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Session 1 AbstractsKaitlyn Haverty (presentation number 1)

Neuro-protective effect of Ayurveda preparation, Saraswatharishtam, on Spectracide induced neurological disorder in fly model

Mentor: Anathbandhu Chaudhuri

Parkinson's disease is a progressive neurodegenerative disorder associated with severe loss of motor functions due to degeneration of dopamine neurons in the brain. The etiology of most cases of the disease is unknown. However, several studies have discovered many possible environmental triggers, Spectracide, a commonly used herbicide, being a major chemical of interest. Some Spectracide related health symptoms include skin diseases, kidney failure, reproductive dysfunctions, cancer and neurodegenerative diseases. This study entirely focuses on the possible neurodegenerative effects of Spectracide exposure using fruit fly a model system to study the human diseases. We are interested to know whether Saraswatharishtam (SWRT), a traditional brain tonic could be an effective treatment for Spectracide induced neurological defects. SWRT is an Ayurveda medicine, mixture of 18 different types of Indigenous plant extracts reported to be very effective for memory loss and several other neurological dysfunctions. Flies were fed Spectracide (25 and 10%) mixed with 5% sucrose solutions to score the mortality and record negative geotaxis. Only 5% sucrose was used as control. Spectracide fed flies showed parkinsonian symptoms like tremor, rotational movement and frequent fall against the gravity. Kaplan-Meier survival curve revealed that both the doses of Spectracide killed the flies within 36-96 hours in a dose dependent manner. The negative geotaxis also being adversely affected recorded by its slow movement. The flies were pre fed with SWRT for 72 hours and transferred to the 10 % Spectracide solution mixed with 5% sucrose to see the rescue effect. We did not find any toxic effects of SWRT, rather flies become more active when treated alone. We conclude that SWRT could have neuroprotective effect and may be useful for the treatment of neurological disorders. The experiment is in progress.

Keywords: Spectracide, Drosophila, Ayurvedic, Saraswatharistham, Neuroprotection

Brianna Goldfon (presentation number 2)

First Baptist Child Development Center Flu Prevention Intervention

Mentor: Lori Turner

First Baptist Child Development Center Flu Prevention Intervention

Background Problem: The flu is caused by influenza viruses that infect the respiratory system. Currently, the flu is at 8.4% statewide and reported widespread in Alabama. It has been increasing since the start of flu season in September. Alabama is in high level of activity with the flu along with 25 other states. Hospitalizations with Influenza happens most among young children.

Purpose: First Baptist exists to magnify Jesus Christ and multiply His kingdom, to mature believers into effective Christ-followers, and to minister to others in Jesus' name.

Methods: First Baptist Child Development Center is a program for children ages 6 weeks through pre-k. The program offers full-day and half day care. Flu health implementation was needed because staff, parents and children all were flu targets. Posters were put around the building informing basic knowledge about the flu. A flyer was sent home to all the parents which was an advised the parents on signs, symptoms and precautions. For the teachers, there was a packet on everyday preventative actions to fight the flu along with a form explaining how to

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clean and disinfect schools to help slow the spread of flu. Also included, was lesson plans on teaching children about the flu. There were also descriptive conversations with other coworkers about the flu, correct handwashing, and making sure the classroom is stocked with the correct items.

Results: First Baptist Child Development Center has taken preventative measures in preparing and informing children, staff and parents about the flu season. First Baptist Child Development Center has helped to obtain resources for the classrooms to decrease the germs in the building.

First Baptist Child Development Center has educated others about the seriousness of the flu.

Brianna Velez (presentation number 3)

Cannabis, Sleep, and Traumatic Brain Injury: A Scoping Review

Mentor: Rachael Mumbower

Background

Estimates suggest that over half of the millions of individuals with traumatic brain injury (TBI) will experience sleep disturbances. In recent qualitative reports, survivors of TBI reported using cannabis to aid in sleep onset, reduce muscle spasms, etc.

Significance

There is scarce literature regarding cannabis for sleep after TBI. The purpose of this scoping review of literature is to investigate and describe the relationship between cannabis and sleep and potential implications for survivors of TBI.

Methods

Scoping literature review of original research articles from SCOPUS, Google Scholar, and PubMed.

Results

Anecdotally, individuals with TBI have reported marijuana use both preceding and following brain injury. Marijuana is considered a risk factor for TBI, but also has restorative implications through limiting neuroinflammation and secondary injury in addition to relief of TBI-induced symptoms. Although marijuana and its effect on sleep has been researched heavily, there is a gap in knowledge on the negative effects marijuana can induce on sleep patterns. Evidence has shown that withdrawal from marijuana that was once used for sleep can have a negative impact in individuals, particularly in women whose metabolism causes them to be more susceptible to addiction and withdrawal symptoms.There is room to broaden the investigation considering additional responses to marijuana following TBI as the current research is limited to patients self-reporting marijuana use.

Conclusion

While there is the potential for cannabis to aid sleep after TBI, much more research is needed to determine safety and efficacy. The necessary research may be hindered by the legality of cannabis and stigma against its use.

Michelle Tan (presentation number 4)

Disproportionate Dental Care Access for Preadolescent Children Under Foster Care in Rural Communities

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Mentor: Darren Surman

There is a growing consensus that oral health is linked to overall body health. Not only is oral fitness an indicator of comprehensive health, but poor oral health may contribute to a variety of diseases such as endocarditis, cardiovascular diseases, and premature birth of infants in infected pregnant mothers (Mayo Clinic, 2018). The necessity for both the development of proper oral hygiene habits starting from a young age and regular access to dental health professionals are evident constituents to the elevation dental care. Children customarily learn basic oral hygiene tips from their parents, guardians, or dental professional; however, a portion of children living under foster care in rural communities tend to be disproportionately incapable of receiving adequate oral hygiene education. Given this information, this participatory action research project aims to voice current and past foster children's opinions on the consequences of the lack of oral health education and access to a dentist. Interviews and testimonies from these individuals depict the necessity for the implementation of a standard oral health education program and easy access to a dentist. The ultimate objective of this study is to equip foster adolescents and their community with resources to self-increase their exposure to oral health education and dentists in their community. Potential solutions such as incorporating America's Tooth Fairy's educational oral hygiene material in local elementary and middle schools' curriculum are proposed and analyzed. Ultimately, dental care in the form of oral health education and visits to the dentist is critical in sustaining oral and general body health. Hence, the results of this investigation enable adolescents and their rural community partners to inaugurate external and internal communal change regarding access to dental care.

Samantha Engel (presentation number 5)

West Alabama Food Bank Secret Meals Nutritional Program

Mentor: Lori Turner

Title: West Alabama Food Bank Secret Meals Nutritional Program

Background: The State of Alabama has a poverty rate of 18%-- one of the highest in the United States. One in five children in Alabama live below the poverty line and many more are faced with "food insecurities", meaning they may have limited access to foods. These children typically rely on free and reduced lunch programs through schools which only provide them with breakfast and lunch meals on the weekdays. However, the weekend causes a nutritional gap among these children.

Purpose: The West Alabama Food Bank (WAFB) was incorporated in 1987 as a 501 (c) (3) non-profit organization whose mission is to help alleviate hunger and food insecurity in nine West Alabama counties including Bibb, Fayette, Greene, Hale, Lamar, Marion, Pickens, Sumter and Tuscaloosa.

Methods: West Alabama Food Bank coordinates food donations and volunteer work to implement the Secret Meals Program by packaging the adequate number of Secret Meals to be distributed to each public school within the aforementioned counties of West Alabama.

Health Education Areas of Responsibility:

I. Identify children affected by food insecurity that utilize free and reduced lunch rates within school districts and counties

II. Train and educate volunteers to organize and pack bags with nutritious snacks/foods to feed and sustain children over the weekend

III. Package individual food packs for each child

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IV. Coordinate with school teachers to evaluate outcomes though child's school performance and behaviors

V. Coordination of continuous food drives, donations, funding, and volunteers to ensure implementation of Secret Meals

VI. Continue research on nutrient dense foods that are shelf-stable and frequently donated

VII. Communicate with donors and educate about which foods are nutrient dense and beneficial for young children

Results: West Alabama Food Bank measures its program's successes through the amount of food distributed. Currently, West Alabama Food Bank has distributed seventeen million pounds of food. WAFB is a member of the Alabama Food Bank Association and an affiliate of Feeding America - The Nation's Food Bank Network.

Hillary Melton (presentation number 6)

Telomere Length, American Heart Association's Life's Simple 7, and Psychosociocultural Factors Among African American Women

Mentor: Theresa Wadas

In the United States, African American women (AAW) are disproportionately affected by cardiovascular disease (CVD). Studies examining telomere length (TL, leukocyte cells), the American Heart Association's Life's Simple 7 (LS7, a cardiovascular health metric), and psychosociocultural factors among AAW are scarce. The purpose of this study is to examine TL, LS7, and psychosociocultural factors using the culturally salient Strong Black Woman (SBW) Schema among N=75 postmenopausal AAW. The specific aims are: 1. Examine TL, LS7, and internalization of the SBW Schema, 2. Determine differences between TL, LS7, and internalization of the SBW Schema, and 3. Determine the moderator effect of internalization of the SBW Schema on LS7 and TL. The overarching hypothesis is greater internalization of the SBW Schema (higher endorsement) will have interactive effects on LS7, leading to shorter TL. AAW will be recruited from local area churches. Participants will complete demographic and SBW questionnaires; and anthropometric, physiologic, and biological sampling. Univariate and multivariate analyses will be performed on associated aims. From an innovative perspective, this study will be used to inform and develop culturally sensitive interventions to reduce CVD among AAW.

Kevin Keller (presentation number 7)

The University of Alabama Project Health Organization

Mentor: Lori Turner

Parker Keller

HHE 480

Dr. Lori Turner

The University of Alabama Project Health Organization

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Background/Problem: The University of Alabama student population has many different health issues and the Project Health organization works to tackle each and every one of these. Project Health picks a new health topic each week to try and educate the student body on how to stray away from the health issue.

Purpose: I am currently volunteering for the Project Health organization based in Russell Hall on campus. The purpose of this organization is to eliminate all health issues on the University of Alabama Campus. This organization is student serving students based so actual UA students are sent around campus to health huts where they teach a specific health topic. The purpose of my assignment was to help an organization address a health topic

Methods: the organization uses word of mouth to communicate to the students of the University of Alabama health issues they choose to talk about each week. They often create games and little quizzes on the specific health topic of the week that student can win prizes if they win or answer the questions correctly.

Results: the way success is measured in this organization is communication to as many of the students on campus as possible. The project health workers count how many student they reach out to on campus.

Kate Bergey (presentation number 8)

RISE Center

Mentor: Lori Turner

The RISE Center is a school based in Tuscaloosa serving children as young as 6 weeks to 5 years old. RISE strives to intertwine traditional learners and those diagnosed with disabilities or a delayed area of learning. In 1974, the first RISE Center was started at the University of Alabama to serve a diverse range of children and provide support for their families. Through service, research, and teaching, the RISE Center in Tuscaloosa is able to serve as an example for numerous other centers to open around the nation. The ultimate goal of the RISE Center is to properly equip all children and families attending the school for their next educational step by offering innovative early childhood special education and integrating therapy into their model. With its long-standing history, implementation of new leadership, and the ever-changing policies via the University, the Center is in a unique position to revamp its brand and marketing strategies. The Center faces the dilemma of many individuals knowing of the RISE Center but not many understanding the work they actually do. Through UA's public relations department, I have the opportunity to partner with the RISE Center to develop a strategic plan based on thorough research and an in-depth needs assessment. With four main objectives, our group intends to enhance its social media and website, implement creative fundraising tools, and develop cohesive branding across the board. Following the presentation and implementation of our work for the RISE Center, we hope to see an increase in donor awareness and action as well as an increase in community engagement.

Jordan May (presentation number 9)

Understanding Common Barriers and Facilitators of Whole Grain Consumption Among the Older Adult Population: A Literature Review

Mentor: Seung Eun Jung

Whole grain (WG) consumption has been distinguished as a key factor in preventing many chronic health issues. The Dietary Guidelines for Americans recommends making half of your grains WGs. Unfortunately, WG consumption among older adults is well below the recommended amount at roughly 0.9 oz. per day. Due to the

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high prevalence of chronic health issues among older adults, understanding the factors influencing on their WG consumption is important in promoting WG foods.

A literature review was conducted to identify common barriers and facilitators of WG consumption among older adults.

A total of 22 research studies, published in English between 2006 and 2018, regarding WG consumption were reviewed and analyzed. The databases of choice were Science Direct, EBSCO, and Scout. Keywords that were used to search the articles within the databases included the following: WG(s), WG consumption, older adults, elderly, aging, low income [population], health benefits, nutrition intervention, chronic disease, diet quality, nutrition-related knowledge, and perceptions of WGs.

Commonly identified barriers to WG consumption included cost, lack of knowledge, self-efficacy, diminished appetite, difficulty identifying WG products, and low acceptability rates toward WGs. Frequently identified facilitators included knowledge of WGs, availability of WGs, support from friends and family, taste preference, and overall sensory appeal.

Strategies for increasing WG consumption among this population include teaching older adults how to identify WG products and improve their self-efficacy through tasting and cooking demonstrations. Additionally, facilitating these activities will encourage the inclusion of more WG foods in areas highly populated with older adults.

Jeffery Stacy Jr. (presentation number 10)

Al's Pals UA Mentorship Program

Mentor: Lori Turner

Background/Problem: University students volunteer as mentors to help students in coursework because their parents may be working jobs and not be able to. Some mentees may not have anyone there for them so that's where mentors come in to place to be that friend that they might need.

Purpose: The name of the organization is Al's Pals UA Mentorship Program. It takes place at Benjamin Barnes YMCA in Tuscaloosa, AL. The goals for the organization is to help and improve mentees skills in reading and math. Mentors also help mentees complete homework. Mentors participate in recreational activities as well with mentees.

Methods: The Al's Pals Mentorship Program coordinates a variety of things for elementary students. Mentors reinforce basic school skills like math, reading, and science. Mentors commit to one afternoon weekly from 4-5pm for 10 weeks during the semester. The grades being mentored range from 1st through 5th.

Results: The Al's Pals Mentorship Program has helped a variety of elementary school students in Tuscaloosa. The Al's Pals Mentorship Program has been great at helping mentees reach the highest success in school coursework. Volunteers learn responsibility to the community, gain management skills, and decision-making skills.

Molly Lukas (presentation number 11)

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Examining the Effects of Virtual Reality on Minimizing Pain in Children Receiving an Injection

Mentor: Sherwood Burns-Nader

Injections are a fear often reported in children during a medical visit. Many studies have examined ways to combat injection-related anxiety. Virtual Reality (VR) has been identified as a possible tool that can help decrease pain associated with receiving injections. VR involves a person placing a headset on and becoming immersed in a virtual interactive world. The purpose of this ongoing study is to examine the effects of VR on decreasing pain children experience when receiving an injection. The study will examine self-reported and observed pain in children ages 4-12 when receiving an injection. Children will be assigned to either a VR group or a control group. In the VR group, children will be engaged in a VR before and during their injection as a tool for distraction. The control group will receive standard care. Parents will be asked to complete a demographic questionnaire and a Faces Pain Scale (FPS). The children will be asked to self-report their pain using the FACES Pain Rating Scale. A researcher will also record their observations with the FPS. We expect that the implementation of VR in a pediatric office setting will reduce pain relating to injections in children ages 4-12.

Victoria Ice (presentation number 12)

Community Impact of Hospice of Western Alabama

Mentor: Lori Turner

Victoria Ice

HHE 480-001

ASSIGNMENT 4: ABSTRACT PREPARATION

TITLE: Community Impact of Hospice of Western Alabama

BACKGROUND/PROBLEM: In the United States today, more than one in three Americans is caring for an ailing family member or friend. Many of these families are facing a serious, life limiting illness for the first time and don't know where to turn for answers and support,

A serious illness can be over whelming for the entire family and that's where Hospice can help.

Hospice is 100% covered by Medicare for all eligible patients and is covered by most Medicaid and commercial insurance plans.

PURPOSE: The focus of hospice relies on the belief that each of us has the right to die pain-free and with dignity, and that our loved ones will receive the necessary support to allow us to do so.

METHODS: Hospice is the model for quality, compassionate care for people facing a life-limiting illness or injury, hospice and palliative care involve a team-oriented approach to expert medical care, pain management and emotional and spiritual support expressly tailored to the person's needs and wishes. Support is provided to the person's loved ones as well. Hospice offers an outlet for grieving families utilizing bereavement groups, counseling, support, grief therapy and friendship. These services can be a guide through some of the challenges of grieving as one adjusts to loss.

RESULTS: Since 1982 Hospice of West Alabama has been serving patients and families from Bibb, Fayette, Green, Hale, Lamar, Pickens, and Tuscaloosa counties. Hospice of West Alabama is the only agency serving West Alabama with its own free-standing inpatient facility, which has served more than 4,000 patients since it opened on November 1, 2004.

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Erika Schemmel (presentation number 13)

Neuroplasticity in Individuals with Stroke-Induced Motor Cortex Lesions

Mentor: Fran Conners

Neuroplasticity is seen in individuals who have suffered brain damage. In order for the brain to recover or change, damaged brain matter it often relies on healthy tissue or functional adaptations. Damage to the motor cortex often results in paralysis. The subjects had cortical lesions to the sensorimotor cortex, resulting from a stroke. Due to loss of motor cortex, the contralesional hand lacked functionality. Our study was interested in brain activity when the subject attempted to use their contralesional hand. The participants' motor abilities in both hands were measured with grip strength and finger tapping tasks. Then, we collected an MPRAGE structural scan of the subject, and functional neuroimaging data was obtained as the subject attempted to open, close, or rest their hand as prompted via screen. We observed an unanticipated amount of brain activity in the non lesioned motor cortex when attempting to move the contralesional hand, suggesting a surprising attempt of the brain to compensate.

Samantha Beard (presentation number 14)

The Capitol School Personal Health Class

Mentor: Lori Turner

Background: According to the U.S. News & World Report, in 2018 20% of Tuscaloosa county adults were reportedly in poor or fair general health. There were 5,904 preventable hospital admissions per every 100,000 people reported, over 26% of adults admitted to not participating in any leisure-time physical activity each day, and it was reported that the average adult experiences 4.5 poor mental health days per month. By increasing health education at the high school level, it is likely the overall general health of the county will increase.

Purpose: The mission of The Capitol School is to educate responsible citizens of the world. The Capitol School is a Multiple Intelligence School founded in 1993.

Since 1993, faculty has worked to find ways to incorporate Multiple Intelligences opportunities for the faculty, staff, and students in pre-school through the 12th grade.

Methods: Health education motivates students to improve and maintain their health, prevent disease, and reduce risky behaviors by building on student knowledge, skills, and positive attitudes about health. This program aims to lower student risk associated with alcohol, tobacco, and other drugs, excessive screen time, sleep deprivation, and preventable injuries. It also aims to educate on the importance of maintaining a positive mental and emotional health, nutritional diet, adequate physical activity, and preventing diseases.

Results: The Capitol School has helped prepare students to become responsible citizens through providing an engaging learning experience. After being subjected to this health education course students are able to better assess potential risky behaviors, are more knowledgeable of the importance of adequate exercise and a healthy diet, and have gained skills needed to prevent disease and injury, navigate through mental and emotional health, and have a positive family life and/or support system.

Amelia Horine (presentation number 15)

Project Health Greek Peer Educators

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Mentor: Charlotte Petonic

HHE 480 Abstract

Project Health Peer Educators

Background/Problem:

Like any college campus, a large population of young adults living independently for the first time will need some guidance for making informed and healthy lifestyle decisions. The University of Alabama is known for it's major sporting events, which typically include binge drinking and other unhealthy behaviors. By establishing peer educators on the campus to reach out to students, Project Health is helping create a safe and health environment for all.

Purpose:

Project Health serves as the go-to source of health education information on the campus of the University of Alabama by actively engaging the campus community in health and wellness programming.

Methods:

Peer education interns for Project Health provide health information aimed at increasing health knowledge and promoting health lifestyle decision making to members of the Greek Organizations on campus. Since the Gamma interns are members of Greek Organizations, they represent Project Health at weekly chapter meetings with presentations of that week's topic. There are also tailored educational programs planned and implemented by Gamma educators for each of the Greek houses. This is in efforts to actively engaged Greek members in increasing their awareness about a diverse range of health topics, in addition to increasing their knowledge about health topics most pertinent to their chapter. Gamma tables in various locations throughout the week, positioned intentionally where Greek members have the most foot traffic. Through those interactions, each outreach effort is tallied and determined through a set of game questions if the interaction was effective or not.

