Janet Cope | Elon University (original) (raw)

Papers by Janet Cope

Research paper thumbnail of Influence of canine on heart rate and rate of perceived exertion during one mile walk test

Journal of obesity and weight loss therapy, Jul 5, 2013

T he purpose of this study was to assess the affect of walking with a canine on heart rate (HR) a... more T he purpose of this study was to assess the affect of walking with a canine on heart rate (HR) and rating of perceived exertion (RPE) during a 1 mile walk. Methods: Subjects > 40 yo were recruited to participate in this study. Twenty individuals (Male=7, Female=13, Mean Age = 52+8) completed the 2 experimental sessions, one with a canine and one without. Prior to these sessions, subjects categorized themselves as having a low (n=8), moderate (n=8), or high (n=4) level of physical activity via the International Personal Activity Questionnaire (IPAQ). During experimental sessions, subjects were randomly assigned to walk 1 mile on a track with or without a canine while RPE and HR were assessed every ¼ mile. Subjects served as their own controls, returning in < 1 week to repeat the walk in the other condition. Results: In this small sample, no significant relationships were observed between variables; however, some interesting trends were observed. In high activity subjects, HR was lower in the canine condition suggesting less physical effort (Mean nchigh =141bpm + 12.5, Mean chigh =137 + 11.9). In contrast, in moderate and low activity subjects HR was increased in the canine condition (Mean ncmoderate =124bpm + 11.1, Mean cmoderate =132.4bpm +10.5; Mean nclow =126.7bpm +18.9, Mean clow =130.75bpm + 16.5). RPE was same or decreased in all subjects in the canine condition. Conclusion: Walking with a canine increased HR without increasing RPE in low and moderately active individuals in this study, providing support for canine walking as an effective fitness activity.

Research paper thumbnail of A human donor (cadaveric) observation study of three needle placements in the piriformis muscle

Journal of Manual & Manipulative Therapy, Jun 5, 2022

Research paper thumbnail of Prefabricated Splints

Research paper thumbnail of Anatomical Gift Programs Continue to Meet Donor Demands of Anatomy Educators During the COVID‐19 Pandemic: Here’s How

Research paper thumbnail of An Ethically Sustainable Model for Anatomic Gifting at a Non‐Medical School

Research paper thumbnail of Comparison of two formaldehyde exposure assessment devices in a physical therapy education program anatomy laboratory

Background and Purpose. Physical therapist (PT) education programs in the United States require t... more Background and Purpose. Physical therapist (PT) education programs in the United States require that students have a strong foundation in human anatomy. As a result, anatomy teachers and physical therapist students in anatomy courses can spend upwards of 100 hours annually studying human donors embalmed with formaldehyde (FA), a known carcinogen. While the Occupational Safety and Health Administration (OSHA) recommends regular FA exposure testing, approximately 42% of PT education program anatomists operate labs without direct access to qualified personnel to conduct such testing. These anatomists are often responsible for interpreting, assessing, and managing FA issues in the laboratory. In this paper, the researchers compare 2 methods for personal FA exposure testing and summarize current FA regulations. While Certified Industrial Hygienists (CIH) recommend the National Institute for Occupational Safety and Health (NIOSH) Method 2016 (active pump attached to sorbent tube) to asses...

Research paper thumbnail of St Peter's, Barton-upon-Humber, Lincolnshire, a parish church and its community. Volume II: The human remains. T. Waldron & W. Rodwell (eds). Oxbow Books, Oxford, 2007; 193 pp ISBN 978 1 84217 283 4

International Journal of Osteoarchaeology, 2009

Research paper thumbnail of Robusticity and osteoarthritis at the trapeziometacarpal joint in a Bronze Age population from Tell Abraq, United Arab Emirates

American Journal of Physical Anthropology, 2005

Osteoarthritis (OA) is a progressive disease of the joints and can cause pain, reduced range of m... more Osteoarthritis (OA) is a progressive disease of the joints and can cause pain, reduced range of motion and strength, and ultimately loss of function at affected joints. Osteoarthritis often occurs at sites where biomechanical stress is acutely severe or moderate but habitual over the course of a lifetime. Skeletal remains from an Umm an-Nar tomb at Tell Abraq, United Arab Emirates (ca. 2300 BC), were recovered and represented over 300 individuals of all ages. The remains were disarticulated, commingled, and mostly fragmented. An analysis of 650 well-preserved adult metacarpal and carpal bones, from the tomb's western chamber, revealed that over 53% of the trapeziometacarpal joint facets showed signs of OA varying from mild to severe. The first and

Research paper thumbnail of A severe case of hyperostosis frontalis interna and multiple comorbidities

Hyperostosis frontalis interna (HFI) is a condition that involves thickening of the frontal regio... more Hyperostosis frontalis interna (HFI) is a condition that involves thickening of the frontal region of the endocranial surface with midline sparing. It is observed in radiographic images of the cranium in living subjects and upon dissection in deceased subjects. There is little information related to the impact that hyperostosis frontalis interna has on living patients. In this case of severe hyperostosis frontalis interna, the subject was a 77-year-old female human donor who had an overwhelming number of co-morbidities. The purpose of this case study is to report an unusual case of hyperostosis frontalis interna.

