College of Health and Pharmacy

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CHARACTERIZATION AND ANALYSIS OF BIOACTIVES IN BLUEBERRY-DERIVED EXOSOMES: NEW INSIGHTS INTO A POTENTIAL ANTIOXIDATION NANOMEDICINE
(2023-04-20) Dunham, Kaitlyn; Canham, Spencer; Palmer, Emilie; Bai, Shuhua; Yang, Tianzhi
Blueberries provide evident benefits of reducing oxidative stress and inflammation, improving cognitive function, and protecting against neurodegenerative diseases as a “super” fruit. However, high levels of bioactive molecules in blueberries, such as anthocyanin, have poor stability and absorption, leading to low bioavailability in the brain. Exosomes attract strong interest as an important vehicle of intercellular communication and as a delivery carrier of bioactive molecules. Herein, the study focuses on characterizing blueberry-derived exosomal nano-vesicles that contain bioactive molecules, and determining if they have better stability and are more readily taken up by cells. Blueberry juice was directly extracted with an electric blender and passed through filter papers. The collected juice was sequentially centrifuged at 1,000 × g for 10 min, 3,000 × g for 20 min, and 10,000 × g for 40 min at 4 °C to remove large particles and debris. The final supernatant was centrifuged at 100,000 × g for 30 min to obtain exosomes. The exosome morphology was observed with scanning electron microscopy (SEM) and the particle size was determined with a Nano Sizing Analyzer. The exosomes had a size of 82.7±6.4 nm and appeared as individually sphere-shaped morphology as shown in SEM images. Exosomes were analyzed and quantified for total proteins and RNAs. Well-known exosome-unique markers, including Cis-Golgi matrix protein GM130, adaptor protein and sort cargo ALIX, tumor susceptibility gene TSG10, intercellular adhesion molecule 1 (ICAM-1), apoptosis ANXA5, integral membrane protein FLOT, epithelial cell adhesion molecule (EpCam), and transmembrane tetraspanin family CD63 and CD81, were detected by an Exo-Check array. MicroRNA sequencing analysis revealed that the intersection between differentially expressed genes and miRNAs contained in exosomes could unveil a set of candidate target genes. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) study demonstrated that the exosomes showed cytotoxicity in neural cancerous cells. The characterized exosomes with biomolecules may deliver therapeutic molecules in the brain and target neural cells, leading to improved efficacy in the treatment of neurodegenerative diseases.
THE EDUCATION DESIGN AND IMPLEMENTATION OF THE CONTINUING EDUCATION COURSE IN ANATOMY FOR REHABILITATION SPECIALISTS
(2023-04-20) Brown, Colby; Conant, Kaicey; Durant, Jordan; Hooker, Cora; Robichaud, Shelby; Smith, Ashely; Howland, Chad
Purpose: Continuing education (CE) is essential to evidence-informed practice for healthcare providers such as licensed physical therapists. However, evidence suggests that approximately 1/3rd of physical therapists have participated in an anatomy-related CE course within the previous three years.1 Our teaching and learning project sought to design and implement a CE course specific to musculoskeletal anatomy for allied health professionals and physical therapy students. Description: A two-day CE course in functional and clinically oriented anatomy was designed and taught by a collaborative team of physical therapy educators and entry-level DPT students. The course implemented components of adult learning theory through experiential learning, peer-to-peer teaching, and collaborative learning in small groups.2,3 Summary of Use: Twenty-three registrants attended the CE anatomy course, with a significant percentage being student physical therapist assistants from a local community college (>70%). Nearly all attendees participated in the entire two-day session for twelve contact hours. After completing the final day of the CE course, all attendees completed the post-course survey. The results showed excellent ratings for an overall learning experience (95.5% of respondents), the quality of course instruction (100% of respondents), and course organization (86.4%). The CE course earned $ 8,120.00, and funds were allocated to DPT student scholarships and educational resources. Conclusion: Entry-level physical therapy education programs can meet the demand through collaborative teaching and learning projects between faculty and DPT students. When targeting a consumer population of healthcare providers, institutions need to consider the needs of the healthcare providers and correlate human anatomy to their area of clinical practice.