Results:

Weekly data is collected through these interactions to determine if the method of programming is effective or not. This data is then interpreted and gives a basis of any modification needed for the future in terms of how the information is being communicated to students. Project Health is one of the largest peer health organizations in the country, and many other campuses have used this organization as a model.

Darby Davenport (presentation number 16)

Distributed Darbs: The Intersections of Blockchain Technology and Healthcare

Mentor: Ashley Ewing

My research focuses on the intersections of Blockchain Technology, the platform on which cryptocurrency runs on, and healthcare. A majority of my research targets the interoperability of healthcare systems as a way to examine how Electronic Medical Records (EMRs) could be placed on the blockchain. By placing EMRs on the blockchain, medical records would exist as permanent, non-alterable blocks on the blockchain which could be accessed by all medical personnel if granted the token key by the patient or patient advocates. Each individual medical event in a patient's life would be characterized as a single block connected in an ordered stream on the blockchain which would present clear data regarding the medical history of individuals. The idea of utilizing blockchain gives the patients the power over their medical records opposed to allowing physicians and hospital personnel the main points of access. This is the opposite of how healthcare currently operates within the United States. Blockchain

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could solve the US's healthcare interoperability issues by instilling power within patients as a way for them to advocate for their healthcare with a clear and defined medical background kept perfectly in track by the blockchain. While Electronic Medical Records is one key example of how blockchain

JaPria Rodgers (presentation number 17)

Turning Point: Domestic Violence and Sexual Assault Services

Mentor: Lori Turner

Background/Problem

In the United States, an average of 20 people are physically abused by intimate partners every minute. This equates to more than 10 million abuse victims annually. There is also around 1 in 3 women and 1 and 6 men who will be a victim of rape in their life time.

Purpose

The mission of Turning Point is to provide comprehensive quality services to primary and secondary victims of domestic violence and sexual assault and to empower survivors to make productive decisions to improve their futures. Turning Point also aims to bring awareness and information to the community to prevent future violence and promote healthy relationships.

Methods

Turning Point offers a great amount of free services in 9 counties in West Alabama. Turning Point provides direct services to both victims and survivors of domestic violence as well as affected family members. Some of those services include emergency shelter; 24-hour crisis line; individual counseling; rural counseling (outside of Tuscaloosa county); support and skill groups; financial literacy training; children's services; legal/court advocacy; prevention and community outreach; follow up services; information and referral.

Results

Turning Point works with several agencies, both locally and statewide, to ensure the provision of quality services to West Alabama. Three agencies that Turning Point works with are United Way of West Alabama (UWWA), The Alabama Coalition Against Domestic Violence (ACADV), and Alabama Coalition Against Rape. UWWA seeks to continually improve the quality of life for area residents by funding effective programs and services throughout the West Alabama community. ACADV is a network of community based programs that provide support and advocacy to survivors of domestic violence and their children. ACADV works tirelessly toward a peaceful society where domestic violence no longer exists. Alabama Coalition Against Rape is a statewide nonprofit organization working to prevent sexual violence in the State of Alabama. They advocate for the rights of victims and strives to affect critical change through its active role in public policy, education, and training.

Zoe Berndt (presentation number 18)

Reducing Obesity and Food Insecurity with Low-Income Families in the United States: A Community-Based Participatory Action Research Proposal

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Mentor: Darren Surman

Obesity rates have never been higher in America than they are today. Access to healthy food, not simply cholesterol and sugar filled food is increasing at an alarmingly slower rate than is necessary to combat the health problems of America. In this review, the relationship between obesity and food insecurity in low-income areas of the United States is investigated. How this relationship should be addressed in terms of federal policy is examined through the work of several case studies. The research is consistent in its emphasis that in the U.S.A, African American and Latino Americans are disproportionately the targets of harmful marketing by the food industry. Some of the methodology used to combat focused on empower low-income communities by not necessarily taking away fast food option, but by promoting healthier options and providing them at equal prices to the junk food. The difference between a food swamp and a food desert was outlined distinctly in many of the articles reviewed. A food desert being parts of the country vapid of fresh fruit, vegetables, and other healthful whole foods, usually found in impoverished areas. This is largely due to a lack of grocery stores, farmers' markets, and healthy food providers. A food swamp on the other hand can be described as areas with a high-density of establishments selling high-calorie fast food and junk food, relative to healthier food options. Alternatively, a more specific definition would be areas in which there are four unhealthy options for every one healthy option. It has been made clear that the elimination of food deserts has become a bipartisan issue. Everyone has to eat and healthier children with more access to super markets means more economic growth and eventually health tax payers. Our proposed participatory action project would involve the utilization of community voices alongside expert research. This project would be drawn out over the course of several years and might involve the implementation of government taxing on junk food or the repricing of healthier items. The focus of our literature review was to collect the background information, understand potential methodologies, and problem solve a timeline and future limitations.

Brooke Rodenberry (presentation number 19)

Health Education and Promotion Program: Verner Elementary School Extended Day Program

Mentor: Lori Turner

Background/Problem:

County Health Rankings states that thirty-five percent of adults in Alabama and thirty-three percent of adults in Tuscaloosa County are considered obese. An individual who is overweight is at a greater risk of obtaining diseases and other health concerns including but not limited to type 2 diabetes, coronary heart disease, stroke, sleep apnea, and mental illness. Healthy People 2020 states that eighty-one-point six percent of adults do not get the recommended amount of physical activity, and on average, adults do not meet the daily fruit and vegetable intake recommendation.

Purpose:

The mission of Verner Elementary School is to provide a safe and secure learning environment and promote optimal student achievement by providing quality instructional programs that speak to the social, emotional, personal, and physical well-being of each student to prepare them for daily life.

Methods:

If students gain knowledge regarding health education, attitudes and behaviors have the potential to change. This program aims to influence students to change improper and inadequate health behaviors in hopes of positively impacting not only the students, but also the student's family, guardians, and future generations. The program aims to teach, implement, and incorporate health education topics including personal and oral hygiene, mental health including how to deal with feelings, body image, worrying, stress, and coping techniques, interpersonal skills

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including making friends, being a good friend, and being a good student, physical activity and exercise, and diet and nutrition through lessons, workbooks, and engaging activities in order for students to learn how to achieve ultimate overall health and wellbeing physically, intellectually, emotionally, socially, and environmentally.

Results:

The Health Education and Promotion Program has aided students, parents, and/or guardians to become more knowledgeable of the importance of proper health behaviors to decrease risk of modifiable diseases and health concerns.

Bolade Ajoloko (presentation number 20)

The Eaton Clinic

Mentor: Lori Turner

The Eaton Clinic Weight Loss Management

Background/Problem: Alabama is ranked as one of the most obese states in America. America routinely ranks at or near the top when it comes to the most obese countries in the world, and Alabama ranks third in the country in obesity rate. Being obese increases your risk of diseases and health problems, such as heart disease, diabetes and high blood pressure.

Purpose: The Eaton Clinic is located in Northport, Alabama. The Eaton Clinic specializes in weight loss management. The mission of The Eaton Clinic is to decrease the obesity rate in Alabama and to lower the risk of chronic diseases. I was assigned to expand their brand by designing a website for their clinic.

Methods: The Eaton Clinic counsel's patients on a proper diet to help them lose weight and also uses medications and vitmatmins for more effective results. I worked with the staff to help design their website for patients to refer to.

Results: The Eaton Clinic has helped many people lower their overall body weight. The Eaton Clinic keeps a record of patients' body weight, blood pressure and waist line within each month. This method they use helps keep track of the patients' progress. The website I constructed helps people contact the clinic to utilize their services.

Sarah Rogers (presentation number 21)

Tuscaloosa's One Place (TOP) and the Importance of Comprehensive Reentry Services for Juvenile Offenders

Mentor: Lori Turner

Background/Problem

Each year, hundreds of children in Alabama are convicted of juvenile offenses and sentenced to detention with the Department of Youth Services (DYS) or another out-of-home placement. Juvenile incarceration has negatively impacts juvenile development, and is a major predictor of poor long-term outcomes for youths. There is also a higher incidence rate of substance abuse and mental health issues among juvenile offenders which poses further challenges to successful reintegration after release. Prior to the establishment of the TOP's program, there were no reentry services for Alabama youth.

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Purpose

The mission of TOP is to build better communities by strengthening families and empowering individuals to overcome obstacles and live up to their full potential. The mission of Juveniles Succeeding Through Integrated Community Engagement (JUSTICE) is to help youths returning from out-of-home placements successfully reintegrate into their communities to improve long-term outcomes and reduce recidivism.

Methods

The juvenile and teen support department of Tuscaloosa's One Place works with at-risk youth in the Tuscaloosa community to reduce the number of children being committed to DYS placements and detentions, and to help those who have been sent to a placements successfully reintegrate and become contributing members of their community. The JUSTICE Program offered by TOP is a court-ordered program for juvenile offenders who have spent longer than 30 days in an out-of-home placement. The program has three main services - case management, mentorship, and civil legal services. The case manager works closely with the family, probation officer, mentorship programs, and the school system to create a comprehensive reintegration plan and monitor the youth's progress. Case management ensures the youth has adequate support systems in place and is in an environment conducive to their success. An on-staff attorney can assist the family with civil legal services that may arise as a result of the juvenile's offender status, and TOP is beginning a program in conjunction with the University of Alabama Law School to help eligible individuals have their juvenile records sealed and/or destroyed.

Results

The JUSTICE Program at TOP is one of only seven juvenile reentry pilot programs in the United States. The recidivism rates for youth who graduate the program is lower than of other juvenile offenders. Juveniles enrolled in the program work with their case manager to create and achieve goals that will help them succeed in the future. Examples include re-enrolling in school or obtaining a GED, receiving access to mental health and counseling services, participating in job training programs, and having their probation sentences shortened. JUSTICE is an essential part of the justice system, as it empowers youths to redirect the course of their lives, make wiser choices, and succeed despite the obstacles they have faced.

Erin Blaney (presentation number 22)

Make-A-Wish Alabama Volunteer Services Internship

Mentor: Lori Turner

Make-A-Wish Alabama

Background

In 1977, a young boy named Chris Greicius was diagnosed with leukemia. Several months later, a U.S. Customs agent, met Chris and his mother for the first time. After hearing Chris' one true dream, he and members of the Arizona Department of Public Safety made Chris' wish to be a police officer come true. Greicius died soon after, but his wish became the inspiration for the Make-A-Wish organization. The experience was so inspiring that several individuals organized a group to attempt to grant another child' wish. In 1980, a cofounder Frank Shankwitz said, "Why can't we do that for other ill children, let them make a wish, and we'll make it happen" thus establishing the foundation for Make-A-Wish.

Purpose

The Make-A-Wish Foundation is a non-profit organization with a mission to grant the wish of every eligible child who is diagnosed with a life-threatening medical condition. When children battle a critical illness, normal childhood

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is taken away from them. They are forced to live a both emotionally and physically exhausting life. A Wish gives kids a restored sense of childhood back and helps the family return to a state of normalcy.

Methods

There is a step-by-step method that Make-A-Wish follows for wish granting. First is eligibility and referral. Family, medical professionals, or the child themselves can make referrals.

In order to qualify for a wish, the child must be between the ages of 2 and a hald and 17 years at the time of the application submitted. They also may not have already received a wish from Make-A-Wish or any other wish granting organization. The second step is medical eligibility. A treating physician must confirm that the children has been diagnosed with a progressive, degenerative, or malignant condition that has placed the child's life in jeopardy. Third step is the wish. Wish teams visit the hospital to connect with the children, awaken their imagination and help them envision an experience that would change their lives. The forth step is creating joy. The wish granters create and plan out an experience that fulfills the child's desired wish. Make-A-Wish finances its work through individual contributions, corporate donations, planned gifts, special events and promotions, and does not solicit contributions over the phone or door-to-door.

Results

The national headquarters and founding chapter of the Make-A-Wish Foundation is located in Phoenix, Arizona. Today, the organization has successfully planted 62 chapters located throughout the United States, as well as operating in 45 other countries around the world. Make-A-Wish has created strong relationships with more than 75 corporations at the national level, including Disney. Other sponsors include Air BnB, American Airlines, Dave & Busters, GameStop, Subaru, Delta, United, and Macy.

Research shows that wishes can help improve a child's quality of life and produce better health outcomes. On average, Make-A-Wish grants a wish every 4 minutes. Since 1980, more than 315,000 children in the United States have been granted wishes. To this day, they have nearly 40,000 volunteers in the United States.

Megan Malloy (presentation number 23)

Examination of Food Disparities at The University of Alabama

Mentor: Lori Turner

Background: Food disparities refer to the large nutritional variances between different socioeconomic groups. Those that eat cheap food often do not do so by choice; however, this food is usually high in fat or calories with little nutritional value. One's pay check or environment can lead to obesity and other health problems.

Purpose: The purpose of this study was to assess the severity of food disparities at The University of Alabama and determine why it is an issue.

Methods: Qualitative and quantitative data were collected from an anonymous survey through responses from voluntary participants. The survey asked background information as well as one's eating habits and money spent on food. In addition, the university supplied data from the dining halls as well as the food pantry.

Results: Findings will be categorized based on classification (year in school), gender, race, and region. We expect to find that freshman use dining halls the most and a large portion of girls to eat at the Greek houses. Upon analyzing data from the university's services including the food pantry and extra meal swipes, we will hopefully be able to classify which group is most likely to be impacted.

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Discussion: To bring awareness to food disparities on campus would begin the process of hopefully eliminating them. Increasing access to affordable healthy food and decreasing waste are two key components. By promoting statistics, healthy recipes, and cheap food tricks on the quad and on social media, we hope to help bridge the gap of food inequalities at The University of Alabama.

Carnell Burden (presentation number 24)

Al's Pals

Mentor: Lori Turner

Al's Pals is a mentorship program for students from the University of Alabama to visit and help with elementary school kids in 1st grade through 5th grade with homework and manners. Al's Pals visits Benjamin Barnes YMCA, Central Elementary, Englewood Elementary, Matthews Elementary, and Maxwell Elementary. Every week a selection of volunteer students from the University of Alabama go and mentor a mentee at the elementary school from around 3pm to 5pm afterschool for 10 weeks. The mentors help their mentee with reading, writing and math, inform their mentee on ways to be nice to people and provide someone for the mentee to talk to. The mentorship program allows mentees and mentors to play games and do other activities together like: coloring, crossword puzzles, times tables, Wal-Mart, heads up seven up, duck duck goose, picnic, tag, throw the football, basketball and play on the playground. The program is beneficial to the young kids by guiding a positive development in healthy habits, character, social skills, and academics. At the same time, the mentors are expected to gain "the confidence and skills to they need to make a lasting difference in the lives of children" wingspanworks.com. The goal is to for the mentors to help the mentees reach their full potential.

Imani Williams (presentation number 25)

Release Through Writing

Mentor: Lori Turner

The Title of my volunteer project is "Release through Writing". The issue that presents itself in my black teenage demographic is a lack of expression for their emotions. My volunteer work focuses on evaluating the mental state of the students before and after practicing catharsis through writing. This program seeks to address student's' mental health. I provided questions to the students that always addressed their feelings, and then asked about different mental health topics to see their reaction. We explore catharsis as a way to address issues and debunk the stigmas that surround mental health in a safe way. After general conversation, we discuss positive strategies to cope with situations. By having the students identify their emotions, and working through the issues behind them, we give the students a sense of control over their emotions. With the target age between 15-18, control is a reoccurring factor in the students' lives. I want the students to grasp the complexity of their emotions, and for them to understand that there is validity in those emotions. There is an evaluation at the end of the students to see what they learned, and if they feel that, they were given skills to better articulate/understand their emotions.

Kevin Keller (presentation number 26)

The University of Alabama Project Health Organization

Mentor: Lori Turner

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Parker Keller

HHE 480

Dr. Lori Turner

The University of Alabama Project Health Organization

Background/Problem: The University of Alabama student population has many different health issues and the Project Health organization works to tackle each and every one of these. Project Health picks a new health topic each week to try and educate the student body on how to stray away from the health issue.

Purpose: I am currently volunteering for the Project Health organization based in Russell Hall on campus. The purpose of this organization is to eliminate all health issues on the University of Alabama Campus. This organization is student serving students based so actual UA students are sent around campus to health huts where they teach a specific health topic. The purpose of my assignment was to help an organization address a health topic

Methods: the organization uses word of mouth to communicate to the students of the University of Alabama health issues they choose to talk about each week. They often create games and little quizzes on the specific health topic of the week that student can win prizes if they win or answer the questions correctly.

Results: the way success is measured in this organization is communication to as many of the students on campus as possible. The project health workers count how many student they reach out to on campus.

Josie Surges (presentation number 27)

Healthcare IT and Medical Sales Research

Mentor: Lori Turner

Healthcare IT/Medical Sales Industry Research Project

Background/Problem: The healthcare industry has needed to transform its communication process to connect with people all around the world. The Healthcare IT field is finding ways that technology can help put patients at the center, shift from illness-based to wellness-based, collaborate between health systems and health plans, increase the adoption/acceptance of virtual care, and put a greater focus on population health.

Purpose: In a world that is so heavily dependent on mobile devices and technology to help make people's lives easier, Healthcare IT strives to better care for patients through technology and infrastructures used to record, analyze, and share patient data via mobile apps and the internet. Achieving better health will improve all aspects of patient care including safety, effectiveness, patient-centeredness, communication, education, timeliness, efficiency, and equity.

Methods: Seeing the effects of digitalized health records, information and communication technology, and mobile apps around the world have proven to have more advantages than disadvantages by surveying patients and professionals in different hospitals that currently use these technologies.

Results: Since the implementation and consistent use of new technologies in the healthcare field, positive results have been the main finding. Electronic Health Records send out alerts and reminders for appointments, contain one central location for all patient information, enhance research, monitor improvement, reduce medical errors, making diagnosing diseases easier, etc. New screening technologies make detecting cancers easier and monitoring progress better. The healthcare field is only going up from here.

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Discussion: Will the new technologies put more people out of jobs, make affording healthcare more expensive, and make face-to-face visits extinct? Further analyzing will be done on the future effects of healthcare technology and the impact they will have.

Garrison Hughes (presentation number 28)

Post-Revolution Health Care in Cuba

Mentor: Jacqueline Morgan

The Communist Revolution in Cuba, culminating in 1959 with the overthrow of Fulgencio Batista, brought radical changes to the country's existing healthcare infrastructure. By the early 1960s, the Cuban National Healthcare System was almost entirely socialized, making it somewhat of an anomaly by global comparisons. The approach taken by the revolutionary government focused heavily on expanding rural access to care. To achieve this goal, rural hospitals and clinics were constructed and doctors recruited to work in these regions. Additionally, Castro's administration established rural work requirements for Cuban physicians following their education.

Unfortunately, such programs have suffered major setbacks. Large numbers of doctors left the island following the revolution, causing a shortage that has persisted over the decades. Low wages and scarce medical resources have further complicated the work of health providers, and the nation's contentious relationship with American legislators has detrimentally affected economic growth. Federal restrictions on private equity have also inhibited medical development, forcing Cuban doctors to accomplish a lot with very little. Despite this fact, Cuba has remarkably managed to (almost) keep up-in terms of life expectancy and infant mortality-with many of its developed counterparts. However, though the life expectancy has steadily risen since the mid-20th century, much of the progress that has been observed follows global trends of vaccination. The growth does not clearly result from the policies of the Cuban government, which often act as obstacles to medical progress. Future improvements will likely depend upon significant restructuring of federal policies, principally including liberalization of current economic constraints.

Kaylyn Kirksey (presentation number 30)

The Effects of Hazardous Chemicals on Occupational Asthma in Nail Salons

Mentor: Kim Bissell

Nail salons are establishments that primarily provide services such as manicures, pedicures, and nail enhancements. The most popular services include the use of hazardous chemical-based ingredients that are known to be causative agents of occupational asthma. In this experiment, nail technicians will use Peak Expiratory Flow (PEF) Meters to measure lung function while exposed to the following three chemicals: formaldehyde (most polishes), acetone (nail polish remover), and methyl methacrylate (acrylic liquids and powders). The data obtained from the experiment will allow interpretations of the effects of asthma as a result of being exposed to the chemical-based products. This study is a work-in-progress that will further validate existing literature regarding the correlation between the occupational exposure to hazardous agents and asthma.