Research paper thumbnail of Bilateral duplicitous renal vasculature

International Journal of Anatomical Variations, 2016

This case study documents a unique bilateral variation of renal vasculature. Renal arterial dupli... more This case study documents a unique bilateral variation of renal vasculature. Renal arterial duplications are relatively common, whereas multiple renal veins occur much less commonly. In this case report the human donor had bilateral arterial and venous duplication. This variation has not been previously reported in the literature. It is important for clinicians to be aware of renal vessel variations for surgical procedures, particularly trauma and transplantation, and in other conditions that may lead to hypertension and/or urologic disorders.

Research paper thumbnail of A robust flexor digiti minimi brevis muscle

Flexor digiti minimi brevis (FDMB) is a hypothenar muscle innervated by the ulnar nerve and acts ... more Flexor digiti minimi brevis (FDMB) is a hypothenar muscle innervated by the ulnar nerve and acts as a flexor of digit V at the metacarpophalangeal joint. While numerous variations of hypothenar musculature are documented in the literature, in this case study the researchers report on an interesting variation of the FDMB in regards to size as well as proximal and distal attachment sites which include crossing the pathways of the ulnar and median nerves. This particular variation of the FDMB has the potential to cause effort-related compression of both of these nerves and thus should be of interest to clinicians and surgeons. © Int J Anat Var (IJAV). 2013; 6: 216–217.

Research paper thumbnail of Comparison of personal formaldehyde levels in the anatomy laboratories of five physical therapy education programs

ABSTRACT Background and Purpose. The current trend in anatomy education requires medical students... more ABSTRACT Background and Purpose. The current trend in anatomy education requires medical students to spend fewer hours with human donors, while physical therapist (PT) students are spending an increasing amount of time working in the human anatomy laboratory. Nearly all PT education programs in the United States use human donors embalmed with formaldehyde (FA), a known carcinogen and sensory irritant. Although there is literature related to FA monitoring and safety in medical schools, there is little to no existing research on this topic in PT education programs. Some existing PT programs at universities have a department of Environmental Health and Safety (EHS) that monitor FA levels. However, an estimated 42% (n = 84/201) of this country’s PT programs are operating anatomy laboratories at colleges or universities that do not have a EHS department that can provide direct access to routine FA exposure monitoring and consulting. Subjects. Physical therapist students and instructors at 5 PT education programs in the United States exposed to FA during human anatomy laboratory sessions were included in this research. Physical therapist students were randomly selected to participate in this study from sites where the instructors volunteered for participation. Methods. Ambient air values, personal FA exposure, and sensory irritation levels from students and instructors at 5 PT education programs in the United States were collected and compared. Outcomes. Of the total personal FA exposure data samples taken for all sites, 57% (n = 60/105) exceeded the American Conference of Governmental Industrial Hygienists (ACGIH) ceiling level of 0.3 parts per million (ppm). The Occupational Safety and Health Administration (OSHA) short-term exposure limit (STEL) of 2.0 ppm was exceeded in 24% (n = 11/45) of sessions at 2 participating sites. Personal FA exposure levels exceeded ambient air test results in 62% (n = 66/105) of samples taken across the 5 institutions. There was no significant correlation found between personal FA exposure and reported irritation levels, or in comparison of personal FA exposure levels between students and instructors. There was a significant difference (P = 0.015) in comparing irritation levels between students and instructors, with students reporting greater than twice the irritation level as compared to their instructors. Discussion and Conclusions. In this study, individuals participating in PT program human donor-based anatomy courses were routinely exposed to higher levels of FA than reported in ambient air quality tests and limits set by ACGIH. At 2 sites, subjects were exposed to levels of FA above OSHA established STELs. These 5 instructors were not irritated by FA and, therefore, may be unlikely to seek out assistance to monitor or control for over exposure to FA. Key Words: Formaldehyde exposure, Anatomy, Physical therapy.

Research paper thumbnail of Arterial stiffness and carotid distensibility following acute formaldehyde exposure in female adults

Toxicology and Industrial Health

Formaldehyde (FA) is a ubiquitous organic preservative used in several industries and represents ... more Formaldehyde (FA) is a ubiquitous organic preservative used in several industries and represents an occupational health hazard. Short-term exposure to FA can increase oxidative stress and cause a decrease in conduit vessel function. These decrements in vascular function may extend to the arterial architecture, predisposing individuals to increased risk of cardiovascular disease. The purpose of this study was to investigate the impact of an acute 90-minute FA exposure period (259 ± 95 ppb) on indices of arterial architecture. Arterial stiffness and carotid distensibility as determined by central pressures, augmentation index (AIx), and carotid-femoral pulse wave velocity (cfPWV) ( n=13F, 24 ± 1 year) as well as carotid stiffness and intima media thickness (IMT) ( n = 9F, 23 ± 1 year) were assessed prior to (Pre-FA) and immediately following (Post-FA) exposure to FA in human cadaver dissection laboratories. Central pressures and cfPWV (Pre-FA: 5.2 ± 0.8 m.s−1, Post-FA: 5.2 ± 1.1 m s−1...

Research paper thumbnail of Vascular dysfunction and oxidative stress caused by acute formaldehyde exposure in female adults

American Journal of Physiology-Heart and Circulatory Physiology

This study was the first to investigate the implications of acute formaldehyde (FA) exposure on a... more This study was the first to investigate the implications of acute formaldehyde (FA) exposure on adult female vascular function in the arms and legs. The main findings from this study were a decrease in conduit vessel function without any alteration to microvascular function following a 90-min FA exposure. Additionally, the oxidative stress marker malondialdehyde increased after FA exposure. Taken together, these results suggest acute FA exposure have deleterious implications for the vasculature and redox balance.