METFORMIN REDUCES ATYPICAL ANTIPSYCHOTIC-ASSOCIATED WEIGHT GAIN IN ADULTS
(2023-04-20) Bosquet, Randy; Caron, Lindsey; James, Shannon
Purpose: Metformin is an underutilized management strategy in preventing and treating antipsychotic-associated weight gain (AAWG). Pharmacists may be in a unique position to educate providers and drive implementation into current clinical practice. This review analyzes recent literature to identify the impact of metformin treatment on AAWG in adult patients. Methods: We performed a review using PubMed with search criteria (antipsychotic induced weight gain) AND (metformin) which yielded 125 results. Articles were included if they discussed AAWG for adult patients along with metformin use for prophylaxis or treatment. Articles were excluded if they focused on the pediatric population or did not include management strategies for AAWG. There were 21 studies that were analyzed and included in this review. The primary endpoint was weight loss or change in weight in patients taking metformin with an atypical antipsychotic. Results: Although AAWG is common amongst all medications within the class, studies showed that some atypical antipsychotics have a much larger incidence rate without metformin use, such as olanzapine, where 30% of individuals were shown to have greater than 7% increase in body weight from baseline. Both short and long-term studies show metformin prevents an increase in weight gain by about 5 kg when it is started at the initiation of an atypical antipsychotic. Treatment based metformin use showed an approximate 3 kg reduction in body weight when started after AAWG occurred. Studies showed that higher doses of metformin (>500 mg) had a greater effect on weight decrease when compared to other dosages. Doses of metformin ranged from 500 to 2250 mg daily for AAWG prophylaxis and treatment ranged from 6 weeks to 18 months long. Conclusion: Use of metformin prophylactically could decrease premature discontinuation of atypical antipsychotics and prevent associated morbidity. Future studies could assess the impact of pharmacist led metformin protocols in patients initiating atypical antipsychotics.
EFFECTS OF BISPHOSPHONATE TREATMENT OF POST-MENOPAUSAL WOMEN ON BONE QUALITY PARAMETERS OF NEWLY FORMED BONE DETERMINED BY RAMAN SPECTROSCOPY. A COMPARISON VS HEALTHY PREMENOPAUSAL WOMEN
(2023-04-20) Phipps, Roger J.; Gamsjaeger, Sonja; Shane, Elizabeth; Cohen, Adi; Dempster, David W.; Eriksen, Erik F.; Paschalis, Eleftherios P.
In the treatment of postmenopausal osteoporosis (PMO), the potent bisphosphonates (BPs) alendronate (ALN; Fosamax), risedronate (RIS; Actonel) and zoledronate (ZOL; Reclast) are first line therapy. They produce similar decreases in fracture risk despite different levels of suppression of bone resorption and bone turnover (ALN>ZOL>RIS). To determine if differences in effects on bone quality may play a role in this apparent discrepancy, this study assessed the effects of these BPs on bone quality indices of newly formed trabecular bone. Methods: Iliac crest bone biopsies from PMO patients treated with ALN (for 3 years and ≥ 5 years), RIS (for 3 years and ≥ 5 years), and ZOL (for 6 months, 2 years, ZOL2 and 3 years, ZOL3) were analyzed by Raman microspectroscopy. Bone quality indices mineral to matrix ratio (MM), mineral crystallite maturity/crystallinity (MMC), and glycosaminoglycan (GAG), and pyridinoline (Pyd) content were determined. Biopsies from placebo treated PMO women (PMO-PLC) were also analyzed. Data were compared with those in healthy adult premenopausal women (HC) by ANCOVA followed by post-hoc testing (significance p<0.05). Results: Both RIS groups had MM, MMC and Pyd values similar to HC. ZOL3 had MM and Pyd similar to HC and ZOL2 had MMC similar to HC. Both ALN groups had only MM similar to HC. None of the BP-treated groups had similar GAG to HC. The PLC group had MM similar to HC but was significantly different for MMC, GAG and Pyd. Conclusion: in this analysis PMO patients treated with RIS (Actonel) formed bone with quality closest to that in HC. Those treated with ALN (Fosamax) formed bone with quality least similar to HC. These differences in effects on bone quality may in part explain how these BPs achieve similar antifracture efficacy in treatment of PMO despite differences in bone turnover suppression.
