Research shows adolescents who eat meals with their family more frequently have improved mental health, diet quality, and academic performance, but no studies have been done regarding the effect of family-style meals among university students. This pilot study explores feasibility of family-style dining at a four-year large university and establishes initial data on how family-style meals in a university dining hall impacts mental health, eating competence, and academic performance among university students. Variance between intervention and control groups and within subjects pre- and post-assessment was assessed. Statistical significance was determined at ɑ<0.1. Intervention group participants with PHQ-4 scores above the normal range (N = 4) at initial intake had a significant two-point decrease in mean PHQ-4 score (p=0.016) following intervention. Decrease in loneliness was marginally significant for the intervention group (38.19 to 36.36, p=0.177). Eating competence scores improved significantly among the intervention group (33.38 to 36.19, p= 0.074). No significant changes in these areas were found in the control group. Acceptability of family-style dinners was high; on a 1 (low) to 5 (high) Likert Scale, intervention participants’ enjoyment of family-style meals was 4.94 (4-week mean). This initial study establishes the feasibility, acceptability, and value of family-style dining for students in university dining halls. Further research with increased statistical power to better approximate effects and explore other potential impacts of family-style dining at universities should be conducted.

Poster #31
Presentation 6pm
Stretching

Comparing acute changes in hip flexion after one session of either static stretching or PNF

Lani Hernandez (Boise State University), et. all

Dr. Philip Ford, PhD, LAT, ATC, PES, CES, Kinesiology (Boise State University)

Introduction: Stretching has often been prescribed prior to physical activity in an effort to increase range of motion (ROM) with the intent of improving performance and reduce the risk of musculotendinous injury. Static stretching (SS) and Proprioceptive Neuromuscular Facilitation (PNF) are two commonly advocated techniques utilized for increasing ROM. Static stretching consists of slow and controlled movements while holding the target muscle stationary in a lengthened position for a given period of time. PNF (hold-relax) combines phases of static stretching and isometric contractions of the targeted muscle to enhance overall range of motion. Purpose: Previous research comparing ROM changes measured via straight leg raise have produced conflicting results, therefore, the purpose of this review is to compare acute changes in hip flexion to determine which stretching method is most effective in an active population. Hypothesis: It was hypothesized that both PNF and SS would produce increases in hip flexion but that there would be no significant difference between the two stretching protocols.

Methods: Inclusion criteria for this review included studies that were conducted within the last 20 years, had a level 2+ evidence, and utilized active participants between the ages 18-40 years old. Major Findings: Both SS and PNF stretching techniques demonstrated increases in ROM however, the literature reports no significant differences between the two techniques. Conclusion: Patient preference and clinician availability and training should dictate which stretching technique is most applicable.

Poster #32
Presentation 5pm
BME Wound care

Cold Atmospheric-Pressure Plasma Inactivation of Pathogenic Biofilms on a Porcine Wound Model

Rachael Neckels (Boise State University), et. all

Faculty Mentor: Dr. Ken Cornell, Biochemistry (Boise State University)

Chronic wounds plague more than 5 million people per year in the United States alone. Their treatment is unusually difficult, expensive, and time-consuming largely due to their prevalence in immunosuppressed, elderly, and diabetic patients. Under any of these conditions, opportunistic bacteria that are native to the skin’s surface are able to sequester themselves within a protective biofilm composed of extracellular polymeric substances (EPS). The result is chronic infection and significant disruption of the normal wound healing process. Due to the gel-like scaffolding of a biofilm and its resulting impenetrability to antibiotics, the most common mode of treatment and disinfection is wound debridement. This method has many drawbacks, such as inadvertent loss of healthy tissue, pain for the patient, and economic unsustainability. To combat this, we have developed a novel cold atmospheric-pressure plasma (CAP) device to study its antimicrobial effects in a porcine chronic wound model. Preliminary results with our CAP device show significant inactivation and removal of pathogenic biofilms from various surfaces. In this study, we sought to reproduce these antimicrobial effects in an ex-vivo wound model. A significant decolonization effect was achieved after 4 minutes of CAP treatment. Our next direction will be to analyze the effect of CAP treatment on mammalian tissue viability. Our findings demonstrate a potential alternative in the treatment of chronic wounds that would significantly reduce patient suffering and economic burden in years to come.

