• Lessons Learned: The Lived Experience of Tribal College & University Students

      Vicki Black
      This is the second part of a large phenomenological study about Tribal College & University students.
    • Management of Crohn's Disease: Early and Aggressive Treatment Using Biologics and Immunomodulators

      Martin, Erin; Sadowski, Catherine (2021)
      Crohn's Disease (CD) is an incurable type of inflammatory bowel disease (IBD), in which the intestines are chronically inflamed, causing intestinal and extra-intestinal symptoms. CD patients experience a cycle of remission and relapse of symptoms as the disease progresses to serious complications, including small bowel obstructions, malnutrition, and decreased quality of life. Since CD is incurable, medical management is the mainstay of treatment to obtain and maintain remission. Traditional treatment relies on anti-inflammatories. New management strategies focuses on early and aggressive therapy with immunomodulators and biologics to reduce the rate of mucosal and intestinal damage early in the disease course.
    • Microparticulate vaccine for transdermal measles immunization

      Joshi, Devyani; Gala, Rikhav; Uddin, Mohammad N.; D'Souza, Martin J. (2021)
      Measles is a major global cause of death. Since children are primary targets for vaccine, we aimed at delivering the vaccine via needle-free transdermal route. Vaccine microparticles were formulated using Buchi spray dryer B-290. The induction of immune response by the microparticles was confirmed by Griess's assay. Expression of antigen-presenting molecules, MHC I, MHC II, and co-stimulatory molecules CD80, CD40 was assessed using flow cytometry. Cytotoxicity of microparticles was assessed by MTT assay. In vivo efficacy of was studied in the mouse model. For transdermal immunization, P.L.E.A.S.E. ablative laser was used. It creates micropores of defined size on the skin for transdermal immunization. The animals were administered with a prime and a booster dose. The serum was collected, and IgG and IgM antibody titers were measured. Microparticulate vaccine showed significantly higher release of nitric oxide compared to the blank microparticles. It resulted in significantly higher cell-surface expression of MHC I, MHC II, CD80 and CD40. The vaccine and adjuvant microparticles were non-cytotoxic. The in vivo studies demonstrated elevated humoral immune responses in the mice receiving vaccine and adjuvant microparticles via both, subcutaneous and transdermal routes. The microparticles augment the immunogenic properties of vaccine. Transdermal administration produced comparable results as of the subcutaneous administration indicating the potential of the transdermal vaccination.
    • On the Shoulders of Giants: Helping Students Understand Mathematics Through its History

      David Henderson
      This is a dissertation on the use of the historical development of mathematical ideas to help secondary students understand the nature of the discipline.
    • Pen Pal Project to Write Away Isolation: An IRB-approved Project Aimed at Decreasing Isolation During a Global Pandemic

      Barfield, Kailey; de la Cruz, Jennifer; Lepp, Erin F. (2021)
      As the COVID-19 pandemic radically upended the daily lives and routines of many people, those considered vulnerable faced increased physical isolation due to efforts of increased protection. While interventions such as social distancing have been appropriate to maintain physical health, mental health has taken the brunt of the pandemic. To create connections while maintaining safe physical distance, a letter writing project was created between Mercer Physician Assistant Students and volunteers in the community. This project was created for the Paul Ambrose Scholars Program in which students in medical professions are selected to design a community health project focusing on one of the Leading Health Indicators (LHI) of Healthy People 2020. Suicide was the LHI chosen for this project. As depression increases among elderly, isolated individuals during the pandemic, the risk of suicide increases as well. Letter writing is a cheap, easy way to maintain emotional connections with others despite social distancing guidelines. This project has been IRB approved and included nineteen Mercer Physician Assistant (PA) students and nineteen volunteer letter recipients throughout the United States. A screening tool was used to assess depression levels of volunteer letter recipients both prior to and after receiving letters from PA students over the course of 4-5 months. This poster is a summary of the research project.
    • Perceptions, Attitudes, and Beliefs of Young, Underrepresented Minorities in Clinical Trials