BLOOD FLOW RESTRICTION TRAINING FOR PERSISTENT KNEE EXTENSOR WEAKNESS
(2023-04-20) Scott, Wayne; Michaud-Gardner, Alyssa; Sylvia, Jack; Topiwala, Dave
This case study presents the effects of 8 weeks of blood flow restriction training (BFRT) for persistent knee extensor weakness following a long standing repaired ACL injury. A 20 year old female with no history of knee injury prior to the initial ACL tear in 2020 received a patellar bone graft 6 months later. The patient received traditional physical therapy for 6 weeks, which was inconsistent due to COVID-19 interruptions. The participant presented with an antalgic gait and difficulty performing stairs as a result of persistent knee extensor muscle weakness. The participant's knee extensor strength was tested using a Biodex force dynamometer. Initial testing demonstrated that the involved side knee extensors could only produce 68.7% of the muscle torque of the uninvolved side knee extensors. The participant underwent BFRT at a frequency of 2 sessions per week for a total of 8 weeks. The participant performed unilateral knee extensions, step ups, and leg presses for sets of 30, 15, 15 and 15 reps. Blood flow was restricted with a tourniquet inflated to 80% of the pressure which caused full arterial blood flow occlusion for the duration of each exercise with 2 minutes of cuff deflation between exercises. Following 8 weeks of training, the participant’s knee extensors on the involved side were able to produce 82.9% of the muscle torque of the uninvolved side knee extensors. In this case, BFRT demonstrated the ability to improve persistent knee extensor weakness following ACL repair. This improvement in strength was maintained at 3 and 6 month follow up testing. Significantly, the patient’s antalgic gait and difficulty performing stairs resolved during the 8 weeks of training.
THE EXPERIENCES OF NURSING FACULTY WITH SCIENCE EDUCATION
(2023-04-20) Sauda, Valerie C.
Nursing curricula have included science courses since early in the 1900s. The influence of faculty on inclusion of science coursework in nursing curriculum is one area in nursing education that has not been well researched. As nursing faculty have significant roles in development of nursing curriculum, a dissection of how faculty history, values and beliefs about the significance of science education, is the focus of this study. A qualitative grounded theory approach (Charmaz, 2014) was used to interview nurse educators about their personal experiences with sciences across their own educational experience. Interviews were coded and themes developed. Using the themes, a model of the interface between the lived science experiences of nursing faculty within personal educational experience and science identity was formed from the study themes. Outcomes from the study include 1) science identity is influenced by personal history of faculty encompassing nursing identity, 2) nursing faculty in general do not identify as “scientists” and 3) gender may play a “hidden role” in nursing faculty science identity. As a result of the study, further research questions were developed including 1) f nurse educators do not identify as “scientists” and have not had significant meaningful connection with sciences (besides “fun” experiences), how can curriculum in nursing education change to meet the innovation needs and demands of an interprofessional environment of healthcare effectively and give voice to nursing? and 2) hidden gender messaging may need to be uncovered and evaluated further in a primarily female driven nursing curriculum to support nursing students based on gender or other barriers identified in STEM education literature.