Poster #33
Presentation 6pm
Cupping

Cupping and Superficial Heat Provide Greater Efficacy for Reducing Chronic Pain than Pharmaceuticals

Haley Lancourt (Boise State University), et. all

Faculty Mentor: Gen Ludwig, EdD, ATC, Kinesiology (Boise State University)

Chronic low back and neck pain affect most of the adult population in the United States. Often when clinicians are presented with a patient presenting this common problem, pain relieving pharmaceuticals tend to the the first line of defense. Dry cupping therapy and superficial heat therapy can offer greater pain relieving benefits to patients without the use of pharmaceuticals. Purpose: To provide evidence-based clinical application of the effectiveness of cupping and superficial heat in reducing chronic low back and neck pain over the use of pain relieving pharmaceuticals. Hypothesis: Dry cupping and superficial heat therapy will provide greater long-term symptom relief of chronic low back and neck pain. Methods: Medline, Academic Search Premier, CINAHL, SPORTDiscus, PubMed, and Google Scholar were used to search for articles pertaining to the efficacy of dry cupping and superficial heat therapy in reducing chronic low back and neck pain when compared to pharmaceutical pain relievers. Inclusion criteria: non-specific chronic low back or neck pain, dry cupping intervention, superficial heat intervention, pain reliving drugs as control. Exclusion criteria: acute injuries, diagnosed back or neck injuries, and studies that used a second intervention in conjunction with dry cupping or superficial heat therapy. Conclusion: Both dry cupping and superficial heat therapy have been proven to provide greater efficacy in reducing chronic pain when compared to pharmaceuticals.

Poster #34
Presentation 6pm
Falls

The Effects of a Community-based Boxing Training Program on Balance in Persons with Parkinson’s Disease: Preliminary Findings

Savannah Kisling (Idaho State University), Jonathan Brubaker (Idaho State University), et. all

Faculty Mentors: Jill Harris, PT, DPT, Physical Therapy (Idaho State University), and Dr. Evan Papa, PT, DPT, Program Director of Physical Therapy (Idaho State University Health Science Center)

Improvements in gait and balance are associated with lower fall risks in persons with Parkinson’s Disease (PD). Community boxing interventions have shown preliminary positive results regarding improvements of balance and gait in those with mild-to-moderate PD in previous research, but no specific balance training component was included. The purpose of this investigation was to determine the effects on balance and functional outcomes of a community boxing training program coupled with focused balance training in persons with mild-to-moderate PD. A participant’s weakest balance domain was determined by the initial Modified Clinical Test of Sensory Integration on Balance test (M-CTSIB). Balance assessments were performed on 5 persons with PD (60-84 y/o age) (1.0-3.0 H&Y). Participants performed the M-CTSIB, Berg Balance Test, Timed Up and Go (TUG) and Functional Reach Test. Subjective measures were reported with the Activities-Specific Balance Confidence scale. Participants took part in a community boxing class for 12 weeks at the Caldwell YMCA with training targeted at the greatest domain of balance dysfunction. Balance assessments were conducted at the 6-week midpoint and at the end of the training. Preliminary results were determined from baseline and midpoint assessments using paired t-tests and a significance level of 0.05. All data except M-CTSIB measures were normally distributed. A statistically significant difference was found in the TUG scores from baseline to the midpoint assessment (-2.1 seconds, p = .035). Community boxing training for persons with PD has demonstrated the potential to improve outcome measures associated with fall risks after 6 weeks of training.

