• C.H.A.R.I.S: A Pilot Study Exploring the Potential Effectiveness of an Intrapersonal Forgiveness Model that Utilizes Spiritual and Psychological Perspectives in a Group Process at Redemptive Life Christian Fellowship

      Peabody Smith, Jaye; McAfee School of Theology
      Six African American women from Redemptive Life Christian Fellowship engaged in a six-week psychoeducational group process to overcome their barriers to forgiveness. The curriculum used was called “The CHARIS Model.” This is a pilot study of the CHARIS Model, a uniquely developed psychoeducational group curriculum that addresses spiritual and psychological aspects of interpersonal forgiveness. This pilot study seeks to explore the potential effectiveness of the CHARIS curriculum in the process of interpersonal forgiveness. The study is a mixed-methods approach, quasi-experimental, pre-post test non-comparative pilot study. The study examined the effectiveness of the intervention on the process of inter-personal forgiveness using the General Measure of Forgiveness (GMF) assessment tool (Law, 2008). Qualitative questions were answered by the participants at the end of each weekly group meeting to acquire participants' views of the CHARIS curriculum and the study. The study shows the promising effectiveness of the CHARIS Model. Participants overcame barriers to forgiveness as indicated in the pre and post-assessment of the General Measure of Forgiveness. The group process, in a church setting, provided a community for the participants. Bridging together spiritual and psychological approaches significantly enhanced the forgiveness process.
    • Caregivers' Perceptions Of Transition Of A Family Member From Acute Care To Hospice Inpatient Care / By Sandra Elaine Monk.

      Monk, Sandra Elaine
      Sandra Elaine Monk Caregivers' perceptions of transition of a family member from acute care to inpatient hospice care Under the direction of Laura P. Kimble, PhD, RN, FAAN Transition at end of life has the potential for fragmenting the delivery of health services and becoming a burden for patients and families according to the Institute of Medicine (2014). In spite of the family caregiver’s essential involvement in caring for a family member at end of life, less recognition has been placed on the emotional needs of the family caregiver (Harrington, Mitchell, Jones, Swettenham, & Currow, 2012). The purpose of this study was to explore the lived experience of caregivers during the transition of a family member from an acute care to hospice inpatient care. The study addressed the following research questions: “What are the lived experiences of caregivers during the transition of a family member from an acute care setting to a hospice inpatient setting?�? and, “What experience mattered most to family caregivers during this transition?�? Subjective experiences of the caregivers were described by the researcher with a focus on transition according to Meleis’ (2010) theory of transitions and a conceptualization of patient-and family-centered care in hospice and palliative nursing. Giorgi’s (2009) procedural method of descriptive phenomenology was utilized to analyze data and to develop a structure of the experiences of caregivers in the transition of a family member from acute care to hospice inpatient care. Study participants included 13 caregivers with a mean age of 55.2 (S.D. 12.6) years. Of those participating in the study, 77% were female. Participants completed qualitative, semi-structured interviews in a hospice inpatient setting. Seven interrelated constituent parts evolved from descriptive phenomenological data analysis to form the structure of a description of the phenomenon. Constituent parts and variations of the structure for caregivers’ experiences during transition of their family member at end of life included: Context, Caregiving, Chaos, Communication, Candor, Communication, Comfort, and Confidence. Findings of the study suggested caregivers gained confidence when shared goals for patient comfort were met through communication and assistance with navigation. Caregiver assessment and anticipatory planning earlier in the process, informed by caregivers’ experiences for evidence-based interventions, could help ease burden, and support a partnership during transition from acute care to hospice inpatient care.
    • CELLULAR EFFECTS OF MERCURY EXPOSURE IN PROXIMAL TUBULAR CELLS