Research paper thumbnail of Regarding the Dead: A Model for Anatomical Gifting Outside the Traditional Medical School Setting

Anatomical Sciences Education

In 2017, Elon University became one of very few universities in the United States without a medic... more In 2017, Elon University became one of very few universities in the United States without a medical school to have an in‐house Anatomical Gift Program (AGP). The program accepts first‐person‐consenting individuals only and within 2.5 years has become self‐sufficient, supporting anatomy curricular needs of its physical therapy, physician assistant, and undergraduate biology and anthropology programs (n = 21 donors annually). This paper describes the timeline, costs, and benefits of developing an in‐house AGP at a university without a medical school. Policy development, public outreach, equipment needs, and cost benefits are discussed. Within 2.5 years of program opening, the AGP Director delivered 161 educational outreach presentations at 86 different venues across the state providing information on anatomical gifting. The program registered 320 individuals (60% female, 40% male) and enrolled 41 deceased donors (69% female, 31% male; average age of 74.6 at time of registration and 74.8 at donation). During the first seven months of the program, donor preparation costs (with outsourcing for transport/donor preparation/document filing/serology testing/cremation) averaged US$ 2,100 per donor. Over the past 23 months, donor preparation has been completed on site, lowering the cost per donor to US$ 1,260. Other costs include personnel salaries, legal fees, and outfitting of the anatomy laboratory and preparatory room. Program benefits include support of anatomy education on campus, assurance that all donors have given first‐person consent, and faculty/student access to donor‐determined health, social, and occupational information. Faculty, staff, and students contribute to the daily operations of the AGP.

Research paper thumbnail of Comparison of 2 Formaldehyde Exposure Assessment Devices in a Physical Therapy Education Program Anatomy Laboratory

Journal of Physical Therapy Education

Background and Purpose. Physical therapist (PT) education programs in the United States require t... more Background and Purpose. Physical therapist (PT) education programs in the United States require that students have a strong foundation in human anatomy. As a result, anatomy teachers and physical therapist students in anatomy courses can spend upwards of 100 hours annually studying human donors embalmed with formaldehyde (FA), a known carcinogen. While the Occupational Safety and Health Administration (OSHA) recommends regular FA exposure testing, approximately 42% of PT education program anatomists operate labs without direct access to qualified personnel to conduct such testing. These anatomists are often responsible for interpreting, assessing, and managing FA issues in the laboratory. In this paper, the researchers compare 2 methods for personal FA exposure testing and summarize current FA regulations. While Certified Industrial Hygienists (CIH) recommend the National Institute for Occupational Safety and Health (NIOSH) Method 2016 (active pump attached to sorbent tube) to assess anatomy laboratory FA exposure levels, there are other methods available. The purpose of this research was to compare NIOSH Method 2016 to a different FA exposure sampling device for ease of use, cost, and effectiveness in assessing FA exposure levels in the PT anatomy laboratory setting. Subjects. Participants included the anatomy course instructor and 10 randomly selected Doctor of Physical Therapy (DPT) students enrolled in a human anatomy course. Methods. The researchers compared personal FA exposure data samples using passive FA‐sensitive diffusion badges against the NIOSH‐recommended Method 2016 (active pump with sorbent tube) during 10 data collection sessions. In addition, the researchers calculated the cost and time spent to use each FA sampling device. Results. The passive FA‐sensitive diffusion badges were less costly and required less time and expertise to use as compared to NIOSH Method 2016. There was a moderately strong correlation between the passive FA‐sensitive diffusion badge data and NIOSH Method 2016 (r = .772, P < .01). However, independent t tests revealed that there was a significant difference in the FA exposure data using the passive diffusion badge as compared to NIOSH Method 2016 (Badge: Mean = .22, SD = .263 versus Method 2016: Mean = .74, SD = .834; P = .004). Discussion and Conclusions. Passive FA‐sensitive diffusion badges are less costly and simple to use as compared to NIOSH Method 2016, but in this study FA exposure badge values were consistently lower than NIOSH Method 2016 data. While the passive FA‐sensitive diffusion badge is convenient for routine personal FA exposure monitoring, these researchers recommend that a CIH conduct a complete FA assessment at least annually to ensure air quality safety.

Research paper thumbnail of Counting the Dead: Who is Teaching Anatomy to Physical Therapy Students?