Jack Kappelman (presentation number 32)

A Study of Youth Suicide By Firearm Rates

Mentor: Richard Fording

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The purpose of this research project is to identify areas of study regarding how certain forms of legislation impact the suicide by firearm rate among youths. We will begin the study by conducting a comprehensive review of the literature to date studying the rate of youth suicide by firearm. Following this review, we will conduct an updated study to determine whether specific forms of legislation aimed at reducing youth suicide by firearm lead to a reduction in the suicide rate. We will tailor the study to specifically look at certain forms of legislation such as Red Flag laws or Extreme Risk Protection Orders (ERPO) laws and Child Access Prevention (CAP) laws. By the end of this study we hope to determine whether these, and other, forms of legislation have led to a reduction in the rate of youth suicide by firearm.

Rachael Addison Crowder (presentation number 33)

Secondary Analysis of the Quality of Life in Caregivers of Dementia Patients

Mentor: Megan Lippe

Caregivers of individuals diagnosed with dementia have a risk of living with a decreased quality of life which is further adversely impacted by stress, limited social support, depression, and sleep irregularities. Existing literature has identified the varying impacts of these conditions on quality of life. However, limited studies have analyzed relationships between all these common conditions impacting in caregiver's quality of life within a singular dataset. The primary aim of the study was to perform a secondary analysis to explore the relationships between caregiving for individuals diagnosed with dementia, quality of life, stress, social support, depression, and sleep. The secondary aim was to compare these variables between caregivers of individuals with chronic illness and non-caregivers. The Behavioral Risk Factor Surveillance System (BRFSS) dataset, a large annual survey dataset, served as the source for secondary analysis. Aim One was assessed for only those individuals who identified as caregivers of individuals with dementia. Aim Two was assessed for individuals who identified as a caregiver of individuals with a chronic illness or not being a caregiver. The results are currently being analyzed, and final results will be presented at the URCA 2019 conference.

Mary Tate Thomas (presentation number 34)

Mental Healthcare in Relation to Cuba and the United States

Mentor: Lauren Kois

In relation to global citizenship, the disparities in mental health care access and resources around the world must be addressed to ensure that those who suffer from mental illness receive proper care. My research compares the different cultural perspectives of countries regarding mental health, particularly, Cuba and the United States. Furthermore, my research studies the country's development through the Cuban Revolution and how that has impacted Cuba's stance and action on mental illness and healthcare today. In recent years, the American Psychological Association and Cuba have worked together in an effort to learn from each other. Prior to these interactions, not much information existed about how Cuba views and treats mental illness. Ever since the embargo, there has been a shortage of resources. Medications, psychologists, and psychiatrists have not been available in the capacities in which they are needed. Therefore, my research attempts to learn how the collaboration between the APA and Cuba are helping both countries improve on their stances on and treatments of mental illness. This research touches on the interesting relationship between the U.S. and Cuba. The fact that both countries have reached out and agreed to learn from each other shows positive interactions between two countries that have had political tensions. However, these differences have been put aside in order to promote increased knowledge and access to mental healthcare resources. Additionally, I am further exploring how these relationships can evolve over time and open doors to new possibilities. The second component of my research is a

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work in progress and will continue over the next few months. This aspect of my research considers how mental illness is tied to recidivism in prison systems of both countries. In particular, my research will study relationships between religion, mental health, and re-offense in both countries. My plan is to gain the perspective from Cubans involved in the mental healthcare and prison systems and from the American psychologists that have been working in Cuba. Overall, my research is unique in that it explores subjects such as mental health and the prison system that Cuba has been historically private about sharing information. However, Cuba has recently been allowing collaboration with the U.S., which is a positive step for both countries. Overall, my research explores the interactions between Cuba and the U.S. in relation to mental illness, as well as how each country provides mental healthcare to its people.

Parker Carmichael (presentation number 35)

How does using blood-flow restriction in rehab influence time-to-progression points in ACL rehab in college football players?

Mentor: Elizabeth Hibberd

How does using blood-flow restriction in rehab influence time-to-progression points in ACL rehab in college football players?

Parker Carmichael and Aimee Travis

Elizabeth Hibberd

Study Objective: The purpose of this study is to evaluate how incorporating blood-flow restriction (BFR) in post-ACL reconstruction rehabilitation impacts time to progression of rehabilitation and return to play time of Division I NCAA football athletes.

Previous Literature: The anterior cruciate ligament (ACL) is a commonly injured ligament, sustained by players of all positions. It has been reported that between 250,000-300,00 ACL injuries occur each year in the United States. Rehabilitation of ACL reconstruction is a strenuous and long process, taking up to 10 months in some cases. Rehabilitation goals of athletic trainers are to find ways to return patients to sport as soon as possible, while decreasing their risk of re-injury and sustaining the patient's performance level to the degree prior to injury. During the ACL rehabilitation process certain rehabilitation milestones are set to allow the patient to progress in the rehabilitation process. Each milestone is a goal set to ensure the patient's new ligament is ready to endure more stresses. End targets of ACL rehabilitation are to regain full range of motion of the tibiofemoral joint and recapture full strength of the quadriceps, hamstrings, and gluteal muscle groups. Use of BFR technology in rehabilitation restricts vascular flow to a targeted limb by an automated cuff increasing in pressure. When BFR is used in conjunction with resistance training, the muscle fibers of the targeted limbs are recruited at a quicker rate, increasing the force of contraction and causing hypertrophy of the muscle groups targeted. Although use of BFR therapy has been suggested to improve the rehabilitation process of ACL repair, the direct impact of this technique has not been studied in collegiate athletes returning to play from ACL injury.

Proposed Methodology: To meet the study objectives, a retrospective medical chart review will be performed for collegiate football players who have torn their ACL and undergone a repair in the past 8 years with the team orthopedic surgeon. Days from surgery to each of the milestones will be calculated. The rehabilitation milestones include: double leg squat, single leg squat, isokinetic strength testing, return to sport-specific training, and return to play. An independent samples t-test will be used to compare differences in time to each of the milestones between the group that had BFR included in their rehabilitation protocol and those that did not. An a priori alpha level of 0.05 will be used.

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Savannah Stewart (presentation number 36)

Food Distribution in Tuscaloosa County

Mentor: Darren Surman

The purpose of this ongoing research proposal is to combat food insecurity in Tuscaloosa County. Currently, 18.4% of county residents are struggling with food insecurity, which means they lack consistent access to the food and nutrients needed to sustain a healthy life. The primary focus of this proposal, however, is not on a lack of food, but rather on the redistribution of it. Every day, the University of Alabama produces an excess amount of food for its students. Instead of throwing this production overflow away, this study aims to find a way to limit food waste by instead giving it to people in need. A smartphone application was recently launched for the Atlanta area, and the company behind the app provides a service that picks up excess food when alerted, and delivers it to homeless shelters and soup kitchens in a timely manner. This proposal discusses the possibility of bringing this application or a similar service to the University of Alabama's campus in an effort to reduce waste and decrease the percentage of the food insecure population in Tuscaloosa.

Addison Stewart (presentation number 37)

The difference in primary care emphasis and its result on the total health of the population in the United States and Cuba

Mentor: James Leeper

Cuba, a country plagued by leadership changes, resource shortages, and various other struggles, should have a failing healthcare system. Yet, in actuality, Cuba's healthcare system is flourishing amidst the many obstacles. On the other hand, the United States of America, a country with virtually unlimited resources, cutting edge technology, and countless advantages, seems to have a declining healthcare system. The difference comes from the degree of focus on primary care between the two countries. Cuban healthcare training focuses on the intricacies on the human body and treatment of an illness in a more holistic sense. In America, there are countless specialists and sub-specialists who appear to practice "shock-therapy" to acutely treat a patient's symptoms. Patients bounce back and forth from physician to physician, losing empathetic and intentional care that is necessary for true health. Cuban healthcare requires physicians to take charge of the health statistics of a particular population and do everything in their power to keep their patients healthy. In doing so, Cuban physicians practice preventative care compared the reactive care of the United States. Through the use of polyclinics, maternity homes, and required physician's appointments, Cuban doctors practice preventative measures to stop health issues before they occur. These fundamental differences result in Cuban populations having a better overall total health outlook than populations of more industrialized countries such as the United States. The Cuban healthcare system focuses on primary care and has allowed for public healthcare in Cuba to thrive compared to the technology based American healthcare system.

Luke Rakers (presentation number 38)

Computer Simulation of Cryoprotectants' Behavior in Cellular Membranes

Mentor: Heath Turner

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Cell lines can be preserved via cryogenic freezing. However, the cell survival rates can be low, and there can be large variability among different organisms. Cryoprotectants like DMSO can be added during the freezing process in order to improve cell viability. However, there is not a good understanding about how the cryoprotectants work and how to design improved cryoprotectants for different cell lines. This research involves performing molecular-level simulations to predict the behavior of different cryoprotectants with different cellular membranes. With the use of simulation software like LAMMPS and Gromacs, we will be able to test the effects of compounds like glycerol, ethylene glycol, or dimethyl sulfoxide on a different cells and measure their effects on the cell's temperature and stability.

Brandon Edney (presentation number 39)

The impact of Lonafarnib on the behavior of glioblastoma stem cells

Mentor: Shreyas Rao

This research project aims to understand how glioblastoma, a type of highly aggressive brain cancer, interacts with a drug called lonafarnib (Sarasar) by examining how it affects certain characteristics of glioblastoma stem cells (GSCs). The current treatment including surgery, chemotherapy, and radiation therapy ultimately leads to development of resistance to treatment and inevitable disease progression. Current tumor interventions fail, in part, because they leave behind an important subset of tumor cells called glioblastoma stem cells. GSCs have been shown to be responsible for relapse and regrowth of the tumor mass, making effective treatment to truly eliminate all tumor cells an integral component of successful glioblastoma treatment. These tumor-regenerating stem cells possess specific stem-like properties such as cell proliferation, sphere formation, and elevated expression of certain genes such as CD133, sox2, and Nestin that are thought to differentiate these cells from normal, specified glioblastoma cells. The cancer drug lonafarnib acts as a farnesyltransferase inhibitor, inhibiting the enzyme farnesyltransferase that farnesylates, or activates, a Ras protein. Farnesylated Ras associates with the cell membrane and activates a variety of receptor tyrosine kinases that are involved in upregulating gene expression associated with cell proliferation, migration, and angiogenesis. Past research indicates that lonafarnib limits tumor and glioblastoma stem cell proliferation in vitro and tumor growth in vivo, especially when combined with established treatments of temozolomide and subsequent radiation treatment. In addition, there is an ongoing phase 2 clinical trial accessing the benefits of lonafarnib in glioblastoma treatment, which provides further motivation for a study of its effects on stemness of GSCs. Assuming lonafarnib observably affects stemness attributes, it can subsequently be compared and combined with temozolomide or another more generalized treatment in future experiments to develop a better understanding of how lonafarnib affects GSCs. The overall goal of this study is to support the development of more effective treatments for glioblastoma.

Elizabeth Kantzler (presentation number 40)

The Opioid Epidemic: Examining the Long-term Effectiveness of Opioids as Pain Relievers

Mentor: Jason Parton

Although the use of opioids has increased, findings from previous studies suggest that self-reported pain is more common now than forty years ago while attempts to medically relieve pain have become less successful. The prevalence of chronic pain and health care costs have exponentially increased over the past two decades, resulting in an opioid epidemic with adverse consequences. Significant factors that have led to this opioid epidemic can be attributed to efforts to increase opioid use through the campaigning of the alleged undertreatment of pain. The purpose of this research is to describe the aspects of opioid use among Alabama Medicaid insured patients in order to provide insight for possible solutions. A multiple linear regression analysis of patients who had undergone procedures that commonly prescribed opioids will be used to compare levels of opioid refills and subsequent

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medical expenses involving pain treatment of the procedure. We expect that there will be a positive association between number of opioid refills and subsequent medical expenses undergone to alleviate pain. These findings will address the long term usefulness of prescription opioids as effective pain relievers and the inaccurate belief of undertreatment of pain.

Hannah Woodard (presentation number 41)

Comparing the Overall Satisfaction of Two West Alabama Lupus Support Groups

Mentor: Pamela Payne-Foster

Introduction- Two lupus support groups, known as WELLS (Wellness in Living with Lupus Successfully), were created to allow those living with lupus (LWL), to have a space to discuss a variety of topics concerning their or a family member's diagnosis of lupus or other related illnesses. Studies have shown that support groups can have a positive impact on the health of its participants, and this survey seeks to ascertain if this is also the case for participants, particularly for rural participants, which is where one of the support groups is located. This study will analyze the results from a survey issued to participants of lupus support groups in Tuscaloosa, AL and Selma, AL.

Methods- The WELLS group in Tuscaloosa will have the survey administered to them face-to-face by student coordinators at the end of one of the monthly meetings, and an email will be sent to participants who might not have had a chance to attend that particular meeting so that the survey can be administered in another manner. For the Selma WELLS group, the survey will be distributed to the Facilitator via email, and that person will be responsible for distributing the survey face-to-face at the WELLS meeting in Selma, followed up with an email to participants who might not have been present to take the survey face-to-face.

Results- The survey has a total of twenty-one questions querying the participant's demographics, program logistics, support sessions, and the resources provided. The results from each WELLS group could be used in to make comparisons between Tuscaloosa as the urban support group and Selma as the rural support group. Items such as attendance for the two groups will also be collected and analyzed to compared effectiveness including topics discussed and overall support group satisfaction.

Implications- The results of this study are important because there is very little literature that analyzes the effects of support groups with those LWL. There are also few studies that have investigated the effectiveness of support groups in rural versus urban locations. We hope that the findings of this study can lead to the improvement of the lupus support groups and create a model for future support groups to be the most effective and beneficial for those LWL.

Ricardo DeLeon (presentation number 42)

Developing a novel equation to estimate body composition: a systematic review and meta-analysis

Mentor: Michael Fedewa

Developing a novel equation to estimate body composition: a systematic review and meta-analysis

Ricardo DeLeon

INTRODUCTION: Accurate body composition assessment is paramount for assessing health and disease. Relative adiposity (%Fat) can be estimated from total body density (BD), as the density of Fat Mass is lower than Fat-Free Mass. Since the Siri and Brozek equations were original developed, it is now understand that the density of Fat-Free Mass varies by race/ethnicity, age, and sex.

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PRIMARY AIM: The primary aim of this systematic review and meta-analysis is to develop a more robust equation to estimate %Fat from aggregate level data across a wide range of participant characteristics.

METHODS: An electronic database search (PubMed, Scopus, Web of Science) identified peer-reviewed manuscripts which presented BD and %Fat. All included studies assessed BD via hydrodensitometry or air displacement plethysmography, and measured %Fat using the four-compartment model (water, bone mineral content, protein, fat). Sample characteristics (race/ethnicity, sex, age, height, weight, body mass index (BMI)) were extracted as potential moderators. Meta-regression analysis were used to to generate %Fat prediction equations (MetaReg) in IBM SPSS 23.0, Inc. Data are presented as M±SD unless otherwise indicated.

RESULTS: A total of 891 participants were included in the current analysis (44.4±49.7% Female, 38.9±16.5 years, 23.7±1.9 kg/m2, 26.5±6.6 %Fat). The cumulative results of 28 effects collected from 10 studies yielded a new prediction equation of 454.1224-(411.089*BD), which used estimates of body density to predict roughly 87.49% of the variance in %Fat.

LIMITATIONS: The results are based on a small subset of the published literature. As this is part of an ongoing research project, we expect that additional studies included in the meta-regression analysis will yield slightly different, although more robust, estimation equation.

CONCLUSIONS: The current study yielded a more accurate equation based on diverse participant characteristics across a wide range of ages, and racial/ethnic groups. In addition, as these results were based on a sample of participants that were predominantly white, there is a need for additional research in other race/ethnic groups.

Laura Carrasquilla (presentation number 43)

Influence of parents on sport specialization and injury rates in adolescent baseball players

Mentor: Elizabeth Hibberd

Influence of parents on sport specialization and injury rates in adolescent baseball players

Laura Carrasquilla and Elizabeth Hibberd (Faculty Mentor)

The objective of this study is to determine the influence of parents and coaches on sport specialization and injury rates in youth baseball players through surveys regarding their child or athletes' injury history, participation extent, and their own demographics and knowledge of current guidelines.

Despite adequate guidelines already being in place for adolescent baseball athletes in the form of the USA Baseball Medical & Safety Advisory Committee Guidelines, a frightening trend exists of more youth athletes sustaining upper extremity injuries such as UCL tears and SLAP tears. These are primarily overuse injuries that result from accumulated microtrauma, and they can be affected primarily by intrinsic or extrinsic risk factors. Intrinsic risk factors are those that are naturally occurring for the athlete such as physical characteristics while extrinsic risk factors are those external to the athlete such as extent of participation. Previous literature has identified intrinsic risk factors that may be related to increased injury risk; however, prospective evaluation of these intrinsic risk factors has not identified significant differences between injured and uninjured athletes. Recently, the influence of extrinsic risk factors has been emphasized as potentially more important than intrinsic risk factors. In a group of high school athletes that reported pitching during the season, there was a high prevalence of "risk-prone behaviors" that have been identified, most notably sport specialization, playing on multiple teams, and pitching on multiple teams. Within this cohort, 34% sustained an elbow injury and 20% sustained a shoulder injury. These findings highlight the need to further understand the reasons behind some of this participation factors and where current guidelines are failing in order to better establish education and intervention programs.

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In order to accomplish the study objectives, 500 parents with adolescents between the ages of 10-18 will be recruited through a Qualtrics panel to complete the survey. The survey includes parent information including their demographics and baseball and guideline knowledge as well as their child's participation and injury history. Descriptive statistics and analyses will be calculate these influences.

Determining how and why these participation decisions are being made can allow guidelines to be updated or more strictly enforced as well as proper education of guidelines and other preventative measures to be put in place to minimize injury for players.

Josiah Sowell (presentation number 44)

Drug Discovery from Natural Products and Traditional Remedies in Cuba

Mentor: Lukasz Ciesla

Innovations in modern medicine often stem from ancient knowledge of traditional remedies. These cures are studied, understood better from a biochemical standpoint, and replicated using modern extraction and replication techniques for the purpose of treating disease in a controlled manner. Approximately 80% of modern pharmaceutical remedies are derived from natural products, with new discoveries made and Nobel Prizes awarded even into the 21st century. These advancements are particularly encouraging for areas of the world without easy access to synthetic drug discovery methods. Historical and current Cuban traditional medicinal practices may be able to serve as an archetype for numerous global communities without ubiquitous and easy access to modern medicine.

This author's past research into the biochemical pathways, history, and significance of modern pharmaceutical therapies from natural products focused on the method of natural ligand screening using cutting edge biochemical techniques. The rich history of Cuba and the Caribbean may provide a substantial basis for this kind of natural product advancement leading to the development of modern pharmaceutical practices in the region. Studying this history and current Cuban practice and policy could lead to extrapolation to other areas of similar climate and culture. Cuba has already embraced their traditional roots of medicinal care and successfully incorporated it into their modern medical educational systems and medical care. Cuba has developed a unique system of healthcare that includes a heavy emphasis on domestic drug discovery using local products, this fact indicating that Cuba will serve as a prime case study into the possibilities of novel drug discovery from a rich cultural and natural history.

Halee Hudson (presentation number 45)

Enriching Happiness, Hope, and Quality of Life

Mentor: David Bolus

Focusing on both the Southland and Perry County Nursing Homes in Marion, Alabama, the Black Belt Nursing Home Project plans to attack the sources of depression, lost self-worth, loneliness, and daily isolation felt by the residents of these facilities. Specifically, the project will consist of implementing new programs and continuing ongoing efforts to involve local churches and colleges by interacting with the nursing home residents on a regularly scheduled basis, completing activities with the residents specifically targeting their needs to have a role left in this life.

