• A Randomized Control Trial of Benefits of Intrahopsital Exercise on Post-Transplantation Deconditioning in the Pediatric Hematopoietic Stem Cell Transplant Population

      Smith, Charles; The University of Arizona College of Medicine – Phoenix; Ngwube, Alexander (The University of Arizona., 2019)
      Deconditioning is a common adverse effect of short and long-term immobilization. For months pediatric hematopoietic stem cell transplant patients can be quarantined while hospitalized, much of which time is spent immobilized putting these patients at a higher risk for loss of muscle strength, functionality, endurance, and quality of life. Studies have shown that exercise as an effective countermeasure to deconditioning in stem cell transplant patients. However, research is lacking in pediatric HSCT due to the complications associated with treatment. This study was conducted to determine if there is a correlation between intrahopsital exercise and improved functionality, endurance, strength, and quality of life. In addition, this randomized control study looked at the merit and feasibility of adding an exercise routine into treatment plans. We have currently recruited 23 of our target 40 patients, 12 in the control arm and 11 in the intervention arm, ages 8-17 at Phoenix Children’s Hospital. Each participant received baseline measured by an OT or a PT for functionality using (WeeFIM), muscle strength using manual muscle testing (MMT), endurance using the 6-minute walk test, and quality of life using the NIH PROMIS measures. Measurements were taken again at discharge and 6-weeks post-discharge. During hospital admittance the intervention group performed exercise routines 3-times weekly while the control group were encouraged to spend time out of bed. Patients recruited were receiving their first HSCT and did not have any post-HSCT complications such as severe infection or GVHD. Data and results are limited due to the timepoint of the study and the limited number of recruited patients affecting the power of the study. No statistically significant difference is noted between the two arms in functional status, muscle strength, or endurance. There appears to be an increase in quality of life patients in the interventional arm compared to the control arm. Simple analysis has shown that compliance with time out of bed decreases across both groups the further away from transplant. Currently the study is midway, and data is limited to make any conclusions but shows promise.
    • A Systematic Review of Physician-Patient Interactions and the Effect of Health Care Provider Bias and Knowledge on Adolescent Contraception Counseling in Developing Countries and Comprehensive Review: Contraceptive Use and Impact of Physician Counseling for Adolescent Patients of Method Choices and Side Effects in Developing Countries

      Cooke, Alexandra; The University of Arizona College of Medicine – Phoenix; Beyda, David (The University of Arizona., 2019)
      Unmet need for contraceptives in developing countries remains a social and health problem and adolescents are more likely to struggle in starting long-acting contraceptive methods, often due to side effect or other concerns. This study aimed to analyze the biases in the provider-patient relationship and counselling practices for adolescent patients in developing countries. Attention was placed on patient’s preferred method, cultural and moral biases, knowledge gaps of patient and providers, side effect knowledge, and attitudes impacting the relationship upon counseling quality and likelihood of contraceptive use. Systematic review of articles with MeSH terms “developing countries,” “contraception,” “adolescents,” and other search terms yielded 6745 articles; 14 articles were chosen for further review. Findings highlight negative impacts of providers’ ethical concerns and knowledge gaps when addressing method use and side effects. Low knowledge base by providers of varying skill level also highlight a need for improved training on family planning methods.
    • A Systematic Review of the Effectiveness of HIV Intervention Programs on HIV Rates, Condom Use, and Abstinence in Adolescents in Low Resource Countries and The Pathophysiology, Role, Prevention, and Treatment of HIV in Low Resource Countries

      Keerthi, Svadharma; The University of Arizona College of Medicine – Phoenix; Yoblonski, Lara (The University of Arizona., 2019)
      There are high rates of HIV in adolescent girls in low resource countries due to the high incidence and prevalence of sexual violence. The purpose of this project is to collect the data of educational programs that aim to decrease rates of HIV and describe their characteristics, specifically, the rates of HIV, the rate of sexual violence, condom use, and sexual practices before and after intervention by education programs. The data shows that none of the studied measures changed after educational programs.
    • A Systematic Review on the Effect of Misoprostol in the Prevention of Postpartum Hemorrhage in Sub-Saharan African Women of Reproductive Age

