2019 CMDA National Convention Program

WELCOME Welcome to this year’s National Convention as we celebrate God’s faithfulness over the last 25 years!

Wow, it is hard to believe it has been that long since I sat down behind my desk on my first day with the ministry in Richardson, Texas and thought, “What in the world do I do first?” I knew little about CMDA, but I knew God had clearly called me to lead this organization, and I also knew that He who began a good work in me promised to accomplish it, because He is faithful!

Since then, God has been transforming CMDA on a daily basis into what He wants it to be. And over the years, He has used this organization as His vehicle to transform you and me and tens of thousands of healthcare professionals. Then, through their faithful witness and service, they have touched millions of patients’ hearts and lives.

General

God has grown our membership to nearly 20,000 members, and we regularly influence almost twice that number. We now have CMDA student chapters on 312 campuses where we train young healthcare professionals how to integrate their faith into their practice. At the same time, we’ve also widened our borders, and now Christian brothers and sisters who are physician assistants, advanced nurse practitioners, optometrists and physical therapists are part of our great organization.

CMDA has grown to more than 40 ministries, while outreaches that have existed for longer than I have been CEO have markedly expanded. We have more than 140 full-time and part-time staff members, with most of them spread out across the country serving at the local level. The real ministry multipliers are the 3,200+ volunteers who contribute their time and service on 80 mission teams a year, lead local ministry groups, serve as student leaders and campus advisors, teach in 90 Side By Side groups, serve as one of our 65 state directors for CMDA’s American Academy of Medical Ethics or serve as members of committee, sections, commissions or on the Board of Trustees.

CMDA provides the framework to enable transformed healthcare professionals to pursue their ministry passions to transform the world.

In 1994, CMDA had no voice in public policy. Today, your voice is heard in Washington, D.C., as well as in state capitals around the country. We have trained more than 200 members to speak out through radio, TV and print. CMDA gives 200 to 300 media interviews annually, has signed on to over 60 court briefs and brought successful court suits to protect your right of conscience. More than 30 organizations use our Freedom2Care website that seeks to protect right of conscience in healthcare. Plus, we have helped place numerous members into government positions. In addition, our members, the media, churches and government officials utilize our 60+ public policy statements regarding a variety of bioethical issues facing healthcare today.

The Global Missions Health Conference was conceptualized on a Global Health Outreach mission trip to Zambia many years ago, and we brought many of the initial sponsoring organizations together. Today it attracts 3,000 attendees and more than 200 exhibitors on an annual basis. It has been the single greatest influence in creating a renaissance in healthcare missions. Through our Center for Medical Missions, we mentor students and residents called to missions during their long years of education, train new medical missionaries and then help sustain them on the field. CMDA’s Christian Medical & Dental Education Conference annually provides 10 days of spiritual renewal and medical education for 600 to 900 missionaries and their children. The Pan-African Academy of Christian Surgeons has trained 88 national missionary surgeons, plus 92 more residents are in training today. Our Malpractice, Human Trafficking and Marriage Commissions are educating and meeting countless needs. Our resources and services equip our members through our Placement Services, the Center for Well-being, publications, Christian Doctor’s Digest, Grace Prescriptions and much more.

God has done all this, and He’s given you and me the joy of being part of it! We have much to thank Him for, so let’s celebrate and rejoice!

David Stevens, MD, MA (Ethics) Al Weir, MD Chief Executive Officer President

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TA B L E O F C O N T E N T S 3

General Daily Schedule.......................................................................................................................................... 4 Campus Maps.......................................................................................................................................... 5 Breakout Sessions..................................................................................................................................... 7 Devotions & Worship............................................................................................................................... 11 Special Events........................................................................................................................................... 12

16

Thursday Daily Schedule ......................................................................................................................................... 17 Plenary Session 1...............................................................................................................................18

Friday Daily Schedule.......................................................................................................................................... 21 Plenary Session 2...................................................................................................................................... 22 Breakout Sessions..................................................................................................................................... 24 Legacy Celebration............................................................................................................................30

32

Saturday Daily Schedule.......................................................................................................................................... 33 Commissioning Service............................................................................................................................ 34 Breakout Sessions..................................................................................................................................... 36

46

Sunday Daily Schedule.......................................................................................................................................... 47

48

Connections Our Sponsors............................................................................................................................................ 49 Exhibitor Map.......................................................................................................................................... 50 Exhibitor Booth Locations........................................................................................................................ 51 Exhibitor Information.............................................................................................................................. 52 Exhibitor Advertisements.......................................................................................................................... 62 VIE Poster Session.................................................................................................................................... 73 Continuing Education Information.......................................................................................................... 114 Session Evaluation.................................................................................................................................... 119 2020 Registration Form............................................................................................................................ 123

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General

20

D A I LY S C H E D U L E Thursday, May 2 4 - 7 p.m.

Registration Check-in / Welcome Reception

Pritchell Lobby

5:30 - 6:30 p.m.

Dinner

Rhododendron

7 - 9 p.m.

Plenary Session 1 — John Stonestreet

Spilman Auditorium

9:30 - 10:30 p.m.

Bookstore Open House and Book Signings

Pritchell 1

9:30 - 10:30 p.m.

Singles’ Reception

Spilman Deck

7:15 - 8:15 a.m.

Breakfast

Rhododendron

7:15 - 7:45 a.m.

Regional Breakfasts

Johnson Spring

7:45 - 8:45 a.m.

Regional Meetings

Johnson Spring

9 - 10:15 a.m.

Devotions — ­ Rev. Stan Key

Spilman Auditorium

10:15 - 11 a.m.

Coffee Break / Exhibit Hall / Heart to Heart Fellowship

Spilman Deck / Spilman 2

11 a.m. - 12:30 p.m.

Plenary Session 2 — Nancy Pearcey, MA

Spilman Auditorium

12:30 - 1:15 p.m.

Lunch

Rhododendron

12:30 - 2:30 p.m.

Estate Planning Luncheon and Seminar

Johnson Spring 1 ABEF

1:30 - 5 p.m.

Breakout Sessions

Various Locations

2:45 - 5 p.m.

VIE Poster Sessions

Johnson Spring 5

3 - 4 p.m.

American Academy of Medical Ethics State Director Meeting

Johnson Spring 3

3 - 5 p.m.

Christian Physical Therapists International Meet and Greet

Johnson Spring 1 DH

5:15 - 6 p.m.

Psychiatry Section Dinner

Johnson Spring 1 ABEF

5:30 - 6:30 p.m.

Dinner

Rhododendron

7 - 8:45 p.m.

Legacy Celebration — David Stevens, MD, MA (Ethics)

Spilman Auditorium

8:45 - 9:30 p.m.

Farewell Reception

Rhododendron

9:30 - 11 p.m.

Women Physicians in Christ Game Night

Mt. Laurel Lobby

9:45 - 10:30 p.m.

Student, Resident and Fellow Bonfire

Mt. Laurel Fire Ring

General

Friday, May 3

Saturday, May 4 7:15 - 8:15 a.m.

Breakfast

Rhododendron

7:15 - 8:45 a.m.

Women Physicians in Christ Breakfast

Johnson Spring 1 ABEF

7:30 - 8:45 a.m.

Past Presidents Breakfast

Johnson Spring 1 DH

7:30 - 8:45 a.m.

Fellowship of Christian Optometrists, International Council Breakfast

Johnson Spring 1 CG

9 - 10:15 a.m.

Commissioning Service for Mike Chupp, MD

Spilman Auditorium

10:15 - 11 a.m.

Coffee Break / Exhibit Hall / Heart to Heart Fellowship

Spilman Deck / Spilman 2

11 a.m. - 12:30 p.m.

Plenary Session 3 — Rev. Stan Key

Spilman Auditorium

12:30 - 1:15 p.m.

Lunch

Rhododendron

1:30 - 5:30 p.m.

Breakout Sessions

Various Locations

1:30 - 5:30 p.m.

National Student Community Meeting and Fellowship

Johnson Spring 1 CG

1:30 - 5:30 p.m.

National Resident & Fellow Council Meeting and Fellowship

Johnson Spring 5

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SCHEDULE AND MAP 3:45 - 4:30 p.m.

Coalition of Christian Nurse Practitioners and Fellowship of Christian Physician Assistants Fellowship

Johnson Spring 1 ABEF

5:30 - 6:30 p.m.

Dinner

Rhododendron

5:30 - 6:30 p.m.

Dental Dinner

Rhododendron

7 - 8 p.m.

Concert — Stephanie Seefeldt

Spilman Auditorium

8:30 - 9:30 p.m.

Global Health Outreach Reception

Johnson Spring 1 ABEF

8:30 - 9:30 p.m.

Medical Education International Reception

Johnson Spring 2C

8:30 - 10:30 p.m.

Women Physicians in Christ Bonfire

Ivy Fire Ring

7:15 - 8:15 a.m.

Breakfast

Rhododendron

9 - 10:30 a.m.

Worship Service — Rev. Stan Key

Spilman Auditorium

Sunday, May 5

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General

CAMPUS MAPS

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B R E A KO U T S E S S I O N S We encourage you to design your day to meet your unique needs. We’ve packed a great deal of information into the convention, so feel free to move in and out of the breakout sessions. Complete session descriptions are available for your use throughout the rest of the program.

Medical Track Johnson Spring 2A

Ethics Track The Robert Orr Lecture Series in Bioethics

Johnson Spring 3 FR ID AY

F RI DAY 1:30 - 2:30 p.m.

Group Dynamics, Human Nature and Medical Decision: Tales of Strange Smoke, Admiral’s Eye and Unmistakable Lines

SATU R D AY

Nancy Pearcey, MA 1 Hour CME and CDE

S AT U R D AY

1:30 - 2:30 p.m.

Ethics, Human Nature and Evidence-based Medicine Burton Lee, MD 1 Hour CME and CDE

1:30 - 2:15 p.m.

Bringing Transparency to the Treatment of Transgender Persons Quentin Van Meter, MD .75 Hour CME and CDE

2:45 - 3:45 p.m.

Marijuana: An Honest Look at the World’s Most Misunderstood Weed James Avery, MD 1 Hour CME and CDE

2:15 - 3 p.m.

The Trajectory from Transhumanism to Transgenderism Christopher Hook, MD .75 Hour CME and CDE

4:30 - 5:30 p.m.

Science, Faith and Healthcare: Unapologetic Apologetics for the Christian Caregiver William Griffin, DDS 1 Hour CME and CDE

3:15 – 4 p.m.

Is Assisted Death in Patients’ Best Interest?

William P. Cheshire, Jr., MD, MA (Ethics) .75 Hour CME and CDE

4 – 4:45 p.m.

Panel Discussion: Cases and Questions Moderator: William P. Cheshire, Jr., MD, MA (Ethics) .75 Hour CME and CDE

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General

Burton Lee, MD 1 Hour CME and CDE

1:30 - 2:30 p.m.

Where Did Transgender Ideology Come From and How Is It Changing the Legal Landscape for Everyone?

B R E A KO U T S E S S I O N S We encourage you to design your day to meet your unique needs. We’ve packed a great deal of information into the convention, so feel free to move in and out of the breakout sessions. Complete session descriptions are available for your use throughout the rest of the program.

Spiritual Life/Family Track

Center for Well-being Track

Johnson Spring 2C

Johnson Spring 2B

General

F R IDAY

FR ID AY

1:30 - 2:30 p.m.

The Joy of Aging Well in Retirement Hal Habecker, DMin

SAT UR D AY 1:30 - 2:30 p.m.

The ABCD’s of Raising Happy, Healthy Children and Teens Walt Larimore, MD, and Barb Larimore

2:45 - 3:45 p.m.

Conflict Resolution Robert Puleo, DDS

4:30 - 5:30 p.m.

What Part of “No” Do You Not Understand Grat Correll, MD

1:30 - 2:30 p.m.

The Road to Well-being: Charting a Course Steve Sartori, MD 1 Hour CME and CDE

2:45 - 3:45 p.m.

The Road to Well-being: Describing the Destination Stan Haegert, MD, MPH 1 Hour CME and CDE

4 - 5 p.m.

The Road to Well-being: Dealing with Moral Injury and Trauma Frauke Schaefer, MD 1 Hour CME and CDE

Being an Everyday Missionary Johnson Spring 2A FR ID AY 2:45 - 3:45 p.m. and 4 - 5 p.m.

Spiritual Interventions in Clinical Care, Parts 1 and 2 Walt Larimore, MD 2 Hours CME and CDE

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B R E A KO U T S E S S I O N S We encourage you to design your day to meet your unique needs. We’ve packed a great deal of information into the convention, so feel free to move in and out of the breakout sessions. Complete session descriptions are available for your use throughout the rest of the program.

Psychiatry Track

Dental Track

Johnson Spring 2B

Johnson Spring 1 DH

SATUR D AY

S AT U R D AY 1:30 – 2:30 p.m.

What is a Truly “Successful” Dental Practice?

Peter Dawson, DDS 1 Hour CDE

2:45 - 3:45 p.m.

Transgender Youth: Developmental, Family and Worldview Perspectives Allan M. Josephson, MD 1 Hour CME and CDE

2:45 – 3:45 p.m.

Pursuing Excellence in Dentistry Without Sacrificing Your Faith William “Bo” Bruce, DMD 1 Hour CDE

4:30 - 5:30 p.m.

Transgender Issues: Going Deeper Allan Josephson, MD, and Nancy Pearcey, MA

4:30 – 5:30 p.m.

Motivating, Educating and Equipping the Next Generation of Leaders in Dentistry Jeff Amstutz, DDS, MBA 1 Hour CDE

Follow Along on Your Mobile Device Visit www.cmda.org/conventionprogram to access the electronic version of the program.

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General

1:30 - 2:30 p.m.

Starbucks, Quantum Physics and Christian Love: Searching for Joy Practicing Today’s Medicine Tom Okamoto, MD 1 Hour CME and CDE

B R E A KO U T S E S S I O N S We encourage you to design your day to meet your unique needs. We’ve packed a great deal of information into the convention, so feel free to move in and out of the breakout sessions. Complete session descriptions are available for your use throughout the rest of the program.

Fellowship of Christian Optometrists (FCO) Track Johnson Spring 4

General

F R IDAY

S AT U R D AY

1:30 - 2:30 p.m.

Omega Fatty Acids: Revisiting Our Chair-side Recommendation Kevin Harris, OD 1 Hour COE

1:30 - 2:30 p.m.

Recent Changes in Ophthalmic Lenses: Specialty Tints and Progressives Clifford Brooks, OD 1 Hour COE

2:45 - 3:45 p.m.

Corneal Collagen Crosslinking for the Treatment of Keratoconus Lon EuDaly, OD 1 Hour COE

2:45 - 3:45 p.m.

Update on Convergence Insufficiency Kelly Frantz, OD 1 Hour COE

4 - 5 p.m.

The Refractive Surgery Cataract Patient: Psychology and Technical Challenges Lon EuDaly, OD 1 Hour COE

4:30 - 5:30 p.m.

Binocular Vision Case Management Using Prism Kelly Frantz, OD 1 Hour COE

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DEVOTIONS & WORSHIP Devotions with Rev. Stan Key

Stan Key has been president of The Francis Asbury Society (FAS) since 2014. He is married to Katy, and they have three children and seven grandchildren. Before coming to FAS, Stan served for 10 years as a missionary in Europe and for 18 years as pastor of an independent church in Albany, New York.

Stan also is a member of the boards of One Mission Society and Sammy Tippit Ministries. He speaks frequently in churches, conferences, retreats and camps, both in the U.S. and abroad. Stan is the author of The Last Word (Warner Press, 2015), a study on the book of Revelation; Marriage Matters (Francis Asbury Press, 2017); and Jeremiah: Fire in His Bones (Warner Press, 2017).

General

Worship with Stephanie Seefeldt

Stephanie Seefeldt loves to lead God’s people in congregational worship, using the best of both historic hymnody and modern worship music. She has worked as the worship leader in megachurches, neighborhood parishes and everywhere in between. She served at Elmbrook Church in Milwaukee, Wisconsin under the leadership of Stuart and Jill Briscoe. As part of the worship leadership team of Anne Graham Lotz’s Just Give Me Jesus event, Stephanie has sung at venues as historic as London’s Royal Albert Hall and as large as Atlanta’s Philips Arena, but her true passion continues to be the local church. At Trinity Church in Baraboo, Wisconsin, where her husband Scott is the pastor, she serves as organist and worship coordinator, as well as women’s ministry and communications director. Stephanie and Scott have four children.

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SPECIAL EVENTS In addition to the robust schedule of encouraging, challenging and stimulating sessions, there are also a mixture of events focused specifically for students, residents and fellows. These special events are designed to help you connect with fellow Christians who are in healthcare training.

Special Events for Students, Residents and Fellows from CMDA’s Campus & Community Ministries Student/Resident Lounge

General

Johnson Spring 5 — Open throughout the entire convention Available for all students, residents and fellows to relax and fellowship with others.

VIE Poster Session

Friday, May 3 ­— 2:45 - 5 p.m.

Johnson Spring 5 See page 73 of the program for more information about the poster session.

Bonfire

Friday, May 3 — 9:45 p.m.

Mt. Laurel Fire Ring

National Student Community Meeting and Fellowship

Saturday, May 4 — 1:30 - 2:30 p.m.

Johnson Spring 1 CG All students are welcome to learn more about the National Student Community.

National Resident & Fellow Council Meeting and Fellowship Saturday, May 4 — 1:30 - 2:30 p.m.

Johnson Spring 5 All fourth year healthcare students, residents and fellows are welcome.

Student and Resident Group Photos Saturday, May 4 — 2:30 p.m.

Outside of Johnson Spring (Pond Side)

Student and Resident Hike: Rattlesnake, Copperhead and Lookout Peaks Saturday, May 4 — 2:45 - 5:30 p.m.

Meet outside of Johnson Spring All students, residents, fellows and adventurers are welcome.

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SPECIAL EVENTS CMDA Bookstore Hours Located in Pritchell 1 Thursday, May 2 4 - 7 p.m.

Conference Check-in

9:30 - 10:30 p.m.

Bookstore Open House

Special Bookstore Discounts

Friday, May 3 8 - 11 a.m.

1:30 - 7 p.m.

Saturday, May 4 8 - 11 a.m.

Get 25% off wall art.

1:30 - 7 p.m.

Sunday, May 5 8 - 9 a.m.

Clearance items available!

Last Chance to Purchase Materials

Shop early, quantities are limited.

Estate Planning Luncheon and Seminar Friday, May 3 • 12:30 - 2:30 p.m.

Johnson Spring 1 ABEF Guest Speaker — Brandon Davis

Leveraging Generosity: Struggles, Tools and Trends to Maximize Charitable Impact Please register at the Information Desk in Spilman Lobby.

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General

Receive 10% off your order when you show your CMDA Member ribbon, plus 10% off with your First Time Attendee ribbon.

SPECIAL EVENTS Regional Breakfasts and Meetings Friday, May 3

7:15 - 7:45 a.m. — Regional Breakfasts 7:45 - 8:45 a.m. — Regional Meetings Join your regional director for fellowship and to hear what CMDA is doing in your region. A breakfast buffet will be set up in the hallway of Johnson Spring 2 for the South, Midwest and Northeast Regions. A separate buffet will be set up inside Johnson Spring 1 ABEF for the Western Region.

General

Region

Regional Director

Location

Midwest

Allan Harmer, ThM, DMin Akeem Walker, DMin, MDiv Grant Hewitt, MDiv Michael McLaughlin, MDiv

Johnson Spring 2A Johnson Spring 2B Johnson Spring 2C Johnson Spring 1ABEF

Northeast South Western

Women Physicians in Christ Activities Women Physicians in Christ is an outreach ministry of CMDA to provide resources for Christian women physicians and dentists to integrate their personal, professional and spiritual lives. We encourage and support Christian women and physicians as we share the unique challenges of our multiple roles.

Friday, May 3

Saturday, May 4

Saturday, May 4

WPC Game Night WPC Breakfast WPC Bonfire 9:30 - 11 p.m.

7:15 - 8:45 a.m.

8:30 - 10:30 p.m.

Mt. Laurel Lobby Johnson Spring 1 ABEF Ivy Fire Ring

Fellowship for Women Friday and Saturday Mornings 10:15 - 11 a.m.

Spilman 2

All women attending the convention are invited to join us for coffee and a time of fellowship before the next plenary session begins. We hope you will join us!

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SPECIAL EVENTS The Robert Orr Lecture Series in Bioethics

Specialty Sections Fellowship Are you interested in getting involved with a CMDA Specialty Section? Organized by CMDA members who wish to connect with their colleagues, Specialty Sections give you a chance to network and provide a voice for your area of specialty. For more information, visit www.cmda.org/specialtysections.

Friday, May 3 Saturday, May 4

Christian Physical Therapists International Meet and Greet Fellowship of Christian Optometrists, International 3 - 5 p.m. Council Breakfast Johnson Spring 1 DH 7:30 - 8:45 a.m.

Johnson Spring 1 CG

Friday, May 3 Saturday, May 4

Psychiatry Section Dinner Fellowship of Christian Physician Assistants 5:15 - 6 p.m. and Coalition of Christian Nurse Practitioners Fellowship Johnson Spring 1 ABEF 3:45 - 4:30 p.m.