As human beings age, their physical mobility, mental health, and quality of life tends to drastically decrease - especially when combined with issues arising from low incomes and geographical separations from family, outside human interaction, and community events. Keeping this aging in mind, it is increasingly important to engage in activities which stimulate one mentally and physically. This creates a healthier mindset and body; additionally, this type of curriculum allows aging adults to feel more in control of their life. Living in a nursing home takes away

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feelings of independence and confidence in oneself, but through small activities, this confidence can slowly be restored. Targeted programming regularly integrated into nursing homes and assisted living facilities helps to combat this geographic separation by providing an opportunity for the outside community to connect with residents inside each facility. To sustain efforts beyond scheduled involvement, folders of activity materials will be created and distributed, containing instructions methodically proven to be beneficial for the intended age group and audience. According to the geriatrics research by Langer and Rodin, a more successful version of aging occurs when an individual feels a sense of worth, encouraging them to continue their lives in a meaningful fashion. One main researched activity we will complete, and help staff continue completing, consists of giving each resident a plant to take care of, personalized and agreed upon by each individual resident.

In interviews, citizens of Perry County have repeatedly requested this type of work in the nursing homes, proving its relevance as a need in the community. Therefore, aiming to improve the residents' quality of life, the goal of this project is to encourage companionship between nursing home residents and the community members through church involvement and the implementation of researched programs into both nursing homes. The Black Belt Nursing Home Project hopes to provide residents with a connection to their community through hosting regular events for them to look forward to attending.

Thomas Bugg (presentation number 46)

Marion on the Move

Mentor: David Bolus

Marion on the Move will use pedometers to encourage healthy living in the rural community of Marion, Alabama. Specifically, the project will be partnering with Sowing Seeds of Hope and its founder, Frances Ford, as well as the University Fellows Experience in the Honors College, and a marketing professor within the University of Alabama to work on promoting the initiative. Before beginning, research will be conducted on the most efficient use of pedometers in rural communities. Once in Marion, individuals that attend Sowing Seeds of Hope's monthly blood pressure reading will use the pedometers in order to equip a targeted number of individuals with pedometers to support sustainable, healthy living while attracting new members of the community to attend the monthly blood pressure readings. In the month of May, a marketing strategy will be deployed.

Marion on the Move hopes ultimately aims to promote a health focused culture within Marion rooted in exercise and diet, and as a result, to see an overall decrease in various conditions afflicting the healthcare system such as diabetes, cardiovascular disease, and obesity. Marion on the Move desires to give the community a sense of hope for attainable healthy habits.

Elizabeth Di Valerio (presentation number 47)

Modeling the Journey of Transgender and Gender Creative (TGC) Patients through Healthcare System Contact Points and Experiences of Stigma

Mentor: Joshua Eyer

Background: According to the Human Rights Campaign, individuals who identify as transgender and gender creative (TGC) endorse a gender identity and/or expression that is different from cultural expectations based on the sex they were assigned at birth. TGC individuals experience prevalent stigma targeted at their gender identity and expression that has been linked to a variety of adverse outcomes. The 2015 U.S. Transgender Survey reported that, compared to the general population surveyed by the Behavioral Risk Factor Surveillance System (BRFSS), more transgender people rate their health as "fair" or "poor" (22% versus 18%) and are nearly eight times more

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likely to report current serious psychological distress (39% versus 5%). Additionally, 23% of respondents did not seek needed medical attention at least once in the last year for fear of discrimination and 33% had a negative experience with a healthcare provider in the last year because they were transgender.

Anti-transgender stigma emerges in many interactions and operates as a significant barrier to receiving adequate health care, where it can undermine coping and produce devastating health disparities and health-harming behaviors. The American Psychiatric Association identified the negative role of minority stress on both physical and mental health care received by gender minorities. Aside from manifestations in typical health care, there is a distinct lack of access to providers who are knowledgeable on both the societal and medical transitions that a transgender individual may choose to undergo. The providers accessible to patients may lack cultural competence or be ignorant about TGC issues. Other barriers within health systems include discrimination as well as financial and psychosocial factors. Thus, appropriate care for TGC individuals requires assessment and action in four domains: knowledge of healthcare providers, bias and stigma in the system, financial barriers, and other barriers such as societal stigma and bias among support staff.

Objective: The purpose of this narrative review is to develop a model of the health care contact points in the health journey of a TGC person that can serve to structure investigation, results, and intervention. The model will help researchers evaluate and identify the barriers to TGC healthcare access due to societal stigma and healthcare provider biases by modeling a prototype for a TGC patient journey.

Method: The literature on TGC health experiences was systematically queried and evaluated. Results were synthesized to highlight important contact points with the healthcare system and associated reports of enacted stigma and bias. Results are a model of the TGC patient healthcare journey that includes experiences of stigma and barriers at 10 distinct contact points. These 10 Contact Points on the Trans Patient Journey are (1) Provider Search, (2) Initial Scheduling, (3) Check In, (4) The Waiting Room, (5) The Exam Room, (6) Patient-Physician Communication, (7) Laboratory Services, (8) Billing & Payment, (9) Pharmaceutical Services, and (10) Referrals to Specialty Care.

Mia McKee (presentation number 48)

A Review of the Literature on Occupational Health, Safety, and Performance of Tactical and Industrial Athletes

Mentor: Hayley MacDonald

Sudden cardiac death is a leading cause of mortality in the United States, accounting for 50% of cardiovascular deaths annually (≈300,000 cases per year). The incidence of sudden cardiac death is higher among certain "occupational athletes", or people whose jobs are characterized by high levels of physical exertion, cardiovascular strain, or extreme thermal environments. Firefighters, law enforcement and military populations represent the most-heavily researched occupational athletes, while data on others (e.g., agriculture or farm workers, construction workers, long-haul truck drivers, among others) are lacking. Therefore, the aims of this systematic review are to (1) summarize of the existing literature on the physical demands and physiological (cardiovascular, metabolic and thermal) strain associated with occupations of interest and (2) examine the cardiovascular and metabolic health and physical fitness of occupational athletes to determine which occupations may be at greater risk due to their physical health and occupation-specific stressors (i.e., physical demands and environmental conditions). We searched for potentially relevant articles published before February 2019 using PubMed (including Medline), using a combination of search terms that captured a range of occupations and outcomes of interest. A total of 1,558 articles were identified. Studies of varying designs were considered if they met the following inclusion criteria: (1) Profiled the cardiovascular or metabolic health, or physical fitness of their occupational population; or (2) investigated the physical demands or physiological (cardiovascular, metabolic and thermal) strain associated with occupations of interest. We expect to find that the physical demands and physiological

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(cardiovascular, metabolic and thermal) strain will be unique to the occupation and tasks associated with that line of work. We also anticipate that each type of occupational athlete will have elevated risk resulting from poor cardiovascular and metabolic health, physical fitness, or both. We expect that the volume of literature will vary based on the occupational athlete and that there will be limited information regarding policies and procedures to optimize worker health, safety and performance. Our review will highlight gaps in current evidence and identify areas for future research, in particular, the development of occupation- and task-specific recommendations that account for the relationship between health, the environment, and performance at work.

Emma Bazarek (presentation number 49)

Trends in Opioid Use Among Alabama Medicaid Enrollees

Mentor: Dwight Lewis

Background: In 2017, an estimated 72,287 people died of prescription and illicit drug overdoses in the United States, with 49,000 deaths being attributed to opioids. The state of Alabama has the highest opioid prescription rate in the United States, with an average 107.2 opioid prescriptions per 100 people in 2017. This is in contrast to a national prescribing rate of 58.7 opioid prescriptions per 100 people in that same year.

Objective: The purpose of this research is to examine epidemiological trends among the Alabama Medicaid population as it relates to opioid prescriptions and opioid addiction during the 2016, 2017, and 2018 fiscal years.

Methods: We performed this study using Alabama Medicaid claims data from 2016-2018 to evaluate the epidemiology of opioid use and abuse. This study included 1.10 million, 1.09 million, and 1.10 million Alabama Medicaid enrollees in 2016, 2017, and 2018 respectively.

Results: Preliminary findings show that white enrollees are at increased likelihood of being diagnosed with an opioid addiction, with white females having the highest odds when compared to women of other races and men from all racial backgrounds. Also, findings suggest that enrollees resdiding in counties in the Northern region of Alabama are at increased odds

having received a opioid addiction diagnosis when compared to enrollees living in the southern region of Alabama.

Conclusion: TBD

James Weiss (presentation number 50)

The Cuban Healthcare System: What Can Be Learned from Its Unique Efficiencies and Limitations?

Mentor: William Rabel

Student Presenter: James Weiss

Title: The Cuban Healthcare System: What Can Be Learned from Its Unique Efficiencies and Limitations?

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Abstract:

Cuba is not often thought of as an economically prosperous nation, but its healthcare system consistently ranks as one of the most effective in the world. This is a fascinating statistic, as quality of healthcare is often thought to be highly correlated to the costs associated. This paper will aim to discern the key drivers of efficiency within the Cuban healthcare system.

The Cuban healthcare system operates as a greatly centralized operation. The government not only pays for, but also provides about 90% of all healthcare treatments in the country, covering everything from wellness checks to surgery to maternal care. In recent history, this immense centralization has allowed Cuba to combat widespread illnesses with unique and effective, however often controversial strategies.

The organization of healthcare in Cuba has unique characteristics that result in a variety of patient outcomes that differ significantly from its peers, even when compared to other countries that have socialized medicine. Clearly, one of the many defining qualities of Cuba's healthcare system is the emphasis put on equity, which can often be observed to lower the quality of care delivered, especially when funding is limited, but in Cuba's case the standard for care remains quite high, even when considering recent economic struggle.

The main qualities of the Cuban healthcare system that appear to distinguish it from its peers are its ability to enact immediate universal change due to its centralized nature and political environment as well as the emphases placed upon prenatal care and community-based clinics. While many political systems will not allow for the same implementation strategies that the Cuban healthcare system uses, specific aspects such as the emphases on primary and prenatal care can be employed in other countries to increase the quality of patient outcomes without increasing national healthcare costs.

Dalton Morris (presentation number 51)

Customizable and Low-Cost 3D Printed Prosthetics for Pediatric Patients

Mentor: Shane Sharpe

Introduction: Currently, economically impoverished communities do not have sufficient access to prosthetics. In particular, children grow quickly, and it can be prohibitively expensive to develop prosthetics that suit their unique needs. The Alabama Prosthetic Project aims to design 3D printed prosthetic hands for children whom have underdeveloped fingers and hands at no cost to the families.

Methods: Our group has developed two mechanical prostheses: partial hand and partial finger. Autodesk Inventor was used to design the prostheses. To improve customizability of the prosthetic for more patients, we are currently applying and testing parametric design principles in order to create a CAD model which can regenerate to fit patients based on hand geometry of the patient's limb. The partial hand prosthesis consists of four fingers and a thumb connected with a wire to a tensioner. The user simply bends their wrist by thirty degrees and the prosthesis grasps the object. The partial finger prosthesis works in a similar way, but it is more compact and realistic-looking. The finger prosthesis is customizable to fit directly onto the remaining finger. A wire inside of a tube which connects to a fitted bracelet which allows the prosthetic to flexes as the wrist bends. The design of the fingers stems from the complete CAD design of the prosthetic hand.

Discussion and Future Directions: By creating CAD models for each finger and having a generalized attachment to the hand, the design could be modified to fit many individuals' needs and would be easily manufactured. We are exploring various materials for the prosthetic in order to balance functionality and cost-effectiveness. In particular, we are researching different coatings for the prosthetic fingertips in order to improve gripping ability. We plan to work with the Limb Deficiency Clinic at Children's of Alabama to provide these prosthetics to pediatric patients and

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individually fit the prosthetic to each patient using their own measurements. The final goal is to merge the partial hand prosthesis and partial finger prosthesis into one parametric designed model.

Alexandra Stanley (presentation number 52)

Evaluating Care Team Communication During An Educational End Of Life Simulation

Mentor: Megan Lippe

Background: Providing end of life (EOL) care is a vital skill for every member of a healthcare team. Unfortunately, many new graduates in healthcare fields feel underprepared to care for patients with life-limiting illnesses. It is imperative that education focuses on adequately preparing students in core competencies of EOL care, such as communication, so that every patient receives an acceptable level of care.

Purpose: The goal of this research study was to determine how an interprofessional EOL simulation experience would affect students' learning outcomes and foster effective communication between team members.

Methods: An EOL simulation was created with three phases. The first phase was designed so that the team would need to communicate with the patient's family members, played by actors. The second phase was an assessment of the patient and focused on communication within the team. The last phase focused on communication with the family members at the end of the patient's life. Each team consisted of nursing (n=7-8), and social work (n=1-2) students and medical residents (n=1-2). Participants not actively involved in a phase of the simulation observed on a live video feed. After the simulations, trained research assistants independently viewed recordings of the simulations and evaluated the team using the Gap Kalamazoo Communication Skills Assessment Form. The evaluations were discussed, and an agreement was reached regarding any discrepancies.

Results: Most of the groups scored "good" through "excellent" in communicating accurate information and gathering information, but the teams varied in demonstrating empathy. The variations in empathy could be due to actor performances or the length of the simulation (one hour versus one and a half hours).

Conclusion: The EOL simulation had a positive impact in fostering interprofessional communication. Future simulations should include other EOL team members, such as chaplains.

Mary Caroline Yuk (presentation number 53)

The Effects of Type 2 Diabetes on High Frequency Hearing Loss

Mentor: Marcia Hay-McCutcheon

Hearing loss is a global condition that is increasing in its prevalence. It can cause a decrease in the quality of life, as well as affecting personal and societal financial costs. Many of the risk factors associated with hearing loss include smoking, cardiovascular disease, and noise exposure, but current available literature has established that those with diabetes are at an increased risk to develop hearing loss. Despite this understanding, it appears that hearing loss is still not recognized as a complication of diabetes. Type 2 Diabetes mellitus is a pervasive, worldwide condition that is currently the 7th leading cause of death in the US. According to the Centers for Disease Control and Prevention, about 9.4% of the US population, had diabetes in 2015. Particularly in the state of Alabama, approximately 12.0% of adults are affected by the metabolic disorder, and this rate is advancing at epidemic proportions. While a considerable amount of research has been directed towards Type 2 Diabetes and its effects, this study intends to specifically analyze the incidence of high frequency hearing loss as an additional complication. Recent studies investigating this matter have produced inconsistent results, and with the increasing prevalence of

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hearing loss and diabetes in both rural and urban communities of Alabama, it becomes a more pressing matter to substantiate the association. Physicians may not be counseling their patients about high frequency hearing loss as a risk factor for diabetes. This study was conducted to examine correlates of hearing loss in a representative sample of diabetic adults in Alabama, and to examine the extent of high frequency hearing loss in a comprehensive manner. The data used was from hearing tests collected from the Here Hear Alabama project with individuals who self-reported a diabetes diagnosis, resulting in a sample of 18 people with diabetes and 61 without. There were 25 males and 54 females who were primarily African American/Black or White. The results demonstrated that among Alabama residents, there existed an association between Type 2 Diabetes and high-frequency hearing loss. Although this rate of high frequency hearing loss was higher in those with diabetes, our results found that they were not significantly different from those without diabetes. This could be attributed to the lack of participants with diabetes, and future studies should focus on having a larger sample of those with diabetes. Additionally, age, gender, race, and income were examined, but not found to be significant variables in explaining the outcomes.

Hayley Strong (presentation number 54)

Barriers and Facilitators of Local Food Consumption in College Aged Students

Mentor: Seung Eun Jung

Introduction:

The local food movement is one way to increase sustainable practices throughout all aspects of food production in order to improve the well-being of a specific place. Nutrition professionals are concerned about the sustainability of the food system. In addition, previous research has indicated that using unsustainable practices could lead to increased food insecurity. College students are establishing eating behaviors and habits for the first time without much guidance, which may lead to an infrequency of quality food. This population may gravitate towards the quickest and cheapest option for food, which many times is something processed. The production of highly processed foods is directly related to negative environmental impacts. Therefore, supporting local food consumption and increasing its availability have the potential to create improved diet quality while providing environmental benefits.

Objective:

The purpose of this qualitative study was to gain an in-depth understanding of college students' perceived barriers and facilitators of local food consumption.

Methods:

In order to recruit a diverse population of in-state, out-of-state, and international students, a purposive sampling method was used. Individual, face-to-face interviews were conducted in a private conference room at the university. Interviews were audio recorded and transcribed verbatim for analysis. A directed content analysis was utilized to analyze transcribed individual interviews.

Results:

A total of 30 college students (n=10, out-of-state; n=10, in-state; n=10, international students) participated in this qualitative study. The five top barriers identified by students included lack of information, lack of availability, inconvenience, higher price, and low self-efficacy. Students described availability, clear advertisement, knowledge of local food, convenience, and social support as facilitators of local food consumption.

Conclusion:

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Findings from this study provide insight into how to help promote the local food consumption among college students. For example, making smaller local farmers markets on campus would make access to local foods more convenient to students. Also, the students could possibly use dining dollars or Bama cash to be able to pay for the local food when utilizing campus dining halls. Lastly, putting fliers around campus or social media would make students aware of the importance of local food consumption and enhance their motivation to consume local foods.

Grace Shirah (presentation number 55)

RELATIONSHIP BETWEEN PEDIATRIC ORAL FEEDING SKILL AND REPORTED BEHAVIOR DURING MEALTIMES

Mentor: Memorie Gosa

Purpose: To determine the relationship between a clinical, observation measure of pediatric oral feeding skill and a parent reported measure of behavior during mealtimes.

Background:

Children who are referred for a clinical feeding assessment may have feeding difficulties because of many factors including: medical, social, and behavioral. Feeding difficulties have been shown to have a undesired consequences on child and caregiver bonding, child growth, and child development. For that reason, it is imperative to perform a comprehensive clinical assessment with validated, psychometrically rigorous clinical tools. To date, the relationship between the clinical measure of oral feeding skill (Adapted Pre-Feeding Skills Checklist, APFSC) and the clinical measure of feeding behavior (Behavioral Pediatric Feeding Assessment Scale, BPFAS) has not been determined.

Methods:

Participants completed a clinical feeding and swallowing evaluation at The University of Alabama Speech and Hearing Center between 2018 and 2019. Each participant and their caregiver completed the following as appropriate: a clinical interview, oral mechanism examination, Adapted Pre-Feeding Skills Checklist, Behavioral Pediatric Feeding Assessment Scale, Food Frequency Questionnaire, Sensory Profile 2, and behavioral observation during mealtime. The measures were analyzed and scored. Deidentified information was entered into a database to allow for statistical analysis. Pearson's correlation coefficient analysis was completed to determine the relationship between the APFSC and the BPFAS.

Results:

A Pearson's product-moment correlation was run to assess the relationship between feeding skill (APFSC) and undesired behaviors associated with feeding (BPFAS) in this pilot cohort of children aged two to six years of age that were referred for clinical feeding evaluation at The University of Alabama Speech and Hearing Center. Twenty-four participants were included in this analysis. There was no statistically significant correlation between observations of feeding skill and reports of undesirable behaviors associated with feeding, r(22) = -.12, p = .583, with feeding competency explaining only 1% of the variation in reported undesired feeding behaviors.

Limitations:

This project is limited by a conservative sample size (N = 24). Recruitment is ongoing and these data represent the first, pilot analyses of this data set.

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Conclusion:

There is no significant relationship between the measure of oral feeding skill and the measure of undesired behaviors associated with feeding. Feeding disorders are a multifactorial issue that require careful analysis of the contributing factors. The initial analysis of this project suggests that clinicians should perform individual measures of feeding behaviors and feeding skill competency.

Rebecca de la O (presentation number 56)

Impact of the UA Culinary Medicine Program on Interprofessional Practice

Mentor: Linda Knol

To address the complex needs of today's patients, the Institutes of Medicine Committee on Quality Health Care in America suggested health care professionals train and work as interprofessional teams. The Academy of Nutrition and Dietetics supports IPE in nutrition as a component of medical education and suggests registered dietitians/nutritionists (RD/Ns) assist in educating medical students to improve understanding of the RD/N's role on the care team. The purpose of this study was to pilot test a novel, interprofessional culinary medicine course, and evaluate whether working together during the program changed the opinions the students had of themselves and of each other regarding nine aspects of interprofessional practice.

The Culinary Medicine Program at UA combines the art of cooking with the sciences of nutrition and medicine. One night weekly for five weeks, nutrition students and medical students work together in teams to discuss case studies and cook recipes that have been modified to reduce saturated fat, sodium, and sugar. Participants completed a survey where they were asked to rate themselves and the other professionals on their team in nine aspects of interprofessional practice on a scale of 1 to 5, where 1 is very low and 5 is very high. T-tests were used to compare student responses prior to and after the IPE.