COMPENSATION FOR BOARD OF PHARMACY MEMBERS IN THE UNITED STATES
(2023-04-20) Pham, Hannah; Ifeji, Chidubem; White, Cassandra
Background: No published data exists regarding compensation and demographic differences between the memberships of the 50 United States (U.S.) Boards of Pharmacy. Objectives: The purpose of this study was to quantify and compare the per diem pay rate for U.S. Board of Pharmacy members. Board member demographics and compensation for mileage and meals were also evaluated. Methods: In June 2022, each state Board of Pharmacy was contacted to gather data including per diem pay, mileage and meal compensation, number of meetings per year, number and gender of Board members, length of appointment, and regulatory statutes. Results: The average per diem pay for Board members was $75.86 (median = $50.00, range = $0.00 to $250.00, n = 48 states). Most states report paying Board members for mileage (95.1%, n = 39 out of 41) and meals (80.0%, n = 28 out of 35). On average, Boards are composed of 8.3 members (median = 7.5, range = 5-17, n = 50), meet 8.3 times annually (median = 8, range 3-16, n = 47), and have a 4.5 year length of appointment (median = 4, range = 3-6, n = 47). Males represented 61.2% of occupied Board positions and pharmacists accounted for 74.1% of all positions. The average year for pharmacy statute update was 2002. Conclusion: Compensation for U.S. Board of Pharmacy members varies greatly, from unpaid (n = 8 states) to a high of $250.00 per diem. Only 38.8% of occupied Board positions are held by women and pharmacy technicians represent just 3.6% of all positions. Fair compensation, increased female and pharmacy technician representation, and more timely pharmacy statute updates are necessary in order to achieve inclusion, diversity, and equity between state Boards of Pharmacy.
RACIALLY CONCORDANT CARE IN THE TREATMENT AND PREVENTION OF POSTPARTUM DEPRESSION IN AFRICAN AMERICAN WOMEN
(2023-04-20) Nyambo, Leslie; Bedi, Sarah
Postpartum depression (PPD) is part of the postpartum mood disorders experienced by women during the postpartum stage. It is characterized by feelings of extreme sadness, depressed mood, and loss of interest in formerly liked activities (Liu et al., 2015). Postpartum depression (PPD) is an ongoing issue notably for African American women. Ethnic, cultural, physiological, and demographic factors all play a role in the high prevalence of PPD in African American women compared to Caucasian women. Racially concordant and culturally aware peripartum care is crucial in the prevention, and treatment of PPD among African American women. Racially concordant care is one that is provided by a healthcare provider of the same racial or ethnic background as the patient (Shen et al., 2019). Its preference among minority populations is vastly due to the evidence that it greatly reduces instances of racism and bias, and increases patient satisfaction (Shen et al., 2019). The review method of the research was done using the PICO question, “In African American women, what is the effect of racially concordant perinatal care on the prevention and treatment of postpartum depression compared with discordant care within the postpartum period?” Using CINAHL Ultimate database, research of relevant literature was conducted using the following key terms: African American women, racially concordant care, and postpartum depression. Evidence-based practices such as racially concordant care and culturally-aware practices are important and should be implemented in nursing education as part of lowering health disparities. While racially concordant care for every African American mother might not be feasible, nurses that are informed and able to provide culturally sensitive screenings and postpartum care are crucial in decreasing the prevalence of postpartum depression in African American women.
ERROR ESTIMATION AND KNOWLEDGE OF RESULTS IN LEARNING A NOVEL MOTOR TASK
(2023-04-20) Duffy, Hannah; Lees, Jennifer; Shamaly, Shannon; Sidaway, Ben
When learning a new motor skill, feedback on the errors in performance, or knowledge of results, is important in order to make adjustments to the future response attempts. However, previous studies have shown that when high frequencies of feedback are provided to a learner such feedback can suppress intrinsic error detection and corrections processes resulting in poorer performance when that feedback is no longer available. Other studies have shown that requiring error estimation during practice prior to feedback being provided enhances learning of the skill. Such research though has not investigated the role of different frequencies of error estimation on learning nor has the combined effect of requiring error estimation while providing different frequencies of knowledge of results been investigated. It remains unknown whether there is an optimal frequency of error estimation for motor learning or whether error estimation may interact with the frequency of feedback. The present study included 6 randomly assigned intervention groups of young adults (18-35 years) that were differentiated on the basis of knowledge results (0%, 33%, or 100%) and error estimation (0%, 33%, or 100%) frequency. Each group was taught a shuffle-board like skill aiming at a target that was hidden from view. Each group performed a series of ten blocks of 12 practice trials followed by three retention tests (5 min, 1 day, 1 week), and a transfer test. Response error (absolute, constant, and variable) was calculated for each phase of the experiment along with the accuracy of error estimation. Preliminary results show that requiring overt error estimation of learners ameliorates the negative impact of high frequencies of knowledge of results feedback on skill learning. Discussion focuses on the potential interaction of error estimation and feedback for motor learning in clinical practice.