      Lotwala, Purva; School of Medicine
      Mercury (Hg) is a lethal and persistent contaminant that does not decompose readily in the environment. Hg, as a pollutant, is distributed globally because of its volatile nature and its ability to convert between chemical forms. Humans are exposed to various forms of Hg by ingestion, inhalation, and dermal absorption. Inorganic forms of Hg accumulate readily in the kidney and can cause significant cellular injury. The purpose of this study was to test the hypothesis that Hg has detrimental effects on cellular components and processes such as protein folding, calcium homeostasis, mitochondrial activity, and junctional complexes. To test our hypothesis, cultured proximal tubular cells (TH1 cells) were exposed to different concentrations of mercuric chloride (HgCl2), and various assays were performed to assess different cellular parameters. A 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay was utilized to identify the specific concentrations of Hg that lead to decreases in cellular viability. Quantitative Polymerase Chain Reaction (qPCR) was used to analyze the mRNA expression of B-cell lymphoma 2 (Bcl-2) and caspase 9 to determine if Hg induces apoptosis in exposed cells. Alterations in cell permeability were detected by measuring the passage of various dextran (4kD, 10kD, and 20kD) across a cell monolayer and immunocytochemistry was used to visualize changes in occludin. In addition, the ability of two antioxidant compounds, α-lipoic acid, and oxo thiazolidine-4-carboxylic acid (OTC), to prevent Hg-induced cellular alterations was also measured. The findings from this study indicate that exposure to inorganic forms of Hg has significant effects on numerous intracellular processes, which leads to cell intoxication and death. Although additional studies are necessary for a complete understanding of the effects of Hg on cellular processes, the current data are an important start to this process.
    • CEREBROVASCULAR COMPLICATIONS OF SARS-CoV-2 IN TYPE-2 DIABETES

      Burnett, Faith; School of Medicine
      Diabetics are more vulnerable to SARS-CoV-2 cerebrovascular complications, including brain fog, cognitive impairment, and strokes. This study aims to identify the molecular mechanisms of SARS-CoV-2-induced cerebrovascular dysfunction in diabetics. We hypothesize that SARS-CoV-2 exacerbates diabetes-induced cerebral oxidative stress and inflammation via activation of the destructive arm of the renin-angiotensin system (RAAS) and toll-like receptor (TLR) signaling. Methods: SARS-CoV-2 spike protein interacts with human ACE2 receptors but not murine Ace2. Therefore, type-two diabetes was induced in humanized ACE2 (hACE2) transgenic knock-in mice using low-dose streptozotocin followed by eight weeks of a high-fat diet. Recombinant SARS-CoV-2 spike protein was injected intravenously in control and diabetic mice. Cognitive functions were tested using Y-maze and Barnes maze. Cerebral blood flow was measured using laser speckle imaging. RAAS system and TLR signaling were assessed using RT-PCR and western blot analysis. The cerebrovascular architecture was measured using immunohistochemistry. Human brain microvascular endothelial cells were treated with hyperglycemia (25 mM glucose) to mimic diabetic conditions. Results: Spike protein exacerbated diabetes-induced cerebrovascular oxidative stress and inflammation as detected by increased (NOX1, NOX5) and (Il-6, Il-1β, and TNF-α) gene expression, respectively. Spike protein enhanced the destructive RAAS arm (angiotensin ll and AT1R) at the expense of the RAAS protective arm (ACE2 and AT2R) gene expression (P<0.05). In parallel, spike-protein exacerbated TLR signaling in diabetes as indicated by the increase in TLR-8 receptor and its ligands (HMGB1 and S100) and downstream adaptor proteins (MyD88, TRAF6, and NF-κB) expression (P<0.05). Spike-protein increased cerebrovascular rarefaction and decreased blood flow and cognitive functions in diabetes compared to control (P<0.05). Conclusion: SAR-CoV-2 spike protein intensified RAAS and TLR signaling in diabetes, increasing cerebrovascular damage and cognitive dysfunction. Targeting RAAS and TLR singling are possible therapeutic strategies to protect against SAR-COV-2-induced cerebrovascular dysfunction in diabetes.
    • Change Agents' Theoretical Beliefs About Change: The Systematic Development And Validation Of A Scale Using Van De Ven And Poole's Typology Of Change Theories

      Bryant, Peter Joseph
      The purpose of this research was to develop a valid and reliable scale to measure higher education change agents’ implicit theoretical beliefs about organizational change. This is important in light of prior research that indicates that implicit theoretical beliefs of change agents in higher education may negatively affect the outcomes of change efforts. The only way to gain an in-depth understanding of beliefs is to assess them through valid and reliable measurement. This study fills an important gap in the empirical research literature on organizational change in higher education. It does this by taking a first step in the development of a reliable and valid scale to measure higher education change agents’ implicit theoretical beliefs about change in terms of a theoretical framework that is applicable to both higher education and organizational studies in general. The Implicit Theoretical Beliefs about Organizational Change (ITBOC) scale was developed using Spector’s (1992) well-tested method. The scale measures theoretical beliefs about change along four dimensions: life cycle organizational change beliefs, teleological organizational change beliefs, dialectical organizational change beliefs, and evolutionary organizational change beliefs. The scale construct is based on Van de Ven and Poole’s (1995) empirically based framework for classifying organizational change theories. A principal component analysis of the final scale clearly shows alignment with the four dimensions of the scale construct. The final 15-item scale has a reliability of Cronbach α = .89. Induvial subscale reliabilities are life cycle change α = .94, teleological change α = .94, dialectical change α = .86, and evolutionary change α = .77. Practitioners should consider which theoretical viewpoint they are taking for a change effort to maximize outcomes. They should also seriously consider the selection of the type of change process for a particular change effort. Further research opportunities lie in replication and enhancement of this study. Researchers should pay attention to differing implicit theoretical points of view in organizational research because they may impact the outcomes of research programs. Exploratory studies of differing implicit theoretical points of view are also recommended.
    • Characterization of Attenuated HSV-2 Mutants as Potential Vaccine Candidates Against Genital Herpes