Poster #35
Presentation 5pm
Fall

Rising From a Supine Position Affect Physical Function in Older Adults

E. Murphy (New Mexico State University), Y. An (New Mexico State University), S-R. Lee (New Mexico State University), R. Wood (Boise State University)

Rising from supine to an upright position has the potential to evoke dizziness, and thereby presents a risk of falling. Surprisingly, little evidence is available to characterize the functional consequences of rising from a supine position. The Timed Up-and-Go (TUG) test is commonly used to describe the risk of falling in older adults. Recently, we have established that the percentage of time spent in the active propulsion (APT) phase of the gait cycle is inversely associated with history of falls.  PURPOSE: To determine the reliability of TUG time and APT following supine and seated rest, and to assess the main effect of position on TUG time and APT. METHODS: 40 older adults (age=73.5±1.0 yrs, height = 165.8±7.9 cm, weight = 74.0±16.2 kg) completed the TUG after at least 10mins of seated and supine rest on two separate days, one week apart. The order of the conditions was randomized. TUG time to completion was recorded and gait data were collected using a force-plate embedded walkway. APT was derived as the proportion of the gait cycle when center of gravity exceeded the base of support in single limb stance to contralateral heel contact. Intraclass correlations (comparing day 1 to day 2 values) were used to determine the reliability of our measures. The main effect of resting condition (seated v. supine) was tested by applying repeated measures ANOVA to day 1 observations. RESULTS: ICC of TUG time after seated rest was 0.91, p<0.001, and after supine rest was 0.95, p<0.001. ICC of APT after seated rest was 0.74, p<0.001 and 0.74, p<0.001 after supine rest. There were significant main effects of condition on time to complete the TUG (10.3±0.4 seconds versus 11.9±.7 seconds after seated and supine rest respectively, p<0.001), and APT (69.3±4.1% and 56.3±4.9% after seated and supine rest, respectively, p<0.05). CONCLUSION: TUG time and APT during the TUG are reliable following either supine or seated resting conditions. These data support the hypothesis that physical function is poorer and risk of falls is heightened immediately after rising from supine rest compared to seated rest. The risk of falls following supine rest is further evident by an average TUG time approaching 12 seconds. These results may assist clinicians in more appropriate screening, and in developing treatment strategies to reduce falls risks and falls.

Poster #36
Presentation 6pm

The Influence of Humor and Spirituality on the Resiliency of Community-Dwelling Older Adults

Bonnie Kenaley (Boise State University)

Older adults are met with challenging life events, including the death of a spouse, sibling, parent or child; divorce; job loss; natural disasters; traumatic experiences; cognitive impairment, financial loss; chronic illness; and decline in functional abilities (Lurie & Monahan, 2015; Bonanno et al., 2012). Considering these distinct challenges, older adults employ various mechanisms to cope and maintain psychological balance, including humor and spirituality (Bonanno et al., 2012; Koenig, 2012). Considering the dearth of literature that examines the influence of humor and spirituality on the resiliency in older adults, 148 members of an Osher Lifelong Learning Institute located in the western region of the United States completed electronic or pen and paper surveys. Overall, older adults often used self-enhancing humor alone or with others to deal with the absurdities of life, to cope with an upsetting situation, to make themselves feel better and to prevent themselves from getting upset. Additionally, the participants used positive religious/spiritual coping strategies, using a spiritual force for strength, support, and guidance. Using hierarchical regression modeling, the final model revealed that higher levels of education, lower levels of Positive Religious/Spiritual Coping, and higher levels Self-Enhancing Humor were statistically significantly associated with high levels of resiliency, with Self-Enhancing Humor recording a higher beta value followed by Positive Religious/Spiritual Coping and lastly education.

Poster #37
Presentation 5pm
Dementia

Using Dementia Knowledge in Patient Care for Radiographers

Ashley Borg (Idaho State University), et. all

Faculty Mentor: Dr. Melody Weaver, ACHPN, APRN, FNP-BC, Nursing (Idaho State University)

Dementia is increasing in all forms and is a leading cause of death in the United States. Older adults 65 years of age and older that were participating in a senior center nutrition program were voluntarily surveyed. The survey encompassed 14 different sites in a 7-county region of Southeastern Idaho. This survey gave these older adults the chance to rate their quality of life, assess their own dementia knowledge, provide categorical background information, and provide comments on their health and happiness. Surveys were handed out to seniors that were physically able to attend the senior center lunches, and food-delivery drivers also helped us hand out surveys to home-bound seniors as well. We received 259 surveys back from our participating sites. The age range of participants was 65-98. The dementia knowledge total score average for the study was a 19, with the perfect score being a 50. These results show the lack of dementia knowledge in the community, which leads to difficulty in patient care and added stress to both the caregiver and the patient. The purpose of this poster is to fill in the knowledge gaps and provide dementia knowledge to radiographers and other healthcare providers. Knowledge is power, simple changes in the behaviors and actions of caregivers can significantly increase the quality of life of affected persons.