Journal of Physical Therapy Education

BACKGROUND AND PURPOSEWhile the term "cadaver" is accurate, many anatomists use the ter... more BACKGROUND AND PURPOSEWhile the term "cadaver" is accurate, many anatomists use the term "human donor" to confer dignity and imply consent of the person who has volunteered or donated his/her body to anatomy education. Unfortunately, there is a long history of anatomy instruction including people who did not directly consent to have their bodies used for education. This practice persists today.1 In this paper, the researchers explore the use of cadavers and the topic of consent in anatomy education in physical therapist (PT) education programs.There is no national system for quantifying cadavers used in anatomy education in PT education programs, and no system in place to track where PT education programs obtain cadavers, but the number of cadavers used in total in all venues of medical education continues to grow. In the early 1970s, there were 101 medical schools in the United States (US),2 and 70 schools offering either a baccalaureate or certificate in physical therapy.3 As of 2015, there were 785 schools of health care provider education, to include 145 programs conferring the degree of Medical Doctor,4 42 Doctor of Osteopathy,5 196 Physician's Assistant,6 163 Occupational Therapy,7 and 239 Physical Therapy.8 Many of the students in these health care education programs study human anatomy with a cadaver. The number of health care education programs is expected to continue to rise,9 with implications for an increasing demand for cadavers.There are 3 general categories of cadavers used for human anatomy instruction: (1) Registered donor, where the person has specifically consented to use of his or her body for medical education or research; (2) next of kin donations, where the person donated has not consented to be used for medical education or research, but the family has; and (3) unclaimed dead, where the state has jurisdiction to donate the cadaver for medical education or research without consent of the deceased.Unclaimed dead are people who die without a will and have no next of kin to claim and bury them.10 Thus, the unclaimed dead are placed under the jurisdiction of public health departments via the coroner's office and are handled differently (cremated, buried, sent to anatomy education departments, or housed for a period of time by the coroner) from state to state. Prior to assignment of an unclaimed body, efforts are made to locate next of kin to take possession of and bury the body, but the extent of these efforts varies state by state. If someone is identified as an active or honorably discharged military member, he or she cannot be classified as unclaimed dead and is transferred to the US Department of Veterans Affairs for burial.11 At present there is no accounting for the numbers of unclaimed dead being used by anatomy education departments across the US.The purpose of this paper is to present baseline information regarding the number, origin, and donation status of cadavers being used in anatomy education in PT education programs. Ideally, quantifying the cadavers used in anatomy education in PT education programs and increasing awareness around donor registration status will create a culture where faculty in PT education programs ensure that every cadaver they teach alongside has consented to participate in anatomy education.Position and RationaleThroughout history, cadavers have been used for medical education. During the 18th century in Great Britain, cadavers were in short supply, as the only legally available bodies were those of executed criminals. The practice at the time to double the punishment of a criminal sentenced to death by hanging was to add dissection to the sentence. These dissections were often completed in public as a means of discouraging others from criminal behavior.12By the mid-19th century, medical education was flourishing and the need for cadavers increased so much that grave robbing was rampant in both the US and the United Kingdom. …

Research paper thumbnail of Naming the Dead: What information do Physical Therapy and Physician Assistant anatomy faculty share with students?

Anatomical Sciences Education

In this novel study, the researchers quantify cadaver information provided to Physical Therapy (P... more In this novel study, the researchers quantify cadaver information provided to Physical Therapy (PT) and Physician Assistant (PA) anatomy faculty and ask what portion of that information is then shared with students. Descriptive statistics were used to the describe demographics of the study respondents and to report survey responses. The majority (60% or greater) of faculty who teach anatomy to PT and PA students have clinical degrees matching the student groups they teach. Chi‐square analysis showed no appreciable difference (P < 0.001) between PT and PA anatomy faculty in the amount of cadaver information they receive or then share with students. There was a difference in the type of cadaver information (identifying vs. non‐identifying) that is received and then shared by these faculty. Faculty are more likely to receive non‐identifying cadaver information (93%) than identifying information (40%) (P < 0.0001) and share non‐identifying information (83%) than identifying information (26%) with students (P < 0.0003). Interestingly, there is no consensus as to whether sharing cadaver information is respectful or disrespectful to those who donate their bodies for anatomy education and research. Further research is warranted into the reasons anatomy faculty withhold cadaver information from students and in the value, if any, for students knowing more about the cadavers they are learning from.

Research paper thumbnail of Quantifying Cadaver Use in Physician Assistant Anatomy Education

The Journal of Physician Assistant Education

Purpose To quantify the number of cadavers used in physician assistant (PA) anatomy education and... more Purpose To quantify the number of cadavers used in physician assistant (PA) anatomy education and to ascertain the origins of those cadavers. Methods An electronic survey was generated and distributed to all schools that had been accredited by the Accreditation Review Commission on Education for the Physician Assistant. Responses were reported using descriptive statistics. Results The survey had a 49% response rate. Among the responding programs, 79% reported working with 655 cadavers, with an average of one cadaver per 5.72 students. Programs reported that 21% receive cadavers from multiple sources. Of all programs using cadavers, 62% receive cadavers from medical schools, 23% from in-house anatomical gift programs, 19% from state anatomy boards, 9% from private organizations, and 8% from other sources. Anatomy educators reported that 55% know the origins of the cadavers in their programs, 18% do not, and 27% are uncertain. In categorizing cadavers at their programs, 56% were reported as registered donors, 4% as next-of-kin donations, 1% as unclaimed dead, 17% as uncertain origin, and 22% as unaccounted for by respondents. Conclusions Among educators who teach anatomy to PA students, 45% do not know or are uncertain of the origins of the cadavers in their programs. Of the reported 655 cadavers used in PA education, 289 were not categorized as registered donors. Facing the expansion of PA programs, educators need to be aware of cadavers' origins to ensure that all aspects of PA education are consistent with the ethics that the students are being taught. Those ethics include the need for informed consent for all cadavers involved in PA education.