In the past two years, forty-eight students (13 nutrition and 23 medical students) completed the five-week course and both the pre- and post-questionnaires. Medical students' opinion of self significantly improved in four of the nine aspects of IPE or academic ability, interpersonal skills, ability to work independently, and confidence. Nutrition students' opinions of self significantly improved in leadership abilities and confidence. Additionally, the medical students' opinions about the academic ability, professional competence, interpersonal skills, ability to make decisions, and confidence of Registered Dietitians improved significantly. The nutrition students' opinions of the medical students' ability to be a team player improved significantly through the program.

The role of an IPE is to help health care professionals understand how to work together toward a common purpose or the welfare of patients. In this IPE, both sets of health care professionals experiences significant growth in aspects of IPE. In addition, opinions of the other profession improved. As these health professionals leave their programs, they may hold opinions of the other profession that makes them better future partners.

Analiese Gerald (presentation number 57)

1. Taste is the most powerful determinant for predicting consumers' intention to consume antioxidant-infused chewing gum

Mentor: Seung Eun Jung

Introduction

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Cardiovascular disease (CVD) is the leading cause of death in the United States for both men and women. Approximately 610,000 people die every year from heart disease. According to the American Heart Association, upwards of 90 million Americans have been diagnosed with at least one form of heart disease, and it is estimated that 720,000 people experience a heart attack every year. CVD costs the United States about $200 billion each year in healthcare, medications, and lost productivity.

Improved eating behaviors can play a vital role in delaying risk factors for, and even preventing the onset of, CVD. Functional foods are a popular and innovative option for potentially decreasing risk of chronic diseases, including CVD. Antioxidant-containing chewing gums have the potential to be an especially useful mode for reducing risk of CVD specifically, due to their functionality and their potential effects on oral and vascular oxidative stress. Furthermore, an increased interest in health has made functional foods a popular trend for consumers. Therefore, it would be beneficial to understand the most impactful determinants that influence consumers to purchase these products.

Health consciousness, attitude, and taste have been hypothesized to be some of the most notable influencing factors, and the Value-Attitude-Behavior Model a comprehensive theory to study these determinants.

Objective

The purpose of this study was to identify significant factors for choosing functional foods, in this case a functional chewing gum infused with spices from antioxidants, using the Value-Attitude-Behavior Model.

Methods/Results

Surveys were distributed to University of Alabama students using a convenience sample technique. Before giving the survey, a sample of chewing gum infused with spices rich in antioxidant compounds was provided to each participant. Multiple regression was conducted to predict the effects of health consciousness, attitude, and taste on intention to consume. The Durbin-Watson d was 1.92 and Variance Inflation Factor values ranged from 1.02 to 1.48, confirming that there were no auto-correlation and multicollinearity issues. Among the three independent variables, taste had the largest impact on intention (t= 11.03, p< 0.001), followed by attitude (t= 5.58, p< 0.001), and health consciousness (t= 3.79, p< 0.001). Adjusted R2 of the model was 0.50, indicating the model explained 50% of the variance of intention.

Conclusions

In introducing functional foods that will be successful on the market, taste is one of the most important factors to consider. Therefore, sufficient sensory testing to ensure taste acceptability and enjoyability by consumers should be part of the development of antioxidant-infused chewing gums. A positive taste may also then have a positive impact on consumers attitude towards functional foods, which can increase their intention to buy. Health consciousness is another factor that affected intention to consume a functional chewing gum. Marketing strategies would benefit from emphasizing the health benefits of antioxidants found in the chewing gum.

Kathleen O`Neal (presentation number 58)

Relationship Between Measures of Oral Feeding Skill and Oral Sensory Processing for Children Suspected fo Pediatric Feeding Disorders

Mentor: Memorie Gosa

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RELATIONSHIP BETWEEN MEASURES OF ORAL FEEDING SKILL AND ORAL SENSORY PROCESSING FOR CLIENTS SUSPECTED OF PEDIATRIC FEEDING DISORDER

Kathleen O'Neal & Memorie M. Gosa

The University of Alabama, Tuscaloosa, Alabama, USA

Purpose: To determine the relationship between a measure of pediatric oral feeding skill (the Adapted Pre-Feeding Skill Checklist) and a parent reported measure of oral sensory processing.

Background: Children with feeding and swallowing problems (dysphagia) often restrict their nutritional intake, leading to referral for clinical feeding assessment. Pediatric dysphagia is a multifactorial issue and requires a comprehensive clinical assessment to include observations of oral sensory processing, oral motor skill, nutritional intake, and behaviors associated with feeding. The Sensory Profile 2 (SP2) is a parent questionnaire that is completed to gain a complete understanding of a child's sensory integrative functioning across all domains. The Adapted Prefeeding Skills Checklist (APFSC) is a clinical tool used to measure oral feeding skill. There is a strong theoretical correlation between oral sensory processing and resulting oral skill for chewing; however, this relationship has not been empirically tested.

Methods:

Participants completed a clinical feeding and swallowing evaluation at The University of Alabama Speech and Hearing Center between 2018 and 2019. Each participant and their caregiver completed the following as appropriate: a clinical interview, oral mechanism examination, Adapted Pre-Feeding Skills Checklist, Behavioral Pediatric Feeding Assessment Scale, Food Frequency Questionnaire, Sensory Profile 2, and behavioral observation during mealtime. The measures were analyzed and scored. Deidentified information was entered into a database to allow for statistical analysis. For the purposes of this project correlational statistics were completed to determine what, if any relationship, exists between a client's oral sensory processing and their resulting oral feeding skill.

Results:

A Spearman's rank-order correlation was run to assess the relationship between APFSC scores (continuous) and classification of oral sensory processing (ordinal) with the SP2 in a cohort of children referred to the University of Alabama Speech and Hearing Center for a clinical feeding evaluation. Twenty four participants, aged 2 years 7 months to 7 years 5 months with a mean age of 4 years 8 months were included in this analysis. There was no statistically significant correlation between the APFSC scores and classification of oral sensory processing with the SP2, rs(22) = -.075, p = .728.

Limitations:

This project is limited by a conservative sample size (N = 24). Recruitment is ongoing and these data represent the first, pilot analyses of this data set.

Conclusion:

There is no significant relationship between the measure of oral feeding skill and the measure of oral sensory processing. Feeding disorders are a multifactorial issue that require careful analysis of the contributing factors. The initial analysis of this project suggests that clinicians should perform individual measures of oral sensory processing and feeding skill competency, as there does not appear to be a direct relationship between the two.

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Amanda Ferrito (presentation number 59)

Physiological Correlates of Energy and Fatigue: An Addison's Disease Case Study

Mentor: Michael Fedewa

Amanda Ferrito

URCA Abstract: Physiological Correlates of Energy and Fatigue: An Addison's Disease Case Study

Background: Addison's Disease is a rare autoimmune disorder affecting approximately 1 in 100,000 people in the United States. Impaired adrenal function limits the release of essential hormones such as cortisol, commonly referred to as a "stress hormone". Although individuals with Addison's Disease can combat this condition with daily pharmacological therapy, physical and mental fatigue are often chronic symptoms. Identifying predictors of potential fatigue are paramount for individuals with Addison's disease, or any fatigue inducing condition.

Study Objective: The primary aim of this study was to identify and assess the relationship between self-reported energy and fatigue, sleep duration, and heart rate variability (HRV). It was hypothesized that sleep duration and heart rate variability would be correlated to an individual's daily feelings of energy and fatigue.

Summary of Previous Literature: Previous research indicates that HRV is inversely correlated with feelings of physical fatigue and decreased performance in athletes, such that higher HRV is associated with lower levels of fatigue. Additionally, lower sleep duration is also associated with higher self-reported fatigue.

Methods: A 19-year-old, female participant with Addison's Disease measured daily HRV, sleep duration, and self-reported feelings of energy and fatigue for a total of 133 consecutive days. Resting HRV was assessed in a supine position immediately upon waking using the natural logarithm of the root-mean square of successive differences (LnRMSSD) using a smartphone application "HRV4Training". Self-reported sleep duration was assessed in hours per night using a single-item question in the smartphone application. Subjective levels of physical fatigue, mental fatigue, physical energy, and mental energy were measured using a 100-mm visual analogue scale in the afternoon of each day. Bivariate correlations between HRV, sleep duration, and feelings of energy and fatigue were assessed using Pearson's r. Statistical significance was assessed using an alpha level of .05.

Results: HRV measures were not associated with self-reported feelings of physical and mental fatigue (0.078 and 0.067, respectively; both p> .05). In contrast, self-reported sleep duration was inversely correlated with self-reported physical fatigue (-0.279, p= 0.006) and mental fatigue (-0.319, p= 0.001) such that greater sleep duration was associated with lower feelings of physical and mental fatigue.

Conclusions: For individuals with fatigue-inducing conditions, such as Addison's Disease, sleep duration may serve as a stronger predictor of energy and fatigue than HRV.

Limitations: The results of this study are potentially limited by the small sample size and should be replicated with a larger sample of participants. Additionally, the method used to measure daily fatigue may have limited the participant's ability to express their true feelings of fatigue for each day.

Riley Raynor (presentation number 60)

Cancer Screening Disparities in Rural Alabama

Mentor: Dr. Hee Yun Lee

Cancer is the second leading cause of death in the US, which accounts for 21.97% of the

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2,712,630 deaths in 2014, only 1.40% lower than heart diseases (US Department of Health and Human Services, Centers for Diseases Control and Prevention and National Center for Health Statistics, 2017). In Alabama, in 2014, there were 25,366 new cases of cancer. The rate of new cancers is 437.9 for every 100,000 people ranking 32 higher, while the US average rate is 436.6 (U.S. Cancer Statistics Working Group, 2017). However, as to cancer mortality rate, Alabama ranked 11 higher, which is 177.7 for every 100,000 people whereas the US average is 161.3. Mokdad et al. (2017) proposed that the geographic disparities in the high rates of cancer mortality are due to a combination of risk factor profile and poor prevention and screening programs. The top ten cancers by rate of death in Alabama are lung &amp; bronchus (52.6 for per 100,000 people), prostate (21.3), female breast (21.0), colon and rectum (15.3), pancreas (11.5), ovary (8.2), liver &amp; intrahepatic bile duct (7.1), leukemia's (6.5), non-Hodgkin lymphoma (5.4) and brain &amp; other nervous system (5.1) (U.S. Cancer Statistics Working Group, 2017).

The literature review will be under subtitles of different kinds of cancers, following a sequence of current screening rate, factors related to the behavior of screening and intervention programs to promote screening rate in Alabama.

Madeline Erwin (presentation number 61)

Maternal Vitamin A Supplementation Modulates Adipose Tissue Development in Offspring of Rats Consuming a High-Fat Diet

Mentor: Libo Tan

Background and Objective:

Since the 1970s, the number of children and adolescents affected by obesity has tripled (CDC 2019). Childhood and adolescent obesity have also been reported to be closely related to maternal obesity. Vitamin A (VA) has shown to be a key regulator of obesity development and associated metabolic complications in adults. Its role in the early life stage, however, has not been investigated yet. The aim of the study was to investigate the impacts of dietary VA supplementation during suckling and post-weaning periods on the adipose tissue (AT) development in rats reared by mothers consuming a high-fat diet (HFD).

Method:

Four Sprague-Dawley rats arrived on their 2nd day of gestation. After 3 days of acclimation, they were randomly assigned to either a normal fat diet (NFD=25% fat) with adequate VA at 2.6 mg/kg (n=2) or a HFD (50% fat) with the same amount of VA (n=2). Upon delivery, pups were transferred to achieve a same number of n=11/litter. Two mother rats, one from each group, were switched to a NFD and a HFD both with supplemented VA at 129 mg/kg (NFD+VA and HFD+VA), respectively. The other two remained on their diets with adequate VA through lactation (NFD and HFD). At postnatal day 14 (P14) and P25, 4 pups/litter were euthanized with body weight (BW), visceral white AT (WAT) mass, and brown AT (BAT) mass recorded. Serum samples from P25 necropsy were analyzed for leptin and adiponectin concentrations. At P25, the rest weanling pups (n=3/group) were fed the diets as their respective mothers until they were euthanized at P35.

Results:

At P14 and P25, the BW and WAT mass of pups in the HFD group were significantly (P<0.05) higher than those in the NFD groups. Comparatively, these measures were significantly reduced in the HFD+VA group as compared to the HFD litter. A similar pattern of change in WAT mass was observed at P35. Additionally, at P25, the BAT mass of pups was significantly reduced by the maternal HFD, but VA supplement restored the level to that in the NFD groups. Serum analysis from P25 revealed a significantly higher adiponectin level in the HFD+VA group. In contrast, VA supplement showed a trend to reduce the leptin level that was raised by the maternal HFD consumption.

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Conclusion:

Results support a regulatory role of VA supplementation during suckling and post-weaning period in the AT development in offspring from mothers consuming a HFD as evidenced by reduced BW and WAT mass, increased BAT mass, and modulation of adipokines. The potential of VA supplementation in both lactating mother and infant diets to improve the outcomes of childhood and adolescent obesity warrants further investigation.

Alex Parks (presentation number 62)

Functional Sugar-Free Gums Infused with Spices Improve the Antioxidant Capacity of Saliva

Mentor: Kristi Crowe-White

Functional Sugar-Free Gums Infused with Spices Improve the Antioxidant Capacity of Saliva

Elisabeth Pettibone and Alex Parks

Faculty Advisors: KM Crowe-White, PhD, RD and SE Jung, PhD, RD

Background: Oral health is directly influential to the risk of developing cardiovascular diseases (CVD), despite its seeming lack of connection to CVD. Oxidative stress and inflammation are mechanisms of CVD, which may originate in the oral cavity and create systemic oxidative stress and inflammation. Recent research suggests that sugar-free gum not only provides a way to prevent dental caries but acts as a vehicle capable of carrying bioactive compounds. Spices containing phenolic compounds that act as antioxidants may lower oxidative stress in the oral cavity. As a result, spices may lower CVD risk through the sublingual absorption of antioxidants.

Objective: The aim of this study was to evaluate functional sugar-free gums infused with spices for improving the antioxidant capacity (AC) of saliva.

Methods: On two testing visits, fifty-five participants (21.3 + 5.8 y, 81.9% female) provided unstimulated saliva prior to chewing a spice-infused sugar-free gum containing cinnamon spice with and without apple pie spice. With guided instruction, stimulated saliva was collected during a five-minute period of gum chewing. AC and total phenolic content of pre- and post-chew saliva was evaluated using the oxygen radical absorbance capacity and Folin-Ciocalteu assays, respectively. Statistical analyses included paired t tests.

Results: Both gums significantly increased hydrophilic, lipophilic, and total AC of saliva (p<0.05), yet to varying extents. The greatest release of antioxidants resulted from chewing the cinnamon-apple pie spice gum with a mean increase in total AC of 45%, while total AC in cinnamon spice gum increased 12.7%. The phenolic content of saliva was significantly higher (p<0.0001) post-chew for both gums, with increases of 73% and 56.3% for the apple pie-cinnamon and cinnamon spice gums, respectively.

Conclusions: Results from this study indicate that spice-infused sugar-free chewing gum may raise salivary AC, rendering it an effective method for delivering antioxidants sublingually. The ability to deliver antioxidants through the oral cavity may be influential in lowering the risk of developing CVD.

Jordan Leigh Pfeffle (presentation number 63)

How do we raise awareness of local food throughout campus?

Mentor: Seung Eun Jung

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Introduction: In order for a population's nutritional health to advance, the food system must be sustainable. Impacts on the environment can be directly correlated with the dietary choices a population makes. Today, our environment contains many problems including shortages in water, water pollution, degradation of land, and climate change. A powerful way to improve the environment is through the local food movement. Through the production and consumption of local food, natural resources are being conserved, and the production of waste is being reduced. College age students were used as primary participants because this time period in most individuals is an extremely influential period. Entering college is the first time many individuals begin to make food choices independently. Through effective implication of health promotion programs, students' behaviors and health will be positively changed. Therefore, there is a need to understand college students' interpretation of the term local food, while also gaining insights on how to promote local food among this population.

Methods: A total of 30 study participants were recruited face-to-face at various locations including the Ferguson Center, Lakeside Dining, and Gorgas Library at the University of Alabama (UA). Individual interviews were conducted in a private conference room at UA. All of the interviews were transcribed by the research team using voice recordings from each interview. Transcriptions were used for data analysis which was completed using the NVivo software.

Results: When student participants were asked to define local food, there was a wide variety of answers. The most frequently heard answer was that local food could be defined as cultural food. Food within a specific region, locally-owned businesses, foods found at farmers' markets, and food within the state were also some typical responses. When the students were asked what specific cues to action they believed would be beneficial on campus, there were several suggestions including hosting events, creating posters, sending out informative emails, food samples, social media messages, and providing incentives. Participants also said they would like to see specific information included in these cues to actions such as where they can find local foods and the health benefits of these local foods.

Conclusion: Findings suggest that a clear local food definition should be incorporated into the suggested cues to action around campus when promoting local food consumption. Major practical implications are the use of social media to increase awareness, educating students on farmer's market location and operating hours, transportation to farmer's markets, and availability of local food to students. By educating the students on UA's campus, the awareness of local food and the importance of sustainability could not only impact Tuscaloosa's community but also lead to a bigger impact in other communities as well.

Andrew Cooper (presentation number 64)

Nanoencapsulation of Curcumin and β-carotene in Amylose Inclusion Complex

Mentor: Libo Tan

Curcumin is a yellow compound found in turmeric, which is a spice commonly found in curry powder. Curcumin has demonstrated promising results as a potential anti-inflammatory and anti-cancer agent, but its lack of stability and low solubility can limit its nutritional value in the body. β-Carotene is a red-orange carotenoid found in foods such as carrots and sweet potatoes. β-carotene is converted in vivo to fat-soluble Vitamin A, which is involved in immune function, cell communication, vision, and reproduction. It also functions as an antioxidant, which inhibits the harmful effects of oxidative stress from free radicals that contribute to many chronic diseases, such as metabolic syndrome, obesity, and cardiovascular disease. However, like curcumin, β-carotene is unstable. Its sensitivity to light and temperature can cause it to degrade, limiting its nutritional benefits.

This study focused on stabilizing curcumin and β-carotene by using nanoencapsulation in amylose, a component of starch which is able to form inclusion complexes with small molecules due to its helical structure. A previous study

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demonstrated the successful formation of the amylose-ascorbyl palmitate (AP)-β-carotene ternary inclusion complex. The purpose of this study was to prepare amylose-AP-β-carotene and amylose-AP-curcumin inclusion complexes and evaluate whether the photostability and storage stability of β-carotene and curcumin could be improved through nanoencapsulation.

Samples of amylose-AP-β-carotene and amylose-AP-curcumin inclusion complexes were subject to a 16-day storage test at 45 °C and a 6-hour photostability test under UV irradiation, using physical mixtures and solutions as the control groups, respectively. Results demonstrated that β-carotene and curcumin in the control samples were degraded much faster than those in the inclusion complex. The degradation of β-carotene and curcumin was also faster in solution than in the inclusion complexes both with and without UV exposure. It was concluded that nanoencapsulation by amylose inclusion complex increased the stability of β-carotene and curcumin during storage and when exposed to UV light.

Aly Gutierrez (presentation number 65)

Inhibitory Effect of Tea on the in vitro Enzymatic Digestion of Starch

Mentor: Lingyan Kong

Previous studies of phenolic compounds have demonstrated their ability to decrease the rate of starch hydrolysis by inhibiting digestive enzymes for starch. A major implication of such inhibition is a slowed rate of starch digestion into glucose, which thereby reduces a sudden rise in blood glucose level after a starchy meal. Tea, rich in phenolic compounds, has been widely reported for its beneficial health effects. Accordingly, this study explored the inhibitory abilities of four types of tea, i.e., green tea, oolong tea, black tea, and white tea, on the in vitro enzymatic digestion of potato starch (PS) and high-amylose maize starch (HAMS). The in vitro digestion was carried out in simulated intestinal fluids and the reducing sugar content released from digestion was measured at 1 h and 2 h using the 3,5-dinitrosalicylic acid assay. Total phenolic content (TPC) in the teas was determined using the phenolic-binding Fast Blue BB assay. Results showed that the TPCs in green tea and oolong tea were significantly (P<0.05) higher than those in black tea and white tea. Yet, all teas demonstrated significant inhibitory effect on the digestion of both starches. No significant difference in the inhibition was found among these teas, except that green tea showed higher inhibition on HAMS digestion at 2 h. It was also noticed that both starches were digested to the same extent after 2 h of digestion, but at different rates. At 1 h, the extent of HAMS digestion was significantly higher than that of the PS, possibly due to its higher content of amylose, which is more soluble than amylopectin and thus more accessible by the digestive enzymes. In conclusion, our results suggested that tea, regardless of its type, can slow down enzymatic digestion of starch and therefore imply a potential benefit for controlling postprandial hyperglycemia.