Poster #38
Presentation 6pm
Aging

I’m Not Old, Just Aging: Perceptions of Subjective Age and Aging amongst Community-Dwelling Older Adults

Anna Kotzian (Boise State University), et. all

Faculty Mentor: Dr. Jill Chonody, MSW, LCSW, Social Work (Boise State University)

Aging is a dreaded process in Western society; however, recent research suggests that this collective perception may be shifting as people are living longer, healthier lives. This cross-sectional survey study sought to understand how older people define their subjective age, or their perception of the age that they feel, by analyzing the content of open-ended questions. Data were collected from older adults (N = 477) recruited through Amazon’s Mechanical Turk (MTurk). MTurk is a survey participant strategy that provides a monetary reward for the completion of surveys. Content analysis was used to analyze the qualitative data. Participants were on average 63 years old (range = 55 – 81), and the average age that one feels was around 10 years younger. The common themes for why individuals did not feel old include (in order from greatest to least): Maintaining an active and engaged lifestyle; “I feel young”; healthy and independent; “I’m not old, just aging”; “I have more time”; I don’t act or look old”; and chronological age. The responses for why individuals felt old include: stopped or changed activities; chronological age; health problems; reflection in the mirror; nearing death; considered or treated “old”; and accomplishments, acceptance, and adaptation. Learning about the age perceptions using qualitative research adds to our understanding of what experiences shape subjective age, and our findings speak to the recent attention that has been given to positive aspects associated with aging, which has the potential to alter perceptions about the process of aging.

Poster #39
Presentation 5pm
Aging

Perspectives on Aging among Graduate Social Work Students

Dr. Jill Chonody, Social Work (Boise State University), et. all

Using Photographs as an Online Pedagogical Activity The United States is experiencing an aging of the population, and by 2030, 20% of Americans will be 65 years or older (Federal Interagency Forum, 2010). However, for many helping professions, including social work, medicine, and nursing, student interest in gerontological practice is quite low. One international study found that only 5.4% of the more than 1,000 social work students who were surveyed indicated that working with older people was their primary area of interest (Chonody & Wang, 2014). Finding ways to improve student interest and break down biases against older adults is essential to improve student interest, and incorporating evidence-based activities that can be incorporated into courses that are offered in an online format are increasingly needed as this mode of instruction continues to expand. The current exploratory study sought to pilot a two-part photo-activity in an online graduate social work practice course focused on working with older adults. Quantitative and qualitative results suggest that the activities helped students’ process their views on aging and older people, and most students reported at least some change in their attitudes. The development of innovative ways to engage students online by repurposing technology that they are already using can advance online pedagogy and facilitate critical thinking.

Poster #40
Presentation 6pm
Obesity

Obesity-linked Hypertension: Could it be a Measurement Error?

Dr. Uwe Reischl, MD, Community and Environmental Health (Boise State University), et. all

The prevalence of obesity worldwide has increased over the past several decades. Obesity has been determined to be a risk factor for hypertension. Diagnosis of hypertension is most frequently based on indirect blood pressure measurements obtained using a sphygmomanometer. Obese patients often exhibit an increased upper arm circumference that influences the sphygmomanometer pressure readings that can result in measurement errors. The impact of upper arm circumference and use of different cuff-bladder sizes on blood pressure reading errors has not been reported in literature. Therefore, tests were conducted to quantify the relationship between upper arm circumference and cuff bladder size and sphygmomanometer pressure readings. The results show that arm circumference and cuff-bladder size, separately and in combination, have opposite effects on sphygmomanometer pressure readings. These effects can lead to serious errors in blood pressure determinations. Using “correction factors” is proposed that will allow clinicians to compare blood pressure values obtained for different combinations of patient upper arm circumference and cuff-bladder size.