      Ross, Allison; Wong, U.; Nguyen, J. (2021)
      Introduction:This study is designed to ask Millennials (1981-1996) and early Generation Zers (1997-2002) about their perceptions of clinical trials. This will provide insight to identify reasons for the lack of diversity in age, ethnicity, and background for the advancement of future medicine. Methods:The data provided evaluated Millennials and Generation Zers using a survey. Participants were recruited via convenience sampling. Questions included personal demographics, knowledge of clinical trials, willingness to participate in clinical trials. Results:A chi-square test was performed to examine potential associations between individual demographics and responses(N=172, Minority=126, Male=37.7%). For the likelihood of participating in vaccine-focused clinical trials, 62.4% of the respondents reported that it would be unlikely for them to participate in a study; 76.9% Millennials versus Gen Z (N=125, p=0.009). When analyzing gender, women were found to be 69.5% more likely than men to deny participating in a clinical trial for vaccines (N=81, p=0.0005). Discussion:In regard to participating in a clinical trial with a focus on vaccinations, Millennials were less likely to indicate participation than Gen Zers. Between both generations, females were most opposed to the concept. Increased representation in gender and minority-based ethnicity (significantly in the Hispanic and/or Asian community) will allow more comprehensive insight for future implementation and analysis.
    • Pharmacovigilance Analysis of Drug-Drug Interactions in the FDA Adverse Event Reporting System: A Retrospective Study

      Awatef Ben Ramadan; Hellen Pham
      The objective of this study is to analyze and assess the drug-drug interactions in the web-based, publicly available FDA Adverse Event Reporting System (FAERS) database in the years 2017, 2018, and 2019.
    • Physical Therapy Evaluation and Management of a Patient with Acute Anterior Cruciate Ligament and Meniscal Tears Complicated by Hereditary Multiple Osteochondromas in the Occupational Health Setting: A Case Report

      Pendergrast, Sarah; Ebert, Jeffrey (2021)
      Background: Hereditary Multiple Osteochondromas (HMO) is a disease that primarily affects the musculoskeletal system. Sequelae of the disease are often treated via outpatient orthopedic physical therapy. There is a lack of literature on HMO in physical therapy. The purpose of this report is to discuss management of a man with HMO and an acute orthopedic injury. Description: A 44-year-old male with HMO and acute knee injury presented with instability and structural abnormalities as well as impaired range of motion, gait, and muscle performance. MRI confirmed anterior cruciate ligament rupture, meniscal tear, and nondisplaced fibular fracture. The examination and plan of care for this patient included special considerations due to the presence of HMO and nuances of the occupational health setting and insurance. Outcomes: The lower extremity functional scale was used to assess the patient�s functional abilities related to his injury, and objective tests and measures were used to assess the impairments. Discussion: Clinicians should treat within the individual context of each patient, including all comorbidities and patient specific findings in order to make effective clinical decisions. Evaluating and treating a patient in the occupational health setting with HMO that has sustained an acute orthopedic injury requires a combination of disease knowledge, clinical reasoning, collaboration with other healthcare providers, and diagnostic imaging.
    • Platelet-Rich Plasma for Chronic Plantar Fasciitis

      Shimada, Yoichiro; Heard, Henry (2021)
      Platelet-rich plasma (PRP), also referred to as autologous platelet gel, has been increasingly used for musculoskeletal injuries, including Achilles tendonitis, shoulder impingement, rotator cuff tear, lateral epicondylitis, patellar tendinopathy, and plantar fasciitis. Chronic plantar fasciitis is defined as degenerative irritation of the plantar fascia that has failed to respond to conservative therapy, and it presents with non-inflammatory, fibroblastic hypertrophy and dysfunctional vasculature. With the chronic degenerative changes of the tissue along with zones of avascularity, chronic plantar fasciitis is difficult to treat, and the recurrence is common even after prolonged rest. Current treatments for chronic plantar fasciitis include corticosteroid injection, extracorporeal shock wave therapy, and surgery. Corticosteroid injections are common treatments for chronic plantar fasciitis; however, there are potential disabling complications associated with corticosteroid injections. PRP has been proposed as an effective, safer alternative treatment option for chronic plantar fasciitis. Due to the hypovascularity and hypocellularity nature of the injury, directly introducing growth factors and cytokines found in PRP to the fascia is believed to promote tissue heal. The purpose of this review is to examine current literature on PRP treatment for chronic plantar fasciitis.
    • Preference and Perception of Mobile Health Applications Educating African American Women on Sexual and Reproductive Health