Johnson Spring 1 ABEF

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General

Dr. Robert Orr received his MD,CM from McGill University in 1966, did residency training in family medicine and practiced in Vermont for 18 years. He was named Vermont Family Doctor of the Year in 1989. Since completing a fellowship in clinical ethics at the University of Chicago in 1990, he has held professorships at Loma Linda University School of Medicine (California), University of Vermont College of Medicine, Trinity International University (Illinois) and the Graduate College of Union University (New York). He continues to teach in two other graduate programs. He has lectured widely and has authored, co-authored or co-edited five books, 16 book chapters and more than 150 articles on ethics, ethics consultation and end-of-life care. His most recent book is Medical Ethics and the Faith Factor. He has been an active CMDA member for nearly 50 years and currently serves on the Board of Trustees.

“The steadfast love of the Lord never ceases; his mercies never come to an end; they are new every morning; great is your faithfulness.”

—Lamentations 3:22-23, ESV

D A I LY S C H E D U L E Thursday, May 2 4 - 7 p.m.

Registration Check-in / Welcome Reception

Pritchell Lobby

5:30 - 6:30 p.m.

Dinner

Rhododendron

7 - 9 p.m.

Plenary Session 1 — John Stonestreet

Spilman Auditorium

9:30 - 10:30 p.m.

Bookstore Open House and Book Signings

Pritchell 1

9:30 - 10:30 p.m.

Singles’ Reception

Spilman Deck

Thursday

Take Time to Pray While you are at Ridgecrest Conference Center, be sure to spend time in prayer throughout the National Convention. If you need someone to pray with you about specific concerns, please visit the Johnson Spring Boardroom on the third floor of Johnson Spring on Friday and Saturday mornings from 7 - 9 a.m. There will be individuals there to share your burden as you go before the throne.

Whether you are praying alone or with newfound friends, you will definitely leave feeling renewed and refreshed after spending some quiet time with the Lord.

“What am I to do? I will pray with my spirit, but I will pray with my mind also; I will sing praise with my spirit, but I will sing with my mind also.”

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P L E N A RY S E S S I O N 1 Speaker Information

John Stonestreet

Thursday

President, Colson Center for Christian Worldview Colorado Springs, Colorado As President of the Colson Center for Christian Worldview, John’s passion is to illuminate a biblical worldview for today’s culture. He is a speaker, writer, cultural commentator and collaborator of worldview initiatives. John directs conferences and curriculum projects, speaks to groups nationally and internationally, consults on worldview education for schools and churches, and appears frequently on web and radio broadcasts. John is the co-host with Eric Metaxas of Breakpoint Radio, the Christian worldview radio program founded by the late Chuck Colson. He is also co-host of BreakPoint This Week with Ed Stetzer, and the voice of the Point, a daily national radio feature on worldview, apologetics and cultural issues. Prior to his current role, John worked in various capacities with Summit Ministries including executive director, overseeing the various aspects of the ministry to accomplish its mission of cultivating rising generations to resolutely champion a biblical worldview. Prior to working with Summit and The Colson Center, John was on the teaching faculty of Bryan College where he helped to develop a Christian worldview sequence for the core curriculum, as well as several non-traditional educational opportunities. John holds a master of arts in Christian thought from Trinity Evangelical Divinity School. He is co-author of Restoring All Things: God’s Audacious Plan to Change the World through Ordinary People (with Warren Cole Smith), of Same-Sex Marriage: A Thoughtful Approach to God’s Design for Marriage (with Sean McDowell), and Making Sense of Your World: A Biblical Worldview (with W. Gary Phillips and William E. Brown). John and his wife Sarah were married in 2002. They and their three daughters and son live in Colorado Springs, Colorado.

Session Information

What is Our Salvation For? Bringing Restoration into Our Current Cultural Moment

The gospel is more than just how sinners are saved, as marvelous as that is. The gospel is a full vision of life. This means that we, as Christians, have a role to play in bringing truth to whatever cultural situation we find ourselves in.

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NOTES

Thursday

Welcome Reception Thursday, May 2 • 4 - 7 p.m.

Pritchell Lobby Sponsored by Christian Healthcare Ministries

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“For you are great and do wondrous things; you alone are God. Teach me your way, O Lord, that I may walk in your truth...I give thanks to you, O Lord my God, with my whole heart, and I will glorify your name forever. For great is your steadfast love toward me...But you, O Lord, are a God merciful and gracious, slow to anger and abounding in steadfast love and faithfulness.”

—Psalm 86:10-15, ESV

D A I LY S C H E D U L E Friday, May 3 Breakfast

Rhododendron

7:15 - 7:45 a.m.

Regional Breakfasts

Johnson Spring

7:45 - 8:45 a.m.

Regional Meetings

Johnson Spring

9 - 10:15 a.m.

Devotions — Rev. Stan Key

Spilman Auditorium

10:15 - 11 a.m.

Coffee Break / Exhibit Hall / Heart to Heart Fellowship

Spilman Deck / Spilman 2

11 a.m. - 12:30 p.m.

Plenary Session 2 — Nancy Pearcey, MA

Spilman Auditorium

12:30 - 1:15 p.m.

Lunch

Rhododendron

12:30 - 2:30 p.m.

Estate Planning Luncheon/Seminar

Johnson Spring 1 ABEF

1:30 - 5 p.m.

Breakout Sessions

Various Locations

2:45 - 5 p.m.

VIE Poster Sessions

Johnson Spring 5

3 - 4 p.m.

American Academy of Medical Ethics State Director Meeting

Johnson Spring 3

3 - 5 p.m.

Christian Physical Therapists International Meet and Greet

Johnson Spring 1 DH

5:15 - 6 p.m.

Psychiatry Section Dinner

Johnson Spring 1 ABEF

5:30 - 6:30 p.m.

Dinner

Rhododendron

7 - 8:45 p.m.

Legacy Celebration — David Stevens, MD, MA (Ethics)

Spilman Auditorium

8:45 - 9:30 p.m.

Farewell Reception

Rhododendron

9:30 - 11 p.m.

Women Physicians in Christ Game Night

Mt. Laurel Lobby

9:45 - 10:30 p.m.

Student, Resident and Fellow Bonfire

Mt. Laurel Fire Ring

Morning Devotions with Rev. Stan Key Three Dangerous Prayers—Lord, I Want to Be Great in Your Kingdom Mark 10:36-45

In his three messages, Stan challenges us to high-risk praying in a play-it-safe world. Using James and John, Rachel and Jesus as models for how to pray, Stan dares us to pray audaciously. Such prayers will be costly, but they have the power to change the world!

Prayer Number One — When James and John asked Jesus to make them great in His kingdom, Jesus told them they didn’t know what they were asking. And yet, Jesus responded to their ill-conceived request by answering their prayer in a way they never could have imagined.

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Friday

7:15 - 8:15 a.m.

P L E N A RY S E S S I O N 2 Speaker Information

Nancy Pearcey, MA

Friday

Bestselling Author, Professor of Apologetics and Scholar in Residence Houston Baptist University Nancy Pearcey is the author of the newly released Love Thy Body: Answering Hard Questions about Life and Sexuality. She is professor and scholar in residence at Houston Baptist University and editor at large of the Pearcey Report. Her earlier books include The Soul of Science, Saving Leonardo and two ECPA Gold Medallion Award Winners: Total Truth and (coauthored with Harold Fickett and Chuck Colson) How Now Shall We Live? Hailed in The Economist as “America’s pre-eminent evangelical Protestant female intellectual,” she has spoken at universities such as Princeton, Stanford, University of Southern California and Dartmouth.

Session Information

Defending Sexual Truth in a Sexual Age 1 Hour CME and CDE

Nancy Pearcey takes on the headline issues of our day: abortion, assisted suicide, homosexuality, transgenderism and more. We often treat these issues separately, but Pearcey shows that we will be much more effective if we realize they all rest on a radically dehumanizing secular worldview that denigrates the body and demeans the person. By contrast, she shows how to craft the biblical ethic in a way that is more positive and more appealing than the secular ethic.

At the conclusion of this program, participants should be able to: • Describe the secular worldview that underlies current bioethical issues.

• Analyze the common themes that connect abortion, euthanasia, homosexuality and transgenderism.

• Discuss well-reasoned arguments for a Christian worldview on bioethical issues.

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NOTES

Friday 2019 CMDA National Convention │ 23

B R E A KO U T S E S S I O N S 1:30 - 2:30 p.m.

Center for Well-being Track — Johnson Spring 2B The Road to Well-being: Charting a Course 1 Hour CME and CDE Steve Sartori, MD Director, CMDA Center for Well-being

Burnout is a well-defined, work-related syndrome, described as “an erosion of the soul,” and it is recognized as a national epidemic, posing a serious threat to healthcare professionals, patients and the healthcare system. The prevention and management of burnout requires charting a course to wellbeing. Attendees will clarify the destination and identify their starting point.

Friday

At the conclusion of this program, participants should be able to: • Define well-being.

• Identify determinants of well-being.

• Describe personal well-being status.

2:45 - 3:45 p.m.

Center for Well-being Track — Johnson Spring 2B The Road to Well-being: Describing the Destination 1 Hour CME and CDE Stan Haegert, MD, MPH Associate Director, CMDA Center for Well-being

Burnout seems to be the common destination of many healthcare professionals. While well-being is the preferred destination, the path to realizing it is often shrouded in confusion. Attendees will gain clarity around the concept of well-being and examine practical steps toward this preferred destination.

At the conclusion of this program, participants should be able to: • Define well-being.

• Discuss behaviors that enhance well-being.

• Design a plan for enhancing well-being.

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B R E A KO U T S E S S I O N S 4 - 5 p.m.

Center for Well-being Track — Johnson Spring 2B The Road to Well-being: Dealing with Moral Injury and Trauma 1 Hour CME and CDE Frauke Schaefer, MD

On the road to healthcare professional well-being, two common injuries need to be understood and sufficiently attended to: moral injury and traumatic stress. Without paying sufficient attention to them, exhaustion may linger. We will discuss common causes and how these injuries can affect bodies, minds and spiritual vitality. Being able to identify such injuries, healthcare professionals are empowered to more specifically address them in order to heal and even grow on their challenging journeys.

At the conclusion of this program, participants should be able to: Define moral injury and traumatic stress.

Name common causes of moral injury and traumatic stress in healthcare professionals.

Identify symptoms of moral injury and traumatic stress.

Use basic tools to address moral injury and traumatic stress.

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Friday

• • • •

B R E A KO U T S E S S I O N S 1:30 - 2:30 p.m.

FCO Track — Johnson Spring 4 Omega Fatty Acids: Revisiting Our Chair-side Recommendation 1 Hour COE Kevin Harris, OD Optometrist, Premier Eyecare Associates

This course discusses biochemistry of omega fatty acids and what clinicians should recommend to patients based on research that showed fish oil was no better than placebo at relieving dry eye symptoms or signs.

Friday

At the conclusion of this program, participants should be able to: • Discuss a recent study that showed taking fish oil did not prove to be better than a placebo at relieving the symptoms or signs of dry eye.

• Review the physiology of omega fatty acids and how they have been shown to provide a number of health benefits.

• Debate whether or not omega fatty acids should still be recommended to certain patients by optometrists.

2:45 - 3:45 p.m.

FCO Track — Johnson Spring 4 Corneal Collagen Crosslinking for the Treatment of Keratoconus 1 Hour COE Lon EuDaly, OD Clinical Optometrist, Discover Vision Centers

This course presents an overview of corneal collagen crosslinking. Early diagnosis and treatment of keratoconus, indications for corneal collagen crosslinking, patient evaluation and candidacy for treatment, postoperative management, complications and treatment outcomes are all discussed.

At the conclusion of this program, participants should be able to: • • • • •

Describe the basic anatomy and physiology of the human cornea.

Discuss the mechanism of keratoconus and post-LASIK ectasia.

Discuss the need for early detection and treatment of keratoconus.

Discuss traditional treatments for ectatic disorders and the role of corneal collagen crosslinking for ectatic disorders.

Identify pearls for post-op care of the corneal crosslinking patient.

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B R E A KO U T S E S S I O N S 4 - 5 p.m.

FCO Track — Johnson Spring 4 The Refractive Surgery Cataract Patient: Psychology and Technical Challenges 1 Hour COE Lon EuDaly, OD Clinical Optometrist, Discover Vision Centers

This course covers technical and psychological challenges of cataract patients with prior corneal refractive surgery. Limitations of IOL calculation formulas, refractive patient mindset, setting expectations preoperatively and refractive management of post-op outcomes will be discussed.

At the conclusion of this program, participants should be able to: Describe the mindset of the refractive surgery patient.

Discuss the importance of pre-op counseling (setting expectations).

Discuss the limitations of IOL calculation formulas.

Instill a working knowledge of the types of FDA-approved premium IOL’s currently available.

Instill confidence when performing post-operative care.

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Friday

• • • • •

B R E A KO U T S E S S I O N S 1:30 - 2:30 p.m.

Medical Track — Johnson Spring 2A Group Dynamics, Human Nature and Medical Decision: Tales of Strange Smoke, Admiral’s Eye and Unmistakable Lines 1 Hour CME and CDE Burton Lee, MD Professor of Medicine, University of Pittsburgh School of Medicine

Friday

Although clinical competence of the individual healthcare professional is undoubtedly essential for good patient outcome, much of patient care occurs through teamwork. Studies suggest that individuals behave very differently in isolation compared to group situations. Therefore, this lecture will explore how people behave in groups versus as an individual and then apply these concepts to patient care, especially how it may influence medical decisions, individual actions and patient outcomes.

At the conclusion of this program, participants should be able to: • Describe the positive and negative effects of group dynamics on medical decision-making.

• Describe common group dynamic phenomenon such as the bystander effect, willful blindness and social conformity as they apply to medical decision-making.

1:30 - 2:30 p.m.

Ethics Track — Johnson Spring 3

The Robert Orr Lecture Series in Bioethics

Where Did Transgender Ideology Come From and How Is It Changing the Legal Landscape for Everyone?

1 Hour CME and CDE Nancy Pearcey, MA Bestselling Author, Professor of Apologetics and Scholar in Residence, Houston Baptist University

In order to provide healthcare professionals with a better understanding of transgender ideology and its implications for managing patients, this session will explain the source of transgender ideology, as well its political consequences. Its philosophical source is postmodernism, which renders the mind and mental constructions predominant over the body and biology. Dr. Pearcey will give a brief history of the rise and development of postmodernism to demonstrate its relation to transgender ideology, illustrating through several examples. Finally, she explains the political consequences for identity, marriage and parenthood when the state no longer recognizes sex but only gender.

At the conclusion of this program, participants should be able to: • • • •

Describe the origin and development of postmodernism and how it led to transgender ideology.

List examples of transgender ideology.

Discuss philosophy of transgender ideology.

Identify the implications for healthcare professionals as they navigate the legal and ethical issues when managing transgender patients.

• Identify the implications for politics when the state does not recognize sex but only gender.

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B R E A KO U T S E S S I O N S 1:30 - 2:30 p.m.

Spiritual Life and Family Track — Johnson Spring 2C The Joy of Aging Well in Retirement

Hal Habecker, DMin Founder, Finishing Well Ministries; Former General Director, CMS (now CMDA) In this workshop we will aim to answer three questions: 1. What does aging well mean?

2. What does aging well look like?

3. Is it true that “the best is yet to be?”

Biblical answers to these questions are essential to finishing well in life.

4 - 5 p.m.

Being an Everyday Missionary — Johnson Spring 2A Spiritual Interventions in Clinical Care, Parts 1 and 2 2 Hours CME and CDE Walt Larimore, MD Family Physician and Author

Jesus is already doing everything necessary to make our participation in His mission simple. He brings sick and spiritually aware people to us every day. As healthcare professionals and spouses, people trust and respect us long before we’ve earned either. There is a distance between the pulpit and the pew that does not exist at the bedside. All we have to do is reorient our minds and ask Jesus: What are You up to today in my life and the life of those You bring into my life TODAY? How would You have me join You in Your work with those You bring into my life each day where You have currently planted me TODAY? Expect to be spiritually encouraged and equipped with practical and applicable principles to join Jesus in His daily mission to heal those He brings into our neighborhoods and practices each day.

At the conclusion of this program, participants should be able to: • Conduct a spiritual assessment.

• Discuss spirituality with patients when indicated.

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Friday

2:45 - 3:45 p.m.

Friday

L E G A C Y C E L E B R AT I O N

The Board of Trustees of the

Christian Medical & Dental Associations

requests the honor of your presence as we celebrate the 25 years of faithful leadership of

Dr. David Stevens and Dr. Gene Rudd Friday, May 3 • 7 p.m.

Spilman Auditorium

30 │ 2019 CMDA National Convention

NOTES

Friday 2019 CMDA National Convention │ 31

“Your steadfast love, O Lord, extends to the heavens, your faithfulness to the clouds.”

—Psalm 36:5, ESV

D A I LY S C H E D U L E Saturday, May 4 Breakfast

Rhododendron

7:15 - 8:45 a.m.

Women Physicians in Christ Breakfast

Johnson Spring 1 ABEF

7:30 - 8:45 a.m.

Past Presidents Breakfast

Johnson Spring 1 DH

7:30 - 8:45 a.m.

Fellowship of Christian Optometrists, International Council Breakfast

Johnson Spring 1 CG

7:30 - 9 a.m.

National Student Council Transition Breakfast

Rhododendron

9 - 10:15 a.m.

Commissioning Service for Mike Chupp, MD

Spilman Auditorium

10:15 - 11 a.m.

Coffee Break / Exhibit Hall / Heart to Heart Fellowship

Spilman Deck / Spilman 2

11 a.m. - 12:30 p.m.

Plenary Session 3 — Rev. Stan Key

Spilman Auditorium

12:30 - 1:15 p.m.

Lunch

Rhododendron

1:30 - 5:30 p.m.

Breakout Sessions

Various Locations

1:30 - 5:30 p.m.

National Student Community Meeting and Fellowship

Johnson Spring 1 CG

1:30 - 5:30 p.m.

National Resident & Fellow Council Meeting and Fellowship

Johnson Spring 5

3:45 - 4:30 p.m.

Coalition of Christian Nurse Practitioners and Fellowship of Christian Physician Assistants Fellowship

Johnson Spring 1 ABEF

5:30 - 6:30 p.m.

Dinner

Rhododendron

5:30 - 6:30 p.m.

Dental Dinner

Rhododendron

7 - 8 p.m.

Concert — Stephanie Seefeldt

Spilman Auditorium

8:30 - 9:30 p.m.

Global Health Outreach Reception

Johnson Spring 1 ABEF

8:30 - 9:30 p.m.

Medical Education International Reception

Johnson Spring 2C

8:30 - 10:30 p.m.

Women Physicians in Christ Bonfire

Ivy Fire Ring

Morning Devotions with Rev. Stan Key Three Dangerous Prayers—Not My Will But Yours Be Done Matthew 26:36-46

Prayer Number Two — Jesus’ prayer in the Garden of Gethsemane not only made possible the salvation of the world, but it also gave us the greatest model of prayer ever given. Philippians 2:1-11 reveals the motivation behind Jesus’ prayer by making known “the mind of Christ.” When we begin to pray like Jesus prayed, our prayers take on a power they never had before.

2019 CMDA National Convention │ 33

Saturday

7:15 - 8:15 a.m.

Saturday

COMMISSIONING

The Board of Trustees also requests that you join us as the celebration continues with the commissioning of

Dr. Mike Chupp who will become CMDA’s new Chief Executive Officer in September Saturday, May 4 • 9 a.m.

Spilman Auditorium

34 │ 2019 CMDA National Convention

NOTES

Saturday 2019 CMDA National Convention │ 35

B R E A KO U T S E S S I O N S 1:30 - 2:30 p.m.

Medical Track — Johnson Spring 2A Ethics, Human Nature and Evidence-based Medicine 1 Hour CME and CDE Burton Lee, MD Professor of Medicine, University of Pittsburgh School of Medicine

Clinicians encounter many ethical issues in practice of medicine. This lecture first explores ethics from the perspective of normal human nature including incentives and social reciprocity. The impact of this human nature on everyday medical practice, medical education, medical research and, ultimately, its implications for evidence-based medicine is discussed.

Saturday

At the conclusion of this program, participants should be able to: • Identify the issues of ethics and conflicts of interest in daily medical practice, education and research.

• Use the scientific evidence about human nature and ethics to interpret scientific research findings in proper perspective.

2:45 - 3:45 p.m.

Medical Track — Johnson Spring 2A Marijuana: An Honest Look at the World’s Most Misunderstood Weed

1 Hour CME and CDE James Avery, MD National Medical Director, Diversicare Healthcare; Visiting Assistant Professor of Medicine, University of Virginia People, including physicians and nurses, often have strong opinions about marijuana, and these opinions, at times, can obscure the scientific realities. This lecture is designed to help separate fact from opinion so that an honest understanding of marijuana will allow people to make educated choices about medical and recreational marijuana. In addition, with the robust belief that the Bible is the Word of God and that it speaks into our time and culture, we believe our faith provides critical insights into the marijuana questions.

At the conclusion of this program, participants should be able to: • Refute prevailing myths about marijuana.

• Discuss the cultural factors driving societal opinion concerning marijuana.

• Describe marijuana to your family members, patients and community.

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B R E A KO U T S E S S I O N S 4:30 - 5:30 p.m.

Medical Track — Johnson Spring 2A Science, Faith and Healthcare: Unapologetic Apologetics for the Christian Caregiver 1 Hour CME and CDE William Griffin, DDS CMDA Vice President of Dental Ministries

At the conclusion of this program, participants should be able to: • Identify the capabilities and limitations of the scientific method.

• Discuss the pros and cons for the necessity of spirituality in our everyday lives • Describe how to have a conversation with patients and colleagues about spirituality.

Don’t Miss a Session Did you miss a session? Or did you enjoy a breakout session so much that you want to experience it again?