Poster #41
Presentation 5pm
Metabolic health

Sedentary behavior, cardiometabolic health, and motivation in student-athletes: A pilot study

Katie Taylor (Eastern Washington University), et. all

Sedentary behavior (SB) has been associated with cardiometabolic and psychosocial health independent of physical activity in the general population. However, little research has investigated these relationships in student-athletes. PURPOSE: To determine the relationships among SB, cardiometabolic health, and motivation in student-athletes. METHODS: Six student-athletes volunteered for this pilot study and visited the lab on two occasions. At the first visit, blood pressure was measured and participants were provided with an accelerometer to assess SB and physical activity levels. During the second visit, participants completed a series of questionnaires to determine motivation levels and completed body composition testing using ultrasound to determine adiposity. Pearson correlations were conducted to determine relationships among variables with an alpha level set at 0.05. RESULTS: There were no associations among SB and cardiometabolic health. Results indicated that superficial adipose tissue thickness was positively associated with diastolic blood pressure (r=0.88, p=0.02) and resting heart rate (r=0.92, p=0.008). SB in 10-minute (r=-0.96, p=0.003) and 20-minute bouts (r=-0.92, p=0.008) was negatively associated with ego-orientation motivation. Further, there were positive relationships between resilience and identified regulation (r=0.89, p=0.02), as well as stress with introjected regulation (r=0.91, p=0.01) and incremental beliefs (r=0.90, p=0.01). CONCLUSIONS: We found associations among SB, cardiometabolic health, and motivation that may be specific to student-athletes. This could support the need for improving education in these areas for student-athletes, particularly to benefit life after sport. Future research would be beneficial in extending this study to a larger cohort of athletes from a diverse variety of institutions and sports.

Poster #42
Presentation 6pm
Breast Cancer

Measuring the Effects of Small Molecule Inhibitors Against Proinflammatory Cytokines in Breast Cancer Metastasis

Darren J. Lighter 1, Biological Sciences (Boise State University), Clyde Pruett, Biological Sciences (Boise State University), Cody Wolf, Biological Sciences (Boise State University), Joey Tuccinardi, Chemistry, Biochemistry (Boise State University), Thomas Conrad, Chemistry, Biochemistry (Boise State University), Grace Coughlin, Chemistry, Biochemistry (Boise State University), Riley Olsen, Chemistry, Biochemistry (Boise State University)

Faculty Mentors: Dr. Matthew King (Chemistry, Biochemistry), Dr. Don Warner (Chemistry, Biochemistry), Dr. Cheryl L Jorcyk (Biological Sciences)

Approximately 1 in 8 women in the United States will develop breast cancer in their lifetime. While localized breast cancer has a 5-year survival rate of 99%, metastatic breast cancer has a limited 5-year survival rate of 27%. Prior research from our lab and others have identified a proinflammatory cytokine that induces invasion and detachment of various breast cancer tumor cells. We hypothesize that small molecule inhibitors (SMI), can bind to proinflammatory cytokines and reduce their potential to activate the signaling pathway that promotes metastasis of breast cancer tumor cells. First, an in silico model was used to identify potential parental inhibitors based on prospective binding affinity. Parental molecules were then synthesized through a multi-step organic synthesis, and optimized analogs were presented for potentially increased binding affinity and drug-like properties. Continuing forwards, various in vitro tests were performed, including enzyme linked immunosorbent assay (ELISA) and western blots, which allow us to compare the effectiveness of each SMI to reduce the signaling cascade. Inhibition of these cytokines may lead to novel therapeutics that can be used to prevent breast cancer metastasis.