IS DUAL TASK ABILITY FULLY RECOVERED IN ATHLETES WHO HAVE COMPLETED THE CONCUSSION RETURN-TO-PLAY PROTOCOL?
(2023-04-20) Hartman, Zachary; Marquis, Gabrielle; Siegel, Sondra
Purpose: This study investigated deficits in dual task ability in collegiate athletes with acute concussions who have completed the return-to-play protocol. While previous research has demonstrated the persistence of deficits using standard cognitive tests, this study specifically addressed performance in a contextually relevant, sports-related challenge. Methods: Concussed and non-concussed college athletes completed a demographics and history questionnaire, and were assessed for balance using the Balance Error Scoring System test. For the novel test, gait parameters were measured under three conditions using an instrumented gait mat. Conditions included: walking at a comfortable pace, walking while watching a sport-related video and performing a cognitive task, and walking while watching the video and performing the cognitive and a secondary physical task. The cognitive task was also performed by the participant in a standing position. Response accuracy on the cognitive task was recorded for all conditions. Outcome Measures: Measures included gait speed, cadence, stance percentage, step variability, and response accuracy for the cognitive task. Results: The control group demonstrated better performance than the experimental group with comfortable gait and with gait plus the cognitive task, with significant differences in stride width percentage, percentage of stance time, and cadence. There were no apparent differences between the two groups for the condition of gait combined with cognitive and physical tasks. There were no significant differences in response accuracy between the groups; participants demonstrated near 100% accuracy under all conditions. Conclusions: Greater impairments in gait were seen in all participants as the cognitive and physical task became more challenging, but accuracy in the cognitive task was not sacrificed in either group. Gait parameters measured during a sport-related cognitive task may be sufficient to discern a difference in performance between concussed and non-concussed athletes and may be more relevant to a return-to-play decision than standard cognitive tests.
INVOLVEMENT OF DIVALENT METAL TRANSPORTER HOMOLOGS IN THE TOXICITY OF LANTHANIDE SERIES ELEMENTS IN Caenorhabditis elegans
(2023-04-20) Ireland, Nicholas; Miller, Lydia; Caito, Samuel
Lanthanide series elements are transition metals that are used in a variety of electronics, including superconductors, electronic polishers, hybrid car components, and rechargeable batteries, as well as in fertilizers, antimicrobials, contrast agents for medical imaging and diesel fuel additives. Lanthanides are also present in electronic waste and are released during electronic cigarette smoking. Levels of lanthanides have risen significantly in both industrial areas and environmentally. While we are starting to recognize health effects of lanthanide exposure, it is currently unknown how lanthanide metals enter cells. If we are to understand their toxicokinetics in the human body, it is imperative to determine mechanisms by which lanthanides are distributed. We hypothesized that endogenous divalent metal transporters (DMTs) are responsible for lanthanide entry into cells, and that genetic ablation of DMT transporters in Caenorhabditis elegans would protect the worms from lanthanide-induced toxicity. In this study, we performed a competitive inhibition survival assay by pretreating wildtype worms with nonlethal doses of metals that enter cells through a variety of mechanisms, then treating the worms with increasing concentrations of lanthanum (La). Lethality was assessed 48 hours post exposure. Worms treated with either manganese or iron, metals that enter cells via DMTs, shifted the La dose-response survival curve to the right, suggesting La was competing for the same transporter as iron or manganese. However worms pretreated with zinc, magnesium, or chromium could not block lanthanum-mediated lethality. These data suggest that DMTs are responsible for lanthanides to enter cells. We then treated transgenic worms that lacked DMT homologs smf-1, smf-2, or smf-3, with increasing concentrations of La or ytterbium (Yb). Knock out of either of the smf genes shifted the dose-response curve for La or Yb to the right, showing protection. These results suggest that DMTs are important mediators for lanthanide series elements to enter eukaryotic cells.