      Kassi, Luce Auriane; The University of Arizona College of Medicine – Phoenix; Brady, Michael (The University of Arizona., 2019)
      Postpartum hemorrhage (PPH) is the leading cause of maternal death worldwide. Oxytocin is the uterotonic drug of choice to prevent PPH. This systematic review was performed to evaluate the use of misoprostol as a possible alternative in resource-poor settings. Articles were selected on PubMed and the International Journal of Obstetrics and Gynecology based on their primary outcomes (estimated blood loss (EBL) in mL), region (Sub-Saharan Africa) and purpose (comparing (1) misoprostol with oxytocin or with a controlled placebo (2) and different doses of misoprostol). All meta-analyses used a Cohen’s D scale. There was no difference between the use of oxytocin over misoprostol and meta-analysis shows that when used separately, both medications decreased total EBL. Misoprostol at 400 and 600 mcg did not show any difference on EBL compared to oxytocin. In combination with oxytocin, there was no difference on EBL compared to misoprostol alone. When oxytocin was not added to misoprostol, there also was no difference on EBL compared to misoprostol alone. This study suggests that misoprostol may be a sustainable alternative to prevent PPH in resource-poor areas where oxytocin is unavailable.
    • Additional Hearing Screenings in Pediatrics: Does Earlier, More Consistent Screening Make a Difference?

      Loeb, Sophie; The University of Arizona College of Medicine – Phoenix; Samaddar, Kristen (The University of Arizona., 2019)
      Phoenix Children’s Hospital has implemented a program, following the guidelines set by the Ear Foundation, to do annual hearing screenings from birth to school age. This is in contrast to the recommendations by Bright Futures, which state that screening should be done at birth and then annually after the child has begun kindergarten. This study may help determine the incidence of failed hearing screenings and frequency with which failed screenings translate to an intervention, as well as drive clinical decisions on the frequency/number of screenings at well-child checks.
    • An Analysis of Mortality, Morbidity, and Primary Care Providers in Arizona's 126 Primary Care Areas

      Wassermann, Michael; The University of Arizona College of Medicine – Phoenix; Cartsonis, Jonathan (The University of Arizona., 2019)
      The United States is currently facing a primary care provider shortage. Medical schools nationwide have increased enrollment in order offset the effects of the shortage. In order to justify the effects of increasing total quantity of future physicians, there should be a demonstrated relationship between total quantity of providers and a reduction in morbidity / mortality at a population health level. This study investigates if there is any association between the total number of primary care providers and mortality per 100,000 persons (all deaths, heart disease, all cancer, chronic lower respiratory disease, and all accidents), or morbidity per 100,000 persons (chronic diseases, congestive heart failure, hypertension, uncontrolled diabetes, and stroke)? Is there any difference in total number of primary care providers, mortality per 100,000 persons, or morbidity per 100,000 persons in rural vs urban primary care areas? Data was gathered from the Arizona Department of Health Services community profiles dashboard. 2013 morbidity / mortality data for all 126 of Arizona’s Primary Care Areas was analyzed utilizing linear regression and Wilcoxon rank sum. Linear regression demonstrated a statistically significant reduction in a number of mortality / morbidity categories as total number of primary care providers increased. Correlation data demonstrated a statistically significant relationship between number of primary care providers and increase in chronic lower respiratory diseases (p value = 0.027). Additionally, rural primary care areas showed higher incidence of congestive heart failure (p < 0.001) and chronic diseases (p = 0.02) and lower total numbers of primary care providers (p < 0.001) compared with urban primary care areas. Our findings demonstrate distinct differences between urban and rural primary care areas. There may be some association between total number of primary care providers and their potential effect on mortality/morbidity incidence. Further research needs to be completed in order to elucidate a greater understanding of these potential relationships.
    • An Analysis of the “Angelina Jolie Effect”: Does the Media Influence Patients’ Contralateral Prophylactic Mastectomy Decisions?