Poster #43
Presentation 5pm
Student athlete engagement

College student-athletes engagement in activism: Target for change and method for increasing awareness

Trystan Weisinger (Boise State University), et. all

Faculty Mentor: Dr. Eric Martin, CC-AASP, Kinesiology (Boise State University)

Recently, professional athletes have used their social influence to promote change in society (e.g., Megan Rapinoe, Colin Kaepernick). However, college and high school student-athletes have been less likely to have media cover them utilizing their platform through activism. The present study examined the type (e.g., protest), theme (e.g., race), and target (e.g., domestic) associated with acts of activism college student-athletes during their high school and college years. A total of 1117 collegiate student-athletes participated in the study. In high school, student-athletes were involved in a total of 1231 acts of activism. The most common type of activism was physical protests (33.4%), most frequently were geared toward political issues (9.2%), and occurred at the domestic level (18.4%). In college, student-athletes were involved in a total of 1253 acts of activism. The most common type of activism was physical protests (27%), most frequently were geared toward race/ethnicity (11.1%), and occurred at the domestic level (15.6%). Student-athletes were using physical protests as well as other forms of activism to promote change throughout a variety of topics, most notably political and race/ethnicity issues. This information allows us to understand the issues important to student-athletes throughout sports and society and see how these issues change with age. With more support, student-athletes could be taught how to use their social influence more strategically, enabling them to more powerfully influence social good both in their sport and society.

Poster #44
Presentation 6pm
Leadership 

Leadership Proficiency: Perspectives of Athletic Trainers New to Practice

Gen Ludwig EdD, ATC, Athletic Training (Boise State University), Janelle Handlos EdD, ATC, Health and Human Performance (University of Montana Western), et. all

Context: A broad range of knowledge, skills, and abilities related to leadership has been suggested as essential for development during the athletic training education process. Though the importance of these characteristics has been established, researchers have not yet evaluated the self-perceived proficiency levels of new-to-practice athletic trainers (ATs). Objective: To determine the level of self-perceived proficiency attained on key leadership competencies by new-to-practice ATs and to determine which factors relate to increased levels of self-perceived proficiency. Design: Quantitative survey research. Setting: Online questionnaire. Patients or Other Participants: One hundred seventy-three ATs within their first 5 years of practice participated in the study. Main Outcome Measure(s) : Participants completed a Web-based questionnaire developed by the researchers to determine the self-perceived level of proficiency attained by the new-to-practice AT on 5 key leadership competencies. One open-ended response item allowed participants to suggest educational experience changes that could lead to increased proficiency in the 5 key leadership competencies. Results : Athletic trainers who completed their professional education at the master’s level selected higher self-perceived proficiency levels for the competency knowledgeable than those who completed bachelor’s degrees to complete their professional athletic training requirements. As years of practice increased, ATs perceived higher levels of proficiency in the competencies of knowledgeable, ethical practice, and credible. Level of self-perceived proficiency ratings for adaptable and resilient were significantly lower than those for other competencies, regardless of demographic variables.

Conclusions: Completion of professional education at the master’s degree level resulted in increased self-perceived levels of knowledge in new-to-practice ATs. Self-perceived proficiency in the characteristic of adaptability and resilience lags behind other key competencies even as years of practice increase. Instructors could use pedagogical and curricular strategies from other health care professions to increase adaptability and resilience in athletic training students.

Poster #45
Presentation 5pm
Educational Attainment

Admission Criteria and Course Performance in an Undergraduate Respiratory Care Program: A Case for Non-Cognitive Measures

Megan Koster EdD, RRT, Respiratory Care (Boise State University), et. all

Introduction: Admission processes for health care programs traditionally focus on a student’s cognitive ability. This unilateral approach to the evaluation of intelligence represents an incomplete understanding of a student’s ability in a clinically-based program, such as Respiratory Care. Research has indicated non-cognitive characteristics are vitally important to the future success of working health care providers. The purpose of this research was to assess the relationships among admission criteria categorized according to Sternberg’s Triarchic Theory and performance in a baccalaureate Respiratory Care program. Methods: In addition to cognitively-focused admission criteria, students applying to an undergraduate Respiratory Care program participated in a multiple mini-interview (MMI) to demonstrate non-cognitive skills described as essential to health care practitioners. Students were ranked by performance and selected for admission. Relationships among criteria classified according to Sternberg’s Triarchic Theory and performance in foundational Respiratory Care courses were explored for significance. Results: Significant relationships among indicators of either componential, experiential, or contextual intellect and course performance were sporadic. However, significant correlations existed between MMI scores and performance in clinical practicum.