      Garza, Bret Kevin; School of Medicine
      A prophylactic and therapeutic vaccine against herpes simplex virus type 2 (HSV-2) infection is necessary to reduce the global disease burden of HSV-2 diseases. Subunit, single-cycle, and DNA vaccines have been studied in pre-clinical and clinical trials but have not been approved mostly due to lack of sufficient efficacy. Using targeted mutagenesis, a live, attenuated HSV-2 could be a likely candidate for a protective vaccine. In this study, we constructed and characterized two novel HSV-2 mutant strains, TKBAC /∆UL24 and TKBAC /∆UL39, that have loss-of-function in genes that are associated with viral pathogenesis. Bacterial artificial chromosome (BAC) technology and recombineering were used for construction of these strains and their revertants, TKBAC /UL24R and TKBAC /UL39R. ∆UL24 and ∆UL39 have internal deletions and TKBAC (the parent virus) has an insertion within the viral thymidine kinase gene consisting of the 7.5 kb BAC sequence. Sequencing of ∆UL24 and ∆UL39 confirmed the expected deletions with the HSV-2 UL24 and UL39 genes while the flanking regions remained intact. BAC DNAs were digested with select restriction endonucleases and fractionated by agarose gel electrophoresis. All constructs showed a similar digestion pattern compared to the parent strain, TKBAC, suggesting the mutant genomes were stable. Mutagenized BACS were used to create infectious virus stocks after transfection into Vero cells. We demonstrated that TKBAC /∆UL24 and TKBAC /∆UL39 were replication-competent in Vero cells. An HSV-2 UL24 mutant was shown to be a potential attenuated vaccine candidate in previous studies. The double mutant containing disruption of the TK gene would provide for an even safer attenuated vaccine candidate that would be less like to reactivate from latency and cause disease. Replication characteristics including a reduction in plaque size for TKBAC /∆UL39 suggested that this virus was crippled in vitro, while TKBAC /∆UL24 demonstrated similar replication characteristics to the parent strain. In vitro plaque reduction assays and viral yield assays against acyclovir suggest that TKBAC /∆UL39 is more sensitive to acyclovir compared to the parent strain, based on a lower IC50. Based on previous studies with individual TK or UL39 mutants, the double mutant should be even more deficient in the establishment of and reactivation from latency. Based on these results, TKBAC /∆UL24 and TKBAC /∆UL39 should be considered for further preclinical evaluation (in animal models) as viable candidates for a protective, safe prophylactic and therapeutic vaccine.
    • Checking The Pulse On Cultural Competence And Bias Literacy In Medical Education

      Gilliard, Veronica Giovanni
      Although medical schools often require diversity training, research indicates individuals from racial and ethnic minorities and those from low socioeconomic backgrounds are adversely impacted by the lower quality of healthcare they sometimes receive from physicians due in part to stereotypes, negative predispositions, and bias. Understanding if and how faculty members are teaching medical students to identify and mitigate their own implicit biases within clinical encounters may reduce current nationwide healthcare disparities for stigmatized groups. This study involved an online mixed methods questionnaire of faculty members at twenty-seven LCME-accredited medical schools in the Southeastern United States. The purpose of this study was to: 1) understand if medical school faculty members, course directors, clerkship directors, and program directors equally integrate cultural competence and bias literacy learning objectives in their respective roles; and 2) understand how medical school faculty members, course directors, clerkship directors, and program directors are integrating learning objectives related to cultural competence and bias literacy in their respective roles. The results of this study indicated medical school faculty members, course directors, clerkship directors, and program directors equally integrated learning objectives regarding health disparities, community strategies, bias/stereotyping, and self-reflection on the culture of medicine; however, integration of learning objectives regarding communication skills specific to cross-cultural communication and use of interpreters were statistically significant. Five participants cited neutral or negative perceptions of cultural competence education as a tool to equip future physicians to address disparities in healthcare and 95% of participants described perceived benefits including: 1) increased self-awareness, 2) increased understanding of the social and historical nature of health disparities, 3) error reduction and improved outcomes, 4) competent and holistic care, 5) specialized care, 6) cultural sensitivity, 7) established trust, and 8) mutual respect. Informal and formal interventions used to integrate cultural competence were reported across institutional curricula. Faculty members self-reported specific curricular interventions, role modeling, critical appraisal of literature, explication of social barriers, and experiential learning within impacted communities to address disparities in healthcare in their respective roles. These findings necessitate standardization within medical education regarding learning objectives related to communication skills specific to cross cultural communication and use of interpreters.
    • Choke Inductors in RF Phantom Circuit