EXAMINATION OF THE POTENTIAL ROLE OF UDP IN INTERLEUKIN-8 EXPRESSION BY FIBROBLASTS DURING CELL INJURY
(2023-04-20) Kennard, Emma; Lindblad, William J.
Prior studies from our lab show scraping a monolayer of fibroblasts, an in vitro wound model, results in cell migration and enhanced expression of inflammatory mediators including interleukin-8 (IL-8) by residual cells. This effect is more pronounced in fibroblasts from the skin of diabetic people than non-affected people. This expression is seen in the cells adjacent to the scraped area but also in cells 2 and 3 cells removed from the scraped edge. Studies in epithelial cells suggest that nucleotides, specifically uridine 5’-diphosphate (UDP) released from cells upon wounding in the same model bind to P2Y6 receptors on cells inducing cell migration. We hypothesized that UDP may serve as a wound mediator for fibroblasts and that it may induce the expression of IL-8. Human dermal fibroblasts (GM 1872 cells, Coriell Institute) were cultured in 100 mm dishes and grown to confluence in DMEM high glucose media containing 10% fetal calf serum and penicillin-streptomycin. Cell monolayers were scraped in a grid pattern and cultured for 24 hrs. with/out additives. UDP at 100 and 10 µM was added to non-scraped and scraped cultures of fibroblasts to determine the potential involvement of UDP that we have seen in IL-8 expression. Following 24 hr. incubation, total RNA was extracted and quantitation of IL-8 mRNA content was assessed by qPCR. Modified culture media used for the 24 hr. culturing was analyzed for UDP content by ion-pairing HPLC. UDP, immediately released from scraped cell monolayers, was determined by HPLC following a 10X concentration of PBS used to maintain cell viability during scraping. Despite a lower limit of detection of 20 ng, no UDP could be detected and further studies with LC/MS are continuing to ascertain if any quantifiable UDP is released from the scraped cells. Cell levels of mRNA for IL-8 normalized to GAPDH are being analyzed to determine if exogenous UDP enhances the expression of this cytokine. These studies will increase our understanding of what factors during fibroblast injury promote migration and the expression of pro-inflammatory mediators.
SEROTONERGIC AND DOPAMINERGIC-DEPENDENT BEHAVIORS ARE ALTERED BY LANTHANIDE SERIES METALS IN Caenorhabditis elegans
(2023-04-20) Radzimirski, Anthony; Ireland, Nicholas; Miller, Lydia; Croft, Michael; Newell-Caito, Jennifer; Caito, Samuel
The lanthanide series elements are transition metals used as critical components of electronics, as well as rechargeable batteries, fertilizers, antimicrobials, contrast agents for medical imaging, and diesel fuel additives. Furthermore, as electronics are limited in lifespan, lanthanides are found in electronic waste. With the surge in their utilization, lanthanide metals are being found more in our environment. However, little is known about the health effects associated with lanthanide exposure. Epidemiological studies as well as studies performed in rodents exposed to lanthanum (La) suggest neurological damage, learning and memory impairment, and disruption of neurotransmitter signaling, particularly in serotonin and dopamine pathways. Unfortunately, little is known about the neurological effects of heavier lanthanides. As dysfunction of serotonergic and dopaminergic signaling are implicated in multiple neurological conditions, including Parkinson’s disease, depression, generalized anxiety disorder, and post-traumatic stress disorder, it is of utmost importance to determine the effects of La and other lanthanides on these neurotransmitter systems. We therefore hypothesized that early life exposure of light (La or cerium (Ce)) or heavy (erbium(Er) or ytterbium (Yb)) lanthanides in Caenorhabditis elegans could cause dysregulation of serotonergic and dopaminergic signaling upon adulthood. Serotonergic signaling was assessed by measuring pharyngeal pump rate, crawl-to-swim transition, as well as egg laying behaviors. Dopaminergic signaling was assessed by measuring locomotor rate, egg laying, and swim-to-crawl transition behaviors. Treatment with La, Ce, Er, or Yb caused deficits in serotonergic or dopaminergic signaling in all assays, suggesting both the heavy and light lanthanides disrupt these neurotransmitter systems. Concomitant with dysregulation of neurotransmission, all four lanthanides increased reactive oxygen species (ROS) generation, while decreased glutathione and ATP levels. This suggests increased oxidative stress, which is a known modifier of neurotransmission. Altogether, our data suggest that both heavy and light lanthanide series elements disrupt serotonergic and dopaminergic signaling and may affect the development or pharmacological management of related neurological conditions.