      Gosney, Jayme; The University of Arizona College of Medicine – Phoenix; Bernard, Robert (The University of Arizona., 2019)
      Following genetic testing and counseling, many women elect to undergo prophylactic surgery to reduce their risk of developing breast and ovarian cancer. Bilateral prophylactic mastectomy (BPM) can decrease a woman’s risk of developing breast cancer by more than 90%.4 However, contralateral prophylactic mastectomy (CPM) does not increase survival for the majority of women with breast cancer, which is contrary to the increasing incidence of CPM.5,7 Angelina Jolie published an op-ed in The New York Times in May 2013 regarding her decision to undergo BPM. She pursued preventative surgery due to her strong family history of breast cancer and positive test for a BRCA mutation. While Jolie’s situation is not analogous to that of women undergoing CPM, it is possible that in many women’s minds, the situations are similar. This study is a retrospective review that examines the relationship between popular magazine articles written about prophylactic mastectomy and the number of CPM surgeries performed.
    • Analysis of Risk Factors Associated with Fatal Motor Vehicle Collisions in Arizona

      Liu, Margaret; The University of Arizona College of Medicine – Phoenix; Fischione, Mark; Skinner, Ruby (The University of Arizona., 2019)
      In 2014, Arizona had 109,554 motor vehicle collisions (MVCs), 708 of which were fatal. The objective of this study was to analyze behavioral patterns in drivers which resulted in fatal MVCs. This was a retrospective chart review of MVCs in 13 Arizona counties from 2007 to 2015. Results showed a high incidence of high-risk behaviors due to substance use and lack of safe driving practices, including 26% of subjects with an ethanol content above the legal limit, 10% with THC in their system at the time of the collision, 9% with amphetamines or cocaine, 8.5% with benzodiazepines, and 5% with opiates. More than 50% had a combination of substances. Other notable characteristics were the lack of seatbelt use in 30% of subjects, and lack of motorcycle helmet use in 69% of motorcycle drivers. More data is needed on distracted driving behaviors, particularly related to cellular phone use, in order to optimally target future legislation and prevention.
    • Associations of Chest Compression Release Velocity and Age, Weight, and Gender during Cardiac Resuscitation

      Sutter, John; The University of Arizona College of Medicine – Phoenix; Bobrow, Bentley J. (The University of Arizona., 2019)
      Higher chest compression release velocity (CCRV) has been associated with better outcomes after out-of-hospital cardiac arrest (OHCA), and patient factors have been associated with variations in chest wall compliance and compressibility. We evaluated whether patient sex, age, weight, and time in resuscitation were associated with CCRV during pre-hospital resuscitation from OHCA. This observational study of prospectively collected OHCA quality improvement data in two suburban EMS agencies in Arizona between 10/1/2008 and 12/31/2016. Subject-level mean CCRV during the first 10 minutes of compressions was correlated with categorical variables by the Wilcoxon rank-sum test and with continuous variables by the Spearman’s rank correlation coefficient. Generalized estimating equation and linear mixed-effect models were used to study the trend of CCRV over time. During the study period, 2,535 adult OHCA cases were treated. After exclusion criteria, 1,140 cases remained for analysis. Median duration of recorded compressions was 8.70 minutes during the first 10 minutes of CPR. An overall decline in CCRV was observed even after adjusting for compression depth. The subject-level mean CCRV was higher for minutes 0-5 than for minutes 5-10 (mean 347.9 mm/s vs. 339.0 mm/s, 95% CI of the difference -12.4 ~ -5.4, p < 0.0001). Males exhibited a greater mean CCRV compared to females [344.4 mm/s (IQR 307.3-384.6) vs. 331.5 mm/s (IQR 285.3-385.5), p=0.013]. Mean CCRV was negatively correlated with age and positively correlated with patient weight. CCRV declines significantly over the course of resuscitation. Patient characteristics including male sex, younger age, and increased weight were associated with a higher CCRV.
    • C-Terminally Truncated Apolipoprotein A1 Glutamate Residue 243 Is a Biomarker for Oxidative Stress in Coronary Artery Disease and Chronic Kidney Disease