Here is your chance! This is also a great opportunity to share the information with your colleagues and friends.

Throughout the convention, Christian Audio Tapes will be recording each session. CDs and mp3s will be available for purchase immediately after each session. Visit their booth located in the Spilman Lobby to purchase your copies of this year’s series of plenary and breakout sessions. You can also visit www.catapes. com to purchase recordings after you return home.

2019 CMDA National Convention │ 37

Saturday

Providing healthcare is a great door opener for spiritual conversations with our patients. However, significant obstacles exist. One of the biggest challenges is the fact that many see science and faith as mutually incompatible. They may view that which can be discerned empirically as certain and reliable, while that which can only be known by faith as subjective and untrustworthy. In response to this false dichotomy, this presentation will seek to equip Christian healthcare professionals with the knowledge and confidence of a sure foundation for communicating the matchless truth of the gospel within the context of everyday patient care.

B R E A KO U T S E S S I O N S 1:30 - 2:15 p.m.

Ethics Track — Johnson Spring 3

The Robert Orr Lecture Series in Bioethics

Bringing Transparency to the Treatment of Transgender Persons

Saturday

.75 Hour CME and CDE Quentin Van Meter, MD Pediatric Endocrinologist

Reviewing the history of the transgender movement is important in order to understand how the current transgender “industry” has been reborn. There are two pathways to management. The first involves extensive evaluation of the psychological basis upon which the decision of the transgender is built.

Treatment is exclusively supportive counseling of the patient, especially through the adolescent years by which time almost all patients identify with their biologic sex. The second pathway involves affirmation of the incongruent gender with counseling, interruption of puberty at its onset, treatment with cross-sex hormones and surgical alteration of the sex organs, both internally and externally. Pathway one leaves the patient unharmed and mentally healthy. Pathway two leaves the patient sterile, at increased risk of heart disease, stroke and cancer and increases mental health morbidity for the patient’s lifetime. It is imperative that all transgender patients be told about the risks and benefits of the path they choose to follow.

At the conclusion of this program, participants should be able to: • Use confidently the terminology of gender ideology.

• Describe the presence of psychological morbidity underlying the patient’s reason for gender incongruency.

• Describe how to compassionately care for and refer the patient to a mental health professional that is ethically and morally going to treat the patient without regard to political agendas.

2:15 - 3 p.m.

Ethics Track — Johnson Spring 3

The Robert Orr Lecture Series in Bioethics

The Trajectory from Transhumanism to Transgenderism .75 Hour CME and CDE Christopher Hook, MD Associate Professor of Hematology and Medicine, Mayo Clinic

Transhumanism, from its origins in the Enlightenment project to its current manifestations, has promoted the malleability of the human body and mind to the desires of the individual. A specific aspect of this fluidity has been sexual orientation and behavior. Transgenderism, with its desire to break down all biological, emotional, spiritual and social norms of what is means to be a gendered creation, is strongly aligned with transhumanism’s goals of breaking down all biological, emotional, spiritual and social norms of what it means to be human. This session will outline transhumanist philosophy and goals, as well as illustrate the connection between transhumanism and transgenderism.

At the conclusion of this program, participants should be able to: • Articulate the fundamentals of transhumanist philosophy and goals.

• List similarity between transhumanism and transgenderism.

38 │ 2019 CMDA National Convention

B R E A KO U T S E S S I O N S 3:15 - 4 p.m.

Ethics Track — Johnson Spring 3

The Robert Orr Lecture Series in Bioethics

Is Assisted Death in Patients’ Best Interest? .75 Hour CME and CDE William P. Cheshire, Jr., MD, MA (Ethics) Professor of Neurology, Mayo Clinic

At the conclusion of this program, participants should be able to: • Discuss the ethical principles relevant to arguments for and against physician-assisted suicide.

• Compare medical assistance in dying versus palliative care in regard to how they serve patients’ best interests.

• Critique proposals that would require physician participation in ending the lives of their patients.

4 - 4:45 p.m.

Ethics Track — Johnson Spring 3

The Robert Orr Lecture Series in Bioethics

Panel Discussion: Cases and Questions

.75 Hour CME and CDE Moderator: William P. Cheshire, Jr., MD, MA (Ethics) Panelists: Christopher Hook, MD; Quentin Van Meter, MD; and William Cheshire, Jr., MD, MA (Ethics) The faculty will discuss cases and address questions from the audience concerning topics previously covered in the Ethics Track, i.e. physician-assisted death, transgenderism, etc.

At the conclusion of this program, participants should be able to: • Identify the relevant ethical principles at issue for each of the cases discussed.

• Discuss examples of biblical wisdom that can provide guidance in situations that occur in opposition to public policy.

2019 CMDA National Convention │ 39

Saturday

Since the time of Hippocrates, an immutable tenet of medical ethics has been that the proper role of physicians is to heal and not to kill. This professional commitment, which has engendered society’s trust and allowed physicians to practice the healing arts with unique freedom, has increasingly been challenged by the claim that the patient’s autonomy is a moral absolute extending to the right to be killed or assisted in voluntary suicide. Which is truly in the patients’ best interest: ending suffering and the fear of being a burden by ending the patient’s life, or palliating symptoms, relieving pain and proving support and comfort? Do laws permitting medical assistance in death supersede medical ethics? Should laws that grant patients access to medical assistance in death mandate participation by physicians and other healthcare professionals?

B R E A KO U T S E S S I O N S 1:30 - 2:30 p.m.

Spiritual Life/Family Track - Johnson Spring 2C The ABCD’s of Raising Happy, Healthy Children and Teens Walt Larimore, MD, and Barb Larimore Family Physician and Author

Saturday

What are the basic principles of raising happy, healthy children? Barb and Walt Larimore as the parents of two highly healthy adults, and these CMDA Educators of the Year will share tips and trips they’ve learned from their 45-year marriage, the Scriptures and the parenting researchers. Whether you’re a parent-to-be, a parent or a grandparent, you’ll come learn and laugh your way to more satisfying and successful parenting.

2:45 - 3:45 p.m.

Spiritual Life/Family Track - Johnson Spring 2C Conflict Resolution Robert Puleo, DDS Dentist

All couples have differences and disagreements. The amount of disagreements is not related to marital happiness and much as HOW they are handled. This workshop will focus on tools to diffuse deadly destructive patterns in communicating and infuse respectful life-giving understanding to the marriage.

4:30 - 5:30 p.m.

Spiritual Life/Family Track - Johnson Spring 2C What Part of “No” Do You Not Understand Grat Correll, MD Family Physician

For many of us, there seems to be a disconnect between what the Bible promises and what we experience in real life. At times, we treat God as a vending machine, putting our prayers in, pushing C23 and hoping something falls from heaven. We even go as far as to judge God by what He does or doesn’t do for us. And when He doesn’t do what we have tried to manipulate Him to do, we conclude He has abandoned us. We fail to appreciate that those promises from Scripture don’t include a life of smooth sailing. We need the storms. Sometimes we need the ship to sink. As strange as it sounds, pain, suffering and even tragedy all have purposes in life. Adversity introduces a person to himself, showing us what we are truly made of. In this lecture, Dr. Correll explores how we can make sense of God’s goodness when everything seems bad. He hopes you will join him for an honest discussion of the paradox of adversity.

40 │ 2019 CMDA National Convention

B R E A KO U T S E S S I O N S 1:30 - 2:30 p.m.

Dental Track - Johnson Spring 1 DH What is a Truly “Successful” Dental Practice?

1 Hour CDE Peter Dawson, DDS Founder Emeritus, Dawson Academy for Advanced Dental Study Too many dentists have a false idea of what success is, so they have a distorted image of how to practice in a manner that achieves true success. Taking a biblical perspective as a health professional can be life changing.

Definitive examples of how that perspective can change a practice and a life will be explained.

At the conclusion of this program, participants should be able to: • Think through a process for changing any practice.

Dental Track - Johnson Spring 1 DH Pursuing Excellence in Dentistry Without Sacrificing Your Faith

1 Hour CDE William “Bo” Bruce, DMD Affiliate Assistant Professor, Medical University of South Carolina College of Dental Medicine Is it possible to stand firm in your faith in this era of political correctness? Learn how to be bold in your convictions while also pursuing excellence in your practice. Learn key elements necessary to give your patients stellar treatment and enjoy the journey along the way.

At the conclusion of this program, participants should be able to: • Learn key elements to give patients stellar treatment.

4:30 - 5:30 p.m.

Dental Track - Johnson Spring 1 DH Motivating, Educating and Equipping the Next Generation of Leaders in Dentistry 1 Hour CDE Jeff Amstutz, DDS, MBA CMDA Vice President for Dental Education

If not us, who? If not now, when? While many experienced dentists are trying to figure out how to move from success to significance, many new grads are approaching their professional careers in a way to gain experience while figuring out how to have an impact beyond the clinic. Together we cannot only impact oral health outcomes, but we can also impact people in significant ways that go beyond the dental operatory.

At the conclusion of this program, participants should be able to: • Articulate the potential outcomes of investing in young professionals to serve through dentistry.

• Describe the concept of “net producers versus net consumer” in meeting the increasing needs of marginalized populations.

• Describe the CMDA Dental Residency program’s efforts to increase dental care to marginalized populations around the world.

2019 CMDA National Convention │ 41

Saturday

2:45 - 3:45 p.m.

B R E A KO U T S E S S I O N S 1:30 - 2:30 p.m.

Psychiatry Track — Johnson Spring 2B Starbucks, Quantum Physics and Christian Love: Searching for Joy Practicing Today’s Medicine

Saturday

1 Hour CME and CDE Tom Okamoto, MD Adult and Adolescent Psychiatrist

How do well-meaning doctors try to help sick people and not succumb to the discouragements of 21st century healthcare? This 40-minute talk will begin with a discussion of today’s healthcare environment turning from the sacred healing doctor-patient relationship to the rise of professional burnout. Recent efforts of the industry to foster “physician wellness” and “resilience” will be reviewed. The emphasis on the doctor-patient relationship and the role of healer will be renewed through recent concepts in the social sciences, quantum physics and the philosophy of information that now are congruent with biblical truth. Identifying new personal and professional spiritual battle lines will reveal the Christian call to heal exists under heavy challenge. Approaches to promote wellness and resilience will be redefined within the context of healthy Christian spirituality and ongoing growth in Christ. There will be a 10 to 15 minute Q&A time at the end of the presentation.

At the conclusion of this program, participants should be able to: • List risk factors for burnout that degrade professional effectiveness and wellness.

• Describe how to identify those at risk for and those who develop professional burnout.

• List biblical principles of Christian spirituality that promote personal wellness, resilience and joy in serving the profession that follows in the footsteps of the Great Physician.

2:45 - 3:45 p.m.

Psychiatry Track — Johnson Spring 2B Transgender Youth: Developmental, Family and Worldview Perspectives 1 Hour CME and CDE Allan Josephson, MD Prof. of Psychiatry and Pediatrics, University of Louisville

In less than a decade, the emergence of transgender youth has been exponential in the Western world.

This presentation will emphasize family and developmental underpinnings of this condition, given that there is no known biologic cause for this rapid increase in the numbers of youth with this condition. Three main points will be made: 1) Very young children do not have the cognitive maturity or development to “choose” their gender; 2) Many adolescents with gender dysphoria have co-existing psychiatric disorders; and 3) The recent description of sudden onset gender dysphoria has been fueled primarily by cultural forces. Clinical management of the transgender child/ adolescent will be discussed from the perspective of helping their parents and families.

At the conclusion of this program, participants should be able to: • Describe the developmental psychopathology of transgender youth.

• List cultural/worldview factors driving the transgender youth clinical phenomenon.

• Identify specific management principles and complications in the treatment of the transgender youth.

42 │ 2019 CMDA National Convention

B R E A KO U T S E S S I O N S 4:30 - 5:30 p.m.

Psychiatry Track — Johnson Spring 2B Transgender Issues: Going Deeper

Allan Josephson, MD, and Nancy Pearcey, MA Prof. of Psychiatry and Pediatrics, University of Louisville Bestselling Author, Professor of Apologetics and Scholar in Residence, Houston Baptist University

At the conclusion of this program, participants should be able to: • List three aspects to our culture that are most threatening to them.

• Articulate a vision for the church in engaging our culture most effectively.

• Identify personal ways to engage others in dialogue about the Christian faith.

2019 CMDA National Convention │ 43

Saturday

Transgender issues are far more than a medical issue, touching on most aspects of our culture—child rearing and family formation, education, religious life and the very essence of what it means to be human. This session will begin by reviewing the previous talk but go deeper. It will start with clinical questions from the participants but then entertain audience participation by going deeper in exploring issues such as: What is happening to truth in our culture? Is the Christian church changing in its approach to truth? How do we remain firm in proclaiming truth in love? Why can’t individuals accept the concept of limits (the meaning of the word “no”)? Is activism taking over science? What do we do when Christians are deemed “hateful” by our culture? Is there a role for Christians using the legal process to defend themselves when under attack? Drs. Pearcey and Josephson will offer their perspective on such issues and engage the attendees in responding to their questions.

B R E A KO U T S E S S I O N S 1:30 - 2:30 p.m.

FCO Track — Johnson Spring 4 Recent Changes in Ophthalmic Lenses: Specialty Tints and Progressives

1 Hour COE Clifford Brooks, OD Professor of Optometry and Executive Associate Dean for Academic Affairs, Indiana University School of Optometry This course discusses recent changes in lenses with emphasis on selective light absorption to improve performance, changes to expand useful areas of progressive lenses and redesigns to enhance left-right eye coordination of progressive lens design.

Saturday

At the conclusion of this program, participants should be able to: • Discuss how some of the newer color-selective lens coatings work and when they may or may not be appropriate for specific patients.

• Describe how researchers are exploring changes to small areas of lens surfaces to deliver more than one lens power at a time, resulting in opportunities to slow myopia progression and increase usable zone width in progressive lenses.

• Describe how lens manufacturers are working toward treating lens pairs as a single entity instead of single lenses for the purpose of increasing binocularity.

2:45 - 3:45 p.m.

FCO Track — Johnson Spring 4 Update on Convergence Insufficiency 1 Hour COE Kelly Frantz, OD Professor of Optometry, Illinois College of Optometry

This courses reviews signs, symptoms and diagnosis of convergence insufficiency, including how to perform pertinent diagnostic tests. It briefly explains management using prisms or vision therapy, including recent research on efficacy of vision therapy.

At the conclusion of this program, participants should be able to: • Describe common patient symptoms of convergence insufficiency.

• Discuss how to test for and diagnose convergence insufficiency.

• Discuss management options and research on efficacy of treatment for convergence insufficiency.

44 │ 2019 CMDA National Convention

B R E A KO U T S E S S I O N S 4:30 - 5:30 p.m.

FCO Track — Johnson Spring 4 Binocular Vision Case Management Using Prism 1 Hour COE Kelly Frantz, OD Professor of Optometry, Illinois College of Optometry

This course addresses management of common strabismic and non-strabismic binocular vision disorders using relieving prism. By means of case examples, methods of determining an appropriate prism prescription are demonstrated, to achieve relief of patient symptoms.

At the conclusion of this program, participants should be able to:

2019 CMDA National Convention │ 45

Saturday

• Discuss the advantages and disadvantages of prescribing prism for binocular disorders.

• Demonstrate methods of prescribing prism for patients with or without strabismus.

“Know therefore that the Lord your God is God, the faithful God who keeps covenant and steadfast love with those who love him and keep his commandments, to a thousand generations.”

—Deuteronomy 7:9, ESV

D A I LY S C H E D U L E Sunday, May 5 7:15 - 8:15 a.m.

Breakfast

Rhododendron

9 - 10:30 a.m.

Worship Service — Rev. Stan Key

Spilman Auditorium

Sunday

Worship Service with Rev. Stan Key Three Dangerous Prayers—Give Me Children, or I Die Genesis 30:1

Prayer Number Three — Rachel refused to be defined by her barren condition, so she prayed boldly that God would make her fertile. God heard her prayer and gave children, but it cost her life. Using principles of reproduction outlined in the opening chapters of Genesis, this sermon urges us to make Rachel’s prayer our own—even if it costs us everything.

2019 CMDA National Convention │ 47

“Let us hold fast the confession of our hope without wavering, for he who promised is faithful. And let us consider how to stir up one another to love and good works, not neglecting to meet together, as is the habit of some, but encouraging one another, and all the more as you see the Day drawing near.”

—Hebrews 10:23-25, ESV

OUR SPONSORS Gold Sponsor

Connections

Bronze Sponsors

2019 CMDA National Convention │ 49

E X H I B I TO R M A P

Connections

Exhibit Hall Located in Spilman Auditorium

50 │ 2019 CMDA National Convention

E X H I B I TO R B O OT H S We encourage you to visit our wide variety of exhibitors throughout the National Convention.

CMDA does not necessarily endorse the views, products or services provided by our exhibitors.

Lobby

Christian Medical & Dental Associations

Lobby

CA Tapes CMDA Placement Services

16 17 18 21

American College of Pediatricians

Medical Education International Fellowship of Christian Physician Assistants Global Health Outreach Christian Healthcare Ministries Jerusalem University College In Jesus Name Medical Ministry Ronald Blue Trust World Medical Mission / Samaritan’s Purse American Association of Pro-Life Obstetricians & Gynecologists HaTikva Project SIM - Egbe Hospital Revitalization Project

39 40

Valley Baptist Family Practice Residency Trinity International University Alliance Defending Freedom MedSend Nazareth Project, Inc. Erskine Seminary’s David Livingston Institute Christian Health Service Corps Equip International Hope to Walk Women Physicians in Christ Fellowship of Christian Optometrists CMDA Psychiatry Section International Christian Medical and Dental Association CMDA Marriage Commission Side By Side

Baptist Global Response

Exhibit Hall Schedule Thursday, May 2 4 p.m. - 7 p.m.

9 p.m. - 10 p.m.

Friday, May 3 8:30 a.m. - 9 a.m.

10:15 a.m. - 11 a.m.

9 p.m. - 10 p.m.

Saturday, May 4 8:30 a.m. - 9 a.m.

10:15 a.m. - 11 a.m.

8 - 9 p.m.

Sunday, May 5 8:30 a.m. - 9 a.m.

10:30 a.m. - 11 a.m.

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Connections

1 2 3 4 6 7 8 11 12 13

22 23 26 27 28 29 31 32 33 34/35 36 37 38

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Alliance Defending Freedom www.adflegal.org

15100 N 90th Street Scottsdale, AZ 85260 Kevin Theriot, Senior Counsel, VP of the Center for Life 800-835-5233

Connections

Alliance Defending Freedom (ADF) is an alliance-building, non-profit legal organization that advocates for the right of people to freely live out their faith.

13

American Association of Pro-Life Obstetricians & Gynecologists www.aaplog.org

P.O. Box 395 Eau Claire, MI 49111 202-230-0997 The American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) is the largest medical professional organization of pro-life medical practitioners in the world. We offer professional guidance and support to our members as well as various constituencies. To realize short-term and long-term objectives, we manage the Watson Bowes Research Institute, offer Continuing Medical Education (CME) modules, distribute informative brochures to physicians and their patients on adverse health outcomes related to abortion, publish peer-reviewed articles in professional journals, submit amicus filings with state and federal courts and appear as medical expert witnesses, sponsor the annual Matthew Bulfin Educational Conference, and mentor pro-life medical students and residents. Check us out at www.aaplog.org and www.members.aaplog.org.

16

American College of Pediatricians www.Best4Children.org

P.O. Box 357190 Gainesville, FL 32635 Ronni Ann Lutovsky, Executive Administrator 357-376-1877 The American College of Pediatricians (ACPeds) is a national organization of pediatricians and other healthcare professionals. The College is committed to fulfilling its mission by producing sound policy, based upon the best available research, to assist parents and to influence society in the endeavor of childrearing. Membership is open to qualifying healthcare professionals who share the College’s mission, vision and values.

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Baptist Global Response www.gobgr.org

2728 Manorwood Trail Fort Worth, TX 76109 Rebekah Naylor, MD, Global Healthcare Consultant 817-922-9211

31

Christian Health Service Corps www.healthservicecorps.org

P.O. Box 132 Fruitvale, TX 75127 Laura Smelter, Director of Training 903-962-4000 Christian Health Service Corps specializes in sending, supporting and caring for healthcare professionals as longterm missionaries. Each day we bring compassionate, life-saving health services to thousands of families in communities around the world. We offer live and online continuing education courses to enhance preparation for short-term and long-term medical missions.

6

Christian Healthcare Ministries www.chministries.org

127 Hazelwood Avenue Barberton, OH 44203 Joy Spriggs 330-798-5243 Since 1981, Christian Healthcare Ministries (CHM) has provided a platform for Christians to voluntarily and reciprocally share healthcare costs. Every month, CHM members experience their healthcare choice as a meaningful expression of Christ-given love for one another.

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Connections

Baptist Global Response (BGR) is an international relief and development organization responding to acute and chronic disasters. In cooperation with its chief partner International Mission Board (IMB), healthcare volunteers are connected to needs all over the world. Persons called into long-term mission service are channeled to appropriate opportunities.

E X H I B I TO R I N F O Lobby

Christian Medical & Dental Associations (CMDA) www.cmda.org

Connections

P.O. Box 7500 Bristol, TN 37621 423-844-1000 Founded in 1931, Christian Medical & Dental Associations is the largest faith-based organization for healthcare professionals in the nation. Called to serve Christ through healthcare, CMDA addresses policies on healthcare issues; schedules foreign and domestic mission trips; sponsors student ministries; offers educational and inspirational resources; conducts marriage and family conferences; provides continuing education; and facilitates academic exchange programs. With more than 40 ministries, Christian Medical & Dental Associations is changing the face of healthcare by changing hearts in healthcare.