Research paper thumbnail of Letter in response to Letter-to-the-Editor regarding Comparison of two angles of approach for trigger point dry needling of the lumbar multifidus in human donors (cadavers) ( Hannah et al., 2016 )

Musculoskeletal Science and Practice

Research paper thumbnail of Influence of canine on heart rate and rate of perceived exertion during one mile walk test

Journal of obesity and weight loss therapy, Jul 5, 2013

T he purpose of this study was to assess the affect of walking with a canine on heart rate (HR) a... more T he purpose of this study was to assess the affect of walking with a canine on heart rate (HR) and rating of perceived exertion (RPE) during a 1 mile walk. Methods: Subjects > 40 yo were recruited to participate in this study. Twenty individuals (Male=7, Female=13, Mean Age = 52+8) completed the 2 experimental sessions, one with a canine and one without. Prior to these sessions, subjects categorized themselves as having a low (n=8), moderate (n=8), or high (n=4) level of physical activity via the International Personal Activity Questionnaire (IPAQ). During experimental sessions, subjects were randomly assigned to walk 1 mile on a track with or without a canine while RPE and HR were assessed every ¼ mile. Subjects served as their own controls, returning in < 1 week to repeat the walk in the other condition. Results: In this small sample, no significant relationships were observed between variables; however, some interesting trends were observed. In high activity subjects, HR was lower in the canine condition suggesting less physical effort (Mean nchigh =141bpm + 12.5, Mean chigh =137 + 11.9). In contrast, in moderate and low activity subjects HR was increased in the canine condition (Mean ncmoderate =124bpm + 11.1, Mean cmoderate =132.4bpm +10.5; Mean nclow =126.7bpm +18.9, Mean clow =130.75bpm + 16.5). RPE was same or decreased in all subjects in the canine condition. Conclusion: Walking with a canine increased HR without increasing RPE in low and moderately active individuals in this study, providing support for canine walking as an effective fitness activity.

Research paper thumbnail of A human donor (cadaveric) observation study of three needle placements in the piriformis muscle

Journal of Manual & Manipulative Therapy, Jun 5, 2022

Research paper thumbnail of Prefabricated Splints

Research paper thumbnail of Anatomical Gift Programs Continue to Meet Donor Demands of Anatomy Educators During the COVID‐19 Pandemic: Here’s How

Research paper thumbnail of An Ethically Sustainable Model for Anatomic Gifting at a Non‐Medical School

Research paper thumbnail of Comparison of two formaldehyde exposure assessment devices in a physical therapy education program anatomy laboratory

Background and Purpose. Physical therapist (PT) education programs in the United States require t... more Background and Purpose. Physical therapist (PT) education programs in the United States require that students have a strong foundation in human anatomy. As a result, anatomy teachers and physical therapist students in anatomy courses can spend upwards of 100 hours annually studying human donors embalmed with formaldehyde (FA), a known carcinogen. While the Occupational Safety and Health Administration (OSHA) recommends regular FA exposure testing, approximately 42% of PT education program anatomists operate labs without direct access to qualified personnel to conduct such testing. These anatomists are often responsible for interpreting, assessing, and managing FA issues in the laboratory. In this paper, the researchers compare 2 methods for personal FA exposure testing and summarize current FA regulations. While Certified Industrial Hygienists (CIH) recommend the National Institute for Occupational Safety and Health (NIOSH) Method 2016 (active pump attached to sorbent tube) to asses...

Research paper thumbnail of St Peter's, Barton-upon-Humber, Lincolnshire, a parish church and its community. Volume II: The human remains. T. Waldron & W. Rodwell (eds). Oxbow Books, Oxford, 2007; 193 pp ISBN 978 1 84217 283 4

International Journal of Osteoarchaeology, 2009

Research paper thumbnail of Robusticity and osteoarthritis at the trapeziometacarpal joint in a Bronze Age population from Tell Abraq, United Arab Emirates

American Journal of Physical Anthropology, 2005

Osteoarthritis (OA) is a progressive disease of the joints and can cause pain, reduced range of m... more Osteoarthritis (OA) is a progressive disease of the joints and can cause pain, reduced range of motion and strength, and ultimately loss of function at affected joints. Osteoarthritis often occurs at sites where biomechanical stress is acutely severe or moderate but habitual over the course of a lifetime. Skeletal remains from an Umm an-Nar tomb at Tell Abraq, United Arab Emirates (ca. 2300 BC), were recovered and represented over 300 individuals of all ages. The remains were disarticulated, commingled, and mostly fragmented. An analysis of 650 well-preserved adult metacarpal and carpal bones, from the tomb's western chamber, revealed that over 53% of the trapeziometacarpal joint facets showed signs of OA varying from mild to severe. The first and

Research paper thumbnail of A severe case of hyperostosis frontalis interna and multiple comorbidities

Hyperostosis frontalis interna (HFI) is a condition that involves thickening of the frontal regio... more Hyperostosis frontalis interna (HFI) is a condition that involves thickening of the frontal region of the endocranial surface with midline sparing. It is observed in radiographic images of the cranium in living subjects and upon dissection in deceased subjects. There is little information related to the impact that hyperostosis frontalis interna has on living patients. In this case of severe hyperostosis frontalis interna, the subject was a 77-year-old female human donor who had an overwhelming number of co-morbidities. The purpose of this case study is to report an unusual case of hyperostosis frontalis interna.