      Wilson, Zachary; The University of Arizona College of Medicine – Phoenix; Breberda, Christian S. (The University of Arizona., 2019)
      High density lipoprotein (HDL) oxidation is a potential biomarker for coronary artery disease (CAD) severity. Methionine sulfoxidation, tyrosine chlorination and C-terminal truncation are Apo A- I modifications that inactivate HDL and lead to pro-oxidant action. We hypothesize that C-terminal truncation of apolipoprotein A1 glutamate residue 243 (Apo A-I Des-Q243) is a byproduct of a protease, such as a matrix metalloprotease (MMP), and it is associated with the presence and severity of coronary artery disease and chronic kidney disease (CKD). We enrolled 103 patients presenting for evaluation of chest pain in this cross-sectional study at Maricopa Medical Center. Plasma and serum samples were collected, processed, and transferred to Arizona State University (ASU) Biodesign Institute for high pressure liquid chromatography-mass spectrometry (HPLC-MS). A statistical analysis was conducted with a spearman’s coefficient, two-tailed linear regression and multivariate analysis of the relative fractional abundance (RFA) of Apo A-I Des-Q243 and clinical variables. Multivariate analysis revealed significantly reduced levels of Apo A-I Des-Q243 in the presence of male gender (-1.5%, P=0.035), atrial fibrillation (-2.8%, P=0.04), and ACEi/ARB use (-2.4%, P=0.001). Additionally, a diagnosis of CKD (2.3%, P=0.037) and the presence of four (9.6%, P=0.005) or five (4.7%, P=0.045) coronary stents, regardless of vessel location, were associated with significantly increased levels of Apo A-I Des-Q243. American Indian/Alaskan race as compared to Caucasian race (Plasma -5.8%, 95% CI -9.9- -1.8%, P=0.005; Serum -4.6%, 95% CI -8.5- -0.8%, P=0.02), and the eGFR (Plasma ρ=-0.024, P=0.014, Serum ρ=-0.291, P=0.003) only reached significance in the linear regression and spearman’s correlation analysis respectively. Apo A-I Des-Q243 is elevated in patients with multiple coronary stents, and thus may be contributing to vascular inflammation and plaque formation. Furthermore, Apo A-I Des-Q243 is elevated in CKD and is directly correlated with its severity as determined by eGFR. These findings highlight the renin-aldosterone system’s (RAS) role in HDL oxidation and the anti-oxidant action of ACEi/ARBs. Apo A-I Des-Q243 appears to be an important link between CAD and CKD and is a promising biomarker that warrants further study.
    • Changes in Body Fat Phenotype After Four-Month Walking Interventions