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CMDA Marriage Commission www.cmda.org/marriage

P.O. Box 7500 Bristol, TN 37621 Melinda Mitchell, Meetings Manager 423-844-1013 The goal of the CMDA Marriage Commission is to stimulate an ongoing process of marital growth by teaching healthcare couples from a biblical perspective the skills to refocus, rekindle and recommit to each other as marriage partners and to Jesus Christ as their common bond and Lord.

1

CMDA Placement Services www.cmda.org/placement

P.O. Box 7500 Bristol, TN 37621 Allen Vicars, Director 423-944-1027 CMDA Placement Services exists to glorify God by placing healthcare professionals and assisting them to find God’s will for their careers. We desire to place individuals in environments that will encourage ministry. We make connections across the U.S. for physicians, dentists, physician assistants, nurse practitioners and practices. For more information, please contact 888-690-9054 or www.cmda.org/placement.

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CMDA Psychiatry Section www.cmda.org/psychiatry

2781 Hunting Hill Lane Decatur, GA 30033 Marshall Williams, Section Administrator 470-755-0495

32

Equip International www.equipinternational.org

126 Rockhouse Road Marion, NC 28752 Larry Litke, PhD, Director of Training 828-803-5841 Equip International is a Christian organization that offers practical training in medicine and other appropriate technologies for those seeking to minister in the resource-poor environments of developing countries. Equip International’s two medical training courses offers continuing education credit for physicians, nurses and mid-level medical professionals. More details can be found on the website www.equipinternational.org.

29

Erskine Seminary’s David Livingston Institute www.seminary.erskine.edu

P.O. Box 338 Due West, SC 29639 David Cathcart, Seminary Admissions 864-379-6596 The David Livingston Institute for Christianity, Medicine, and the Sciences offers graduate certificate programs in Christian worldview, apologetics and biomedical ethics in both online and live course formats.

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Connections

The CMDA Psychiatry Section seeks to promote fellowship and provide community to support and encourage Christian physicians in the practice of psychiatry, as they explore the relationship between their faith and professional practice; to promote within the church the knowledge and understanding of valid psychiatric approaches to mental health and healing, consistent with Christ’s redemptive love; to contribute to the ministry of CMDA through participation, mentorship, prayer and sharing of our specific gifts and expertise; to join in the ministry of Christian missions; and, to present a positive witness of God our Father, and Jesus Christ our Savior, and the work of the Holy Spirit to colleagues, patients and society.

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Fellowship of Christian Optometrists www.cmda.org/fco

P.O. Box 7500 Bristol, TN 37621 Jenifer Smith, Program Manager 812-652-6200

Connections

The Fellowship of Christian Optometrists (FCO), originally founded in 1986, recently became a Section of the Christian Medical & Dental Associations (CMDA) in 2017. FCO was established as an evangelical organization of Christian optometrists, optometry students and allied ophthalmic personnel committed to worldwide eye care missions and intra-professional Christian fellowship.

3

Fellowship of Christian Physician Assistants www.cmda.org/fcpa

P.O. Box 7500 Bristol, TN 37621 Sarah Steffens, PA-C, President of PA Section 978-407-3327 Fellowship of Christian Physician Assistants (FCPA) is a specialty section of CMDA whose mission is serve the needs of Christian physician assistants through offering the services and ministries of CMDA to equip each of us for service to the Great Physician.

4

Global Health Outreach www.cmda.org/gho

P.O. Box 7500 Bristol, TN 37621 Patricia Burgess, MD, Director, Global Health Outreach 423-844-1000 Global Health Outreach is the short-term mission arm of Christian Medical & Dental Associations. We use our general medical and dental teams, as well as orthopedic and general surgical teams, in 24 different countries to share help for the physical hurting and hope for the spiritual needy. We offer many different team focuses including family/student friendly trips, refugee care, human trafficking, orphan care, volcano relief, public health and prison ministry.

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HaTikva Project www.hatikvaproject.org

9218 Metcalf Avenue, #277 Overland Park, KS 66212 Evan Levine, Executive Director 469-242-3681

33

Hope to Walk www.hopetowalk.org

3635A South Main Street Blacksburg, VA 24060 Michael Mabry, MD, CEO 423-416-8267 Hope to Walk has developed a below the knee prosthetic device which can be made for less than $100.00. Volunteers travel to underdeveloped countries and provide them at no charge to the poor. They also train locals to manufacture these prostheses.

8

In Jesus Name Medical Ministry www.injesusnamefreeclinic.org

1520 Virginia Ranch Road, Ste. 1B Gardnerville, NV 89410 Ted Nagel, Marketing Director 775-782-1573 In Jesus Name Medical Ministry is a non-profit organization partnering with doctors and local churches to provide FREE medical clinics once a month! All medical staff are volunteers and provide their services for FREE to those who have less than adequate medical insurance, and they all do it in Jesus’ name.

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Connections

Making Jesus Known through Dental Care in Israel. HaTikva Project is meeting Israel’s dental care crisis through excellent, full-range dental services at our HaTikva Dental Clinics. HaTikva Dental is the only dental organization in Israel that is boldly treating patients in the name of Jesus. HaTikva Project is also impacting at-risk children and believers in financial crisis through HaTikva Families and HaTikva Aid.

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International Christian Medical and Dental Association www.icmda.net

Connections

2 Fountain Court, Victoria Square St. Albans AL1 3TF UK Peter Saunders, CEO +44 1727 884727 The International Christian Medical and Dental Association (ICMDA) connects Christians in medicine and dentistry all around the world, equipping them to live out their faith at work. ICMDA is interdenominational, and we welcome interaction with individuals or groups who are able to affirm our basis of belief. ICMDA is a global movement uniting national Christian medical and dental organizations in over 60 countries, and it is developing and supporting new movements in other places. ICMDA seeks to encourage and equip Christian medical and dental students and graduates to grow to Christian maturity and live out their faith within their clinical practice and beyond. Christians in medicine and dentistry take their inspiration from Christ, the Great Physician. The example of Jesus in humility washing His disciples’ feet and wiping them with the towel wrapped around His waist is reflected in our logo.

7

Jersusalem University College www.JUC.edu

1185 Wesley Avenue Xenia, OH 45385 Jonathan Webb, Program Coordinator 800-891-9408 As a Christian educational institution located in Jerusalem, the mission of JUC is to deepen understanding of the Bible in its geographical and cultural settings. We exist to explore the ancient and modern contexts of the world of the Bible—our students get to know the Word of God better.

2

Medical Education International www.cmda.org/mei

P.O. Box 7500 Bristol, TN 37621 Misty Carter, Administrative Assistant Dr. Shari Falkenheimer, Director 423-844-1049 Medical Education International (MEI) is a short-term missions program with teams teaching healthcare professionals in academic or clinical settings to bring transformation by advancing medical, dental, bioethical and educational knowledge while modeling and sharing Christ with them.

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MedSend

www.medsend.com

999 Oronoque Lane Stratford, CT 06614 Anny Reed, Donor Relations Director 803-802-4555

28

Nazareth Project, Inc. www.nazarethproject.org

237 N. Prince St, Suite 305 Lancaster, PA 17603 Howard good, Executive Director 717-290-1800 Nazareth Project (NPI) raises financial resources and facilitates exchanges with Nazareth Hospital and Nazareth School of Nursing in northern Israel. NPI also promotes visits to Nazareth Village and volunteer assignments through SERVE Nazareth. These entities are owned by Nazareth Trust, a very well-established and prominent Christian organization in Israel.

11

Ronald Blue Trust www.ronblue.com

300 Colonial Center Parkway, Ste. 300 Roswell, GA 30076 Shay Mallick, Event Planning Manager 330-564-5414 With nationwide capabilities, Ronald Blue Trust provides wealth management strategies and trust services based on biblical principles to help clients make wise financial decisions, live generously and leave a lasting legacy. With over $8 billion of assets under management and advisement and a network of 13 branch offices, we serve over 8,000 clients* in all 50 states through four distinct divisions and offer services across the wealth spectrum in these key areas: financial, retirement, and estate planning; investment management and solutions; charitable giving strategies; personal trust and estate settlement services; bill paying services; family office services; business consulting services; and institutional client services. *As of 12/31/17 and subject to change.

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Connections

MedSend strategically funds qualified and committed American Christian healthcare professionals serving around the globe. We also help national Christ-followers obtain the advanced medical and biblical training they need to serve the underserved in their home countries. Together, they care for the medical and spiritual needs of people throughout the world who live in poverty and oppression.

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Side By Side

www.cmda.org/sidebyside

Connections

P.O. Box 6692 Rochester, MN 55903 888-230-2637 Side By Side is a network of local chapters that encourage and minister to women in healthcare marriages through fellowship and Bible study. We are a CMDA ministry for women who are married to medical and dental students, residents and fellows, as well as staff physicians and dentists. We seek to encourage, support and minister to women in medical marriages through fellowship, Bible study and prayer. We commit to standing side by side our husbands, side by side our sisters in Christ and side by side our Lord. We are here at the convention to spread the word of the ministry, as well as look for bold women to begin new chapters and/or join one of our 80+ chapters.

18

SIM – Egbe Hospital Revitalization Project www.egbehospital.org

5360 NW 20th Terrace Fort Lauderdale, FL 33309 Robert Read, Recruitment Coordinator 954-492-3554 The aim of this project is to revitalize the ECWA Hospital Egbe to ensure the hospital’s sustainability as a leading medical and teaching facility. Staff recruitment of qualified Nigerian medical and executive personnel as well as missionary consultants; upgrading the 33-acre, 68-building hospital complex infrastructure; developing the technology platform, implementing solar power, and restoring consistent electrical and water supply; as well as re-establishing effective laboratory, pharmacy, maternity, surgical and out-patient services, will all play a role in the success of the revitalization.

23

Trinity International University www.tiu.edu

2065 Half Day Road Deerfield, IL 60015 Alexander Oppong-Mensah, Graduate Enrollment Counselor 847-317-8159 Trinity International University’s Master of Arts in Bioethics degree offers cutting-edge bioethical training where and how you want it. Earn your degree with our online classes, full-time residential program, our modular program of weekend seminars or any combination of these formats for a program that truly fits your schedule.

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Valley Baptist Family Practice Residency www.valleybaptistfp.com

2222 Benwood Street Harlingen, TX 78550 Arber Nuhaj, MD, Faculty 956-389-2448 Valley Baptist Family Practice Residency – preparing followers of Jesus Christ to share the beautiful gift of healing.

We are not healthcare providers; we “seek to save the sick.”

Women Physicians in Christ www.cmda.org/wpc

P.O. Box 7500 Bristol, TN 37621 Debbie McAlear, Administrator 423-844-1022 The mission of Women Physicians in Christ (WPC) is to encourage and support Christian women physicians and dentists as we share the unique challenges of our multiple roles 1) through authentic relationships; 2) through personal growth; 3) through discipleship and mentoring; and 4) through professional development. Celebrating 25 years of ministry to women physicians and dentists in 2019!

12

World Medical Mission / Samaritan’s Purse www.samaritanspurse.org

P.O. Box 3000 Boone, NC 28607 Becky Williams, Director of Development 828-278-1138 As the medical arm of Samaritan’s Purse, we place volunteer Christian physicians, dentists and other medical personnel in mission hospitals and clinics around the world. We also staff a biomedical department/warehouse that provides medical equipment and supplies to mission facilities.

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Connections

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VIE POSTER SESSION VIE is a French word for “life” and represents the acronym for “Vignettes, Initiatives, Innovations and Education” as well as our recognition of and commitment to stirring godly passions and life throughout CMDA and His kingdom through presentation of salient scholarly work.

CMDA VIE Poster Session Post-event Evaluation Johnson Spring 5

I participated as a

☐ Poster Presenter

☐ Poster Judge

Not at all

Somewhat

☐ Attendee

Moderately so

Very much so

Was the day and time of the session convenient for you to attend? If not, what other day or time would you recommend?

Was the session executed in a professional manner?

Was the length of time allotted for the session appropriate?

Is the poster session a valuable addition to the CMDA National Convention?

What could have been done differently?

Comments

For Presenters How did you hear about the poster session?

Did your university give you time off or financial support to attend the poster session? How much financial support (optional)?

Would you have attended the CMDA National Convention were it not for the poster session?

Which days of the CMDA National Convention did you attend? If you were unable to attend the entire convention, what was the reason?

Will you attend the CMDA National Convention again in the future? Why or why not?

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VIE Posters

Thank you for participating in the third annual VIE Poster Session. Please take a moment to complete this evaluation to help us improve for next year. You may submit this form at the Poster Session (Johnson Spring 5) or in the conference office. Please email nrfc@cmda.org with any questions.

VIE POSTER 1 A Bifurcation of Faith and Science: Should Exorcisms Be Supported in the Treatment of Psychiatric Disorders?

Mallory Grove, MD; and Dan Schellenberg, MD Pine Rest Christian Mental Health Services

Introduction

It is evident and quite possibly irrefutable that an individual’s faith/spirituality can have positive effects on one’s overall health. It goes without saying that for the 400 million people who suffer from a psychiatric illness, this truth is especially apparent. Knowing the evidence of the positive impacts that religion can have, is the medical community adequately supporting those patients who desire to integrate their faith and religious practices with their medical care?

VIE Posters

Case Presentation

A 15-year-old Hispanic male with no prior psychiatric history presented to the hospital with complaints of seeing and speaking to “Lucifer.” The patient’s family noted bizarre behaviors and an abrupt change in his personality. They believed that the patient was possibly possessed by a demon. The patient wrote long prophecies and was frequently heard screaming in his room. The family’s local priest performed multiple exorcisms during visitation hours. The patient’s family was overall resistant to the patient being on medications and desired that the patient’s symptoms be addressed spiritually without the use of medications. His medication had not improved his symptoms. Ultimately, it was determined that the patient could be safely discharged. A referral was placed to a local Christian psychiatric provider with special interest in the integration of spirituality and psychiatric illness.

Discussion

Research has shown that religion can have positive effects on mental health, including maintaining mental health or preventing psychiatric illness. If this patient’s family’s religious practices were better supported and understood on the unit, would they have been more agreeable and patient in trialing medications? Would there have been a different outcome? Are exorcisms a reasonable adjunct treatment, and should one’s worldview alter the treatment and medical support one provides?

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VIE POSTER 2 A Low Fructose Diet as a Complementary or Alternative Treatment for Depression: A Nutritional Psychiatry Review Karissa Braden Columbia University School of Nursing

Background

Over 300 million people worldwide suffer from depression; it is the leading cause of disability across the globe. One current firstline treatment for depression is antidepressant medications; however, there is significant variability in their treatment response.

Specific diets have been established as complementary and alternative treatments for other health diagnoses, but there has been little research regarding the effect of diet on depression. This review will explore the low fermentable oligosaccharides, disaccharides, monosaccharides and polyol (FODMAP) diet and its effect on depression.

Methods

Results

A relationship between the low FODMAP diet and depression was not found during the review of articles. However, malabsorption of fructose, a monosaccharide, was found to be associated with depression in multiple studies. In a large cohort study, 65 percent of the patients with fructose malabsorption had a diagnosis of depression. Only one study to date has evaluated a low fructose diet in individuals with depression, and results showed depression scores reduced by approximately 65 percent.

Conclusion

Based on the evidence provided, a low fructose diet has the potential to be an effective complementary or alternative treatment to antidepressant therapy. The correlations found between fructose malabsorption and depression are significant and warrant further research.

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VIE Posters

Two databases, Ovid MEDLINE and PubMed, were searched using the keywords: “FODMAP diet” and “depression.” After further review, another search was done in the same databases to include more keywords: serotonin, tryptophan, fructose, “fructose malabsorption,” and “gut-brain axis.” Four peer-reviewed studies and one systematic review were chosen to further evaluate.

VIE POSTER 3 A Student Group Designed to Maintain Missions Interest Through Medical Training Andrew Stein, Stephanie Song, Nolan Coallier, Ashley Creager and Theodore MacKinney, MD, MPH Medical College of Wisconsin

Background

Only 2 percent of pre-medical students originally interested in a career of faith-based international missions work follow through with their interest after graduating, and only 1 percent continue long-term. Despite numerous on-campus ministries, global health clubs, missions-focused conferences and church activities, this discrepancy remains. The aims of this study are to establish a student interest group focused on faith-based global health and to evaluate its effectiveness.

VIE Posters

Methods

Students at the Medical College of Wisconsin formed the Missions Interest Group (MIG) under the local Christian Medical & Dental Associations (CMDA) chapter. Monthly meetings were scheduled off-campus and were open to all students interested in mission work. Key session elements included community meals with missionary mentors, cross-cultural guest speakers from multidisciplinary domains and small-group prayer for global populations. A retrospective survey was administered after 20 sessions to all MIG student participants to evaluate how MIG influenced their approach to missions, culture, community/networking and action/opportunities.

Results

A total of 15 of 21 participants, representing every class, completed the survey. Over 50 percent of participants reported involvement in the on-campus CMDA group and nine respondents attended more than three sessions. Of those nine participants, 89 percent reported the group both helped increase their desire to engage other cultures in addition to their understanding of prayer as a tool in missions. Eight group members found participation to help their connections with other missions-minded students, while 89 percent of students who attended greater than three sessions expressed increased openness to include short-term missions in their future practice, and 78 percent were more open regarding long-term missions.

Conclusion

A mission-focused medical school interest group can help address the current disparity between expressed interest and actual longterm medical missionaries. More extensive long-term follow-up, increased sample sizes and additional MIGs on other campuses are needed to fully evaluate the effectiveness of this model.

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VIE POSTER 4 Alterations in Sodium Channel Organization at the Post-Infarct Injury Border Zone Tom Liu; Jourdan Jane, BS; He Jia, PhD; and Gourdie Robert, PhD Virginia Tech Carilion School of Medicine

Background

Development of arrhythmia following myocardial infarction (MI) is tightly linked to lateralization of connexin 43 (Cx43) gap junctions (GJ) at the injury border zone (IBZ). Previous studies have suggested that the interaction of Cx43 hemichannels and sodium channels at the perinexus, a specialized domain of the GJ, is critical to proper cardiac conduction; however, the extent of sodium channel remodeling within this context has not been extensively studied. Thus we sought to quantify the extent of sodium channel remodeling and characterize its interaction with Cx43 in the post-infarct IBZ.

Methods

Results

Overall, examination revealed that IBZ myocytes had increased frequency of b1 punctae compared to remote myocytes (165.2 ± 69.7 vs 147.9 ± 64.23) and overall smaller punctae size (27.58 ± 9.6um vs 47.0 ± 22.2um). Differences between organization, punctae size and frequency of β1 were not evident at the acute post-infarct stage (166.2 ± 37.7 vs. 169.9 ± 61.27 and 32.6 ± 4 um vs. 36.6 ± 14.3 um), however, were clearly delineated at the chronic post-infarct stage (165.2 ± 84.8 vs. 134.8 ± 69 and 31 ± 15um vs. 52 ± 16um). Finally, both Cx43 and b1 showed decreased levels of co-localization at both the intercalated disc and lateralized border regions.

Conclusion

The sodium channel beta-subunit demonstrates post-infarct remodeling notable for increased β1 punctae formation and decreased size, especially in chronic post-infarct injury border zone tissues. These findings support the need for further investigation of the sodium channel in the context of aberrant post-infarct rhythms.

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VIE Posters

Male 8 to 10-week-old Sprague Dawley rats (n=12) underwent a 40-minute left anterior descending ischemia reperfusion MI and hearts were extracted at 24 hours (acute) or 28 days (chronic). Distribution of immunolabeled sodium channel β1 subunit; SCN1B and Cx43 was quantified at the IBZ and remote tissue regions using Matlab and ImageJ.

VIE POSTER 5 Assessing the Quality of Life in Head and Neck Cancer Patients Before and After Treatment Nicholas Cameron; Sergey Koyfman, DO; Sara Sargente; and Matthew Brennan, DO Greater Hudson Valley Health System

Background

Cancers of the head and neck are some of the most complex and unique cancers in terms of their development, treatment profiles and effects on quality of life (QOL). It is our goal to determine how treating the disease grossly affects the patient’s QOL. Our hope is to use the results of this study to better identify how physicians can target their efforts to improve the QOL of each individual patient as he or she manages a potentially difficult recovery.

VIE Posters

Methods

The planned study focuses on a survey created at ORMC. This survey utilizes 46 separate questions, each designed to assess a different QOL issue. The questionnaire is completed at multiple stages: one prior to treatment, four weeks post-treatment and at six months post-treatment. The analysis evaluated the responses in each survey group using an ANOVA statistical analysis. The top questions with the greatest change in reported QOL assessments were reported.

Results

To date, data has been collected from 60 patients at ORMC. Demographic information was gathered and showed that the mean age was 62 years, while the group was overwhelmingly male (79 percent) and Caucasian (97 percent). Cancer site varied with disease of the oropharynx and larynx tied for the most frequent, each accounting for 33 percent of the total population. 94 percent of cases were squamous cell carcinoma on pathology, and 86 percent of the population had documented current or former tobacco use. Patients reported complaints in almost every general category including, but not limited to, eating, drinking, speech and pain.

Comparison of the data showed that of the 46 questions asked, a total of 37 (81 percent) saw increases in average responses, while 7 (15 percent) saw decreases and 2 (4 percent) saw no change. The top five questions with the greatest increase in average response were selected and using a Wilcoxon Signed Rank testing, the differences between questions 12, 15, 16 and 22 were found to be statistically significant while question 46 was not.