Conclusions: Health care workers are required to demonstrate not only cognitive aptitude, but also the ability to apply new concepts in new contexts. How- ever, most traditional admission practices overlook the value of non-cognitive ability. Clinically-focused undergraduate programming may benefit from incorporating non-cognitive measures into admission practices. The adoption of a revised MMI, in addition to a review of academic performance, may help to highlight contextual abilities inherent to the clinical environment that are often overlooked by traditional admission practices.

Poster #46
Presentation 6pm
Mental training for athletes

The Effects of Mental Training on Acute Psychophysiological Stress Responses in Endurance Athletes

Shelanda Kujala (Boise State University), et. all

Faculty Mentor: Dr. Eric Martin, CC-AASP, Kinesiology (Boise State University)

Introduction: In sports, pre-competition stress responses can influence performance. Mental skills training is a strategy used to successfully mitigate stress responses and positively impact performance. Psychological (e.g., anxiety) and physiological (e.g., cortisol) stress responses are not often measured in a single study, providing an incomplete picture of athlete experiences. When researchers have measured these constructs together, studies have excluded endurance athletes and ways to effectively buffer stress responses. Purpose: To measure the effects of mental skills training on psychophysiological stress responses of cortisol and anxiety levels in endurance athletes. Hypothesis: Athletes participating in mental skills training sessions, compared to a control group, will have lower levels of anxiety and salivary cortisol pre-race and will experience improved race performances. Methods: Endurance athletes will be recruited and randomly assigned into a control or an intervention group. Cortisol and anxiety testing will occur on three occasions (Baseline, Time 1 and Time 2). Participants will complete three mental training sessions between Time 1 and Time 2. Mental skills training will include imagery, goal setting and self-talk. Anxiety will be quantified using the Competitive State Anxiety Inventory (CSAI-2R). Salivary cortisol levels will be analyzed using the AgileReader Elisa Plate reader. Statistical Analysis: A mixed model repeated measures ANOVA (Time X Group X Gender) will assess anxiety, cortisol levels, and race results. Expected Outcomes: Mental skill training will lead to lower levels of anxiety and cortisol, as well as improved race performances.

Poster #47
Presentation 5pm
Pharmacy care

Pharmacist-provided direct patient care services in Idaho: Current practices, capacity, and barriers

Dr. Elaine Nguyen, MPH, BCPS, BCACP, Pharmacy (Idaho State University), et. all

Introduction: Pharmacists are accessible but underutilized healthcare providers in the community. Through the provision of direct patient care services, pharmacists have an expanding opportunity to impact chronic disease prevention and management across the state. However, current practices surrounding pharmacist-provided direct patient care services are unknown. Research Question: What are current practices, capacity, and barriers to pharmacist-provided direct patient care services for Idaho community and ambulatory care pharmacists? Study Design: Cross-sectional survey Methods: The 20-minute survey included 63 questions, although not all participants answered every question due to survey logic. A link to the final web-based survey was emailed to all Idaho-based pharmacists registered with the Board of Pharmacy (n=1,595) on April 25, 2019. Two additional email reminders were sent to eligible participants before survey promotion ended on May 24, 2019. Survey responses were exported from Qualtrics and analyzed using descriptive statistics.

Results: The survey was completed by 243 community and ambulatory care Idaho pharmacists with 90% (n=219) reporting that their work sites currently offer direct patient care services. Medication therapy management and patient medication self-management services were the most common services provided. Pharmacists most often prescribed naloxone (n=106), devices for patients with diabetes (n=78), and medications for cold sores (n=67). The top three barriers to offering direct patient care services were dispensing load, point-of-care devices, and patient interest. Conclusion: Idaho community and ambulatory care pharmacists currently offer direct patient care services to patients across the state, but face barriers in providing and increasing services offered.