Sara Ferguson (presentation number 66)

Assessing Risk Factors for Cardiovascular Disease and Type 2 Diabetes in Low-Income, Minority Preschool Children

Mentor: Michele Montgomery

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Childhood obesity is a significant public health concern and is associated with health conditions such as cardiovascular disease and type 2 diabetes, two of the leading causes of death in the United States and Alabama. Rates of obesity are significantly higher in minority and low-income residents of Alabama. Statistically, children who experience obesity in childhood are much more likely to be obese into adulthood. Research consistently shows a relationship between obesity and a less favorable blood lipid profile among children. Research also suggests that community-level social, economic, and physical barriers and facilitators may contribute to health disparities, such as obesity, by impacting behavioral risk factors and via differential distribution in rural, low-income, and minority communities. This study examined the relative contribution of environmental, psychosocial, behavioral, and biological determinants of health and interpersonal characteristics (e.g., age, race) on BMI of vulnerable preschool children. The study consisted of 365 preschool aged children at several Tuscaloosa City Elementary schools. Results found 49.5% of individuals living below the U.S. poverty line and facing economic hardships. In addition to those, the study found that 79% of participants identified themselves as minorities. Of the children participating in the study, 186 required a follow-up with the doctor regarding specific health risks of BMI, blood pressure, and blood lipid profiles. Of these individuals, 83% were of minority background. 170 of the children in the study found to have nonfavorable BMI, blood pressure, and blood lipid profiles were from family incomes that fell below the U.S. National poverty line. As a result, this study confirmed a disproportionate increase in the risk of cardiovascular disease and type II diabetes among low income, minority children in Tuscaloosa, Alabama as compared to the national average. There is an increased need for intervention and education in these communications as well as an ability to bring in access to resources.

Riley Raynor (presentation number 67)

Factors associated with HPV Literacy among adults in Minnesota

Mentor: Dr. Hee Yun Lee

As the second leading cause of cancer death in women aged 20 to 39 years, cervical cancer is mainly caused by persistent infection with certain types of human papillomavirus (HPV). Previous studies have shown that higher HPV literacy, such as knowledge about the disease and how it can be prevented, increases the likelihood of getting HPV vaccine. The HPV vaccination prevents the spread of the HPV. Therefore, the predictors related to HPV literacy level need to be identified. A cross-sectional survey was completed with 733 adults aged 18 years and older. Applying Anderson's Behavioral Model of Health Services Use, we conducted a multiple regression analysis to examine the factors associated with HPV literacy. Although the mean score of HPV literacy of participants were 6.05 (SD = 1.50) out of total possible 8 points, only 52.8% of the participants answered correctly on item "Pap test will almost always detect HPV" and only 44.7% of the participants answered correctly on item "A negative test for HPV means that you do not have HPV". HPV literacy was positively correlated with race/ethnicity, education level, and having insurance coverage, while it was negatively associated with age and self-reported health status. This study indicated both age and race/ethnicity disparities regarding HPV literacy. We also highlighted a need for future efforts to improve HPV literacy among those who have lower education level and those who are uninsured. Additionally, lower scores on certain HPV knowledge provide implications for future intervention aiming to improve general HPV literacy.

Madelyn Campbell (presentation number 68)

Developing and Testing the Acceptability of a Novel Behavioral Intervention for Individuals with Opioid Use Disorders

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Mentor: Mercy Mumba

Developing and Testing the Acceptability of a Novel Behavioral Intervention for Individuals with Opioid Use Disorders

Madelyn Campbell, Research Assistant

Audrey Balentine, Research Assistant

Josie Niedermeier, Research Assistant

Mercy N. Mumba, PhD (Faculty Mentor)

Introduction

Throughout the United States, and especially within Alabama, there is an urgency to discover the most efficient way to treat opioid use disorders (OUD) and prevent relapse. Approximately 1000 people die everyday from opioid overdoses and finding effective behavioral interventions to use in combination with medication assisted treatments (MAT) is a national priority. The purpose of this research effort was to develop and test the acceptability of a novel behavioral intervention that combines cognitive behavioral therapy (CBT) and motivational Interviewing (MI) for individuals with OUD who are on MAT.

Methods

The novel behavioral intervention was developed based on recommendations from the Substance Abuse and Mental Health Services Administration (SAMHSA), the Centers of Disease Control and Prevention (CDC), and based on the review of the literature on effective behavioral interventions for the treatment of substance use disorders. Also the novel intervention sought to fill gaps in the literature that have mixed results such as using counselors with extensive backgrounds in treating addictive disorders, addressing comorbid psychiatric and mental health conditions, and delivery of the intervention in group settings. The intervention included 12 sessions on topics such as stages of change, stigma, and relapse prevention. Focus groups were used to test the acceptability of the intervention. These sessions were developed largely based on the transtheoretical model of change. Five individuals with opioid use disorders participated in focus groups with five experts and were interviewed. Each focus group and interview was audio taped and transcribed.

Results

The qualitative data collected was analyzed using NVIVO software for qualitative analysis and utilized a thematic approach for data analysis. Additionally, the coding followed the seven procedures of qualitative analysis by Phillip-Pula. The trustworthiness of the emerging themes was established through triangulation by two different researchers, who independently coded the transcripts and then compared themes to come up with an overall coding structure and final themes. The data indicated that focus group participants believed that the intervention would assist with relapse prevention by providing social support, address comorbid mental health problems, and provide accountability for the recovery process. Experts also indicated that this would be an intervention they would consider using in practice because it is based on current, evidence-based recommendations from SAMHSA and the CDC, is feasible in many settings, and provides adjunct therapy for MAT to promote sustained recovery.

Conclusion and Implications for Practice

This intervention is currently being piloted for effectiveness with a group of individuals with OUD disorders who are on MAT. Since adherence to MAT is currently an issue, adding this novel behavioral therapy has the potential to not only improve mental and psychiatric outcomes of persons with OUD, but also to increase adherence to

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MAT, thereby producing sustained sobriety, which ultimately reduces the mortality and morbidity associated with OUD.

Erika Hochhaus (presentation number 69)

The Moderating effect of Alcohol Use on Physical and Mental Well-being of Older Adults

Mentor: Mercy Mumba

The Moderating effect of Alcohol Use on Physical and Mental Wellbeing of Older Adults

Introduction

Despite the overall decline of alcoholism in the United States, AUD has been steadily climbing in adults over the age of 50. In fact, people aged 65 and older have the highest frequency of binge drinking episodes, with projections that approximately 6% of older adults will suffer from alcoholism by 2020. Compounded with the normal physiologic processes of aging, alcohol negatively effects the overall mental and physical health by increasing incidence of depressive symptoms, suicide risk, and mental illness, while at the same time increasing somatic comorbidities, cognitive and memory impairments.

Purpose:

Although current literature exists on relationships between older adults' alcohol consumption and morbidities, from the review of literature, few studies have examined the effects of alcohol use disorder (AUD) on overall physical and mental well-being in older adults. The purpose of this study is to examine the moderating effects of alcohol consumption on physical activity and the mental wellbeing of older adults.

Methodology

Analyses were conducted using data provided by the Behavioral Risk Factor Surveillance System (BRFSS, 2017). The BRFSS is administered and funded by the Population Health Surveillance Branch of the Center for Disease Control (CDC), which is in the Division of Population Health at the National Center for Chronic Disease Prevention and Health Promotion. The BRFSS is a telephone survey created to collect health-related data from adults (≥ 18 years of age) in all 50 states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands.

Results

Participants (N = 450,016) were adults who completed the BRFSS in 2017. Forty nine percent of participants reported drinking alcoholic beverages in the past 30 days. About 27% did not engage in any physical activity per week, whereas 29.42 were highly active. Thirty two percent reported experiencing poor mental health in the past 30 days, including stress, depression, and problems with emotions. About 44% of participants were male, majority were non-Hispanic white (76.6%) and were college graduates (37.4%). Hierarchical linear regressions revealed that alcohol consumption moderated the relation between physical activity and mental health problems, F(4, 160453) = 727.05, p < .001. Results also indicated a significant inverse relationship between education and heavy alcohol consumption, heavy alcohol consumption and physical activity, and physical activity and education, p < .01.

Conclusion

Older adults with high alcohol consumption are especially at risk for mental health problems and low levels of physical activity, which may contribute to complications of treatment for comorbid medical conditions, and ultimately resulting in high mortality rates. Screening for and treating AUD in older adults should be a priority

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for healthcare providers in order to reduce its negative effects on the mental and physical wellbeing of older adults.

Limitations

This was a secondary data analysis, therefore there were limited variable for use in data analysis to appropriately answer the research questions. Additionally, these data represent a cross-sectional timeframe and more longitudinal studies are needed to examine these effects over time.

MacKenzie Robb (presentation number 70)

Physical Activity Predicts Depression in Older Adults

Mentor: Mercy Mumba

Physical Activity Predicts Depression in Older Adults

Introduction

Depression affects more than 6.5 million of the 35 million Americans aged 65 and older. Many assume that depression is a normal part of aging. However, from the review of the literature, it is evident that among older adults, engaging in physical activity can improve mental health by increasing quality of life, self-care ability, and reducing social isolation.

Purpose

The purpose of this study was to examine whether exercise decreases depressive symptoms in older adults after controlling for age, gender, and level of education. Some studies in the literature review compared different types of workout regimens to determine which would be more likely to increase self-efficacy/decrease depressive symptoms in the participants.

Method

This was a secondary data analysis of the 2015-2016 CDCs National Health and Nutrition Examination Survey (NHANES). Trained interviewers used the Computer-Assisted Personal Interview (CAPI) system to administer questionnaire items. Items of interest to the present study included demographic items, the Physical Activity Questionnaire (PAQ), and the Mental Health - Depression Screener (DPQ)

Result

The sample included 2474 older adults. Age ranged between 50 and 80, with average age of 65. Of these, 35% were Caucasian, 31% were Hispanic, and 20% were African American. The scoring system for depression level consisted of three levels: low (score of 0), moderate (score of 1), and high (score of 2). Asians had the lowest depression scores whereas Hispanics had the highest scores of depression. A nominal logistic regression revealed that the addition of physical activity variables to the model significantly improved the fit between the model and the data beyond the intercept, including vigorous recreation, X2 = 20.31, p < .0001, and moderate recreation, X2 = 16.06, p < .001. The Odds ratio of low depression over moderate depression increased by .45 units for every additional hour of vigorous recreation. The odds ratio of low depression over moderate depression increased by .11 units for every additional hour of moderate recreation. The odds ratio of moderate depression over high depression increased by .38 units for every additional hour of vigorous recreation. Along with these results, the literature review conducted confirms the research performed by Dr. Mumba.

Conclusion

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Although any amount of physical activity if preferred over a sedentary lifestyle among older adults, our study indicates that increasing both duration and intensity of physical activity among older adults can decrease depressive symptoms. Additionally, light physical activity may not be as effective in promoting mental well-being. Since a significant number of individuals aged 65 and older report some type of physical disability, healthcare providers have to personalized workout plans in order to optimize benefits and limit adverse events. Depression should never be considered as a normal part of aging and encouraging physical activity in older adults may be a non-pharmacologic way improve depression outcomes among older adults.

Limitations

Variables were limited because this was a secondary data analysis and these data represent a cross-sectional timeframe, therefore, more longitudinal studies are needed to examine these relationships over time.

Kaitlyn Towers (presentation number 71)

What exercises can help prevent overuse shoulder and elbow injuries in baseball pitchers?

Mentor: Lizzie Hibberd

Project Title: What exercises can help prevent overuse shoulder and elbow injuries in baseball pitchers?

Project Authors: Kaitlyn Towers and Lizzie Hibberd (Faculty Mentor)

Study Objective: The purpose of this study was to evaluate what exercises can help reduce the risk of shoulder and elbow injuries in baseball pitchers.

Summary of Previous Literature: Shoulder and elbow injuries are the most common injuries seen in baseball pitchers. These injuries typically occur due to inadequate strength, muscular fatigue, and decreased internal rotation range of motion (ROM). Clinical findings have shown that posterior shoulder musculature endurance is relatively weak due to the role these muscles play in deceleration of the pitching motion. Pitchers typically suffer internal and external rotation deficits, with internal rotation being more severe than external rotation.

Proposed Method: A comprehensive literature was searched using UA SCOUT, Pubmed, and reference lists from cited articles.

Results/Findings: A pre-season 20 week intervention program can be effective at increasing posterior shoulder endurance - which can serve as a protective mechanism during the baseball pitch. This program includes low resistance, high repetition exercises to improve the endurance and strength of the posterior shoulder muscles. During a game, pitchers can perform the two-out drill to help with internal and external rotation ROM deficits. The two-out drill is a program for pitchers to perform when their team is batting with two outs and about to return to the field. This program focuses on exercises that help to restore pre-pitching measurements of internal and external ROM. The exercises included in this program are internal rotation stretch, elbow extension stretch, big arm circles, small arm circles, forearm touch, 90/90 internal and external rotation, and trunk rotation. Stretching of the posterior shoulder muscles is also important for injury prevention. Stretches that have been shown to be effective include internal rotation stretch, sleeper stretch, arm circles, and elbow extension stretch. Finally, many people focus solely on upper extremity exercises for baseball pitchers, but it is important to include lower extremity exercises as well. Lumbopelvic control is an important factor to consider when looking at baseball pitchers. Proper control can lead to decrease stress placed on the upper extremity. Exercises focusing on strengthening the gluteus maximus, such as single-leg bridges, can help to improve lumbopelvic control.

Conclusions/Discussions: Implementing strengthening and stretching programs for baseball pitchers is important to help reduce injuries and muscle fatigue. It is important to have a pre-season program, as well as one that is

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followed throughout the season. These programs should include exercises such as internal and external rotation with resistance bands for the upper extremity, and lunges, single leg squats, and step-ups for the lower extremity. Consistently performing these exercises cam improve strength and ROM in baseball pitchers which will reduce microtrauma during the pitching motion. Performing upper extremity as well as lower extremity exercises are important in order to prevent overuse shoulder and elbow injuries in baseball pitchers.

Limitations: The current literature evaluates the effectiveness of exercises acutely at improving physical characteristics but does not evaluate the influence of these exercises on changes in injury risk. Future research should evaluate how incorporating these interventions decreases injury risk in baseball pitchers.

Grace Hitchcock (presentation number 72)

The Importance of Breastfeeding on Physical, Cognitive, and Adaptive Behavior Development in Infancy

Mentor: Maria Hernandez-Reif

Many researchers have shown an interest in the relationship, or lack of relation, between breastfeeding and cognitive development (Boutwell, Young, & Meldrum, 2018; Tawia, 2013). Some evidence has shown that breastfeeding is associated with higher cognitive functioning later in life (Huang, Peters, Vaughn, & Witko, 2014). Many confounding variables have not been assessed in these studies, such as maternal and paternal education, maternal and paternal intelligence, social status, etc. One study in particular took confounding variables into account and found that breast fed versus formula fed babies scored higher in cognitive functioning (Anderson, Johnstone, & Remley, 1999). The goal of this study is to take into account not only breast fed versus formula fed, but also length of breast feeding, as it pertains to both parent and teacher assessment of cognitive development. The correlation between breastfeeding and physical development, as well as breastfeeding and adaptive behavior will also be assessed.

The research question is that "Is there a correlation between breast feeding and cognitive, adaptive behavior, and physical development in infancy?" We hypothesized that breastfeeding was expected to be associated with higher scores on cognitive, adaptive behavior, and physical assessments. Longer breastfeeding was expected to be associated with higher scores in these three areas.

Thirty children, their parents and teachers, recruited from a high-quality childcare program in Alabama participated in the study. The thirty participants range in age from zero to five years. All of the participants are white.

The study includes two questionnaires. In order to assess whether or not the participant was breast fed and the length of time the participant was breast fed, survey questions were administered to the parents every six months. The Daily Family Activity (DFA) questionnaire consists of two questions relative to breast feeding. The Developmental Profile 3 (DP3) is completed by teachers, every six months, and has five sections including physical, adaptive, social-emotional, cognitive, and communication. Teachers were asked to complete the DP3 every six months in order to assess physical, adaptive, social-emotional, cognitive, and communicative behaviors.

There is a significant positive correlation between breastfeeding and cognitive development in time two r=.365, p<.05, n=30 and time three r=0.436, p<.05, n=26. There is another significant positive correlation between breastfeeding and physical development in time two r=0.488, p<.05, n=30. There is also a significant positive correlation between breastfeeding and adaptive behavior in time four r=.713, p<.01, n=21.

Mother's breastfeeding of children predicts progression of cognitive development at twelve and eighteen months of age. No correlation was shown at later ages. Mother's breastfeeding of children predicts progression of physical development at twelve months of age. Mother's breastfeeding of children also predicts progression of adaptive development at the age of two years. This could be due in part to children's ability at two years old to express their emotions using words, as well as to complete activities such as putting on shoes or eating using silverware on their

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own. In future studies, researchers can examine effects of breastfeeding on cognitive, adaptive, and physical development in preschool children.

Katelyn Kcomt (presentation number 73)

Burnout and Empowerment among Medical Faculty, Staff, and Residents in an Academic Medical Center

Mentor: Nathan Culmer

Overview:

This study is about burnout in differing populations in an academic medical center. The effects of burnout in academic medical centers is not well understood. This study measures four distinct populations: residents, nurses, faculty, and staff. The study focuses on the relationship between empowerment and burnout. Empowerment is broken down into four subcomponents: meaning, impact, competence, self-determination. Burnout is broken down into three subcomponents: exhaustion, cynicism, professional efficacy. These subcomponents are analyzed both individually and together.

Purpose:

The purpose of this study is to identify which populations experience the highest rates of burnout and lowest rates of empowerment. It is part of a larger study that identifies the prevalence of factors associated with burnout in an academic medical center. It identifies what variables are highest in each population and what correlations are present. The objective of the larger study is to generate a holistic understanding of burnout in physicians, nurses, and other staff. It has been found that as burnout increases in healthcare providers, patient care decreases. Thus, focusing on burnout will improve overall quality of life of staff members and the overall patient experience.

Methods:

The study utilizes a survey composed of the Maslach Burnout and Psychological empowerment inventories and demographic questions. The inventories incorporated quantitative and qualitative data for holistic understanding. Approximately 225 participants were invited to take the inventory in the University Medical Center, and 128 responses were received. These responses were separated based on population - administration, resident, nurse, or faculty. The quantitative data was analyzed using statistical correlations. Qualitative data was categorized according to emergent properties and those categories were analyzed using statistical correlations.

Results:

The data analysis shows a negative correlation between burnout and empowerment across the four populations, meaning the more burned out a person is feeling, the less empowered they are. The strongest correlations across all populations are among the meaning subcomponent of empowerment and all subcomponents of burnout. The correlations among the subcomponents of empowerment and burnout were expected to vary across populations. Residents have a stronger negative correlation between meaning and cynicism. Faculty has the strongest negative correlation between the overall empowerment construct and professional efficacy. Nurses experience the strongest negative correlation with the overall empowerment construct and cynicism. Administrative staff has the strongest negative correlation between meaning and professional efficacy.

Conclusion:

This research allows for the creation and implementation of specialized interventions and the potential decrease of effects of burnout on the populations. It is now more clearly understood how those working in an academic medical center respond to stressors of their individual jobs. Generalized burnout interventions are not as effective

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because populations experience burnout in different ways. For example, residents do not experience burnout the same as nurses (see results). Interventions targeted to the needs of each population will improve both overall quality of life and patient care. This study is planning on implementing those interventions and then following up with the original survey to fully understand how the impacts of burnout can be lessened.