      Panchanathan, Roshan; The University of Arizona College of Medicine – Phoenix; Angadi, Siddharta (The University of Arizona., 2019)
      Walking is an excellent health-promoting activity for obese, sedentary individuals. Visceral fat is linked to cardiovascular disease and mortality. We hypothesized that walking (steps/day) would decrease visceral adiposity and improve laboratory markers of cardiometabolic health in a dose-dependent manner. In the primary study, 79 sedentary, overweight subjects (77% female, 65% Caucasian) were enrolled in a 2x2 factorial randomized controlled walking intervention, with steps measured using a wearable Fitbit fitness tracking device. Participants underwent dual x-ray energy absorptiometry and basic cardiometabolic laboratory measurements (glucose, insulin, total cholesterol, HDL, LDL, triglycerides) before and after the intervention. Lean mass increased from 49.9 ± 9.5 to 50.3 ± 9.4 (p=0.05). No significant changes were observed in any of the cardiometabolic outcomes or localization of fat. The change in steps had no correlation with weight, visceral fat, lean mass, and VO2 peak, refuting the original hypothesis. When analyzing common laboratory markers and demographic characteristics, there were no significant predictors for visceral or total fat mass change, with significant heterogeneity of change in the group. Our study supports the likely contribution of genetic and environmental factors to the physical and laboratory changes seen following a walking intervention in sedentary and insufficiently active overweight people.
    • Comparative Assessment of Severe Pediatric TBI Management between Developed and Developing Country Institutions: A Study Comparing Phoenix, Arizona to Neiva, Columbia

      George, Laeth; The University of Arizona College of Medicine – Phoenix; Adelson, P. David (The University of Arizona., 2019)
      Traumatic Brain Injury (TBI) is an etiologically heterogeneous condition that represents a global public health issue with major socioeconomic impact. Evidence-based guidelines for pediatric TBI management exist, and were last updated by the Brain Trauma Foundation in 2012. There are, however, limitations and barriers to their implementation; one such are the differences in resource utilization and availability in developed versus developing countries. In this study, we performed a retrospective review of pediatric patients with severe TBI in two tertiary, pediatric hospitals in the United States and Colombia, comparing characteristics, management and outcomes.
    • Comparing the Effects of Narrative Nonfiction and Literary Fiction on Empathy Retention in Medical Students

      Shi, Aishan; The University of Arizona College of Medicine – Phoenix; Hartmark-Hill, Jennifer (The University of Arizona., 2019)
      Integration of medical humanities into medical student curricula has been shown to improve medical student empathy and resilience. The purpose of this study is to determine if narrative nonfiction pieces help students retain equal or more empathy skills compared to reading literary fiction. Previous studies show that interventions that utilize medical humanities can vary in medium and genre, and face the challenge of small sample size and confirmation bias due to a lack of randomized trials. In contrast, this study compares the reading of Narrative Nonfiction and Literary Fiction in building empathy in second year medical students randomized to each genre. Participants were asked to read selections from their assigned genre during the intervention period. Baseline, pre-intervention, and post-intervention assessments were measured by the Reading the Mind in the Eyes –Revised. Results demonstrated a statistically significant decrease in empathy across the overall study period, and there was no empathy retention difference between genres. Additionally, female gender identity and increased engagement in the arts and humanities prior to medical school were correlated with higher empathy scores across time. These findings indicate the need for longitudinal and personalised learning in medical humanities for more thorough studies and maximised benefits on empathy retention.
    • Comparison of Autografts vs. Allografts in the Surgical Repair of Pediatric Obstetrical Brachial Plexus Injuries

      Hamant, Laura; The University of Arizona College of Medicine – Phoenix; Adelson, P. David (The University of Arizona., 2019)
      Obstetrical Brachial Plexus Injuries(OBPI) occur during delivery with a global incidence ranging from 0.2- 4% of live births, and generally, prognosis is excellent with spontaneous recovery in up to 95% of patients. For patients with OBPI that do not obtain a functional recovery by 4-6 months of life, treatment is primarily surgical in nature. Surgical treatment involves testing of the nerves to determine whether they remain connected distally and proximaly, removal of scar tissue/ neurolysis, and then bridging the nerve discontinuity or block with a nerve graft. Nerve grafting provide a three-dimensional extracellular matrix that promotes Schwann cell migration and axon regeneration. Historically, nerve graft was autograft using sural nerve. More recently, a decellularized processed cadaveric nerve allograft (Axogen) has been utilized in numerous peripheral nerve injury repairs, mostly in adults, but has not been reportedly used in pediatric OBPI. The aim of this study is to determine if using nerve allografts (Axogen) will have similar functional outcomes as compared to sural nerve autografts in reconstruction of the brachial plexus after OBPI.
    • Comparison of Occipito-atlanto-axial Parameters on Computed Tomography in Pediatric Trauma Patients