      Radi, Amjad; School of Engineering
      This research work provides examples of how different inductors can be used for RF isolation in a range of circuits from relatively narrow band applications like portable devices up to broadband networks for data distribution. The different types of inductors used in these applications are identified and discussed. As an RF circuit designer choosing RF inductor choke might become a challenge, as this inductor is critical to get the desired signal from the antenna to get received to get processed and deny the undesired one from passing through. Common choke type are the ones used for common applications such as radio reception (FM and AM), modern digital radio reception (XM and DAB) and GPS. A failure of choosing this RF choke can cause the loss of the desired signal, increasing noise level and therefore failure of design. In this research work, the author would experiment, discuss and show results for choke inductors used for 100MHz which is used for FM reception and 220MHz which is used for DAB radio.
    • Chronic Stress and the Immune Response's Impact on Ghrelin and its Role in the Development of Cardiovascular Disease.

      Chastain, Ronnie; School of Medicine
      The purpose of this study was to investigate how the chronic ‘stress of life’ and stress- induced changes in immune reactivity plays a role in the development of cardio-vascular disorders with an emphasis on the appetite hormone, ghrelin. Ghrelin is pertinent as it has been found to be an anti-inflammatory and cardio-protective peptide hormone. Chronic stress more often affects poorer and medically underserved communities which consists of about three- fourths of Georgia’s counties. Additionally, the state ranks fifteenth in death rates due to cardio-vascular disease in the U.S. This study could provide further insight as to how poorer and stressed-out Georgians’ health are significantly affected by the stress in their lives. In our murine model of chronic stress, we infected a group of mice with murine herpes virus (MHV) 4 Strain 68, as viruses have been implicated in cardiovascular related diseases. Half of infected and half of the uninfected animals were subjected to different stressors for 30-day period. Data analysis was performed with Jamovi v2.3 (The jamovi project http://www.jamovi.org) and SigmaPlot (Systat Software, Inc., CA) statistical software. One- and Two-Way ANOVA and ANOVA on Ranks followed by the post-hoc t-test were used to determine statistical significance in observed changes. Throughout the study the mice and their food were weighed at regular intervals to track how the stress and/or viral infection affected their food consumption and weight. After the month of stress, the mice were sacrificed, and key organs (heart, brain, spleen, and stomach) were collected to evaluate tissue-specific expression of genes of interest. Additionally, blood was drawn to characterize the systemic distribution of leukocytes via flow cytometry. Plasma was separated from the blood for analysis of systemic levels for markers of the endocrine (cortisol) and immune (cytokine) responses. Post-stress challenge statistically significant differences in leukocyte subset distribution were observed between the non-infected and infected animals. Additionally, a significant decrease in overall food intake throughout the stress period between the stressed and non-stressed groups based on viral infections as well as the viral and non-virally infected groups based on stress. Differences in gene expression for genes encoding Atrial Natriuretic Peptide, Brain Natriuretic Peptide, Vascular Endothelial Growth Factor Alpha, and Endothelial Nitric Oxide Synthase along with both Ghrelin and its receptor, Growth Hormone Secretagogue Receptor within the heart. Changes in gene expression were also observed for the Growth Hormone Secretagogue Receptor within the brain in addition to changes in Ghrelin mRNA levels in both the brain and stomach. Altered plasma levels of cytokines were observed in groups subjected to stress and/or viral challenges in comparison to control group. Collected data suggests chronic stress in the setting of the immune stress response negatively impacts the heart and decreases Ghrelin expression in the heart.