      Griswold, Allison McKenzie; Ramadan, Awatef A. Ben (2021)
      The Preference and Perception of Mobile Health Applications Educating African American Women on Sexual and Reproductive Health First author: Allison Griswold Co-author: Awatef Ben Ramadan Abstract Background: Previous studies have found that African American women are affected by sexually transmitted diseases and reproductive health issues at a higher rate than any other race. Study Aims: To increase awareness of cultural barriers, and to explore the need for medically accurate sexual and reproductive health information through mobile health applications. Methods: The Institutional Review Board approved an anonymous online survey using convenience sampling of African American women between the ages of 18-50. Respondents answered questions regarding past sexual education course experience, use of women�s health applications, interest in health messages, the importance of health information, personal knowledge satisfaction, and preference for receiving information. The study results presented as graphs, which were generated through excel spreadsheets. Results: Of the 159 respondents that completed the survey, 38.5% currently use any form of women�s mobile health application very frequently. However, 65.8% are interested in receiving information on sexual and reproductive health through women�s health applications. Of the 159 respondents, only 27% were very satisfied with their current sexual and reproductive health knowledge. Conclusion: This study proves that African American women are open to learning and gaining sexual and reproductive facts through mobile applications. Keywords: African American women, period trackers, mobile health applications, sexual health, reproductive health
    • Promoting Intrapersonal Resilience: Women of Color in STEM Programs

      C. Peeper McDonald; Kirstin Sylvester
      The presented study aims to provide a quantitative analysis of the relationship between resilience and experienced microaggressions, and how that relationship influences retention, progression, and degree completion in underrepresented Women of Color in STEM programs. Understanding resilience characteristics allows for the identification of traits and behaviors that can be encouraged.
    • Recovery and Discovery: Developing a trauma-sensitive theology model which informs wholistic pastoral care for African American Women

      Stubbs, Tiffany (2021)
      Abstract: This research study seeks to examine the experience and responses of trauma within the realms of intersectionality and trauma informed care for African American women. The criticality of examining the duality of trauma and theology is filtered through a literature review and theological discourse. There is evidence of a correlation between the StrongBlackWoman schema and intergenerational epigenetic trauma. The trauma of living through the intersectional lanes of what it means to be an African American woman has consequently imbued African American Women with an obligation to bear the burden of strength and resiliency. This obligation has had detrimental effects on African American women’s physical, emotional and spiritual well-being. In order to provide space for transformative healing, I have suggested a construct of pastoral care model that encompasses a trauma-sensitive theological approach as a pathway to transformative healing. The goal of the pastoral care model is to provide strategies of recovery from trauma and discover ways to cope.
    • Reliability of Low-Cost Thermometers for Monitoring Foot Temperature

      Doolittle, Kristen M.; Wendland, Deborah M. (2021)
      Diabetes prevalence is high and often burdens the economically disadvantaged. With the risk for foot complications in those with diabetes, foot temperature monitoring can help lessen ulcer risk. Higher cost thermometers have been validated. Validation of lower cost thermometers could improve access for the underserved. Purpose: To assess device repeatability, reliability, and ease of use. Methods: 3 inexpensive infrared thermometers were compared against a reference thermometer for repeatability. Rater reliability was assessed by 2 raters using 3 trials at 3 sites across 25 subjects. Feasibility was assessed by subjects ranking the thermometers after testing them. Data Analysis: Descriptive statistics were used for device repeatability. Intra-class correlation coefficient was used to assess rater reliability. Results: Device repeatability: single day coefficients of variation (CV) ranged from 0.20%-0.91%; all days CVs ranged from 3.32%-4.69%. Rater reliability: 25 subjects (49.6�15.8 years). Intra-rater ICC was >0.99 for researchers and thermometers. Inter-rater ICC was 0.965 - 0.975. Thermometers were ranked based on comfort, handling, size, and the light presence. Discussion: Reliability and repeatability of thermometers were good and measurements correlated strongly with the reference. The subjects had little difficulty using the devices. Conclusions: Inexpensive, commercially available infrared thermometers can be a reliable/valid way to assess local skin temperature.
    • Return to Golf Post Subscapularis Repair: Consideration of Regional Interdependence

      Williams, Katelyn; Ebert, Jeffrey G. (2021)
      Return to golf post subscapularis repair Background Isolated subscapularis tears are uncommon in relation to the frequency of rotator cuff (RTC) pathology. However, in specific populations such as golfers, the subscapularis is the second most torn RTC muscle. Purpose The purpose of this case is to encourage clinicians to consider regional interdependence between a subscapularis tear/repair and a history of low back pain in a recreational golfer. Standard rehabilitation specific to the shoulder post subscapularis repair achieved full functional use of the upper extremity, but limitations persisted specific to golf. This case report highlights the importance of assessing golf mechanics with regional interdependence in mind in order to assist a patient in returning to functional golf performance. Case description A 42-year-old male, recreational golfer since age 14, presented to the clinic post subscapularis RTC repair with a goal of returning to golf. Golf swing analyses were performed pre and post treatment and test retest treatment methods assessed patient�s lingering pain complaints during golf. Outcomes The FOTO and numeric pain rating scale were used to measure improvement along with the patient�s subjective report and golf swing analysis with video footage. The patient�s FOTO score improved by 50 points over 6 months of rehabilitation indicating return to functional use of the UE. Patient�s pain decreased to 0/10 during golf game.
    • School-Based Health Centers and Mental Health Access among Minority and Low-Socioeconomic Adolescents