Poster #48
Presentation 6pm
Marijuana

Weeding Through The Facts: Marijuana Use And The Developing Brain

Rebecca Gomez (Boise State University), et. all

Faculty Mentor: Dr. Cara Gallegos, RN, Nursing (Boise State University)

Marijuana is the most commonly used illicit drug in the United States. Eleven states and Washington DC have legalized marijuana for recreational use, and 33 states and DC have legalized marijuana for medical use. With legalized marijuana in more areas of the United States, more adolescents and young adults are gaining access to it. The purpose of this study was to determine the impact of marijuana on adolescent cognitive development, specifically to determine neurocognitive function relating to behavior and test scores in school settings. The majority of the evidence found a strong association between early, frequent and heavy adolescent cannabis exposure and poor cognitive outcomes in adulthood. It was also found that students with Cannabis Use Disorder (CUD) had poorer grades than their peers who consumed little or no alcohol or marijuana. And had lower overall GPAs compared to their non/low substance peers. There is also significant evidence that acute and chronic marijuana exposure to cannabinoids impaired cognition, especially in the domains of verbal learning, memory and attention. The research shows that the age of onset and frequency of marijuana use were shown to impact the cognitive performance. Earlier onset of marijuana use is related to poorer cognitive function and the damage produced by cannabis use may be permanent. The research that is being gathered can help create public policy to combat the growing perception among youth that cannabis is not harmful to their health.

Poster #49
Presentation 5pm
Child fatality

Child Fatality Review Boards in Rural Areas: Opportunities for Creation and Collaboration to Reduce Child Deaths in Underserved Areas

Dr. Max Veltman, RN, CPNP, Nursing (Boise State University), et. all

Rural counties are often under-resourced in their ability to deal with investigations of child fatality. Child Fatality Teams often are formed at the state level to ascertain important information about child deaths, however many rural states are limited in the amount of data that is accessible to these boards. Idaho has recently begun to provide funding to support Child Fatality Review teams to assist with investigation(s) and review of suspicious deaths of children at the county level. A rural county in southwestern Idaho entered into a partnership with Boise State University in 2012. The purpose of the project was (and continues to be) to assist the local prosecutors, law enforcement, coroner and medical staff with streamlining and updating the child review process to better align with national standards. As this collaboration has progressed, many key changes have occurred, including an increase in the standardization of data collection, a higher quality and amount of data from the multiple agencies involved in the investigation of child fatality events and a more modernized system of safely securing data for analysis.

Poster #50
Presentation 6pm
Children’s Health

Stratification Tool Development in Pediatric Patients with Complex Health Care Needs

Dr. Hillary E. Swann-Thomsen (Idaho State University Idaho Center for Health Research & St. Luke’s Applied Research Division), Dr. Jared Vineyard (Idaho State University Idaho Center for Health Research & St. Luke’s Applied Research Division), Dr. John Hanks, DO, FAAP (St. Luke’s Children’s Specialty Center), Rick Tivis (Idaho State University Idaho Center for Health Research & St. Luke’s Applied Research Division)

Existing tools for identifying chronic conditions in children with special health care needs fail to consider medical and behavioral complexity. Thus, the purpose of the current study was to examine a stratification tool that would consider medical and behavioral complexity, as well as social determinants of health. A retrospective chart review of a pediatric PCP panel was conducted in order to examine the stratification ability of the St. Luke’s Children’s Acuity Tool, as well as to compare the SLCAT to an existing and validated stratification tool used to identify children with complex chronic conditions, the Pediatric Chronic Conditions Classification System (CCCv2). Results indicate that the SLCAT assigned pediatric patients into meaningful levels reflective of resource utilization, including total dollars billed, number of encounters, and number of problems such that children with highly complex chronic conditions had significantly higher utilization than children with mild and moderate complex conditions, and similarly, children with moderate complex conditions had significantly higher utilization than children with mild complex conditions. Additionally, the SLCAT identified 515 patients that were not identified by the CCCv2. Nearly half of those patients had a mental/behavioral health diagnosis. The findings of this study provide evidence that a tiering model that incorporates all aspects of a child’s care may result in more accurate identification of CSHCN, allowing for PCP and care coordination teams to match patients and families with the appropriate amount and type of care coordination services.