Research paper thumbnail of Bilateral duplicitous renal vasculature

International Journal of Anatomical Variations, 2016

This case study documents a unique bilateral variation of renal vasculature. Renal arterial dupli... more This case study documents a unique bilateral variation of renal vasculature. Renal arterial duplications are relatively common, whereas multiple renal veins occur much less commonly. In this case report the human donor had bilateral arterial and venous duplication. This variation has not been previously reported in the literature. It is important for clinicians to be aware of renal vessel variations for surgical procedures, particularly trauma and transplantation, and in other conditions that may lead to hypertension and/or urologic disorders.

Research paper thumbnail of A robust flexor digiti minimi brevis muscle

Flexor digiti minimi brevis (FDMB) is a hypothenar muscle innervated by the ulnar nerve and acts ... more Flexor digiti minimi brevis (FDMB) is a hypothenar muscle innervated by the ulnar nerve and acts as a flexor of digit V at the metacarpophalangeal joint. While numerous variations of hypothenar musculature are documented in the literature, in this case study the researchers report on an interesting variation of the FDMB in regards to size as well as proximal and distal attachment sites which include crossing the pathways of the ulnar and median nerves. This particular variation of the FDMB has the potential to cause effort-related compression of both of these nerves and thus should be of interest to clinicians and surgeons. © Int J Anat Var (IJAV). 2013; 6: 216–217.

Research paper thumbnail of Comparison of personal formaldehyde levels in the anatomy laboratories of five physical therapy education programs

ABSTRACT Background and Purpose. The current trend in anatomy education requires medical students... more ABSTRACT Background and Purpose. The current trend in anatomy education requires medical students to spend fewer hours with human donors, while physical therapist (PT) students are spending an increasing amount of time working in the human anatomy laboratory. Nearly all PT education programs in the United States use human donors embalmed with formaldehyde (FA), a known carcinogen and sensory irritant. Although there is literature related to FA monitoring and safety in medical schools, there is little to no existing research on this topic in PT education programs. Some existing PT programs at universities have a department of Environmental Health and Safety (EHS) that monitor FA levels. However, an estimated 42% (n = 84/201) of this country’s PT programs are operating anatomy laboratories at colleges or universities that do not have a EHS department that can provide direct access to routine FA exposure monitoring and consulting. Subjects. Physical therapist students and instructors at 5 PT education programs in the United States exposed to FA during human anatomy laboratory sessions were included in this research. Physical therapist students were randomly selected to participate in this study from sites where the instructors volunteered for participation. Methods. Ambient air values, personal FA exposure, and sensory irritation levels from students and instructors at 5 PT education programs in the United States were collected and compared. Outcomes. Of the total personal FA exposure data samples taken for all sites, 57% (n = 60/105) exceeded the American Conference of Governmental Industrial Hygienists (ACGIH) ceiling level of 0.3 parts per million (ppm). The Occupational Safety and Health Administration (OSHA) short-term exposure limit (STEL) of 2.0 ppm was exceeded in 24% (n = 11/45) of sessions at 2 participating sites. Personal FA exposure levels exceeded ambient air test results in 62% (n = 66/105) of samples taken across the 5 institutions. There was no significant correlation found between personal FA exposure and reported irritation levels, or in comparison of personal FA exposure levels between students and instructors. There was a significant difference (P = 0.015) in comparing irritation levels between students and instructors, with students reporting greater than twice the irritation level as compared to their instructors. Discussion and Conclusions. In this study, individuals participating in PT program human donor-based anatomy courses were routinely exposed to higher levels of FA than reported in ambient air quality tests and limits set by ACGIH. At 2 sites, subjects were exposed to levels of FA above OSHA established STELs. These 5 instructors were not irritated by FA and, therefore, may be unlikely to seek out assistance to monitor or control for over exposure to FA. Key Words: Formaldehyde exposure, Anatomy, Physical therapy.

Research paper thumbnail of Arterial stiffness and carotid distensibility following acute formaldehyde exposure in female adults

Toxicology and Industrial Health

Formaldehyde (FA) is a ubiquitous organic preservative used in several industries and represents ... more Formaldehyde (FA) is a ubiquitous organic preservative used in several industries and represents an occupational health hazard. Short-term exposure to FA can increase oxidative stress and cause a decrease in conduit vessel function. These decrements in vascular function may extend to the arterial architecture, predisposing individuals to increased risk of cardiovascular disease. The purpose of this study was to investigate the impact of an acute 90-minute FA exposure period (259 ± 95 ppb) on indices of arterial architecture. Arterial stiffness and carotid distensibility as determined by central pressures, augmentation index (AIx), and carotid-femoral pulse wave velocity (cfPWV) ( n=13F, 24 ± 1 year) as well as carotid stiffness and intima media thickness (IMT) ( n = 9F, 23 ± 1 year) were assessed prior to (Pre-FA) and immediately following (Post-FA) exposure to FA in human cadaver dissection laboratories. Central pressures and cfPWV (Pre-FA: 5.2 ± 0.8 m.s−1, Post-FA: 5.2 ± 1.1 m s−1...

Research paper thumbnail of Vascular dysfunction and oxidative stress caused by acute formaldehyde exposure in female adults

American Journal of Physiology-Heart and Circulatory Physiology

This study was the first to investigate the implications of acute formaldehyde (FA) exposure on a... more This study was the first to investigate the implications of acute formaldehyde (FA) exposure on adult female vascular function in the arms and legs. The main findings from this study were a decrease in conduit vessel function without any alteration to microvascular function following a 90-min FA exposure. Additionally, the oxidative stress marker malondialdehyde increased after FA exposure. Taken together, these results suggest acute FA exposure have deleterious implications for the vasculature and redox balance.