      Barfield, Kailey; Martinelli, LeAnne (2021)
      School-Based Health Centers (SBHCs) are comprehensive health clinics that provide a myriad of services to the students that they serve. SBHCs are meant to overcome barriers students face when it comes to accessing healthcare such as transportation, limited clinic hours, and parent work schedules. However, many of the most vulnerable populations - like those living in poverty and those that identify as racial/ethnic minorities - may still encounter barriers when it comes to accessing mental healthcare. A review of previous studies was done, and suggestions were provided for improved access to mental health services through SBHCs to even the most vulnerable populations.
    • Sex Differences in an Fmr1 Knock-out Mouse Model of Fragile X Syndrome

      Jessica Armstrong; Yiming Chen; Tanishka Saraf; Clinton Canal
      Possessing a single X-chromosome, fragile X syndrome (FXS) occurs more frequently in males than females, and FXS males typically have more severe clinical symptoms than FXS females. Genetic mosaicism (X-inactivation) in females with FXS is the presumed, exclusive reason for the lower symptom severity; we explored the hypothesis that other factors - sex hormones or sexually dimorphic brain systems - could be involved.
    • Social Determinants of Health That Affected Covid-19 Outcomes

      Carter, Angelique; Couch, Valerie; Mullinax, Jonathan; Willis, Steffenie; Walthall, Sabrina (2021)
      The covid-19 pandemic has exposed the longstanding structural drivers of health inequities, such as race, economic disparities, and housing insecurities. These important determinants of health have interlinked with other factors during covid-19 to exacerbate existing social vulnerabilities in society. People from racial and ethnic minority groups are disproportionately affected by lack of access to quality health care which leads to inequities in treatment. People from lower incomes, experience challenges that make managing expenses, paying medical bills, accessing nutritious food, and reliable childcare difficult. Some groups are disproportionately affected by difficulties finding affordable and quality housing. This may limit their housing options to neighborhoods and residences with crowded conditions. These conditions are often time family members of many generations living in one household which can lead to exposure of older adults to illnesses and diseases. This research discusses how these determinants may increase risk of COVID-19 exposure, leading to hospitalization, long-term health issues, social consequences, and death.
    • Spaciotemporal analysis of COVID-19 to study impact of mobility on infection rate

      Hamza, Syed Ali; Bukhari, Syeda Sydra; Chandio, Sara Khan; Khan, Shakeel (2021)
      Background: COVID-19’s asymptomatic nature in some people makes it undetectable in initial days of contact and results in spread of the infection. Some countries have contained its spread, whereas some are still experiencing increasing cases. This study includes spaciotemporal analysis of COVID-19 and mobility data to provide insights in how the infection spreads while comparing the public mobility between the best and worst performing countries. Study Design/Method: The data about cases, recoveries, and deaths from Jan ’20 to Feb ’21 from John Hopkins-CSE is integrated with mobility data from Google. It is then analyzed at global level with further drilldowns into continent, countries, and states in US. Study includes comparative analysis between US and New Zealand to show which mobility parameters influenced the spread. Locations such as transit stations, retail, grocery, workspaces, residential areas, and parks were studied to find their impact. Findings: The analysis indicates that there was a short-term drop in mobility around workplaces, retail and grocery stores, and transit stores in United States along with a spike in the mobility across parks during the initial period. On the other hand, mobility has been under control in New Zealand. The study highlights that the areas with higher public activity shows higher infection rate, thus controlling the public movement around retail and grocery places has positive influence than complete shutdown of the workplaces.
    • Stress in Cancer Patients

      McLean-Clark, Stephanie (2021)
      o A major insurance company that employees over 70,000 persons and provides healthcare coverage to approximately 180 million people in more than 30 countries across the world. Every year they receive thousands of prior authorization requests related to tests for cancer patients. Currently, providers must submit these requests through a designated electronic system and these requests may take up to seven business days for processing. During this waiting period, Cancer patients experience stress upon learning that they may have cancer. Additional stress can be added when they are forced to wait for approval from the insurance company to have additional testing performed. The goal of this proposal is to decrease the wait time for cancer patients by providing an approval or denial by reconfiguring the system to move these requests to the top of the processing list.