      Calhoun, Matthew; The University of Arizona College of Medicine – Phoenix; Connell, Mary (The University of Arizona., 2019)
      Spinal cord injury without radiographic abnormality is a prevalent issue within the pediatric population. Children under the age of 10 are prone to sustaining injury at C1 to C4 because their biomechanical fulcrum exists between C2 and C3. The incidence of spinal cord injury in pediatric population has been estimated to be 4.6 per million per year or 1-2 % of all pediatric trauma cases. There may be subtle findings on computed tomography (CT) that may be able to identify occult cervical spine injury in pediatric trauma patients, which would be evident on magnetic resonance imaging (MRI). This study aims to measure various dimensions of the atlantoaxial and atlantooccipital joints in the pediatric cervical spine in patients with normal spines to detect subtle irregularities on CT scans to warrant further work up with an MRI in trauma patients. Additionally, having an accurate diagnosis will help guide the appropriate type and duration of treatment, which can range from conservative treatment with immobilization to surgery.
    • Comparisons of Emergency Medicine Residency Programs in Their Inclusion of Allopathic and Osteopathic Graduates

      Auerbach, Lauren; The University of Arizona College of Medicine – Phoenix; Stapczynski, J. Stephan (The University of Arizona., 2019)
      Residents entering residency come from two lines of medical education, allopathic (MD) and osteopathic (DO). While schooling is nearly identical, there is a discrepancy between the specialties in which these graduates enter. In 2018, emergency medicine residency programs were made up of three-quarters allopathic graduates and one-quarter osteopathic graduates. This study sought to better understand the diversity of emergency medicine programs as it relates to their location, duration, and credentials of members.
    • Confocal Microscopy Provides a Rapid Intraoperative Histological Assessment of Brain Neoplasms: Experience with 106 Cases

      Carotenuto, Alessandro; The University of Arizona College of Medicine – Phoenix; Preul, Mark C. (The University of Arizona., 2019)
      Frozen section histological analysis is the mainstay for intra-procedural tissue diagnosis during resection of intracranial neoplasms and for evaluating tumor margins. However, frozen sections are time-consuming and sometimes inaccurate. This study describes potential advantages of CSM imaging of fresh human brain tumor tissues labeled various fluorophores within the neurosurgical operating room facility.
    • Deep Interarytenoid Notch in Young Children Managed with Systematic Thickener Wean and Injection Laryngoplasty

      Basharat, Usmaan; The University of Arizona College of Medicine – Phoenix; Williams, Dana (The University of Arizona., 2019)
      A deep interarytenoid notch (DIN) is a normal congenital variation of the larynx where the interarytenoid notch height is below average. It is frequently found in young children and often associated with dysphagia and aspiration. The Aerodigestive Clinic (ADC) at PCH reported that 30% of young patients presenting with dysphagia and aspiration in 2013 were diagnosed with DIN. There exists both functional management with thickeners2 and surgical management with injection laryngoplasty (IL) 3-5. Thickener Wean Protocol (TWP) is a PCH developed 6 month protocol where thickening agents are systematically reduced on a weekly basis while clinical signs of aspiration, respiratory health, and oral motor skills are monitored to ensure safety with the least restrictive diet. An initial modified barium swallow (MBS) score is used in equivalence of thickener level, and patients do not repeat MBS during TWP. A gel (IL) is injected into the interarytenoid notch to close the anatomical gap. Our objective was to evaluate DIN patients who were managed with both thickeners and IL.
    • Determination of the Correlation Between Types of Strabismus and Certain Medical Conditions

