Auburn Research Day 2021

Christopher G. Vann 1 ; Casey L. Sexton 1 ; Shelby C. Osburn 1 ; Morgan A. Smith 1 ; Cody T. Haun 2 ; Melissa N. Rumbley 1 ; Petey W. Mumford 3 ; Johnathon H. Moore 1 ; Carlton D. Fox 1 ; Bradley A. Ruple 1 ; Adil Bashir 4 ; Ronald J. Beyers 4 ; Darren T. Beck 1,5 ; Kaelin C. Young 1,5 ; Stuart M. Phillips 6 ; Michael D. Roberts 1,5* 1 School of Kinesiology, Auburn University; 2 Fitomics, LLC; 3 Department of Exercise Science, Lindenwood University; 4 MRI Research Center, Auburn University; 5 Edward Via College of Osteopathic Medicine - Auburn Campus; 6 Department of Kinesiology, McMaster University B i omed i ca l Resea rch | Med i ca l Res i dent / Pos t Doc tor a te Effects of High-Volume Versus High-Load Resistance Training on Skeletal Muscle Growth and Molecular Adaptations 038

Background: Recently there has been enthusiasm surrounding the differential training adaptations that result from higher-load (HL) versus higher-volume (HV) resistance training. The purpose of this study was to evaluate the effects of HL versus HV training on markers of skeletal muscle hypertrophy and strength, as well as a broad spectrum of molecular markers obtained from skeletal muscle biopsies. Methods: Trained college-age males (n=15, age: 23±3 years old; training age: 7±3 years; squat 1RM relative to body mass: 1.9) performed unilateral lower body training three days per week over six weeks, with one leg being randomly assigned to HV training and the other to HL training. Vastus lateralis (VL) biopsies were obtained prior to the start of the study (PRE), 72 hours following the last exercise bout (POST), and following 10 days of passive recovery (POSTPR). Body composition and strength tests were also performed at each testing session, and various biochemical assays were performed on muscle tissue. Local Problem: The over-prescription of antibiotics in the United States has become widespread, despite well-defined medical guidelines and extensive educational campaigns aimed at reducing antibiotic usage. Viral respiratory tract infections are the main culprit for which antibiotics are improperly prescribed. This inappropriate prescribing of antibiotics contributes to antimicrobial resistance (AMR), which causes roughly two million illnesses and 23,000 deaths annually in the United States. AMR is associated with increased healthcare costs, longer hospital stays and increased mortality rates. A company review was completed at a local urgent care center in Alabama to determine the appropriateness of prescribed antibiotics from November 2018 to February 2019. It was found that 51% of antibiotic prescriptions were given for viral respiratory conditions. The top three diagnoses for which antibiotics were inappropriately prescribed were acute pharyngitis, acute upper respiratory infection and acute bronchitis. Project Purpose: The purpose of this research project was to develop, implement and evaluate the effectiveness of an antibiotic stewardship program on the inappropriate prescribing of antibiotics in an urgent care setting aimed specifically at viral respiratory infections. This stewardship program involved only prescribing antibiotics for conditions which antibiotics have been proven clinically effective according to evidence-based treatment guidelines, as well as prescribing the correct type, dose and duration Christy Greenhalgh, DNP Auburn University School of Nursing, Auburn, Alabama 039

Results: Condition×time interactions were observed for unilateral leg extension 1RM (HL>HV at POST and POSTDL) and VL muscle cross-sectional area (post hoc tests indicated no significance between conditions over time). A main effect of condition was observed for unilateral leg extension 1RM (HL>HV) and sarcoplasmic protein concentrations (HV>HL). A main effect of time was observed for unilateral leg press 1RM (PREPOST and POSTDL). Conclusion: In summary, our data suggest that short-term HV and HL training elicit similar hypertrophic, strength, and molecular adaptations.

Cl i n i ca l Resea rch | Med i ca l Facu l t y Quality Improvement Project to Combat Over-Prescription of Antibiotics Through an Antibiotic Stewardship Program

for the patient. The overall goal of the program was to reduce the prescribing of antibiotics for viral respiratory infections. Methodology: For the purpose of this research project, Azjen’s Theory of Planned Behavior was used to evaluate prescribers’ attitudes, subjective norms and perceived behavioral control in deciding whether to prescribe antibiotics. The findings were used to evaluate the prescribing behavior of providers. Evidence- based educational information was selected based on prescribing behaviors and emailed to the healthcare providers in the practice once weekly. During the program, patient educational materials were placed in patient rooms, a large educational banner was placed in the waiting room and providers were sent weekly educational emails regarding appropriate antibiotic prescribing practices. Results: The antibiotic stewardship program was implemented from February 1, 2020 through February 29, 2020. Patient charts meeting inclusion criteria with diagnoses of acute pharyngitis, acute upper respiratory infection and acute bronchitis were reviewed for treatment plans. It was found that the overall prescribing rate for the selected viral conditions was 45%, which is a reduction of 11.77% from the same time frame during the previous year. Implications for Practice: Antibiotic prescribing practices can be improved by implementing an antibiotic stewardship program in outpatient urgent care centers.

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