Conclusions

The observed worsening of quality of life measures in this initial analysis sheds new light on the complexities of cancer treatment recovery. It is likely that the observed worsening in the initial four-week post-treatment cohort was due to radiation and/or chemotherapy effects. Using these findings, providers can individualize their plans for treatment and follow-up care. As this review process becomes more streamlined, we will be able to analyze these responses and tailor treatment strategies in real time.

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VIE POSTER 6 Atypical Presentation of Mycoplasma Pneumoniae-associated Mucositis Syndrome with No Skin Involvement in a Young Adult Lauren Larkin, MS31; and Oltion Mesi, MD2 1 Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio 2 Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio. Cleveland Clinic Lerner College of Medicine of Case Western Reserve University

Introduction

Mycoplasma pneumoniae-induced rash and mucositis (MIRM) is a rare extrapulmonary manifestation that typically presents in the pediatric population (1,3,5,8). MIRM typically includes ocular and mucocutaneous eruptions, with no skin involvement reported in only about 30 percent of cases (1,2,4,6).

Case Presentation

Discussion

The proposed diagnostic criteria for MIRM, include: less than 10 percent body surface area affected, involvement of two or more mucosal sites, scattered atypical targets, and clinical and laboratory evidence of atypical pneumonia (1,7). These distinguishing features are useful in ruling-out more severe diagnoses, such as Stevens-Johnson syndrome (SJS), which was a concern in this case given the patient’s lack of response to azithromycin. This case highlights a challenging, rare presentation of MIRM in an adult with ocular, oral and urethral involvement and sparing of the skin.

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VIE Posters

We present a 24-year-old male with bilateral conjunctival inflammation along with oral and urethral ulcerations, sparing the rest of the skin and perianal regions. He reported previous treatment for a suspected bacterial respiratory illness with azithromycin the week prior to admission without significant improvement in symptoms. On initial presentation, the patient was febrile and tachycardic with leukocytosis (17.3) and elevated ESR (84) and CRP (11.7). Chest x-ray, blood cultures, respiratory viral panel, Legionella urinary antigen, Streptococcus pneumoniae, gastrointestinal polymerase chain reaction (PCR) panel, HIV, Herpes Simplex Virus (HSV)1/2, Syphilis IgG with confirmation, and Gonorrhea/Chlamydia testing were negative. On exam, there was diffuse conjunctivitis and multiple prominent erythematous lesions appreciated within both vermilion borders in various stages of healing with some eschars. Ulceration was present at the urethral meatus with shallow erosion extending 1-2 mm circumferentially onto glans penis. Mycoplasma pneumoniae IgM was positive (5.21) and he was treated with IV levofloxacin for five days. The patient was discharged with rapid improvement in clinical condition on oral levofloxacin, prednisone and moxifloxacin/bacitracin/ prednisone ophthalmic suspension.

VIE POSTER 7 Case Study: Rare Heidenhain Variant of Creutzfeldt-Jakob Disease Presenting as Homonymous Hemianopia Jake Sims; Cameron Holicki; David Kaufman, DO; and Joseph Holicki, DO Michigan State University College of Osteopathic Medicine

Introduction

Creutzfeldt-Jakob disease (CJD) is a human transmissible spongiform encephalopathy (TSE), also known as a prion disease. CJD is a rapidly progressive neurodegenerative disorder, and cardinal symptoms include rapid-onset dementia, ataxia and startle myoclonus. This study’s intent is to increase awareness of this condition and reduce work-up costs and potential iatrogenic transmission.

VIE Posters

Case Presentation

A 73-year-old female presented to her optometrist with one-week history of new-onset green tinted vision. Patient presented to the ophthalmology clinic one week later with new onset worsening vision and difficulty with writing. Best corrected visual acuity was 20/20 bilaterally, ocular examination unremarkable and Humphrey visual field test displayed left homonymous hemianopia.

Magnetic resonance imaging (MRI), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) displayed no abnormalities. At follow-up visit two weeks later, her husband reported recent personality changes and progressive confusion. Anterior and posterior eye examinations, intraocular pressures and pupil sizes and reactions revealed no abnormalities, but Humphry visual field test now displayed complete bilateral vision loss. Urgent CT, electrocardiogram, CSF analysis and bloodwork were all unremarkable. Patient was admitted to hospital and on day seven of admission diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) images reveal bilateral occipital and frontal hyperintensities, EEG revealed new changes in right and left frontal lobes, and CSF analysis was positive for 14-3-3 protein and neuron specific enolase (NSE). Patient was diagnosed with probable CJD; she continued to rapidly deteriorate and died within 53 days of presentation.

Discussion

Patient’s findings support diagnosis of “probable” sporadic Creutzfeldt-Jakob disease (sCJD). We believe our patient had a rare “Heidenhain” variant of sCJD (HvCJD); uniquely, HvCJD is the only CJD variant that has isolated visual symptoms at initial presentation. Incorrect initial diagnosis with primary optic disorders could result in unnecessary work-ups, improper treatments and/or potential iatrogenic spread.

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VIE POSTER 8 Correlation of EBV and HHV 6 Viral Titers to Lyme Disease Keerthana Srinivasan; Harpal Mangat, MD; and Sagar Matharu University of Maryland, College Park

Background

Lyme disease is diagnosed based on the U.S. Center of Disease Control (CDC) criteria, which requires the identification of five Western blot IgG bands. In a previous study, the effect of Lyme disease on the CD4/CD8 ratio was determined. It was noted that the CD8 count lowered, hence the higher ratios. Other Lyme specialists use CD58 (variant of CD8) as a means of evaluating Lyme disease. Patients with an increased CD4/CD8 ratio also depicted symptoms of fatigue, weakness and muscle or joint pain. The presence of Lyme disease may cause patients to become immunodeficient as depicted by the high CD4/ CD8 ratios; therefore, the correlation between certain viral titers with Lyme was evaluated.

Methods

Results

Of the 148 patients that were tested for their CD4/CD8 ratios, 105 showed highly elevated EBV levels and 103 showed highly elevated HHV 6 levels, which corresponded to altered CD4/CD8 count. Viral titers for EBV and HHV6 were deemed positive if they exceeded the normal expected range. Applying the null hypothesis, the p-value for EBV Igg and HHV 6 Igg levels on the two-tailed test were p=.00169 and p=.00023 respectively thus, showing that this is not chance occurrence.

Conclusions

Lyme disease further causes immunodeficiencies and symptoms such as fatigue in patients can be correlated to the presence of elevated EBV and HHV 6 viral titers.  

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VIE Posters

A total of 183 patients at two medical centers were evaluated in Lyme endemic communities in Maryland. The CD4/CD8 ratios of 148 of these patients were tested. A viral panel was conducted including EBV and HHV 6 to see whether IgG titers exceeded the expected range. A two-tailed test was performed.

VIE POSTER 9 Depression and Associated Risk Factors in Rural Haiti: Results of a Preliminary Survey Joseph Hennig, MD; David Holmes, MD; James Lohr, MD; Mohamed Awayda, PhD; and Vincenzo Polsinelli, MD Jacobs School of Medicine and Biomedical Sciences

Background

VIE Posters

Research on mental health and depression is important for many reasons: (1) Depression is the leading cause of disability-adjusted life years in both high and low-income countries; (2) Research can help aid in efforts to implement task-shifting for health worker shortages by developing good, culturally informed, screening strategies and protocols for treatment; and (3) Identifying risk factors in these underserved populations may help develop prevention strategies. We sought to determine the prevalence and risk factors of depression and their relationship with chronic disease in a SES disadvantaged afro-Caribbean population in rural Haiti with poor access to mental health resources.

Methods

We conducted a cross-sectional convenience sample of 628 adults in rural Haiti. Participants completed a questionnaire recording demographic information, body measurements and PHQ-9 depression risk score questionnaire. Pearson bi-variate correlation was used to assess relationships between measured variables and PHQ-9 score. Linear regression analysis was performed to determine associations between demographics, body measurements and depression severity. Multivariable regression was used to control for confounding variables.

Results

Mean age was 40.0 ± 17.6, and the mean PHQ-9 score was 9.9 ± 3.7 (range: 0-22). PHQ-9 depression severity ranged from none (6.4 percent) mild (39.4 percent), moderate (43.6 percent), moderately severe (10.2 percent) and severe (0.6 percent) in our population. Greater (worse) PHQ score was associated with diagnosis of hypertension (r2= 0.02, p= 0.0008), lower weight (r2= 0.006, p= 0.029), lower achieved education (r2= 0.026, p= 0.0002) and increased age (r2= 0.44, p< 0.0001). After multivariable regression analysis only, age remained (β =0.0224, r2= 0.066, p< 0.001)

Conclusions

More than half of people surveyed in this rural, socioeconomically disadvantaged, afro-Caribbean population reported at least moderate severity depressive symptoms. Additionally, worse depression severity is associated with increased age.

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VIE POSTER 10 Double Sequential Defibrillation in the Setting of Refractory Ventricular Tachycardia Jordan Jacobsen, MD; Vincent Marsh, MD; and Son Pham, MD Wright State University

Introduction

Cardiac arrest continues to be an important topic of discussion in health literature. Specifically, pulseless ventricular tachycardia and ventricular fibrillation, which have the highest rate of ROSC, upwards of 60 percent. Refractory VF/VT, albeit a sub topic, is gaining more attention as we strive to increase survival rates. DSD (Double sequential Defibrillation) is gaining support as a therapeutic intervention to combat the proposed biological and anthropometric issues, which propagate refractory VF/VT. Given the incidence and time sensitive nature of VT/VF, there are few studies detailing the efficacy of DSD (1,2).

Case Description

Discussion

The case as described above supports the validity of DSD in the setting of shock resistant VF/T. An important aspect of this case is the use of DSD early in the resuscitation. Timely implementation of DSD is especially important considering that the underlying arrhythmia may become more resistant to treatment as time progresses. DSD is a simple and potentially lifesaving technique.

Further research is required to evaluate the efficacy of early DSD implementation in the setting of VF/T. â&#x20AC;&#x192;

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VIE Posters

A 55-year-old male was found to be in pulseless VT after induction for definitive airway management, at which point ACLS was initiated and monophasic shocks were delivered. Initial anti-dysrhythmics / defibrillation was unsuccessful, and the patient was deemed to be in shock refractory VT. The patient was prepped for DSD with the second set of pads being placed in the A/P position. The first DSD attempt delivered a total of 720 J (360 J x 2). This converted the patient back into sinus rhythm; however, shortly thereafter, he went back into pulseless VT. Another attempt at DSD was initiated which did result in ROSC and a sustained sinus rhythm. The patient underwent TTM and was extubated three days later with a modified Rankin score of 1.

VIE POSTER 11 Effect of Significant Family Life Events in the First Year of Type 1 Diabetes (T1D) Kelly R. Stanek; Shideh Majidi, MD; Erin Youngkin; Amy Noser; Mark Clements, MD; and Susana R. Patton, MD University of Colorado

Background

Examine the impact of stressful life events on families in the first year after diagnosis of T1D in a young child using a mixed methods design.

Methods

VIE Posters

In a prospective study of 5 to 9-year-olds new to T1D (mean age 7.4±1.3 years, T1D duration 4.7±3.3 months), we measured A1c, changes in family health, marital status, coping and income every three months up to 12 months post-baseline using surveys.

Results

Of 135 families, 40 reported job/income changes (11 promoted, 20 changed job, seven quit job, two lost job), four marital changes (two divorces, one separation, one spouse death), and 42 health changes (78.6 percent family member health, 21.4 percent child).

Of those, four family members were also diagnosed with T1D and three youth were diagnosed with an additional autoimmune disorder in the 12-month follow up. Income decrease at any time point in first 12 months correlated with health change (r=0.142, p=0.048) and marital status change (r=0.169, p=0.049) at any time point in the first 12 months, while baseline Active Avoidance Coping correlated with future income decrease (r=0.169, p=0.03). There was a cross-sectional association between A1c and income decrease at time point four, corresponding to about one year post-T1D diagnosis.

Conclusions

Families can experience significant concurrent life stressors during the first year of T1D. Future research should explore if these events have a direct effect on T1D management and long-term glycemic control.

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VIE POSTER 12 Endogenous Endophthalmitis Mistaken for Conjunctivitis in Acute Care, Resulting Delayed Treatment, Vision Loss and Interrupted Rehabilitation Casey Sevy, DO; Rani Lindberg, MD; and Lauren Poindexter, MD University of Arkansas for Medical Sciences

Introduction

Endogenous endopthalmitis is an uncommon, devastating complication following meningitis. It is a difficult diagnosis to make as it can easily be mistaken for conjunctivitis and uveitis; therefore, routine eye exam is important. Misdiagnosis can cause delay in treatment, vision loss and an interrupted acute rehab course.

Case Presentation

Discussion

Endogenous endopthalmitis is a rare (2 to 8 percent of endophthalmitis cases), condition requiring emergent treatment to preserve vision. It is difficult to diagnose in the absence of systemic symptoms and can mimic other conditions such as uveitis and conjunctivitis. 30 to 50 percent of U.S. and European cases are from Streptococci; however, gram negative infection is more common worldwide. The liver, endocardium, urinary tract and meninges are the most common sources of infection. Diagnosis is clinical but positive blood, vitreous, or aqueous cultures are confirmatory. Treatment includes vitrectomy, intraorbital antibiotics and steroid eye drops. Less than 50 percent of patients achieve 20/200 vision or better. This particular patient had a much better outcome.â&#x20AC;&#x192;

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A 68-year-old female was admitted to acute rehabilitation for encephalopathy and generalized weakness from Streptococcus pneumoniae meningitis and bacteremia. Continued on ceftriaxone and ciprofloxacin eye drops started for conjunctivitis diagnosed during acute hospitalization. Antibiotic eye drops ordered and continued upon rehabilitation transfer. On admission she complained of blurred vision in left eye and exam notable for impaired left eye visual fields. Daily ocular exam was stable until hospital day eight, when patient developed acute vision loss of the left eye with 3mm pupil and reduced light reactivity. Opthalmology consulted and exam showed significant debris in the ocular chamber, obstructing retinal evaluation. Patient discharged from rehab for emergent vitrectomy with intraorbital antibiotics for treatment of endogenous endophthalmitis, then readmitted to complete her rehabilitation course. She steadily regained vision during rehab and was discharged home with only mild complaints of blurry vision.

VIE POSTER 13 Enhancing Medical Education through CAD and 3D Printed Nasopharynx And Tracheal Abnormality Models Ross Ellery Michaels; Djordje Jaksic; Kyle VanKoeverying, MD; and David Zopf, MD University of Michigan Medical School

Background

Medical education of medical trainees in procedural medicine is largely taught through a “see one, do one, teach one” process.

There are inherent limitations of this teaching method that stem from the risk of allowing inexperienced trainees performing their first attempts at often-complicated procedures on a live patient. This is also further complicated when it comes to teaching management of rare abnormalities where the ratio of number of cases to trainees is very low.

VIE Posters

Methods

Using CAD based software we created anatomically correct 3D models using de-identified scans of the upper airway +/- abnormalities. These models were then used to create negative molds printed by way of fused filament fabrication on additive 3D printers.

These molds were then used to create silicone models for procedural education and submitted to physicians for expert validation.

Trainees were given pre- and post- surveys to gauge level of comfort, understanding and knowledge gained during the training.

Results

Thus far we have created models of the nasopharynx for endoscopy training; tracheal stenosis models for training with dilators, stenosis resection or airway stenting; and disposable tracheal models for tracheostomy. Laryngectomy models are in the process of being created for emergency ventilation training. Survey data showed these models are both effective for training and highly valued by trainees.

Conclusion

The use of 3D printing is enhancing the training of upcoming physicians in procedural base medicine. The integration of technology allows for case-specific, hands-on training at low costs that has proven to be highly valued by trainees. The simulation based training enable by these models also eliminates the need for trainees to learn procedures on live patients and thus should translate to higher levels of care.

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VIE POSTER 14 Extracranial Olfactory Ensheathing Cell Tumor: Case Report of a New Clinical Entity Brian P. Anderson; and Henry F. Butehorn, III Edward Via College of Osteopathic Medicine â&#x20AC;&#x201C; Carolinas Campus.

Introduction

Olfactory ensheathing cells are glial cells that surround the axons of olfactory cells. These cells can grow into tumors that share radiographic and histologic similarities to olfactory schwannomas. Generally, they present with seizures and grow intracranially.

Case Presentation

Discussion

OECTs have rarely been reported. Only immunohistochemical staining for CD-57 can differentiate them from olfactory schwannomas. Our case is the first to present with epistaxis and the only to present within the nasal cavity without intracranial involvement.

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VIE Posters

A 44-year-old female patient with left-sided epistaxis from a mass in the left nasal cavity. CT and MRI imaging found a 4.8 cm mass extending from the left olfactory cleft. Differential included inverted papilloma, esthesioneuroblastoma and metastatic melanoma. The patient underwent endoscopic sinus surgery. The tumor was removed and analysis suggested an olfactory ensheathing cell tumor, which on immunohistochemical staining is positive for S-100 and Neural-Cell Adhesion Molecule (CD-56), and negative for CD-57.

VIE POSTER 15 Free Dermal Fat Autografts for Complex Craniofacial Wounds: A Three-Decade, Retrospective Cohort Study Mikaela I. Poling; and Craig R. Dufresne, MD Georgetown and Virginia Commonwealth Universities

Background

Complex craniofacial wounds (CCW) are those refractory to initial treatment and may involve chronic infection, exposed hardware, irradiated tissue, and soft tissue volume loss. Typical reconstruction with microvascular flaps involves considerable morbidity.

While free dermal fat autografting (DFA) is used extensively in many applications, its use treating CCW remains an unexplored but attractive possibility.

VIE Posters

Methods

Data from a retrospective cohort of 33 consecutive patients (13 male; 20 female and aged 2- and 79-years), who underwent free DFA between 1985 and 2018 for CCW by a single plastic surgeon, were analysed. Post-operative follow-up was 1-24 years (M=6.53, SD=7.91).

Results

Many patients had several concomitant wound complications. Primary pre-operative wound complications were dominated by infection (N 19), of which over 73 percent (N 14) were associated with non-autogenic material. Seventeen had resolution of their pre-operative infection. Of the total (N 33), 78.79 percent were had stable grafts at follow-up [X2(3)=51.24, p<0.001], with only 3 experiencing observable atrophy and 1 graft necrosis. Most of the cohort was complication free [X2(1)=8.76, p=0.003], with 75.76 percent experiencing no problems involving the graft. Twenty-eight (84.85 percent) of 33 patients had therapeutic success with free DFA [X2(1)=16.03, p<0.001]. Mechanism of injury (β=0.34, p=0.037) and pre-operative wound status (β=0.42, p=0.016) predicted therapeutic success [R2=0.96, F(11,6)=12.6, p=0.003]. While 5 (15.15 percent) did not have therapeutic success, no additional problems arose related to graft.

Conclusions

Free DFA appears to be beneficial and show low morbidity. Future studies must evaluate these findings. In this context, their use should be considered in recalcitrant craniofacial wounds.

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VIE POSTER 16 Gastric Schwannoma: A Case Report of a Gastric Schwannoma on the Lesser Curvature of the Stomach Presenting with Upper Gastrointestinal Bleeding Matthew Hager Florida State University

Introduction

Gastric schwannomas are extremely rare mesenchymal tumors that represent only 0.2 percent of all gastric neoplasms. These tumors arise from the Auerbach or Meissner’s plexus and are most commonly found incidentally. Of those presenting with a gastric schwannoma only 12.8 percent of patients will present with upper gastrointestinal bleeding.

Case Presentation

Discussion

With only a handful of reported cases, the need for inclusion of gastric schwannomas to the differential diagnosis of a bleeding gastric mass is essential. From these figures the likelihood of a patient with a gastric mass and upper gastrointestinal bleeding being caused by a gastric schwannoma is 0.026 percent. This points to the fact that this patient presentation is extremely rare but that gastric schwannomas do occur and need to be on the differential diagnosis of a patient with a gastric mass and signs of upper gastrointestinal bleeding.

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VIE Posters

In this report, we present the case of a 51-year-old female with signs and symptoms of upper gastrointestinal bleeding from a gastric schwannoma. The patient’s computed tomography revealed a 6.4 x 5.7 cm mass on the lesser curvature of the stomach near the pylorus. She subsequently underwent esophagogastroduodenoscopy with endoscopic ultrasound and fine needle aspiration revealing SMMS-1, Pankeratin, CD34, DOG-1 and CD117 negative immunohistochemical stains, which suggested a spindle cell neoplasm. The patient’s tumor was surgically resected two weeks later via laparoscopic distal gastrectomy with gastrojejunostomy.

On immunohistochemistry, the tumor stained positive for S100, suggesting a gastric schwannoma. The patient’s postoperative course was complicated by possible early dumping syndrome which resolved in one week with dietary changes. She is tolerating regular food on follow-up and doing well.

VIE POSTER 17 He Said, She Said: Sexual Dimorphism in Trauma Radiology Elizabeth Swezey, MD; Kevin Spence; and Austin McEvoy American University of the Caribbean School of Medicine

Introduction

VIE Posters

Traumatic injury is often worked up with little consideration of gender. Literature suggests that key morphological variations can have a role in the patterns of injury commonly seen. Knowledge of gender differences is especially critical in forensic radiology.