Nicole Conde (presentation number 74)

Mindfulness-Based Relapse Prevention for Opioid Use Disorders

Mentor: Mercy Mumba

Introduction

Every day in America 130 people die from an opioid overdose. This problem has been exacerbated by overprescribing of opioids. The opioid epidemic costs society $78.5 billion every year and is the leading cause of accidental deaths in the U.S. Therefore, finding ways to successfully treat opioid use disorders has become a national priority. One of the treatment modalities gaining much acceptance is called mindfulness- based relapse prevention. Mindfulness meditation (MM) has its roots in Eastern philosophy and has been utilized in the treatment of many conditions including, depression, anxiety, and many different types of addictive disorders.

Purpose

The purpose of this systematic literature review was to examine the effects of MBRP on opioid use disorder outcomes such as relapse and other mental health correlates such as depression, anxiety, and stress.

Methods

This is a systematic review of literature. All articles related to the research question and published between 2014 and 2019 were reviewed. Using the PRISMA method and checklist, the articles were reviewed for relevance to the research topic. Research databases used include CINAHL, PubMed, Psych Infor and Google Scholar. Key words included mindfulness medication, relapse prevention, opioid use disorder, depression, anxiety, and stress. The initial literature search yielded 40 articles. After careful consideration, 20 articles that met the inclusion criteria for the study were selected.

Results

MM involves the practice of attending to present-moment experiences in a self-directed and non-judgmental manner that promotes non-reactive affect management and self-regulation skills. This results in improved emotional regulation, increased tolerance and acceptance, improved coping, and emotional well-being. MM has been shown to reduce cravings, which are significant risk factors for relapse in many addictive disorders. Advantages of MBRP include the emphasis on approach-based goals, controlling of negative affect and craving, and recognizing underlying reasons for maladaptive behaviors. In a randomized trial comparing MBRP to usual continuing care in 168 individuals who had completed acute care treatment for SUDs, the MBRP group reported significantly fewer days of drug or alcohol use (2.1 versus 5.4 days) and significant reductions in craving in the two months following intervention. Reductions in craving partially mediated decreased substance use and the MBRP group was less likely to crave in response to depressed mood, but the MBRP impact was not explained by improvements in depression.

Conclusion

Despite all the positive outcomes associated with MBRP, several limitations have been identified. In a meta-analysis of mindfulness-based treatments for addictive disorders conducted by Garland and Howard, although

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preliminary evidence was largely positive, many of the studies evaluated had serious limitations, including small sample sizes, high attrition rates, relied extensively on self-report measures for substance abuse and other constructs, and lack of post-treatment and follow-up interviews of personal experiences with the programs. Additionally, conclusions about efficacy are difficult because of a lack of standardized outcomes for these studies and heterogeneity of interventions. Recommendations to counteract these limitations include further studies using high-quality research methods including a written treatment manual.

Abigail Boucher (presentation number 75)

A Novel Meta-Analytic Approach to Developing an Accurate Body Composition Prediction Equation Based on the Body Density

Mentor: Michael Fedewa

A Novel Meta-Analytic Approach to Developing an Accurate Body Composition Prediction Equation Based on the Body Density

A. G. Boucher, E. G. Dunbar, M. V. Fedewa

Accurate measurement of body composition is important for assessing health and disease risk and monitoring athletic performance. The Siri and Brozek equations are commonly used to derive percent body fat (%Fat) by converting measured body density (BD). PURPOSE: The purpose of this investigation was to develop a more accurate prediction equation to estimate %Fat based on aggregate level data from a combined sample of participants across a wide range of demographic characteristics using weighted meta-regression analysis. METHODS: Peer reviewed research studies presenting a measure of total body density were identified using an electronic database search and included in the current analysis. All included studies (total 15) assessed BD via hydrodensitometry or air displacement plethysmography and measured %Fat using a 4-compartment model (bone mineral content, total body water, fat, and protein). Participant age (years), race/ethnicity, sex, height (cm), weight (kg), body mass index (BMI, kg/m2) were extracted as potential moderators. RESULTS: The meta-regression analysis based on the combined sample of participants (n=958, 36.13±20.47 yrs, 164.22±10.82 cm, 68.63±10.86 kg, BMI=25.78±3.07 kg/m2, 4-C %Fat= 30.15±8.70) yielded the equation 397.618 - (357.553*BD). CONCLUSION: The revised %Fat prediction equation yielded greater accuracy than the original equation due to the larger sample size and diverse participant characteristics and is recommended for use in allied health and athletic performance settings.

Sydney Perreault (presentation number 76)

Cultural Differences in USA and Kenya Children's Anxieties as Depicted by Drawings

Mentor: Sherwood Burns-Nader

A healthcare visit, such as a hospitalization, can be an anxious experience for children; therefore, there is some research that examines children's perspectives of these visits. While verbal expression is not always utilized, drawings can aid in researcher's assessments of a child's beliefs regarding hospitalization. Previously, the idea that children experience healthcare differently depending on their culture has been explored. Using a drawing as a projective measure of their emotions, this study compares children's perspective of healthcare experiences in the United States and Kenya. Twenty-eight children, 14 from the Unites States and 14 from Kenya, were recruited during hospitalization. Of the participants, 16 were male and 12 were female, ranging in age from 5 to 12 with the mean age being 8.25. Children were asked to draw a person in the hospital and complete a demographic questionnaire. Drawings were assessed using The Child Drawing: Hospital measure, as an indicator for anxiety. The measure looks at specific variables, such as size of person in the drawing, the presence and size of hospital

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equipment, facial expression in drawing, number of colors included, and expression of eyes in the drawing, which are known to be indicative of projecting anxiety. The drawings of hospitalized children in the United States displayed significantly more anxiety than the hospitalized children in Kenya. The difference in projected anxiety was depicted in a few variables, including presence and size of hospital equipment. The present study and a review of the literature children's anxiety about hospital visits may be impacted by cultural differences.

Richard (Trip) Crowley (presentation number 77)

Rural Health Care Provider's Perspective: Implications for use of a Health Literacy Tool in Primary Care

Mentor: JoAnn Oliver

Rural Health Care Provider's Perspective Study: Implications for use of a Health Literacy Tool in Primary Care

Background: According to the U.S. Department of Health and Human Services, Health literacy is defined as "the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions". Low health literacy is associated with a variety of adverse health outcomes, including increased mortality, hospitalization, and in some cases poorer control of chronic health conditions. In the state of Alabama, 59% of adults are categorized as having low health literacy. Age, gender, race, ethnicity, education and income have all been found to impact health literacy. Some studies indicate that the negative impact of low health literacy may be magnified in the rural elderly population. The United States national health policy indicates that the annual economic impact of low health literacy is between $106 billion and $238 billion, and that patients with low health literacy are 1.5 to 3 times more likely to experience poor health outcomes. Further, studies have indicated that health care providers routinely overestimate the ability of their patients to understand the medical information. However, very few health care provider studies were found that specifically focused their use of health literacy tools and older African Americans in primary care.

Objective: Using data from the larger research study, these finding focus on how primary HCPs (physicians and nurse practitioners) practicing in rural settings and who participated in the study assessed patient health literacy, specifically among older African American patients.

Methods: An exploratory qualitative study was used by the researcher and included 12 HCPs. Face to face interviews were completed using interview guide questions. The study included participants from four (4) rural counties in Alabama.

Results: The study findings reported from a larger study, indicated that the majority of the HCP patient population were elderly - 66% of HCPs interviewed described their patient population as being over the age of 55 years old. Majority (58% of health care providers) reported their patients being mostly African Americans. Of the HCPs interviewed, 91.6% stated they did not have an official method to assess the health literacy of their patients, and half of the HCPs interviewed (6/12) stated that they gave their patients reading material as a baseline in order to determine the patient's health literacy level. As quoted by one HCP "...we don't do a formal literacy test It's just a matter of us knowing ... I mean, seeing the papers and things that they (patients) fill out."

Conclusions The study results indicate a majority of rural HCPs participating in the study did not use an evidence based tool to assess the health literacy of their patients. Knowing patient's health literacy may impact the communication strategies used by HCPs during primary care visits to improve patients' understanding of information. There is no indication that the study results reported here are generalizable to the population.

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Jessica Bentley (presentation number 78)

Sex-related Differences in Anthropometric Measures in Young Adults

Mentor: Michael Fedewa

Jessica Bentley

Claire Lewis

URCA Abstract: Sex-related Differences in Anthropometric Measures in Young Adults

The prevalence of obesity in the United States has increased dramatically in previous decades. The development of accurate, non-invasive, and cost-effective methods of body composition assessment is necessary to monitor future population trends.

Purpose: The primary aim of this study was to assess the potential sex-related differences in anthropometric measures obtained from a digital image that could be used to estimate body composition. in umbilical height ratios and shoulder height ratios between men and women using the dual x-ray absorptiometry (DEXA) scan. Previous research it was believed that men had larger umbilical and shoulder height ratios than women

Methods: Male and female participants aged 18-24 years underwent data collection that spanned up to an hour. Total height and umbilical height were measured to the nearest 0.1 cm; body mass was measured to the nearest 0.1 kg. Total height and shoulder height were assessed manually from digital images of the participant using a digital ruler tool. An independent samples T-test was used to describe the data. Additionally, data are reported as mean±standard deviation. Statistical significance was assessed using an alpha level of 0.05.

Results: For the male participants (n=5), shoulder/height ratio ranged from 0.76 to 0.86 (0.83±0.04), and umbilical/height ratio from 0.58 to 0.63, (0.60±0.02). For the female participants (n=12), shoulder/height ratio ranged from 0.83 to 0.86(0.78±0.01), and umbilical/height ratio from 0.59 to 0.63 (0.61±0.01). No differences in shoulder/height or umbilical height ratios were observed between male and female participants (both p>.05).

Conclusion: Previous research suggested that potential sex-related differences in shoulder and umbilical height ratios existed, however no significant differences were observed in this study. These results provide evidence that body dimensions can be estimated from a single 2-dimensional digital image with similar accuracy in men and women.

Limitations: This study was limited by a small sample size (n=17), and should be replicated in larger studies with more diverse participant characteristics.

Camille Howarth (presentation number 79)

Perceived vs. Actual Alcohol Use At The University Of Alabama

Mentor: Jen Nickelson

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Perceived vs. Actual use of Alcohol at The University of Alabama

Introduction: According to the American College Health Association's National College Health Assessment there is a discrepancy between the perceived and actual use of alcohol on college campuses. According to the assessment, students believed 93.2% of college students used alcohol, when the research showed 61.7% did. The National Institute of Alcohol Abuse and Alcoholism cites drinking to be traditional on college campuses, but the drinking behaviors are associated with dangerous and harmful consequences, such as academic problems, sexual assault, issues with police, and in the most extreme cases, death. The Theory of Reasoned Action is a theory that explains people are more likely to perform a behavior if they believe another person is performing that behavior. Identifying the importance of subjective norms about alcohol use among college students can be used to create an intervention aimed at changing perceptions of alcohol use through a media campaign. The purpose of this study was to identify the perceived versus actual alcohol use among college students at The University of Alabama.

Methods: Data was received through a research study performed by HHE 467 students from both sections within The College of Human Environmental Sciences. Participants were University of Alabama students that were 18 years of age and older. They took self-administered surveys (Qualtrics). They surveys were modeled after the ACHA-NCHA and enabled us to compare the UA data to the ACHA-NCHA data.

Results: A total of 234 survey responses were received. Participants consisted of 145 females and 85 males. Of those participants, 97.44% of them were current undergraduates. The mean age of participants was 20 years of age. Fifty-one percent of participants were in a social fraternity or sorority. The ACHA-NCHA data reported on average students believed that 93.2% of students drank alcohol within the last 30 days, while the UA students believed that 68% of UA students drank alcohol within the last 30 days. However, the ACHA data showed that actual use was 61.7%, while the actual use at UA was 82% in the last 30 days drank alcohol.

Discussion: Findings suggest that perceived alcohol use vs. actual alcohol use among UA's students contradicts findings from past research studies on this subject. Many students that participated in the survey reported they received information on alcohol, yet the usage at UA is much higher than the national average. Since social norms campaigns may not be beneficial in reducing alcohol usage, another intervention may be more useful such as a media campaign.

Katherine Hendry (presentation number 80)

Measured Emotional Intelligence in RN to BSN Students

Mentor: Haley Strickland

Title: Measured Emotional Intelligence in RN to BSN Students

Presenter: Katherine Hendry

Mentor: Dr. Haley Strickland

Background: Emotional intelligence (EI) is a mental ability that allows people to identify, understand, and manage the emotions of themselves and others. This ability is vital to the field of nursing.

Objective: The purpose of this study is to assess overall and branch emotional intelligence scores in RN to BSN students enrolled in a distance learning program.

Methods: A quantitative design was selected to examine overall and branch emotional intelligence scores in RN to BSN students through the delivery of the online Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). The

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recruiting sample included a convenience sample of 106 RN to BSN students enrolled in the same cohort within a distance learning program.

Results/Findings: In overall emotional intelligence, 49% of the students scored in the low range, 42% in the middle range, and 8% in the high range. In Branch 1, perceiving emotions, 29% scored in the low range, 41% in the middle range, and 20% in the high range. In Branch 2, using emotional intelligence, 36% scored in the low range, 42% in the middle range, and 23% in the high range. Branch 3, understanding emotions, was the worst performer with 74% scoring in the low range, 21% in the middle range, and 6% in the high range. Branch 4, managing emotions, was similar with 61% scoring in the low range, 32% in the middle range, and 6% in the high range.

Conclusions/Implications: Due to the significance of emotional intelligence to the nursing profession, nursing programs should integrate emotional intelligence within their curriculum to increase student nurses' emotional intelligence.

Limitations: The generalizability of this study is limited by the sample size. Future studies should include larger sample sizes from multiple sites in order to increase generalizability. Additionally, a future study is proposed to implement EI modules into the RN to BSN curriculum to assess if the EI of the students is increased.

Juliette Daniel (presentation number 81)

The Mental Health Assessment of The University of Alabama College Students

Mentor: Lori Turner

The Mental Health Assessment of The University of Alabama College Students

Juliette Daniel and Shanquita Ruffin

February 25th, 2019

Background / Problem:

Mental health affects our emotional, psychological and social well-being. It affects how we think, feel, act, handle stress, relate to others, and make choices. There is a stigma associated with seeking help for mental illnesses, symptoms and conditions. Students with poor mental health are challenged to accomplish daily tasks and cope with daily stressors. Those students may lack the desire to devote their time to participating in events on campus and could lead to isolation, depression, anxiety or even suicidal feelings. We are not always able to prevent mental health conditions or issues from arising. Nevertheless, we can take steps to protect our mental health by raising awareness of those related symptoms and by utilizing available resources to seek help.

Purpose:

The purpose of this study was to collect data from The University of Alabama students to determine what health education information they would like to receive and to assess their mental health.

Methods:

After creating a mental health survey, it was administered to 75 enrolled University of Alabama students via email, text messaging, social media, and face to face interactions.

Results:

As a result of the study, 43.2% males and 56.8% of female students responded to the survey, 82.4% stated they were white, 14.9% reported they were black or African American and 2.7% reported they were of other ethnicities. The classification of students who responded to the survey reported they were first year undergraduate (12.2%), second year undergraduate (12.2%), third year undergraduate (32.3%), fourth year undergrad (27.0%), fifth year

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undergraduate (8.1%) graduate or professional (6.8%) and other was (1.4%). Of those students 15.3% were Greek affiliated and 87.4% were not. Students described their general health as (1.4%) excellent, (42.5%) very good, (37.0%) good, (4.1%) fair, (2.7%) poor and (0.0%) reported they do not know. Students have reported receiving health education information from UA on the following topics: suicide prevention (74.3%), depression and anxiety (68.9%), how to help others in distress (54.1%), sleep difficulties (47.3%), and relationship difficulties (32.4%); In comparison, students reported wanting to receive health education information from UA on the following topics: suicide prevention (49.3%), depression and anxiety (54.1%), how to help others in distress (55.4%), sleep difficulties (52.1%), and relationship difficulties at (48.6%). The top five factors reported that affected students' academic performance include: drug use (4.1%), roommate difficulties (5.4%), sleep difficulties (17.8%), stress (35.1%) and other (4.5%).

Discussion:

In conclusion, our findings convey that majority of students at The University of Alabama suffer from stress, which affects their overall mental health and impacts their academic performance. Mental health should continue to be addressed at UA.

Tomasz Gruchala (presentation number 82)

Mental Health Consequences of Digital Media Addiction

Mentor: Alan Blum

Objective: To identify any adverse mental health consequences that arise from the use of modern digital media devices in individuals and determine potential solutions for how these issues can be addressed.

Background: Technology is ubiquitous and provides many benefits in the fields of communication, science, and entertainment. However, the rising dependence on digital media, coined digital media addiction and including cellphones, television, and social media, poses concerns to digital media users' mental health. In the past several years there has been an increase in the number of peer-reviewed articles relating technology use to increased symptoms of depression, anxiety, and poor body image. Little is being done in the fields of medicine, academia, and psychology to combat this issue, which manifests worldwide.

Methods: A search of the peer-reviewed scientific literature was conducted in order to create information resources on the mental health consequences of digital media addiction. A secondary search of articles in the lay media was also performed. In addition, interviews were conducted with individuals who are currently addressing the issue as well as University of Alabama college students selected randomly.

Results: Frequent use of digital media devices can result in greater symptoms of depression and anxiety, decreased positive mood, and decreased self-esteem in all age groups, as well as an increased likelihood of developing eating disorders in young individuals. The correlation between attention-deficit hyperactivity disorder and digital media use is still unclear.

Conclusions: A growing and alarming body of evidence suggests that digital media use is causing adverse mental health consequences in all groups and ages that use digital media. As dependence on digital media grows, these consequences are likely to intensify. More needs to be done to address the issue worldwide.

Brandon Lucas (presentation number 83)

Enhancing Brain Segmentation Quality: Application in Aging and Alzheimer's Disease Risk

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Mentor: Ian McDonough

The exponential rise in freely available MRI data necessitates efficient methods for analyzing brain data. Tools aimed at increasing visualization and interpretation capabilities of brain

data from large datasets play a vital role in increasing the quality and reliability of neuroscience research. Mindcontrol is an open-source web application that has tools for brain tissue classification quality control by plotting histograms to detect outliers. However, relying solely on sample distributions to detect outliers runs the risk that some people with very small or very large brain structures might be categorized as an outlier, when they really just have a very small or large brain, especially in the case of aging and Alzheimer's Disease (AD), both of which are characterized by shrinking brains. One way to solve this issue is by comparing one hemisphere of brain data against the other. The logic is that if a person has a shrinking brain, both hemispheres should be relatively small, but a large deviation in hemisphere size might be indicative of processing errors. Thus, a bilateral view of selected brain regions can help accelerate the detection of outliers that may be related to AD or other neurodegenerative diseases. We developed a scatterplot feature addition to Mindcontrol that addresses this issue by allowing users to view both hemispheres of the selected brain region simultaneously and in relation to an identity line that would indicate perfect symmetry. The aim of this project is to develop and refine tools that will be utilized in the advancement of the study of neuroscience research as applied to risk factors for AD.

Gracie Trulove (presentation number 84)

DIFFERENCES IN TEMPORAL MEASURES OF INFANT SWALLOW FUNCTION

Mentor: Memorie Gosa

DIFFERENCES IN TEMPORAL MEASURES OF INFANT SWALLOW FUNCTION

Bailee Gist, Gracie Trulove, & Memorie M. Gosa

The University of Alabama, Tuscaloosa, Alabama, USA

Purpose: To document both the oral and pharyngeal components of infant swallows of thin liquid and to compare the differences in temporal measures of safe and unsafe infant swallows.

Background:

Swallowing is a key function in acquiring primary nutrition. The skill emerges as a reflex in early infancy, allowing for the attainment of proper nutrition necessary for growth and development. Likewise, infants consume all calories in the liquid form, allowing them to more readily experience laryngeal penetration and/or aspiration during a swallow. Most infants that present with dysphagia produce swallow sequences that include swallows with varying degrees of laryngeal penetration and aspiration. Videofluoroscopic swallow studies have been used in the clinical setting in order to better evaluate the oral and pharyngeal components of the infant swallow. This clinical method has been used to determine temporal measures of the swallow and to assign Penetration-Aspiration Scale Scores.