HOMELESS AND HUNGRY IN BANGOR: RX 504 SERVICE LEARNING CAPSTONE PROJECT
(2023-04-20) Johnson, Jessica; Doctor of Pharmacy Candidates, Class of 2024
Husson University School of Pharmacy Class of 2024 enrolled in RX 504 - Clinical Pharmacy Capstone, a required service-learning course that allows students to apply knowledge developed over the course of their studies to a real-world problem in their local community. Doctor of Pharmacy candidates established a goal of assessing the needs of individuals experiencing homelessness in Penobscot County. First, students held a discussion surrounding the documentary “Hungry Now,” which explored the current homelessness crisis in the state of Maine. Second, students read published scientific literature evaluating the barriers to healthcare and medication adherence unique to persons experiencing homelessness. Students proposed possible solutions and explored how their various ideas might help individuals to overcome barriers to accessing needed medical care. Third, we visited the Bangor Area Homeless Shelter on two separate occasions with the goal of sharing a nutritious meal and speaking with residents to explore their needs and concerns regarding their medication regimens. Additionally, students advocated for expanded access to vaccinations in Maine by writing and delivering verbal testimonies at the Maine State House and provided community education at the Maine Science Festival. Through this community-engaged service-learning experience, Pharmacy students explored themes of access, wellness, identity, responsibility, and sustainability; developed a better understanding of the daily struggles faced by unhoused individuals in their local community; and were empowered to take evidence-based action in response to identified health disparity.
TRAINING STUDENTS TO THINK LIKE A PHARMACIST – A STRUCTURED TOOLKIT FOR P1S
(2023-04-20) Frail, TJ; McLean Peter; Vigue, Elizabeth; Nash, Jamie; Dhing, Conrad; Yang, Tianzhi; Johnson, Jessica; Domina, Aaron
Recognizing that many students struggle with the transition between undergraduate prepharmacy coursework and the demands of a professional Doctor of Pharmacy program, Husson University School of Pharmacy (HUSOP) developed a semester long “Toolkit” to support and mentor first-year PharmD students. The primary goals of the Toolkit included: (1) support the development of highly effective study habits for academic success and (2) improve cohesion of the entering cohort to support individual well-being and sense of belonging. Method: First professional year pharmacy students were required to participate in a two-part Toolkit initiative. Prior to the start of the academic term, students attended a two-day live orientation to explore evidence-based study strategies and tools, goal setting, and growth mindset development. Throughout the fall term, HUSOP partnered with numerous stakeholders to facilitate weekly one-hour meetings for students to discuss application of study strategies within professional coursework and to provide cohort-building activities. Students completed a survey-based evaluation tool to provide feedback on Toolkit activities and delivery. Results: Nineteen students were admitted in the cohort and sixteen completed the post-survey (84% response rate). Seven of 16 students (44%) reported agreement with the statement, “I used toolkit strategies to prepare for quizzes and exams.” 14 of 16 students (87.5%) reported agreement with the statement, “I feel like part of the P1 cohort.” Post-survey data suggested the Toolkit sessions most valued by students were led directly by faculty who could provide additional context and perspective for course content, as well as interactive feedback on assessment performance. Conclusion: The Toolkit program supported students’ transition into the PharmD program through faculty and staff-led sessions targeting student success and group cohesion. Feedback from students and faculty will guide the new iteration of Toolkit programming for Fall 2
NANOVESICLES IN BROCCOLI SPROUTS AS A NATURAL POTENTIAL MEDICINE FOR THE TARGETED TREATMENT OF INFLAMMATORY BOWEL DISEASE
(2023-04-20) Palmer, Emilie; Kaserman, Elise; Dunham, Kaitlyn; Kuhn, Brian; Yang, Tianzhi; Bai, Shuhua