Mass casualty situations may involve processing and identification of many unknown victims, sometimes with commingled remains. Traumatic brain injury (TBI) is more common in males. Male athletes experience head trauma twice as often as female ones, although the female cohort has worse outcomes. This may be related to gender-based skeletal differences of the skull and spine.

Crash car dummies are based on the average male, hence the effects of MVA trauma on females remains less explored. Smaller vertebrae and alterations of muscular biomechanics may lessen c-spine stability in women, who are more prone to whiplash injuries.

Additional examples of gender differences relevant to trauma include a womanâ&#x20AC;&#x2122;s smaller rib cage and weaker overall bone structure.

Cases

Head and Neck Variations of the male skull tend toward dolichocephaly while those of the female toward brachycephaly. Male skulls are larger, with a more prominent supraorbital ridge, mastoid process, mandible and zygoma. Nevertheless, female skulls are proportionally thicker and heavier. Males tend to have more zygomatic fractures and less mandibular fractures than females.

Spine Females have smaller vertebra in all dimensions than males. Decreased facet size and segmental support area contributes to less stability. Women have a greater lordotic curvature than males, an adaption for pregnancy.

Thoracic Because of greater rib inclination, females can accommodate greater volume expansion. This may help explain why men have more diaphragmatic ruptures. Furthermore, the stiffness of female ribs is less with blunt impacts accounting for increases intrathoracic injury. Always be mindful of breast hematomas as a complication.

Abdomen Premenopausal women store more fat externally while even lean men carry more of their body fat viscerally, hence the decreased abdominal injury severity in women.

Pelvis The pelvis offers the most definitive traits of sexual differentiation. From below, it has an inverted V shape in males and broad inverted U shape in females. Females have greater acetabular, which may improve hip stability during A-P loading, decreasing posterior hip dislocations. Pelvic fractures are associated with urethral injuries. Anatomical differences are pertinent regarding catheterization.

MSK Sexual differentiation in skeletal radiology is unreliable until after puberty. The male skeleton is more robust with more prominent musculoskeletal attachments. With aging, hyperostotic changes become more pronounced. Men have stronger bones as they get older, while women are more prone to osteoporotic fractures.

Discussion

Structural changes amongst men and women are seen from head to toe, involving both bone and soft tissue. In trauma radiology, it is imperative to recognize that minor gender differences can amplify the discrepancies seen in patterns of injury.

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VIE POSTER 18 How Can We Be More Prepared to Meet the Needs of Our Patients? A Retrospective Chart Review of a Medical Mission Trip to Jarabacoa, Dominican Republic Taylor L. Jarvill; Madeline MacDonald; Jessica T. Phan; Stephanie Z. Yee; Paul J. Wells; Liwei Chen, MPH; Rahul Mhaskar, MD, PhD; and Javier Cuevas, PhD University of South Florida Morsani College of Medicine

Background

Latino Medical Student Association (LMSA) at the University of South Florida Morsani College of Medicine (USF MCOM) conducts an annual student run medical mission trip to Jarabacoa, Dominican Republic (DR). The focus of this quality improvement project is to identify the conditions we diagnose but are unable to treat and identify disparities in gender or age groups.

Methods

Results

940 patient charts were analyzed. 70 patient charts were omitted from the study due to incompleteness. Frequent chief concerns were upper respiratory infections (n=221, 22.9 percent), gastrointestinal concerns (n=177, 15.85 percent), headache (n=92, 13.4 percent), musculoskeletal pain (n=70, 8 percent), and low back pain (n=58, 6.6 percent). Frequent diagnoses were upper respiratory infections (n=165, 19 percent), parasite prophylaxis (n=124, 14.3 percent), hypertension (n=88, 10.1 percent), headaches/ migraines (n=59, 6.9 percent), gastrointestinal problems (n=53, 6.1 percent), and musculoskeletal pain (n=53, 6.1 percent). Frequently prescribed medications were acetaminophen (n=183, 21 percent), albendazole (n=161, 18.5 percent), NSAIDs (n=103, 11.8 percent), multivitamins (n=97, 11.2 percent) and antibiotics (n=64, 7.4 percent).

Conclusion

While hypertension was the third most common diagnosis, hypertension medications were not commonly prescribed due to concerns of patients’ abilities to continue their medication upon finishing initial supply. We were better equipped to treat acute conditions and identified areas to improve to increase the utilization of our clinics. We recognize the need for community clinicians who can provide longitudinal care for our clinic patients.

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VIE Posters

An IRB was obtained from USF MCOM to conduct a retrospective chart review of 940 medical charts from the 2017 and 2018 LMSA medical mission trips to Jarabacoa, DR. SPSS software was used to conduct mean and standard deviation for age. Frequencies were conducted for categorical variables for chief concern, diagnoses, and medications prescribed. Chi-square and CochranMantel-Haenszel tests were performed to investigate an association between outcomes and age or gender. Association of chief complaints, diagnosis prevalence and prescriptions were explored while controlling for age or gender.

VIE POSTER 19 Implementation of the Below-Knee Johnson Prosthetic Leg in Tegucigalpa, Honduras Phil Johnson; Sue Beatty, MD; and Michael Mabry, DO Bristol Medical Center

Background

VIE Posters

In 2015, the World Health Organization (WHO) estimated that 80 percent of the 110 to 190 million people living with disabilities resided in developing nations. They also estimated by 2010 over 25 million people worldwide would need prosthetic or orthotic devices to best function in society. Many of these patients lack access to prosthetics due to poverty, high prosthetic costs and technician shortages. The purpose of this study seeks to explore the hypothesis that a newly designed prosthetic leg, that costs less than $100 to manufacture, can assist amputee patients by increasing their ability to gain employment, thus improving their quality of life. The specific criteria to accept the hypothesis is greater than 50 percent of the amputee participants, who previously reported they were unable to work, would be able to obtain a paying job as a direct result of using the prosthetic leg used in this research.

Methods

This study was approved by the Edward Via College of Osteopathic Medicine (IRB #2014-033). Amputee patients over the age of 17 were seen at the James Moody Adams Clinic at Baxter Institute in Tegucigalpa, Honduras. They received an approved consent form prior to participating in an investigational prosthetic leg research and their medical history was collected. Each participant was assessed by a medical doctor and board certified prosthetist for their ability to safely use the newly designed prosthesis called the Johnson Prosthetic Leg (JPL). Amputees received a prosthetic leg at no cost if found to be an appropriate candidate. Participants were followed by a physician and a follow-up survey was administered after using the prosthetic device for a minimum of six months.

Results

In this study, 306 amputee patients were surveyed and 149 had below knee amputations. Amputation due to diabetic infection was most prevalent with 118 (38 percent) while traumatic injuries accounted for 95 (31 percent). Participants received the JPL and surveys were obtained after prosthetic use of six to 27 months. It was found that 64/66 participants (96.9 percent) reported wearing their prosthesis six to seven days a week. Prior to this research, 38/66 participants (57.6 percent) had some ability to perform a paying job. After having the ability to walk using the JPL, 59/66 participants (89 percent) reported an ability to obtain employment and provide financially for themselves and their families. This indicated that 21 of the 28 (75 percent) participants, who previously reported the inability to work, were able to obtain a job after receiving the JPL.

Conclusion

The research hypothesis was accepted based on a criteria of greater than 50 percent of the participants, who were previously unable to work, had an increased ability to obtain employment after using the JPL. It was also noted that 65/66 participants (98.48 percent) self-reported improved self-esteem using a researcher developed survey and would recommend this prosthetic device to other amputee patients. By greatly reducing financial barriers, the $100 JPL is a potential cost effective solution to help amputees living in developing nations acquire prosthetic legs. This successful pilot study provides justification for continuation and monitoring for any additional refinement. Further, it provides the basis for future studies, in additional countries, to determine efficacy to assist amputee patients living in poverty.

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VIE POSTER 20 Lipocalin 2 (LCN2) Knockout Mice are Protected Against Acute Liver Failure Induced by Acetaminophen Overdose Christine J. Okaro; E’Joven D. Reed; Christopher J. Moses; Harish Parihar, PhD; Rangaiah Shashidharamurthy, PhD; and Vishakha S. Bhave, PhD Philadelphia College of Osteopathic Medicine (PCOM) - School of Pharmacy

Background

Methods

Recent data from our lab indicates that LCN2 KO mice are protected against ALF caused by APAP-overdose compared to WT mice. Protection is due to differences in liver injury progression at later time points (24-48hr), not decreased bioactivation. KO mice exhibit significantly less hepatocellular damage (ALT and histopathology) and higher liver regeneration post-APAP overdose.

Pro- and anti-inflammatory cytokine expression in WT and KO mice subjected to APAP overdose (400mg/kg) were assessed by ELISA and immunoprecipitation over a time course. We observed significantly higher IL-6 expression at 0, 24, 36, 48hr in KO mice as compared to WT.

Conclusion

Findings corroborate with previous data suggesting IL-6’s role in promoting liver regeneration and higher PCNA in KO mice. No difference in IL-10 expression negates its role in the observed protection. Ongoing studies investigate HMGB1 and Beclin-1 binding between KO and WT mice as a potential mechanism of liver injury progression. Findings identify pathways involving LCN2 and recognize potential APAP-induced liver injury attenuation targets.

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VIE Posters

Acetaminophen (APAP) overdose is the most common cause of Acute Liver Failure (ALF) in the U.S. Following APAP overdose, toxicity is initiated by the conversion of APAP to its reactive metabolite N-acetyl-p-benzoquinone imine (NAPQI), which binds covalently to mitochondrial proteins leading to centrilobular necrosis and sterile inflammation. Lipocalin-2 (LCN2) is an acute-phase innate immune protein upregulated during tissue injury in various organs including the liver. LCN2’s mechanism in APAP-induced ALF is the objective of this study. During APAP-induced necrosis, hepatocytes release High Mobility Group Box 1 (HMGB1), a Damage Associated Molecular Pattern (DAMP). HMGB1 is protective or damaging based on its location (nucleus, cytoplasm, or extracellularly). Cytoplasmic HMGB1 binding to Beclin-1 induces autophagic responses in support of hepatocyte regeneration. We hypothesize relationships between IL-6, HMGB1, Beclin-1 and LCN2 mediate injury progression.

VIE POSTER 21 Map to the Axillary Nerve Katelyn Fellows; Andrew N. Odland, MD; Jonathan T. Hagen, MD; Michael T. Lee, BS; Katelyn M. Fellows, BS; Gabriella M. Doyle, MD; Britta L. Swanson, PhD; and Kyle E. Swanson, MD University of Nevada Reno School of Medicine.

Background

Subpectoral biceps tenodesis using a bicortical button for fixation has been associated with risk of damage to the axillary nerve.

This study examines the anatomical relationships between the bicortical button, the tenodesis location, the pectoralis major (PM) tendon and the axillary nerve.

Methods

VIE Posters

Bicortical subpectoral biceps tenodesis was performed on six cadaveric shoulders from three specimens. The deltoid was excised from the acromion and the axillary nerve (AN) was identified and dissected. Measurements were taken between the button and the AN as well as between the center of the reamed cortical opening and the superior border of the PM tendon.

Results

The distance between the button and the axillary nerve was strongly positively correlated with the distance from the reamed cortical opening and the superior border of the pectoralis major tendon (R = 0.9785; P-value < 0.01).

Conclusion

The proximal border of the pectoralis major tendon may be a useful landmark which strongly correlates to the level of the anterior branch of the axillary nerve. The subpectoral bicep tenodesis using a bicortical button is a very safe procedure with regards to the axillary nerve given it is performed below the superior border of the pectoralis major tendon. Level of Evidence = V.

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VIE POSTER 22 Mass in the Mons Pubis: An Unusual Presentation of Clear Cell Adenocarcinoma Meg Mathis; Thomas S. Powell, III, MD; and Tobe S. Momah, MD University of Mississippi

Introduction

In general, clear cell carcinomas (CCC) are considered to arise from the kidneys, ovaries and endometrium. Few recorded cases have originated from the peritoneum, and many that do have had high mortality. Here we present a case of CCC of peritoneal origin in a lady presenting with a mass underlying the mons pubis.

Case Presentation

Discussion

This case of CCC arising from the peritoneum underscores the importance of early recognition of pelvic masses. A history of endometriosis could serve as a diagnostic clue as it is frequently associated with CCC. One literature review observed that management of these patients typically consisted of cytoreductive surgery followed by chemotherapy and that prognosis seemed to be correlated with the amount of residual tumor. Awareness of this presentation of CCC is of value to the clinician as early diagnosis could help improve patient outcomes.

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VIE Posters

Our patient is a 43-year-old G2P1011 African-American female with a history of endometriosis who presented to the emergency department for worsening fatigue and a mass on her mons with left inguinal fullness for the past year. We ordered a CT abdomen/ pelvis which showed an 8x7 cm mass underlying the mons with retroperitoneal and inguinal lymphadenopathy. Ultrasoundguided biopsy revealed invasive adenocarcinoma; tissue testing confirmed CCC of Mullerian origin. Gynecologic oncology was consulted, who referred the patient to a tertiary institution. There she was placed on neoadjuvant chemotherapy and underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy, peritoneal tumor debulking, left pelvic lymph node dissection, and excision of the left inguinal mass. Pathology revealed that the primary tumor had invaded adjacent muscle tissue and that the inguinal mass was fibroadipose tissue. Additionally, one of three dissected pelvic lymph nodes was positive for metastatic carcinoma. The remaining specimens and all resection margins were clear. This patient is currently following up with the tertiary center.

VIE POSTER 23 Maternal Asthma and Length of Hospital Stay for Infants with Neonatal Abstinence Syndrome Kyndall Sara Smith ETSU Quillen College of Medicine

Background

Asthma is one of the most common chronic conditions in pregnant women, affecting between 3.7 and 8.4 percent of pregnant women in the U.S. Maternal asthma has been associated with adverse pregnancy outcomes, including preterm birth. Another pregnancy risk factor that has increased exponentially over the last decade is opioid use, causing a spike in the number of infants born with Neonatal Abstinence Syndrome. This study aimed to determine whether maternal asthma was associated with additional complications for NAS newborns, measured by the length of the newborn hospital stay.

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Methods

A medical record review was performed for 137 newborns with prenatal drug exposure, an NAS diagnosis and a NICU stay after delivery. Maternal asthma status was considered positive if asthma was noted anywhere in the prenatal or delivery chart, or if an ICD code indicating asthma was present.

Results

Chi square analysis revealed that 29.2 percent of infants in this sample born to asthmatic mothers had a newborn hospital stay exceeding four weeks, compared to 15.0 percent of infants whose mothers did not have asthma. After controlling for potential confounders, logistic regression showed that infants born to asthmatic mothers were almost twice as likely to stay in the hospital for > four weeks. Lastly, an analysis was performed to examine potential differences between the two infant groups and their respective peak NAS scores. Infants born to women with asthma didn’t have significantly higher peak NAS scores compared to infants born to non-asthmatic women.

Conclusions

Given the significant increase in length of hospital stay in the infants with asthmatic mothers and the non-significant relationship in peak NAS scores, in utero asthma exposure combined with opioid exposure may be leading to newborn complications outside the scope of traditional NAS symptoms. Findings suggest that controlling asthma should be a priority when addressing opioid exposure during pregnancy.

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VIE POSTER 24 Minimally Invasive Gynecologic Surgery in the Global Health Setting Kayla E. Nixon, MD Mayo Clinic

Background

One-third of the world’s population lives in low- or low-middle income countries, but only 6 percent of surgical procedures occur in these areas. Basic surgical care could avert 6 to 7 percent of deaths in these countries. There is growing consensus that surgical capacity building must be a priority of global health interventions. Further, minimally invasive surgery (MIS) involving no or few small incisions—including endoscopic, laparoscopic and robotic techniques—decreases complications, such as surgical blood loss, wound complications, post-operative pain and recovery time.

Methods

Results

Often cited barriers to performing MIS in low-income countries were low stakeholder priority, perceived high cost and limited training/expertise. National political leaders and key stakeholders infrequently give attention to MIS. Hospital pay-structures or hierarchies can also counteract advocacy. There are misperceptions regarding cost-effectiveness of MIS because of upfront equipment costs, despite long-term benefits of decreased medical complications, hospital stays and earlier return to work. Limited trained personnel with experience in minimally invasive techniques is another barrier. Solutions were also reviewed, which include partnerships with high-income institutions for supplies and medical volunteers, MIS surgical camps, surgical curriculum development and online libraries with training resources.

Conclusion

MIS in low-income healthcare settings has many barriers, including arguable misconceptions like increased cost, along with successful examples of how barriers have been overcome. Global MIS improves patient safety and can be accomplished largely through institutional and provider relationships, curricular development and creative resources.

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A literature review was conducted of Pubmed and Ovid Medline databases using a combination of the terms “minimally invasive surgery,” “low- or middle- income countries,” “laparoscopy,” “endoscopy” and “global surgery.” Key articles were identified and reviewed, along with relevant references if pertaining specifically to the title subject.

VIE POSTER 25 Neuroborreliosis and Empty Sella Sign Keerthana Srinivasan; Sagar Matharu; and Harpal Mangat, MD University of Maryland, College Park Howard University School of Medicine

Background

The pituitary gland lies in the Sella Turcica (Turkish saddle). Adjacent to the Sella Turcica is the Cavernous Sinus with many key anatomical structures. Lateral to the Cavernous Sinus is the Subarachnoid space. Routinely, on MRI images, minimal CSF is seen.

When there is excess fluid in this space, it is deemed Empty Sella. Empty Sella refers to the accumulation of cerebrospinal fluid in the subarachnoid space next to the cavernous sinus. This study aims to discover if the symptoms of Neuroborreliosis causes inflammation in regions of the brain, which results in an increase in intracranial pressure affirming a flattened pituitary gland and appearance of an empty Sella.

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Methods

19 patients, all previously diagnosed with Lyme, had MRIs of the orbits and cavernous sinus with contrast taken. Patients who had MRIs of the brain taken were excluded from the study.

Results

Eight of these patients were found to have an empty sella. 18 patients were diagnosed with Argyll Robertson Pupil and Sixth Nerve Palsy. 12 patients were diagnosed with fourth nerve palsy. Six patients were diagnosed with trigeminal neuralgia.

Conclusion

Neuroborreliosis has a correlation with Empty Sella and Argyll Robertson, Sixth nerve Palsy and Fourth Nerve Palsy, which can potentially be used as an effective clinical approach to Lyme disease diagnosis. â&#x20AC;&#x192;

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VIE POSTER 26 Outcomes of Total Joint Arthroplasty in Developing Countries: A Critical Analysis and Review of the Literature Curtis T. Adams, MD; and Isaac Adams, JD Albany Medical Center, Dept of Orthopaedics, Albany, NY.

Background

Total joint arthroplasty (TJA) is increasingly performed in developing countries by both local and itinerant surgeons. However, the safety profile and outcomes of TJA in these environments have not been thoroughly evaluated, unlike those performed in the United States. The purpose of this review is to identify current outcomes and concerns involving TJA in developing countries.

Methods

Results

Current literature shows a slightly higher rate of complications in developing countries compared to the U.S. The two most significant complications were cardiac mortality, up to 2 percent in one series of 100 patients, and component loosening or intraoperative fracture, found to be related to surgeon skill. Thorough cardiology workup and better technical training were advocated in both cases. Causes for revision mirrored those in the U.S., most commonly for infection, then aseptic loosening, then fracture. As expected, small volume surgeons had a greater length of stay for most patients. The development of a local joint replacement registry was strongly encouraged by multiple studies for training, research and follow-up purposes. Finally, two studies noted indigenous patient concerns for inadequate follow-up and procedure expense when being treated by itinerant surgeons.

Conclusion

The outcomes of TJA in developing countries are largely reassuring, whether performed by itinerant or indigenous surgeons. Better training, appropriate patient selection, adequate preoperative workup, post-operative follow-up and activity regimens, and the development of local joint registries will all serve to increase the safety and efficacy of this procedure in limited resources environments.

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We searched current orthopaedic literature for articles discussing TJA in developing countries. We included 40 articles in our review; each was PubMed indexed, published in the past four decades, and comprised a case report, study or observation regarding outcomes or concerns surrounding TJA in developing countries.

VIE POSTER 27 Pediatric Intellectual Disability and Inter-provider Communication Satisfaction Kyle Baumann Virginia Commonwealth School of Medicine Edward Via College of Osteopathic Medicine

Background

Approximately 1 percent of the world’s population has an intellectual disability. Significant health disparities within this population have been recognized over the past two decades. Adequate inter-provider communication is critical for quality clinical outcomes and patient/family satisfaction among persons with intellectual disabilities, though little attention has been given to this population. This study investigates guardian satisfaction of the communication between the healthcare providers of children with intellectually disabilities, under the hypothesis that guardians of these children report lower satisfaction with healthcare provider communication as compared to the general population.

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Methods

Data from the 2016 National Survey of Children’s Health (NSCH) was used. The association between intellectual disability and satisfaction of communication between providers was assessed using a chi-square test; associations between satisfaction and nine important other measurements were also investigated. The weighted percentages of the two groups were then compared to determine the location and nature of the association.

Results

The evidence suggests a statistically significant association between pediatric intellectual disability and satisfaction with interprovider communication (p=<0.0001), where those guardians of children with intellectual disabilities reported lower satisfaction with inter-provider communication than those guardians of children without such disabilities.

Conclusion

These results encourage re-evaluation of current inter-provider communication methods among physicians who care for pediatric patients with an intellectual disability. Consideration of greater use of care coordination services within this population is warranted. Further research to determine the main factors contributing to the lower satisfaction level should be pursued.