Methods:

A secondary analysis of an existing dataset of videofluoroscopic swallow studies from the project entitled "Determining the Effective Frame Rate of Accurate Interpretation of Infant Feeding Studies" was conducted using deidentified footage from a sample of twenty infants with known dysphagia. During the initial project, it became apparent that unsafe swallows (those that result in aspiration) co-occur with safe swallows during continuous swallowing sequences in infant populations. Temporal input of measures and Penetration/Aspiration Scale Scores

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for 2 swallows per infant were taken and recorded using X-keys. Penetration/Aspiration Scale Scores of 1 (no airway compromise) or 2 (shallow laryngeal penetration that clears the larynx after swallow) were categorized as a safe swallow, while those ranging from 3 to 8 (aspiration with no cough or attempt to clear aspirated material) were categorized as an unsafe swallow. The temporal input data was then entered into Excel for calculation of the temporal measures. Data was then tested for reliability. Data from each of the 2 swallows per infant was then input into SPSS to run a nonparametric statistical analysis regarding the differences in temporal measures between safe and unsafe swallows in the continuous infant swallow sequence.

Results:

A nonparametric statistical analysis was run in order to assess significant differences in temporal measures between safe swallows (Pen/Asp scores 1-2) and unsafe swallows (Pen/Asp scores 3-8). In the preliminary results, fifteen of the total sample of twenty infants were included. Preliminary findings indicate that ten of fifteen infants show clinically significant differences in Penetration/Aspiration Scale Scores between their two swallows. These ten were then included in the preliminary statistical analysis. Preliminary analysis indicates significant difference between Oral Transit. Oral Transit Times of Swallow 1 (less impairment) were faster (M = 0.136 seconds) than Swallow 2 (more impairment) (M = 0.313 seconds).

Limitations:

This project is limited by a conservative sample size (N = 20). Recruitment has ceased as this is a secondary analysis of an existing dataset.

Conclusion:

There is a significant difference between the Oral Transit Times of safe swallows (Swallow 1, less impairment) and unsafe swallows (Swallow 2, more impairment). This indicates that penetration and aspiration may share a common cause as temporal variances in the oral cavity or may originate in the oral cavity.

Sydney Miles (presentation number 85)

Adipose Tissue Development of Neonatal and Weanling Rats in Response to Maternal High Fat Diet Supplemented with Lycopene

Mentor: Libo Tan

Adipose Tissue Development of Neonatal and Weanling Rats in Response to a Maternal High Fat Diet Supplemented with Lycopene

Sydney Milesa, Katelyn Senkusb, Shu Kwanb, Dr. Kristi Crowe-Whiteb, Dr. Libo Tanb

Department of Biology, University of Alabama

Department of Human Nutrition, University of Alabama

Faculty Mentors: Dr. Libo Tan, Dr. Kristi Crowe-White

Background and Objectives: According to the CDC, 18.4% of children and 39.8% of adults in the U.S. are obese, with obesity-related diseases such as cardiovascular disease and diabetes leading the list of preventable causes of death. As such, research exploring the relationship between diet composition and obesity from conception until adulthood is of great importance to improving public health. Lycopene, a potent antioxidant in the carotenoid family, is one dietary component which may play a regulatory role in adipose tissue hypertrophy and hyperplasia. Lycopene has high free radical scavenging potential, resulting in reduction of obesity-related inflammation and

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obesity-induced oxidative stress. Prior research has supported this relationship between lycopene and obesity but hasn't examined the result of lycopene supplementation in early stages of organismal development. Thus, the purpose of this study is to investigate effects of dietary lycopene supplementation during the lactation and post-weaning periods on adipose tissue development in neonatal rats.

Methods: Three Sprague-Dawley rats arrive on their second day of gestation. After three days of acclimation, mothers are randomly assigned to two groups: a 25% normal fat diet (NFD) group (n=1) and 50% high fat diet (50% fat diet) group (n=2). After delivery, the pups are redistributed among mothers of the same diet group such that each mother has an equal number of pups and to control for differences that may have presented in mothers' metabolisms during pregnancy. One of the HFD mothers was transitioned to a HFD supplemented with 1% lycopene. Four pups/litter were euthanized at postnatal days 14 and 25 (P14 and P25) with body weight (BW) as well as the mass of visceral white adipose tissue (WAT) and brown adipose tissue (BAT) recorded. At P25, the remaining weanling pups (3 pups/litter) were fed the diets of their individual mothers until euthanizing at postnatal week 5 (P35).

Results: The HFD effectively induced weight gain as evidenced by increases in BW and WAT in the HFD group not receiving lycopene supplementation compared to pups from the NFD litter across all time points. In the HFD group, lycopene-supplemented pups euthanized on P14 and P25 demonstrated a significantly (P<0.05) smaller amount of WAT. In addition, lycopene supplemented pups of the HFD group euthanized on P25 showed a significantly larger BAT amount. Albeit non-significant, BW and WAT in the lycopene-supplemented HFD group remained lower while BAT remained higher through P35.

Conclusions: Results indicate that dietary lycopene supplementation during the suckling and post-weaning period may have a regulatory role in adipose tissue development in the early life stage, as evidenced by the lower WAT mass and higher BAT mass in lycopene supplemented rats. Additional research is warranted to determine diet-induced signaling pathways by which lycopene may influence adipocyte differentiation.

Samatha Johns (presentation number 86)

Parental Involvement in Adolescent Health Literacy

Mentor: Nathan Culmer

Background

Asthma rates are higher in children in Alabama than the national average (Zahran et al., 2018) and school-aged children with asthma face difficulty in understanding health material (Forbis & Aligne 2002). Increased cost, decreased health outcomes, and decreased academic outcomes result from this (Sullivan et al., 2017; Moonie et al., 2008). Educational programs for asthma demonstrate symptom improvement (McGhan et al., 2010) and knowledge retention (Horner & Fouladi, 2008). However, removing a child from school is disruptive, and some may not be able to obtain transportation. Providing remotely administered telemedical asthma education modules can increase students' health access (Bergman et al., 2007). Telemedical communication of asthma management is equally as beneficial as face-to-face interactions (Kayleigh & Cates, 2016), and school-based asthma education has proven to be effective (Mickel et al., 2017). Parental involvement can also increase quality of life for asthmatic children (Hussain-Rizvi et al., 2009). This study further examines the relationship between student asthma knowledge, asthma symptoms, and parental involvement. Specifically, we ask does parental involvement influence asthmatic students' ability to retain information about their condition, and how does parental involvement influence asthmatic elementary students' self-reported symptom improvement?

Methods

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Asthmatic adolescents from Tuscaloosa county elementary schools were identified and their parents were consulted for consent. Children participated in a series of four tele-educational sessions delivered by a pediatrician on how to manage their asthma. Each participant took a pretest and posttest to gauge the effectiveness of knowledge transfer and to determine whether or not there was symptom improvement. Parents of the children were called and asked to orally complete a survey on their child's asthma symptoms. Willingness to participate in this survey serves as the indication of parental involvement, and we hypothesized that the presence of parental involvement would result in an increased student knowledge of their condition, illustrated by strong improvement in their test scores, as well as bettered asthmatic symptoms, shown by the self-reported symptom severity ranking.

Results

The pretest and post-test scores along with the participation of parents who completed the survey will be compared and analyzed. Through the use of an ANOVA test, the significance of parental involvement upon student knowledge obtainment and symptomatic improvement can be determined.

Conclusion

A significance score below 0.05 will propose that the data is significant, and that there is a relationship between parental involvement and children's knowledge retainment and asthma symptom severity. This would indicate that similarly to classroom education, health literacy increases among adolescents as parents become more involved. A significance score above 0.05 will suggest that there is no significant relationship. A lack of significant findings of parental involvement may indicate that parental involvement may not affect asthma knowledge and symptoms in elementary students despite evidence from other studies have shown with young children (Hussain-Rizvi et al., 2009). From these results we can begin to formulate future analysis such as why was or wasn't there significance? Or, can parental involvement be further divided to determine what levels of involvement relate to score improvement?

Elisabeth Dunbar (presentation number 87)

Four-Compartment Models of Body Composition Analysis: A Meta-Analytic Approach to Developing Race and Sex-Specific Methods

Mentor: Michael Fedewa

Four-Compartment Models of Body Composition Analysis: A Meta-Analytic Approach to Developing Race and Sex-Specific Methods

Elisabeth G. Dunbar, Michael V. Fedewa Ph.D., Abigail G. Boucher. Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, USA 35487

The Body Fat Percentage (BFP) of an individual is used as a measure of adiposity without regard to height or weight, and is an important indicator of health and athletic performance. A human's body composition, as well as BFP, can be measured by assessing his or her Body Density (BD). This method is sustainable for calculating body fat, but does not accurately represent total body density, as bones and muscle tissues have different densities than fat. The Brozek equation, developed in 1993, was created to factor in the difference between the density of Fat and of Fat-Free tissues in a 2-Compartment Model. The original Brozek equation is The Brozek study was formulated several decades ago, and contained a small sample of participants.

Purpose: The primary aim of this study was to create a more robust prediction equation based on aggregate level data collected from participants across a wide range of demographic characteristics using meta regression analysis of pooled data. While Brozek used a 2-Compartment Model, our analysis assessed data from a 4-Compartment model, which divides weight into subcategories including fat mass, total body water, fat-free mass, and bone

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mineral mass. By compiling the data of multiple studies, an increased number of participants will allow for an equation to be formulated that encompasses a greater population of individuals.

Methods: A systematic literature review was conducted to create a comprehensive summary of previous research articles and data was collected from each sample to create an integrated sample total based on several studies. A statistical analysis of the new compiled data yielded a new equation representing several participants of different nationalities and physical activity levels. Peer reviewed research studies presenting a measure of total body density were identified using an electronic database search (Web of Science, Scopus, PubMed) and were included in the current analysis. All included studies assessed BD via hydro-densitometry or air displacement plethysmography, and measured %Fat using a 4C model. Participant age (years), race/ethnicity, sex, height (cm), weight (kg), body mass index (BMI, kg/m2) were extracted as potential moderators.

Results: The data from 9 different studies published between 1998 and 2009 yielded the following data. Anthropometric measurements were taken from 205 participants. About half of the participants were female. The sample averages included N=25.62±23.81, age=24.10±4.39 years (younger adults), height=174.6±5.99 cm, weight=70.28±11.01 kg (normal weight), BMI= 24.44±0.975 kg/m2, BD=1.046±0.027g/cm3, and Fat Mean=5.50±5.77g. The weighted meta-regression analysis yielded the equation

Conclusion: Our results yielded a more accurate equation based on diverse body compositions and participant demographics, including a greater portion of the population than the original Brozek Equation. This study is important in progressing towards a more accurate method to assess body composition, and the larger sample size proportionally increases our confidence level.

Hannah Meyer (presentation number 88)

A Systematic Literature Review of Ambulance-Based Telemedicine

Mentor: Nathan Culmer

Objective: To critically apprise evidence from the literature related to the costs, quality, and satisfaction of in-ambulance telemedicine initiatives, as well as the feasibility of in-ambulance telemedicine initiatives, we conducted a systematic review where we analyzed data from relevant articles and summarized the findings on telemedicine.

Background: Research on in-ambulance telemedical care, which uses telecommunications to provide pre-hospital medical care and transmit clinical information from patient to physician (typically located in a hospital emergency department), is relatively sparse. We initiated this systematic review in order to move this field of research forward and to understand potential benefits of telemedicine in prehospital care in terms of cost, quality, and satisfaction with care. We anticipate that the process of a systematic review will equip us for a stronger understanding of the field and assist us in implementation.

Methodology: Before beginning a systematic review, researchers must devise a clear research question to guide their study. The three main aspects of a systematic review include a literature search, reviewing the abstracts, and evaluating relevant articles to write up the publication. We used the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool to enable standardized measures of precision and quality in methodology (Jackson, 2005; Thomas, 2004; Deeks, 2003). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for searching, inclusion, and exclusion criteria (Moher, 2015; Moher, 2009). We blindly reviewed 1,564 abstracts and found 13 met our inclusion criteria. Finally, we analyzed data findings among the remaining articles and then summarized our findings.

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Discussion: Systematic reviews provide a broad understanding of a specific line of research, data, and concluding evidence for a specific question that is not yet fully understood. As such, they provide opportunities for growth. Cost-wise, two of the thirteen articles (Cabrera, 2002; Langabeer, 2017) discovered telemedicine decreases cost for both patients and healthcare providers, indicating an advantage with telemedicine-based ambulance care over traditional care. The remaining articles did not discuss cost in their findings. Regarding satisfaction, seven articles (Cabrera, 2002, Langabeer, 2016; Bergrath, 2013; Yperzeele, 2014; Pavlopoulos, 1998; Bergrath, 2011; Buscher, 2014) focused on patient views while others focused on caregiver views. Both demonstrate a uniform method of measuring satisfaction must be implemented to standardize future comparisons. With quality, eleven articles (Cabrera, 2002, Langabeer, 2016; Bergrath, 2013; Yperzeele, 2014; Bergrath, 2011; Buscher, 2014; Brokmann, 2016; Kwak, 2009; Felzen, 2017; Cho, 2015; Curry, 1998) discovered that telemedicine-based care allows for similar or better care than traditional means. Two of the thirteen articles (Langabeer, 2017; Pavlopoulos, 1998) did not report on quality of care outcomes.

Conclusion: Systematic reviews summarize current research data in order to answer research questions accurately, allowing researchers to gain better understandings of the feasibility of their research as well as giving background knowledge. We determined that telemedicine has the potential to increase quality and satisfaction of care while decreasing costs, though more research of in-hospital telemedical care is warranted in order to fully understand the feasibility and benefits of in-ambulance healthcare.

Erica Martin (presentation number 89)

The Effects of High Volume Barbell Squatting on Quadricep and Hamstring Strength

Mentor: Michael Esco

Anterior cruciate ligament (ACL) injuries are the fifth most common injury among athletes with approximately 150,000 ACL injuries occurring in the United States every year. An ACL injury can occur if the hamstring and quadricep muscles surrounding the knee are not equal in strength. Although it is difficult to generalize due to individualization, the normal hamstring to quadricep (H:Q) ratio is considered to be 50% to 80%. As the ratio approaches 100% (1:1), the hamstrings have an increased functional capacity for providing stability to the knee and a decreased risk for injury. A significantly less balanced ratio could be an indicator for future injuries. The decline in hamstring and quadricep muscle strength after a fatiguing lower body workout could cause an unbalanced H:Q ratio. Purpose: The purpose of this study was to analyze the strength changes in the hamstring and quadricep muscles over the course of 72 hours after a fatiguing back squat protocol. Methods: Twelve asymptomatic, trained individuals participated in this study. Each participant entered the laboratory on five separate occasions, four of those days occurring consecutively in this repeated measure design. Session one was used to assess one rep max (1RM) on the back squat, as well as to familiarize the subjects with testing modalities they would be performing in subsequent sessions. Following at least 72 hours of recovery, subjects returned to the laboratory to complete baseline (BL) testing. Participants performed three isokinetic leg extensions and flexions at 180 degrees/second. Following the testing sequence, participants completed a fatiguing back protocol consisting of 8 sets of 10 at 70% of their previously established 1RM. Participants then returned to the laboratory 24, 48, 72 hours after the baseline testing session to complete three isokinetic leg extensions and flexions. The average peak torque for both flexion (i.e., hamstring strength) and extension (i.e., quadricep strength) values were calculated for each day to be used in subsequent statistical analyses. Results: A repeated measures ANOVA revealed a significant effect of time on peak torque during leg extension (p = .004) where peak torque was significantly lower than baseline at 24, 48, 72 hours (p < .05). There was no significant effect of time on peak torque during leg flexion (p = .832). Lastly, there was a significant effect of time on H:Q ratio (p = .001) with peak torque significantly decreasing from the baseline assessment and remaining depressed during the 24, 48, and 72 hour conditions (p < .05). Conclusion: The results of this study suggest high volume squatting significantly decreases quadricep strength but has no effect on hamstring strength. Additionally, the decrement in quadricep strength without a concomitant decrease in hamstring strength significantly decreases the H:Q ratio. This could suggest there is an

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increased risk of an ACL injury after a high-volume squatting protocol in individuals with a fairly balanced H:Q ratio prior to performing a squatting protocol. Therefore, athletes should allow an adequate recovery time (i.e., <72 hours) between strength training and competitive play to decrease the risk of an ACL injury.

Sarah Burnash (presentation number 90)

Sex Differences in Cardiovascular Drift and Maximal Oxygen Uptake During Heat Stress

Mentor: Dr. Jonathan Wingo

Sex differences in cardiovascular drift and maximal oxygen uptake during heat stress

S. Burnash, T.M. Stone, J.E. Wingo

Department of Kinesiology, University of Alabama, Tuscaloosa, AL 35487

Cardiovascular (CV) drift-a progressive increase in heart rate (HR) and decrease in stroke volume (SV)-occurs during constant rate aerobic exercise in the heat and is related to reduced maximal oxygen uptake ( O2max). V̇Hyperthermia [i.e., high core body temperature (Tc)] results in the greatest magnitude of CV drift and corresponding decrement in O2max. During exercise at elevated rates of metabolic heat production, women V̇have a lower sweat production and evaporative heat loss than men, which could result in greater levels of hyperthermia and thereby magnitude of CV drift and decrement in O2max, but this has not been tested. V̇PURPOSE: To test the hypothesis that women will experience a greater magnitude of CV drift and accompanying decrement in O2max than men during exercise performed at a rate of metabolic heat production known to resultV̇ in sudomotor sex differences. METHODS: Men (n = 7) and women (n = 7) completed a total of 3 trials performed on separate days. The first trial (control) was a graded exercise test (GXT) performed on a stationary cycle ergometer to determine O2max in a temperate environment [22 °C, 40% relative humidity (RH)]. For the V̇remaining 2 experimental trials, subjects cycled for 15 min or 45 min at a rate of metabolic heat production equal to 500 W in a hot environment (35 °C, 40% RH), then immediately completed a GXT to measure O2max. The V̇purpose of the separate 15- and 45-min trials was to measure O2max during the same time interval that CV drift V̇occurred. PRELIMINARY RESULTS: Core temperature (Tc) rose more between 15 and 45 min in women (0.90 °C) compared to men (0.73 °C), but these differences were not statistically significant (P = 0.21 for interaction effect). As expected, HR increased (11%) and SV decreased (12%) over time (P < 0.05), but groups were not different (P > 0.05 for interaction effects). O2max decreased over time as well (12%), but since the magnitude of CV drift was V̇similar between sexes, the magnitude of decrease in O2max was not different between men and women (P > V̇0.05 for interaction). CONCLUSION: Although slightly greater in women, the change in Tc was not significantly different from men, which likely explains why CV drift during 45 min of submaximal cycling in the heat was not differentially affected, thereby resulting in proportional decrements in O2max for both groups. Tc began to V̇plateau at ~35 min of exercise in men but continued to rise in women, which provides further evidence that women reach a sudomotor threshold at high requirements for heat loss. If exercise had been protracted, perhaps greater differences in Tc between sexes would have resulted in greater CV drift and accompanying decrements in

O2max. V̇Melissa Sharpe (presentation number 91)

Examining Opioid Use and Socioeconomic Disparity Among College Students

Mentor: Michael Fedewa

The opioid epidemic has been sweeping the nation over the past decade taking over 130 lives every day. As rural, urban, and suburban families in the east coast are suffer from the epidemic, it is imperative to understand the demographics of users and those who misuse opioids during their youth. Students between the ages of 18 to 24

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years old enrolled at UA during the fall semester of 2018 were contacted via their student email accounts through a list serve provided by the University Registrar's Office. Participants were asked to self-report their home zip-code of their permanent address, substance use and misuse, as well as demographic characteristics. The Townsend Index of Material Deprivation (Household Renter Status, Car Ownership, Household Overcrowding, and Median Home Cost) was used to assess the socioeconomic characteristics of the student's geographic region of residence based on data collected from the 2017 American Community Survey. A random sample of participants were selected from the original 2,345 respondents, representing a subset equal to 10% of the original sample. The results revealed opioid use was weakly correlated with Marijuana and Binge Drinking frequency (r=.238 and .184, both p<.01). The Socioeconomic status was not associated with Opioid use, Marijuana use, or Binge Drinking frequency within the current sample (r=.007, .026, -.063, all p>.05).