      Warrington, Nicole; The University of Arizona College of Medicine – Phoenix; Salevitz, Mark (The University of Arizona., 2019)
      There are numerous subtypes of strabismus: esotropia where one eye deviates inward compared to the other, exotropia where one eye deviates outward compared to the other, hypertropia where one eyes is higher than the other, concomitant strabismus where the degree of deviation is the same in each gaze, incomitant strabismus where the degree of deviation varies in different gazes. Adult strabismus can be caused by various conditions including vasculopathic diseases (diabetes, hypertension, and stroke), compressive CNS lesions, myasthenia gravis, sensory strabismus, thyroid ophthalmopathy, multiple sclerosis, trauma, post-surgical strabismus, recurrent childhood strabismus, longstanding adult strabismus without proven cause, syndrome related strabismus, restrictive orbital masses, and congenital fibrosis of the extraocular muscles. It is currently unknown whether any of these underlying conditions correlate with a specific type of strabismus. The purpose of this study is to determine if underlying conditions correlate with a certain misalignment (i.e. esotropia, exotropia, hypertropia, concomitant, or incomitant). If there is a statistically significant correlation between a certain misalignment and systemic disease, this could add to the algorithm that physicians use to diagnose these systemic conditions. This was a retrospective review of 692 patients >=21 years of age who presented to a pediatric ophthalmologist with adult strabismus from September 2008 to September 2015. The inclusion criteria were: (1) an age of 21 years or older, (2) a confirmed diagnosis of new-onset or recurrent childhood strabismus, (3) any severity and type of deviation, and (4) documentation of diplopia in any field of gaze. The variables that were extracted from the files were: the type of misalignment (esotropia, exotropia, hypertropia, concomitant, incomitant) and the underlying disorder (vasculopathic diseases (diabetes, hypertension, and stroke), compressive central nervous system (CNS) lesions, myasthenia gravis, sensory strabismus, thyroid ophthalmopathy, multiple sclerosis, trauma, post-surgical strabismus, recurrent childhood strabismus, longstanding adult strabismus without proven cause, syndrome related strabismus, restrictive orbital mass caused strabismus, and congenital fibrosis). Interpretation of the data consisted of determining if a correlation between type of misalignment and underlying condition exists. The average age of the population is 60.5 years with a standard deviation of 16.9, of which 49.6% were male. Results of this study indicate that multiple conditions that cause strabismus have a proclivity to negatively or positively predict a certain type of strabismus. Specifically, post-surgical patients are more likely to have hypertropia than esotropia or exotropia, sensory strabismus patients are more likely to have exotropia. Adult patients with recurrent childhood strabismus are more likely to have exotropia and concomitancy. Compressive CNS lesions, thyroid ophthalmopathy, and traumatic causes of strabismus are more likely to cause incomitant strabismus. Vasculopathic causes of strabismus do not have a tendency to cause any certain type of strabismus. These findings will assist ophthalmologists in delineating a cause of their patient’s strabismus based on which types of strabismus correlate with certain conditions.
    • Does Animal Assisted Therapy (AAT) have an effect on mood in United States Veterans?

      Baumann, Alysa; The University of Arizona College of Medicine – Phoenix; Nelson, Erin (The University of Arizona., 2019)
      Research has shown benefit for United States veterans with service dogs and emotional support animals. However, the literature is lacking in research on the beneficial effects and impact of therapy animals specifically on the disabled veteran population. This pilot study explored the effects of a single therapy dog on various aspects of mood, including depression and anxiety, in disabled veterans by incorporating five weeks of thirty-minute therapy sessions to a group of eight veterans. Although this was a small sample population, we concluded that five weeks of consecutive animal assisted therapy resulted in a general decrease in anxiety and depression, and an overall positive increase in mood as evidenced by Beck Anxiety Inventory, Beck Depression Inventory, and Trauma Symptom Inventory scores. Further large-scale studies will need to be conducted with a greater number of participants to help support the data in this study.