Research paper thumbnail of Regarding the Dead: A Model for Anatomical Gifting Outside the Traditional Medical School Setting

Anatomical Sciences Education

In 2017, Elon University became one of very few universities in the United States without a medic... more In 2017, Elon University became one of very few universities in the United States without a medical school to have an in‐house Anatomical Gift Program (AGP). The program accepts first‐person‐consenting individuals only and within 2.5 years has become self‐sufficient, supporting anatomy curricular needs of its physical therapy, physician assistant, and undergraduate biology and anthropology programs (n = 21 donors annually). This paper describes the timeline, costs, and benefits of developing an in‐house AGP at a university without a medical school. Policy development, public outreach, equipment needs, and cost benefits are discussed. Within 2.5 years of program opening, the AGP Director delivered 161 educational outreach presentations at 86 different venues across the state providing information on anatomical gifting. The program registered 320 individuals (60% female, 40% male) and enrolled 41 deceased donors (69% female, 31% male; average age of 74.6 at time of registration and 74.8 at donation). During the first seven months of the program, donor preparation costs (with outsourcing for transport/donor preparation/document filing/serology testing/cremation) averaged US$ 2,100 per donor. Over the past 23 months, donor preparation has been completed on site, lowering the cost per donor to US$ 1,260. Other costs include personnel salaries, legal fees, and outfitting of the anatomy laboratory and preparatory room. Program benefits include support of anatomy education on campus, assurance that all donors have given first‐person consent, and faculty/student access to donor‐determined health, social, and occupational information. Faculty, staff, and students contribute to the daily operations of the AGP.

Research paper thumbnail of Comparison of 2 Formaldehyde Exposure Assessment Devices in a Physical Therapy Education Program Anatomy Laboratory

Journal of Physical Therapy Education

Background and Purpose. Physical therapist (PT) education programs in the United States require t... more Background and Purpose. Physical therapist (PT) education programs in the United States require that students have a strong foundation in human anatomy. As a result, anatomy teachers and physical therapist students in anatomy courses can spend upwards of 100 hours annually studying human donors embalmed with formaldehyde (FA), a known carcinogen. While the Occupational Safety and Health Administration (OSHA) recommends regular FA exposure testing, approximately 42% of PT education program anatomists operate labs without direct access to qualified personnel to conduct such testing. These anatomists are often responsible for interpreting, assessing, and managing FA issues in the laboratory. In this paper, the researchers compare 2 methods for personal FA exposure testing and summarize current FA regulations. While Certified Industrial Hygienists (CIH) recommend the National Institute for Occupational Safety and Health (NIOSH) Method 2016 (active pump attached to sorbent tube) to assess anatomy laboratory FA exposure levels, there are other methods available. The purpose of this research was to compare NIOSH Method 2016 to a different FA exposure sampling device for ease of use, cost, and effectiveness in assessing FA exposure levels in the PT anatomy laboratory setting. Subjects. Participants included the anatomy course instructor and 10 randomly selected Doctor of Physical Therapy (DPT) students enrolled in a human anatomy course. Methods. The researchers compared personal FA exposure data samples using passive FA‐sensitive diffusion badges against the NIOSH‐recommended Method 2016 (active pump with sorbent tube) during 10 data collection sessions. In addition, the researchers calculated the cost and time spent to use each FA sampling device. Results. The passive FA‐sensitive diffusion badges were less costly and required less time and expertise to use as compared to NIOSH Method 2016. There was a moderately strong correlation between the passive FA‐sensitive diffusion badge data and NIOSH Method 2016 (r = .772, P < .01). However, independent t tests revealed that there was a significant difference in the FA exposure data using the passive diffusion badge as compared to NIOSH Method 2016 (Badge: Mean = .22, SD = .263 versus Method 2016: Mean = .74, SD = .834; P = .004). Discussion and Conclusions. Passive FA‐sensitive diffusion badges are less costly and simple to use as compared to NIOSH Method 2016, but in this study FA exposure badge values were consistently lower than NIOSH Method 2016 data. While the passive FA‐sensitive diffusion badge is convenient for routine personal FA exposure monitoring, these researchers recommend that a CIH conduct a complete FA assessment at least annually to ensure air quality safety.

Research paper thumbnail of Counting the Dead: Who is Teaching Anatomy to Physical Therapy Students?