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VIE POSTER 28 Penetrating Intracranial Trauma of Two Minors Treated with Endovascular Technique with Use of Temporary Balloon Occlusion for Proximal Arterial Control Brian N. Kacheris; George I. Jallo; Jeffrey W. Crooms; Narlin B. Beaty; T. Adam Oliver; and Matthew F. Lawson Florida State University College of Medicine

Introduction

Penetrating intracranial trauma in children is extremely rare. Utilization of temporary balloon occlusion for proximal arterial control to remove penetrating intracranial objects has only been reported once before in the literature. Cunningham et al demonstrated the first successful orbitocranial removal of a penetrating object from the cavernous sinus and orbit utilizing temporary balloon occlusion of the cavernous carotid artery. We present the first and second cases reported of successful simultaneous removal of penetrating objects from intracranial, intradural injuries suffered by two children treated with balloon occlusion of the internal carotid and vertebral artery and who both recovered and discharged home.

We present two children treated with endovascular techniques to gain proximal arterial control of the internal carotid and vertebral artery prior to removal of penetrating objects from the skull base. Both siblings (8 month and 22 month boys) were injured by different sharp objects (knife and scissor) by a guardian. They were transported to the emergency room where vascular control, including coil embolization and internal carotid balloon occlusion were performed in the neuro endovascular suite for safe removal of penetrating objects. Both minors recovered and were discharged home without any focal neurological deficits. In two children with scissor and knife stab with intracranial penetration, endovascular technique allowed safe removal of objects and ensured proximal arterial control was maintained to control for possible extravasation of blood upon removal from the skull base.

Discussion

Penetrating intracranial trauma in children is extremely rare. Compared to blunt head trauma, penetrating intracranial injury is more lethal due to risk of vascular injury leading to intracranial bleeding and death. Temporary balloon occlusion ensured proximal arterial control in penetrating intracranial injury in two minors. Coil embolization and temporary balloon occlusion allowed safe removal of intracranial penetrating objects from the skull base in two children. First report of two cases of intracranial, intradural injuries suffered by two children treated with temporary balloon occlusion of internal carotid and vertebral artery who recovered and discharged home. â&#x20AC;&#x192;

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Case Presentation

VIE POSTER 29 Registered Nurse Students Collaborating with Dental Screening Linda D. O’Boyle, EdD Barton College

Introduction

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The first time the dental van was used in Wilson County, we turned many patients away because of uncontrolled hypertension.

There were patients who had undiagnosed hypertension or did not have the money for their prescribed medications. As a member of First Baptist Church of Wilson, North Carolina and the Program Director for the Barton College RN-BSN program, I volunteered the RN students who were enrolled in the program to make home visits the next year to reduce the number of patients that were unseen due to medical conditions. As in most rural areas, there are many patients without dental insurance. The dental van provides the only dental care that these patients can receive. For the next three years, the Department of Social Services organized a County Health Fair that collaborated with the NCBM Health Screening Ministry mobile unit for medical and dental care. Patients were screened by DSS, then referred to Barton College faculty who coordinated the RN students in the BSN program to make home visits for the dental patients.

Case Presentation

RN students enrolled in the RN-BSN program at Barton College in Wilson, North Carolina made home visits to all patients scheduled to be seen on the dental van. BP were obtained with instructions for dietary and pharmacologic compliance. By making a home visit, the RNs could assess the patient’s environment as well as provide the necessary teaching to ensure that patients would not be turned away for dental care due to uncontrolled hypertension, anticoagulation use or lack of prophylactic antibiotic therapy.

Discussion

No patients were unseen due to hypertension. The RN students also participated the day of the dental care. This opportunity provided an excellent community clinical experience for RN students in which they were able to provide their expertise and a valuable service to the community.

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VIE POSTER 30 Restored from Leprosy: A Case in Rural Indonesia John D. Scott Pacific Northwest University of Health Sciences

Introduction

Leprosy is a treatable bacterial skin infection caused by Mycobacterium leprae, which, if left to its natural course, is disfiguring physically. However, the stigmatizing social and psychological effects can be the most challenging aspects of the disease. Before the pathophysiology and effective treatment of leprosy was understood, social and physical isolation of lepers was the standard of care.

Unfortunately, much of this social and physical isolation remains in countries where leprosy is still endemic, such as India, Brazil and Indonesia.

Case Presentation

Discussion

The case of Hendrik illustrates that isolation of lepers is still indicated in some situations, but for opposite reasons than in past history. Instead of protecting the populations from infection, it is to protect the individual from harshness of society. In addition, the care needed for leprosy complications can be effectively delivered.

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In 2006, a medical team from International Friends of Compassion (IFC), working in remote Halmahera, Indonesia, found a leprosy patient named Hendrik, who was abandoned by his village, couldn’t walk or work, and lived in a tiny jungle shack on village outskirts. Many villagers referred to him as a monkey, as his face, hands and feet were especially deformed by his illness. IFC staff convinced Hendrik to come to the IFC Clinic, where he was treated with the standard of care for leprosy while living in a secluded facility called Tamariska. He also received physical therapy, which led to regaining his ability to walk. In additional, through spiritual care he was able to leave behind his prior bitter resentment of his circumstances and live in thankfulness. Hendrik has been free from M. leprae since approximately 2008, but continues to live in the safe environment at Tamariska. His continuing medical needs most commonly include foot wound care, cellulitis, and respiratory infections and disfunction.

VIE POSTER 31 Restoring Wholeness to Healthcare: An International, Qualitative Study of the Value, Use, and Impact of Whole Person Medicine Training Sharon Ann Falkenheimer, MD, MPH, MA (Bioethics), PhD Albany Medical College

Background

Whole person medicine (WPM) considers all facets of the person and has the potential to improve physician-patient interaction and satisfaction.

VIE Posters

Methods

This qualitative, interview study of 24 healthcare professionals in 15 nations explored what makes PRIME: Partnerships in International Medical Educationâ&#x20AC;&#x2122;s WPM training valued and applied by healthcare professionals and what impacts resulted. The study addressed two major areas: (1) the educational methods used to train healthcare professionals; and (2) the high level of dissatisfaction of healthcare professionals and patients.

Results

The results substantiated the benefits of WPM and whole person teaching in improving clinical care, healthcare professional and patient communication and satisfaction, healthcare professional education, and healthcare leadership and administration. It confirmed the continued predominance of teacher-centered instruction for the training of healthcare professionals in many locations.

Students in multiple countries and cultures enthusiastically accepted interactive, student centered instruction and appreciated the more relational, open, caring teacher-student relationships of whole person teaching.

Conclusions

Healthcare professionals who experience transformation through and develop a passion for the whole person approach to healthcare and education tend to model and practice it in their professional lives and to seek to pass it on to others.

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VIE POSTER 32 Retrospective Cohort Study to Assess the Prevalence of Metabolic Syndrome in Central Centrifugal Cicatricial Alopecia Patients Yostina Farid; Grace B. Ayandibu, MS; Yostina Farid, BS; and Wilma F. Bergfeld, MD, FAAD Cleveland Clinic Foundation

Background

Chronic inflammatory diseases are associated with metabolic syndrome. Studies associating metabolic syndrome with Central Centrifugal Cicatricial Alopecia are scarce. Our objective was to determine the prevalence of metabolic syndrome and its major factors in Central Centrifugal Cicatricial Alopecia patients.

Methods

Results

In our patients with Central Centrifugal Cicatricial Alopecia, the prevalence of metabolic syndrome was 40.23 percent. This is significantly higher than the 4 percent prevalence in normal weight, black female adults (p<0.001).

Conclusion

Our results highlight the comorbidities in patients with Central Centrifugal Cicatricial Alopecia. As with other chronic inflammatory diseases, these patients have an increased prevalence of metabolic syndrome and its factors. Therefore, patients with Central Centrifugal Cicatricial Alopecia are at a higher risk of developing insulin resistant diabetes mellitus and cardiovascular diseases.

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A retrospective chart review was performed at the Cleveland Clinic Foundation dermatology clinic. Medical records of 90 adult, black female patients with a diagnosis of Central Centrifugal Cicatricial Alopecia made by biopsy and clinical presentation were carefully reviewed. Participants were examined for factors contributing to metabolic syndrome and were compared to two populations of black female adults published in the National Health and Nutrition Examination Survey. Population 1 (General population) included all black female adults while Population 2 (Normal weight population) included black female adults with normal weight (BMI 18.5 â&#x20AC;&#x201C; 24.9).

VIE POSTER 33 Secondary Sclerosing Cholangitis in Critically Ill Patients: A Case Report Dana Penfold; and Michael Herman, DO Lake Erie College of Osteopathic Medicine

Introduction

Secondary sclerosing cholangitis (SSC) is an unusual disease found in critically ill patients after a prolonged hospital course. It is characterized by progressive intrahepatic and extrahepatic bile duct inflammation leading to hepatic fibrosis and biliary strictures.

We present a case of SSC along with a review of the literature.

VIE Posters

Case Presentation

A 76-year-old male was evaluated for biliary cholestasis after a tortuous medical course complicated by sepsis, septic shock, aspiration pneumonia, renal failure and metabolic encephalopathy. There was no history of chronic liver disease or liver decompensation.

He was on multiple medications but no recent exposure to common hepatotoxic agents. Transaminases prior to admission were normal and subsequently increased over six weeks, aspartate aminotransferase at 109 U/L, alanine aminotransferase at 105 U/L, alkaline phosphatase 1379 U/L and gamma-glutamyl transferase at 600 U/L. Total bilirubin was normal. Liver and abdominal imaging were notable for a small amount of ascites, normal liver contours and no splenomegaly. Hepatitis panel was negative.

There were no subjective complaints and physical exam was otherwise fairly benign. SSC was diagnosed and patient treated with supportive care.

Discussion

Literature on SSC is limited and only recently described. Few treatment options exist. Bacterial cholangitis as a result of SSC biliary strictures should be treated with broad spectrum antibiotics, although studies report frequent antibiotic resistance of isolates that may present therapy challenges. Endoscopic retrograde cholangiopancreatography (ERCP) may be used for removal of biliary casts, intermittent stenting, sludge extraction, endoscopic dilations, or sphincter of Oddi sphincterotomy. These therapies may be associated with short-term improvement, but they do not appear to prevent disease progression. The majority of cases require liver transplantation with a resulting one-year survival rate of 85 percent and three-year survival rate of 83 percent reported. â&#x20AC;&#x192;

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VIE POSTER 34 Tending to the Spirit in a Newly-Diagnosed Cancer Patient Thuy Le, DO; Obiefuna Okoye, MD; and Muhammad Zafar, MD Southeastern Regional Medical Center

Introduction

Cancer affects every aspect of an individual’s life and comes with serious challenges. Often overlooked are the spiritual needs of those struggling to cope with the new, devastating diagnosis. We describe a case where recognizing and addressing the spiritual needs significantly improves the patient’s perception of his overall quality of care.

Case Presentation

Discussion

Cancer often causes great distress in patients. Patients learn to handle and understand their sufferings through their spiritual beliefs.

Physicians must sensitively address the most common spiritual needs starting at diagnosis and throughout treatment.

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A 76-year-old male presented to the hospital with three-month history of weakness. He also endorsed poor appetite, cough, fatigue and dyspnea. During hospitalization he had intermittent fever. On physical examination, he was thin, strong-willed, and stated, “God hates me.” Computerized tomography showed numerous pulmonary nodules, left retroperitoneal soft tissue mass, and hepatic hypodensities, suggestive of metastatic disease. CT-guided liver biopsy demonstrated diffuse large B-cell lymphoma. As the patient was lying in the hospital bed comfortably, the PGY-1 resident entered the room and informed the patient and spouse about the new cancer diagnosis. Later, the spouse informed the senior resident that they were not pleased, perceiving that the resident had shown a severe lack of compassion. He became devastated, anxious, dyspneic and developed sinus tachycardia and hypertensive urgency. Rapid response was called to evaluate for ICU transfer. Aggressive pulmonary measures stabilized his condition.

His restlessness continued unabated. The PGY-2 resident took 30 minutes sitting, holding his hands and listening to his stories.

Soothing Christian music played in the background. Anxiety and restlessness resolved. Throughout his 11-day hospitalization, the PGY-2 resident spent time daily to reiterate that his entire treatment team “are and will always be here for him.” Upon discharge, he expressed that he was “at peace” and grateful that spiritual care was provided to him.

VIE POSTER 35 The Effect of Newer Therapies of Choral Singing on Language Function of Aphasic Patients Sonia Dela Cruz; Bertha Ben Khallouq, MA; and Stephen Berman, MD, PhD University of Central Florida College of Medicine

VIE Posters

Background

A curious phenomenon is that while non‐fluent aphasic patients cannot speak, they preserve the ability to sing prior learned songs.

Thus, therapies have been developed utilizing choral singing (singing in synchrony with an auditory model). There is sparse research on newer strategies, such as SIPARI ® which adds the element of singing improvisation, SMTA (Speech Music Therapy for Aphasia patients) which combines musical elements and speech language therapy techniques, and CST (Choral Singing Therapy) which adds performance and group aspects. Studies which used choral singing in their protocol without a therapy name were also included. In patients with severe aphasia, treatment response is limited and efficacy outcomes are low so exploring other avenues for recovery is imperative. This literature review aims to determine whether newer therapies utilizing choral singing improve language function in patients with aphasia.

Methods

An extensive literature search was done utilizing PubMed, CINAHL Plus, EBSCOhost and Science Direct databases.

Results

Four studies showed language function improvement in all subjects, one showed improvement in 50 percent of patients and one showed no improvement. Disparate methods, measures and designs make inter-study comparison challenging although the presence of an auditory model was shown to improve word repetition and recall. Future considerations for researchers would be to agree on standardized measures and methods, test for reproducibility, establish a control group and recruit a larger sample size.

Conclusion

Choral Singing Therapy (CST) shows most promise with its low implementation cost, community‐based focus, one-one-one benefits of singing with an auditory model and group benefits on mood and sense of isolation.

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VIE POSTER 36 The Impact of Cultural Competency Training on Short-Term Mission Team Members Shelia B. Talbott; and Deborah Gray Old Dominion University

Background

Each year over two million Americans participate in global short-term mission (STM) trips providing healthcare, yet the sparse literature available indicates that many of these teams are inadequately prepared to work with other cultures. More evidence and new models for standardized cultural sensitivity training are needed. This project examines cultural competency in first time and returning STM team members and determines the impact of structured cultural sensitivity training on levels of cultural competency, perceptions of culture shock and the overall mission experience.

Methods

Results

Significant changes in cultural competency knowledge, perceptions of culture shock and mission experience following standardized cultural competency training were seen. There were no changes in cultural competency self-assessment scores.

Conclusion

Culturally sensitive care guides the practice of nurse practitioners. This study seeks to close some of the evidence-based gaps in current knowledge as well as capture and quantify cultural competency outcomes as it relates to short-term missions. This knowledge can help STM team leaders prepare and provide culturally sensitive training, improve patient outcomes and provide positive mission experiences. â&#x20AC;&#x192;

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A quasi-experimental pre-test/post-test design was used. Participants include English-speaking mission team members ages 18 years and above. They participated in a cultural competency educational session as part of their existing pre-mission trip training.

Outcomes were assessed pre and post-intervention as well as post-mission trip. Within group differences in pre and post knowledge and cultural awareness, levels of self-purpose, and post trip perceptions of their mission experience were measured using researcher developed tools.

VIE POSTER 37 The Role of the Healthcare Provider in Caring for Victims of Human Sex Trafficking Cynthia D. Stanton; and Lubaba Haque Marian University College of Osteopathic Medicine

Background

Human sex trafficking is a long-standing epidemic that has plagued society for many generations, but it has only gained traction in recent years as an issue worth investigating and confronting. According to the International Labor Organization, an estimated 4.8 million people are currently subjected to forced sexual exploitation worldwide. This crisis is not limited to developing parts of the world, but is pervasive in all 50 U.S. states and not restricted to a particular race, sex, socioeconomic status or sexual orientation.

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Methods

This project is a literature review seeking to recapitulate best clinical practices for the care of individuals who are or have been subjected to sexual abuse.

Results

Through their review, the authors provide a definition of sex trafficking, identify red flags that every clinician should recognize, including commonly missed signs. They suggest screening tools, recommend viable history and physical examination techniques, summarize specific health issues plaguing victims and synthesize a network of resources.

Conclusions

With so many individuals exploited by this massive industry, victims are routinely seen in healthcare settings. One study estimated that nearly 50 percent of victims saw a healthcare provider during the period of their exploitation. Thus, it is imperative that healthcare providers recognize the warning signs of sexual exploitation in order to respond safely, urgently and appropriately.

If healthcare providers are properly equipped and made aware of this ubiquitous humanitarian disaster, a great movement can be made against it as a pragmatic approach is taken in caring for individuals who have been victimized. â&#x20AC;&#x192;

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VIE POSTER 38 TPP: A Reflexive Diagnosis Samantha J. Allen, MD; Juan N. Lessing, MD, FACP; and Mel Anderson, MD, FACP University of Colorado Internal Medicine

Introduction

Thyrotoxic periodic paralysis (TPP) causes intermittent attacks of proximal muscle weakness and, rarely, respiratory muscle failure.

Like other forms of periodic paralysis, it is a membrane channelopathy. Its pathogenesis involves a potassium channel regulated by thyroid hormone. Here we present a case of TPP in the clinic, emphasizing its unique characteristics.

Case Presentation

Discussion

TPP findings may be suggestive of thyrotoxicosis. However, it is an important distinction to make. A useful distinguishing finding is deep tendon reflexes, which are absent or diminished in TPP but exaggerated in thyrotoxicosis. Treatment is potassium replacement, management of thyrotoxicosis and treatment of the underlying thyroid disorder.

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A 43-year-old woman presented with one week of weakness, palpitations, and heat intolerance. She had a history of panhypopituitarism following Rathke’s cleft cyst resection. Medications included levothyroxine, prednisone, transdermal estrogen and medroxyprogesterone injections. She had tachycardia (HR 105) and her weight was down seven kilograms from three weeks prior.

HEENT, chest, lung and abdominal exams were normal. Bilateral thighs and calves were tender to palpation. Upper extremity strength was intact; lower extremity strength was symmetrically diminished. She could not rise from a chair or walk without support. Deep tendon reflexes were diminished in the upper extremities and absent in the lower extremities. Neurologic exam was otherwise normal. CBC was normal. ESR was 34 (0-20), CRP was 7.77 (≤3) and creatine phosphokinase was 190 (19-131).

Potassium was 2.8 with an otherwise normal BMP. TSH was undetectable. Free thyroxine was 2.43 (1-1.85). Her exam and labs suggested a diagnosis of TPP. It was noted that her levothyroxine dose was increased six weeks prior due to an elevated TSH. She now disclosed that at that time, she had not been forthcoming about inconsistent levothyroxine use; therefore, the dose increase was inappropriate and caused iatrogenic hyperthyroidism complicated by TPP. Symptoms resolved quickly with potassium supplementation.

VIE POSTER 39 Vaccine Coverage of U.S.-based Latin Americans and Puerto Ricans: A Comparative Study of the National Immunization Survey Daud Lodin, MD; Laura Franqui-Domínguez, BS; Ada Santiago, MD; Yolanda Rodríguez, MD; Kelvin Díaz, MD; Zulmarie Maisonet, BS; Luz Reiley, BS; and Ada Cortez-Rodríguez, MSc San Juan Bautista School of Medicine

Background

In the United States, one of the groups that are most vulnerable of not receiving vaccinations is the Latin American community.

In Puerto Rico, very limited research related to the immunization coverage status in the island has been developed. Noteworthy, no data contrasting the Puerto Rican’s population with the U.S. Latin- American community is available in regard to this topic.

VIE Posters

Methods

In order to obtain this information, a retrospective cross-sectional study model was implemented, using the dataset of Center for Disease Control & Prevention National Immunization Survey 2015. Data from the survey was used to make a comparison between the two populations with a chi-square test. Univariate analysis was done using central tendency measures. Bivariate analysis was performed using chi-square and multivariate analysis was completed using ANOVA.

Results

The results showed that Puerto Rican families reported decreased vaccine coverage for rotavirus (59.7 percent versus 93.7 percent, p <0.001), pneumococcus (86 percent versus 94 percent, p<0.001), diphtheria and tetanus (79.0 percent versus 85 percent, p.

0.0192) when compared to U.S. Latin Americans. Hepatitis B vaccinations at birth were comparable in both groups (76 percent versus 81 percent, p=0.07). Results also showed that there is a statistical difference in coverage for MMR (88 percent versus 92 percent, p=0.03) and pneumococcus (86 percent versus 94 percent, p <0.001) in the Puerto Rican and U.S. Latin American populations, respectively.

Conclusion

This study emphasizes the importance of the education and preventive health service for the Hispanics in the U.S. and Puerto Ricans on the island in order to increase vaccine coverage and achieve better health outcomes for both communities. Therefore, the improvement of the communication among healthcare providers, adults, teenagers and children regarding immunizations should be promoted.

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VIE POSTER 40 Verruca Plantaris Prophylaxis: Three Month Outcomes Joshua Patton, OMS4; Shabnam Shahrestani, OMS3; Ashton Federico, OMS3; Michele M. Roth-Kauffman, JD, MPAS, PA-C, DFA; and Mark Kauffman, DO, MS (Med Ed), PA LECOM-Bradenton

Background

Verrucae plantaris (VP) affect approximately 14 percent of the population. Transmission occurs via direct skin contact in shared environments such as locker rooms and swimming pools. Warts may be treated in a variety of ways; however, no prophylactic treatment currently exists.