Journal of Physical Therapy Education

BACKGROUND AND PURPOSEWhile the term "cadaver" is accurate, many anatomists use the ter... more BACKGROUND AND PURPOSEWhile the term "cadaver" is accurate, many anatomists use the term "human donor" to confer dignity and imply consent of the person who has volunteered or donated his/her body to anatomy education. Unfortunately, there is a long history of anatomy instruction including people who did not directly consent to have their bodies used for education. This practice persists today.1 In this paper, the researchers explore the use of cadavers and the topic of consent in anatomy education in physical therapist (PT) education programs.There is no national system for quantifying cadavers used in anatomy education in PT education programs, and no system in place to track where PT education programs obtain cadavers, but the number of cadavers used in total in all venues of medical education continues to grow. In the early 1970s, there were 101 medical schools in the United States (US),2 and 70 schools offering either a baccalaureate or certificate in physical therapy.3 As of 2015, there were 785 schools of health care provider education, to include 145 programs conferring the degree of Medical Doctor,4 42 Doctor of Osteopathy,5 196 Physician's Assistant,6 163 Occupational Therapy,7 and 239 Physical Therapy.8 Many of the students in these health care education programs study human anatomy with a cadaver. The number of health care education programs is expected to continue to rise,9 with implications for an increasing demand for cadavers.There are 3 general categories of cadavers used for human anatomy instruction: (1) Registered donor, where the person has specifically consented to use of his or her body for medical education or research; (2) next of kin donations, where the person donated has not consented to be used for medical education or research, but the family has; and (3) unclaimed dead, where the state has jurisdiction to donate the cadaver for medical education or research without consent of the deceased.Unclaimed dead are people who die without a will and have no next of kin to claim and bury them.10 Thus, the unclaimed dead are placed under the jurisdiction of public health departments via the coroner's office and are handled differently (cremated, buried, sent to anatomy education departments, or housed for a period of time by the coroner) from state to state. Prior to assignment of an unclaimed body, efforts are made to locate next of kin to take possession of and bury the body, but the extent of these efforts varies state by state. If someone is identified as an active or honorably discharged military member, he or she cannot be classified as unclaimed dead and is transferred to the US Department of Veterans Affairs for burial.11 At present there is no accounting for the numbers of unclaimed dead being used by anatomy education departments across the US.The purpose of this paper is to present baseline information regarding the number, origin, and donation status of cadavers being used in anatomy education in PT education programs. Ideally, quantifying the cadavers used in anatomy education in PT education programs and increasing awareness around donor registration status will create a culture where faculty in PT education programs ensure that every cadaver they teach alongside has consented to participate in anatomy education.Position and RationaleThroughout history, cadavers have been used for medical education. During the 18th century in Great Britain, cadavers were in short supply, as the only legally available bodies were those of executed criminals. The practice at the time to double the punishment of a criminal sentenced to death by hanging was to add dissection to the sentence. These dissections were often completed in public as a means of discouraging others from criminal behavior.12By the mid-19th century, medical education was flourishing and the need for cadavers increased so much that grave robbing was rampant in both the US and the United Kingdom. …

Research paper thumbnail of Naming the Dead: What information do Physical Therapy and Physician Assistant anatomy faculty share with students?

Anatomical Sciences Education

In this novel study, the researchers quantify cadaver information provided to Physical Therapy (P... more In this novel study, the researchers quantify cadaver information provided to Physical Therapy (PT) and Physician Assistant (PA) anatomy faculty and ask what portion of that information is then shared with students. Descriptive statistics were used to the describe demographics of the study respondents and to report survey responses. The majority (60% or greater) of faculty who teach anatomy to PT and PA students have clinical degrees matching the student groups they teach. Chi‐square analysis showed no appreciable difference (P < 0.001) between PT and PA anatomy faculty in the amount of cadaver information they receive or then share with students. There was a difference in the type of cadaver information (identifying vs. non‐identifying) that is received and then shared by these faculty. Faculty are more likely to receive non‐identifying cadaver information (93%) than identifying information (40%) (P < 0.0001) and share non‐identifying information (83%) than identifying information (26%) with students (P < 0.0003). Interestingly, there is no consensus as to whether sharing cadaver information is respectful or disrespectful to those who donate their bodies for anatomy education and research. Further research is warranted into the reasons anatomy faculty withhold cadaver information from students and in the value, if any, for students knowing more about the cadavers they are learning from.

Research paper thumbnail of Quantifying Cadaver Use in Physician Assistant Anatomy Education

The Journal of Physician Assistant Education

Purpose To quantify the number of cadavers used in physician assistant (PA) anatomy education and... more Purpose To quantify the number of cadavers used in physician assistant (PA) anatomy education and to ascertain the origins of those cadavers. Methods An electronic survey was generated and distributed to all schools that had been accredited by the Accreditation Review Commission on Education for the Physician Assistant. Responses were reported using descriptive statistics. Results The survey had a 49% response rate. Among the responding programs, 79% reported working with 655 cadavers, with an average of one cadaver per 5.72 students. Programs reported that 21% receive cadavers from multiple sources. Of all programs using cadavers, 62% receive cadavers from medical schools, 23% from in-house anatomical gift programs, 19% from state anatomy boards, 9% from private organizations, and 8% from other sources. Anatomy educators reported that 55% know the origins of the cadavers in their programs, 18% do not, and 27% are uncertain. In categorizing cadavers at their programs, 56% were reported as registered donors, 4% as next-of-kin donations, 1% as unclaimed dead, 17% as uncertain origin, and 22% as unaccounted for by respondents. Conclusions Among educators who teach anatomy to PA students, 45% do not know or are uncertain of the origins of the cadavers in their programs. Of the reported 655 cadavers used in PA education, 289 were not categorized as registered donors. Facing the expansion of PA programs, educators need to be aware of cadavers' origins to ensure that all aspects of PA education are consistent with the ethics that the students are being taught. Those ethics include the need for informed consent for all cadavers involved in PA education.

Research paper thumbnail of Letter in response to Letter-to-the-Editor regarding Comparison of two angles of approach for trigger point dry needling of the lumbar multifidus in human donors (cadavers) ( Hannah et al., 2016 )

Musculoskeletal Science and Practice