Methods

Results

At the first three-month follow-up, of 81 enrolled participants, four had withdrawn and 60 presented for assessment. No new VP was identified. One patient with VP at time of enrollment had an unchanged lesion.

Conclusion

No VP occurred in any study arm at the three-month follow-up. Potential factors include improved foot health with resultant decrease in nidus for implantation, antiviral properties of the active ingredients in the control group and short duration of the study to date. The researchers will continue monitoring at the six, nine and 12 month follow-ups and enroll new participants.

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This study consists of three arms: No Treatment (NT); Control (C) with emollient only; and Combined Treatment (CT) with emollient, herbal and vitamin. Participants are randomly assigned to one of the three arms and undergo an initial examination of the feet for presence of VP. Participants to lotion groups apply the topical once daily via metered dose pump and document days involving a high-risk exposure activity. At three month intervals, participants return to check for new incidence of VP.

C O N T I N U I N G E D U C AT I O N To obtain your CE certificate, you must complete the online evaluation at https://www.surveymonkey.com/r/2019NatlConvention.

Use the above link to access the survey. If you have any problems opening this survey or completing it, please contact your Course Director or email the Department of Continuing Education Office at ce@cmda.org.

Accreditation The Christian Medical & Dental Associations is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CE Credits

Physician Credit The Christian Medical & Dental Associations designates this educational activity for a maximum of 7 AMA PRA Category 1 Credit(s)™.

Physicians should only claim credit commensurate with the extent of their participation in the activity.

Optometric Credit The Christian Medical & Dental Associations is registered as an Administrator for COPE (Council on Optometric Practitioner Education). The Optometry CE Track, COPE Activity #116581, is accredited by COPE for continuing education for optometrists. Optometrists may receive up to 6 hours of CE credit by completing this activity. COPE accreditation does not imply acceptance by a state or provincial board of optometry. This CE track is provided by the Fellowship of Christian Optometrists, a specialty section of CMDA. Physician Assistant AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit(s)™ by an organization accredited by the ACCME or a recognized state medical society. Physician assistants may receive up to 7 credits for completing this activity.

Nurse Practitioner The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. Individuals are responsible for checking with the AANPCP for further guidelines. Nurse practitioners may receive up to 7 credits for completing this activity.

Dental Credit Christian Medical & Dental Associations Nationally Approved PACE Program Provider for FAGD/MAGD credit.

Approval does not imply acceptance by any regulatory authority or AGD endorsement.

1/1/2019 to 12/31/2022. Provider ID#218742. 7 Lecture Hours Available. No prior level of skill, knowledge, or experience is required (or suggested). Course designed for physicians and dentists and other healthcare professionals.

Medical and Dental Objectives • Refute prevailing myths about marijuana.

• Discuss the cultural factors driving societal opinion concerning marijuana.

• Describe marijuana to your family members, patients and community.

• Discuss the ethical principles relevant to arguments for and against physician-assisted suicide.

• Compare medical assistance in dying versus palliative care in regard to how they serve patients’ best interests.

• Critique proposals that would require physician participation in ending the lives of their patients.

• Identify the relevant ethical principles at issue for each of the cases discussed.

• Discuss examples of biblical wisdom that can provide guidance in situations that occur in opposition to public policy.

• Identify the capabilities and limitations of the scientific method.

• Discuss the pros and cons for the necessity of spirituality in our everyday lives.

• Describe how to have a conversation with patients and colleagues about spirituality.

• Define well-being.

• Discuss behaviors that enhance well-being.

• Design a plan for enhancing well-being.

• Articulate the fundamentals of transhumanist philosophy and goals.

• List similarity between transhumanism and transgenderism.

• Describe the developmental psychopathology of transgender youth.

• List cultural/worldview factors driving the transgender youth clinical phenomenon.

• Identify specific management principles and complications in the treatment of transgender youth.

• Conduct a spiritual assessment.

• Discuss spirituality with patients when indicated.

• Describe the positive and negative effects of group dynamics on medical decision-making.

• Describe common group dynamic phenomenon such as the bystander effect, willful blindness and social conformity as they apply to medical decision-making.

• Identify the issues of ethics and conflicts of interest in daily medical practice, education and research.

• Use the scientific evidence about human nature and ethics to interpret scientific research findings in proper perspective.

• List risk factors for burnout that degrade professional effectiveness and wellness.

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• • • • •

Identify those at risk for and those who develop professional burnout.

List biblical principles of Christian spirituality that promote personal wellness, resilience and “joy” in serving the profession.

Describe the secular worldview that underlies current bioethical issues.

Analyze the common themes that connect abortion, euthanasia, homosexuality and transgenderism.

Discuss well-reasoned arguments for a Christian worldview on bioethical issues.

Define well-being.

Describe the origin and development of postmodernism and how it led to transgender ideology.

List examples of transgender ideology.

Discuss philosophy of transgender ideology.

Identify the implications for healthcare professionals as they navigate the legal and ethical issues when managing transgender patients.

Identify the implications for politics when the state does not recognize sex but only gender.

Identify determinants of well-being.

Describe personal well-being status.

Define moral injury and traumatic stress.

Name common causes of moral injury and traumatic stress in healthcare professionals.

Identify symptoms of moral injury and traumatic stress.

Use basic tools to address moral injury and traumatic stress.

Use confidently the terminology of gender ideology.

Describe the presence of psychological morbidity underlying the patient’s reason for gender incongruency.

Describe how to compassionately care for and refer the patient to a mental health professional that is ethically and morally going to treat the patient without regard to political agendas.

Articulate the potential outcomes of investing in young professionals to serve through dentistry.

Describe the concept of “net producers versus net consumer” in meeting the increasing needs of marginalized populations.

Describe the CMDA Dental Residency program’s efforts to increase dental care to marginalized populations around the world.

Learn key elements to give patients stellar treatment.

Think through a process for changing any practice.

Optometry Objectives • Discuss how some of the newer color-selective lens coatings work and when they may or may not be appropriate for specific patients.

• Describe how researchers are exploring changes to small areas of lens surfaces to deliver more than one lens power at a time, resulting in opportunities to slow myopia progression and increase usable zone width in progressive lenses.

• Describe how lens manufacturers are working toward treating lens pairs as a single entity instead of single lenses for the purpose of increasing binocularity.

• Describe the basic anatomy and physiology of the human cornea.

• Discuss the mechanism of keratoconus and post-LASIK ectasia.

• Discuss the need for early detection and treatment of keratoconus.

• Discuss traditional treatments for ectatic disorders and the role of corneal collagen crosslinking for ectatic disorders.

• Identify pearls for post-op care of the corneal crosslinking patient.

• Discuss a recent study that showed taking fish oil did not prove to be better than a placebo at relieving the symptoms or signs of dry eye.

• Review the physiology of omega fatty acids and how they have been shown to provide a number of health benefits.

• Debate whether or not omega fatty acids should still be recommended to certain patients by optometrists.

• Describe common patient symptoms of convergence insufficiency.

• Discuss how to test for and diagnose convergence insufficiency.

• Discuss management options and research on efficacy of treatment for convergence insufficiency.

• Describe the mindset of the refractive surgery patient.

• Discuss the importance of pre-op counseling (setting expectations).

• Discuss the limitations of IOL calculation formulas.

• Instill a working knowledge of the types of FDA-approved premium IOL’s currently available.

• Instill confidence when performing post-operative care.

• Discuss the advantages and disadvantages of prescribing prism for binocular disorders.

• Demonstrate methods of prescribing prism for patients with or without strabismus.

Agenda Time

Topic Title

Faculty Name

Number of Credits

May 3: 11 a.m. - 12:30 p.m.

Plenary Session: Defending Sexual Truth in a Sexual Age

Nancy Pearcey, MA

1 Hour CME and CDE

May 3: 1:30 - 2:30 p.m.

Where Did Transgender Ideology Come From and How Is It Changing the Legal Landscape for Everyone?

Nancy Pearcey, MA

1 Hour CME and CDE

Group Dynamics, Human Nature and Medical Decision: Tales of Strange Smoke, Admiral’s Eye and Unmistakable Lines

Burton Lee, MD

1 Hour CME and CDE

The Road to Well-being: Charting a Course

Steve Sartori, MD

1 Hour CME and CDE

Omega Fatty Acids: Revisiting Our Chair-side Recommendation

Kevin Harris, OD

1 Hour COE

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CE Credits

• • • • • • • • • • • • • • • • • • • •

C O N T I N U I N G E D U C AT I O N May 3: 2:45 - 3:45 p.m.

Spiritual Interventions in Clinical Care, Part 1

Walt Larimore, MD

1 Hour CME and CDE

The Road to Well-being: Describing the Destination

Stan Haegert, MD, MPH

1 Hour CME and CDE

Corneal Collagen Crosslinking for the Treatment of Keratoconus

Lon EuDaly, OD

1 Hour COE

Spiritual Interventions in Clinical Care, Part 2

Walt Larimore, MD

1 Hour CME and CDE

The Road to Well-being: Dealing with Moral Injury and Trauma

Frauke Schaefer, MD

1 Hour CME and CDE

The Refractive Surgery Cataract Patient: Psychology and Technical Challenges

Lon EuDaly, OD

1 Hour COE

May 4: 1:30 - 2:15 p.m.

Bringing Transparency to the Treatment of Transgender Persons

Quentin Van Meter, MD

.75 Hour CME and CDE

May 4: 2:15 - 3 p.m.

The Trajectory from Transhumanism to Transgenderism

Christopher Hook, MD

.75 Hour CME and CDE

May 4: 3:15 - 4 p.m.

Is Assisted Death in Patients’ Best Interest?

William P. Cheshire, Jr., MD, MA (Ethics) .75 Hour CME and CDE

May 4: 4 - 4:45 p.m.

Panel Discussion: Cases and Questions

William P. Cheshire, Jr., MD, MA (Ethics); Chris.75 Hour CME and CDE topher Hook, MD; and Quentin Van Meter, MD

May 4: 1:30 - 2:30 p.m.

Ethics, Human Nature and Evidence-based Medicine

Burton Lee, MD

1 Hour CME and CDE

What is a Truly “Successful” Dental Practice?

Peter Dawson, DDS

1 Hour CDE

May 3: 4 - 5 p.m.

CE Credits

ETHICS TRACK

May 4: 2:45 - 3:45 p.m.

May 4: 4:30 - 5:30 p.m.

Starbucks, Quantum Physics and Christian Love: Searching for Joy Practicing Today’s Tom Okamoto, MD Medicine

1 Hour CME and CDE

Recent Changes in Ophthalmic Lenses: Specialty Tints and Progressives

Clifford Brooks, OD

1 Hour COE

Marijuana: An Honest Look at the World’s Most Misunderstood Weed

James Avery, MD

1 Hour CME and CDE

Pursuing Excellence in Dentistry Without Sacrificing Your Faith

William “Bo” Bruce, DMD

1 Hour CDE

Transgender Youth: Developmental, Family and Worldview Perspectives

Allan Josephson, MD

1 Hour CME and CDE

Update on Convergence Insufficiency

Kelly Frantz, OD

1 Hour COE

Science, Faith and Healthcare: Unapologetic Apologetics for the Christian Caregiver

William Griffin, DDS

1 Hour CME and CDE

Motivating, Educating and Equipping the Next Generation of Leaders in Dentistry

Jeff Amstutz, DDS, MBA

1 Hour CDE

Binocular Vision Case Management Using Prism

Kelly Frantz, OD

1 Hour COE

Total CME Credits = 7.0 Hours

Total COE Credits = 6.0 Hours

Total CDE Credits = 7.0 Hours

Disclosure As a sponsor accredited by the ACCME, the Department of Continuing Education of Christian Medical & Dental Associations, must ensure balance, independence, objectivity, and scientific rigor in all its sponsored educational activities. All faculty and planning committee members participating in this CME Symposium were asked to disclose the following: 1. The names of proprietary entities producing health care goods or services, with the exemption of non-profit or government organizations and non-health related companies with which they or their spouse/partner have, or have had, a relevant financial relationship within the past 12 months. For this purpose, we consider the relevant financial relationships of your spouse/partner that they are aware to be theirs; 2. To describe what they or their spouse/partner received (ex: salary, honorarium etc.); 3. To describe their role; 4. To disclose that there was no relevant or financial relationships.

Course Director, Speaker Names, CMDA staff, CMDA/CME Committee and Planning Committee Members

Name of the Commercial Interest

The Nature of the Rela- I do not have any relevant tionship the Person has financial relationships With Each Commercial with any commercial Interest (speaker, stocks, interests speakers’ bureau, clinical trials)

Conflict Resolved

I intend to discuss off-labeled investigation use(s) of drug(s) or device(s) in my presentation

PLANNERS Brian Briscoe, MD Psych Section Dean

NONE

NONE

NO

NA

NA

William P. Cheshire, Jr., MD, MA (Ethics) Ethics Track Dean

NONE

NONE

NO

NA

NA

Mike Chupp, MD Director of Planning

NONE

NONE

NO

NA

NA

Peter Dawson, DDS Dental Section Dean

NONE

NONE

NO

NA

NA

Kelly Frantz, OD Optometry Section Dean

NONE

NONE

NO

NA

NA

William Griffin, DDS Dental Chair

NONE

NONE

NO

NA

NA

116 │ 2019 CMDA National Convention

C O N T I N U I N G E D U C AT I O N Melinda Mitchell Coordinator

NONE

NONE

NO

NA

NA

John Pierce, MD Medical Track Dean

NONE

NONE

NO

NA

NA

Barbara Snapp CE Administrator

NONE

NONE

NO

NA

NA

Sharon Whitmer, EdD, MFT Accreditation Officer

NONE

NONE

NO

NA

NA

CE Committee Members

NONE

NONE

NONE

NONE

NA

Jeff Amstutz, DDS, MBA

NONE

NONE

NO

NA

NO

James Avery, MD

NONE

NONE

NO

NA

NO

Clifford Brooks, OD

NONE

NONE

NO

NA

NO

William “Bo” Bruce, DMD

NONE

NONE

NO

NA

NA

William P. Cheshire, Jr., MD, MA (Ethics)

NONE

NONE

NO

NA

NA

Peter Dawson, DDS

NONE

NONE

NO

NA

NO

Lon EuDaly, OD

NONE

NONE

NO

NA

NO

Kelly Frantz, OD

NONE

NONE

NO

NA

NO

William Griffin, DDS

NONE

NONE

NO

NA

NO

Stanley Haegert, MD, MPH

NONE

NONE

NO

NA

NO

Kevin Harris, OD

NONE

NONE

NO

NA

NO

Christopher Hook, MD

NONE

NONE

NO

NA

NO

Allan Josephson, MD

NONE

NONE

NO

NA

NO

Walt Larimore, MD

NONE

NONE

NO

NA

NO

Burton Lee, MD

NONE

NONE

NO

NA

NO

Tom Okamoto, MD

NONE

NONE

NO

NA

NO

Nancy Pearcey, MA

NONE

NONE

NO

NA

NO

Steve Sartori, MD

NONE

NONE

NO

NA

NO

Frauke Schaefer, MD

NONE

NONE

NO

NA

NO

Quentin Van Meter, MD

NONE

NONE

NO

NA

NO

FACULTY

THERE IS NO IN-KIND OR COMMERCIAL SUPPORT FOR THIS ACTIVITY

2019 CMDA National Convention │ 117

CE Credits

The CMDA CE Review Committee of John Pierce, MD, Chair; Lindsey Clarke, MD; Stan Cobb, DDS; Jon R. Ewig, DDS; Gary Goforth, MD; Elizabeth Heredia, MD; Curtis High, DDS; Bruce MacFadyen, MD; Dale Michels, MD; Shawn Morehead, MD; Michael O’Callaghan, DDS; Jonathan Spenn, DMD; and Richard Voet, MD do not have any relevant financial relationships with any commercial interests.

Evaluation Transform: CMDA’s 2019 National Convention Indicate the appropriate rating using the following scale: N/A = Not applicable

1 = Poor

2 = Fair

3 = Average

Session Evaluations

4 = Above Average

Quality of Speaker’s Delivery

Quality of Material Presented

5 = Outstanding Quality of Usefulness to Visual Aids & Your Practice Documents of Life

Thursday, May 2 — 7 p.m.

What is Our Salvation For?: Bringing Restoration into Our Current Cultural Moment

John Stonestreet

Friday, May 3 — 9 a.m.

Three Dangerous Prayers—Lord, I Want to Be Great in Your Kingdom Rev. Stan Key

Friday, May 3 — 11 a.m.

Defending Sexual Truth in a Sexual Age Nancy Pearcey, MA

Friday, May 3 — 12:30 p.m.

Leveraging Generosity: Strategies, Tools and Trends to Maximize Charitable Impact Brandon Davis

Friday, May 3 — 1:30 p.m.

Group Dynamics, Human Nature and Medical Decision: Tales of Strange Smoke, Admiral’s Eye and Unmistakable Lines Burton Lee, MD Where Did Transgender Ideology Come From and How Is It Changing the Legal Landscape for Everyone?

Nancy Pearcey, MA The Joy of Aging Well in Retirement Hal Habecker, DMin The Road to Well-being: Charting a Course Steve Sartori, MD Omega Fatty Acids: Revisiting Our Chair-side Recommendation Kevin Harris, OD

Friday, May 3 — 2:45 p.m.

The Road to Well-being: Describing the Destination Stan Haegert, MD, MPH Spiritual Interventions in Clinical Care, Part 1 Walt Larimore, MD Corneal Collagen Crosslinking for the Treatment of Keratoconus Lon EuDaly, OD

Friday, May 3 — 4 p.m.

The Road to Well-being: Dealing with Moral Injury and Trauma Frauke Schaefer, MD Spiritual Interventions in Clinical Care, Part 2 Walt Larimore, MD The Refractive Surgery Cataract Patient: Psychology and Technical Challenges Lon EuDaly, OD

Friday, May 3 — 7 p.m.

Legacy Celebration David Stevens, MD, MA (Ethics)

2019 CMDA National Convention │ 119

Saturday, May 4 — 9 a.m.

Commissioning Service for Dr. Mike Chupp

Saturday, May 4 — 11 a.m.

Three Dangerous Prayers—Not My Will But Yours Be Done Rev. Stan Key

Saturday, May 4 — 1:30 p.m. - 4:45 p.m. Ethics Track Bringing Transparency to the Treatment of Transgender Persons Quentin Van Meter, MD The Trajectory from Transhumanism to Transgenderism Christopher Hook, MD Is Assisted Death in Patients’ Best Interest?

William P. Cheshire, Jr., MD, MA (Ethics) Panel Discussion: Cases and Questions Moderator: William P. Cheshire, Jr., MD, MA (Ethics)

Saturday, May 4 — 1:30 p.m.

Ethics, Human Nature and Evidence-based Medicine Burton Lee, MD The ABCD’s of Raising Happy, Healthy Children and Teens Walt Larimore, MD, and Barb Larimore Starbucks, Quantum Physics and Christian Love: Searching for Joy Practicing Today’s Medicine Tom Okamoto, MD What is a Truly “Successful” Dental Practice?

Peter Dawson, DDS Recent Changes in Ophthalmic Lenses: Specialty Tints and Progressives Clifford Brooks, OD

Saturday, May 4 — 2:45 p.m.

Marijuana: An Honest Look at the World’s Most Misunderstood Weed James Avery, MD Conflict Resolution Robert Puleo, DDS Transgender Youth: Developmental, Family and Worldview Perspectives Allan Josephson, MD Pursuing Excellence in Dentistry Without Sacrificing Your Faith William “Bo” Bruce, DMD Update on Convergence Insufficiency Kelly Frantz, OD

Saturday, May 4 — 4:30 p.m.

Science, Faith and Healthcare: Unapologetic Apologetics for the Christian Caregiver

William Griffin, DDS

What Part of “No” Do You Not Understand Grat Correll, MD Transgender Issues: Going Deeper Allan Josephson, MD, and Nancy Pearcey, MA Motivating, Educating and Equipping the Next Generation of Leaders in Dentistry Jeff Amstutz, DDS, MBA Binocular Vision Case Management Using Prism Kelly Frantz, OD

Saturday, May 4 — 7 p.m.

Concert Stephanie Seefeldt

Sunday, May 5 — 9 a.m.

Three Dangerous Prayers—Give Me Children, or I Die Rev. Stan Key

120 │ 2019 CMDA National Convention

Overall Conference Evaluation

Indicate the appropriate rating using the following scale: N/A = Not applicable

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2 = Fair

3 = Average

4 = Above Average

5 = Outstanding

Overall organization of the conference Conference registration procedures Lodging Food quality and service Meeting rooms

How did you learn about the convention? (Check all that apply.) ☐☐ Today’s Christian Doctor ☐☐ Brochure ☐☐ Email ☐☐ Word of Mouth ☐☐ Social Media — Which form? ☐☐ Website ­— Which site? ☐☐ Other Please list additional topics you would like to see incorporated into future conferences.

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Thank you for attending TRANSFORM: CMDA’s 2019 National Convention!

Please leave your completed evaluation form at the convention office before you leave, or you can email it to meetings@cmda.org.

This evaluation is also available online at https://www.surveymonkey.com/r/ConEval2019.

2019 CMDA National Convention │ 121

Join us in Ohio in 2020 Transform: CMDA’s 2020 National Convention April 16-19, 2020 Northern Kentucky Convention Center Covington, Kentucky (Cincinnati area)

Early Bird Registration - Convention Special Deadline: May 5, 2019 Name Healthcare Degree Preferred Mailing Address

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