Inflammatory bowel disease (IBD) is an incurable small intestine and colon disorder. While exerting anti-inflammatory effects, bioactives in broccoli sprouts cannot treat IBD well probably due to their instability in the gastrointestinal (GI) tract and/or inadequate transit into colon cells. The study aimed to investigate if broccoli sprout-derived exosome (BSDExo) nanovesicles can protect bioactives from the upper GI extreme environments and confer selectively targeted delivery of bioactives to inflamed colon cells in IBD. Microparticles with 1198.3±86.2 nm and nanovesicles with 40.1±17.2 nm were isolated from broccoli sprout juice using differential centrifugations and measured by a DelsaTM Nano C nanosizing system. They showed different morphologies under a scanning electron microscope (SEM). Total protein and RNA were characterized in both broccoli sprout-derived microparticles and nanoparticles. Exosomes expressed the highest level of transmembrane protein CD63 evaluated by an Exo-Check array. These nanosized and identified proteins are known to be associated with exosomes. BSDExo protected bioactive sulforaphane for 2 hours in stomach-mimicking acid and 24 hours in intestine-mimicking conditions. BSDExo with a total protein level of 25 ng/mL could promote the proliferation of human normal colon epithelial CCD841 CoN cells with a cell viability of 154±5% (p<0.05). Both colon CCD841 CoN and Caco-2 cellular uptake of fluorescence-labeled BSDExo significantly increased with more severe inflammation stimulations. Interleukin 8 (IL-8) secretion from inflammation-stimulated normal colon cells was significantly reduced by the BSDExo treatment (p<0.05). BSDExo also significantly recovered the decreased transepithelial electrical resistance (TEER) values caused by inflammations in Caco-2 cells (p<0.05). Overall, the isolated BSDExo improved the stability, inflammation-targeting, and therapeutic efficacy of bioactives in colon epithelial cells via a naturally formed nanostructure. Demonstrating that BSDExo interacts with the targeting gut inflammatory cells and regulates anti-inflammatory responses would be a significant step forward in treating IBD.
The Opioid Crisis: A Primary Care Perspective
(2023-05) Day, Cheyanne L.
Cannabis has been medicinally used for thousands of years. It has been studied extensively for many years and is now legal in thirty-eight states due to its analgesic properties and potential to reduce opioid addiction. Chronic pain affects an estimated fifty million adults in the United States, and in the next ten years, it will cost over ten billion dollars annually. As a result of the high number of opioid prescriptions leading to overdoses and deaths, many policymakers, clinicians, and providers are considering alternative pain management options. This Capstone Project aimed to explore and analyze the most current scientific and empirical evidence relating to medical cannabis as an alternative treatment to opioids for chronic pain. The question that guided the project was, in adults 18 and over, does the use of medical cannabis, compared to opioids, result in improved pain management within a six-month period? Evidence suggests that cannabis is a promising alternative to opioids and supports medical cannabis as a treatment option for chronic pain management. As a result of this research, it is hoped that current and future providers can apply it to their practice when treating chronic pain.
Domestic Violence and Children’s Mental Health
(2023-05) Thompson, Zainab
Exposure to domestic violence is a significant predictor of children’s mental health problems. Children exposed to domestic violence will likely develop internalizing and externalizing disorders, substance abuse disorders, poor school outcomes, and a lack of prosocial behaviors (Colizzi et al., 2020). Exposure to family violence contributes to adverse childhood experiences (ACEs), which are linked to causing trauma and long-term psychological distress (Lloyd, 2018). Most mental health problems begin during the teenage years when children encounter ACEs and continue to adversely affect them in adulthood (Colizzi et al.). Children's mental health problems become a burden to the guardians, community, and society and are associated with increased healthcare costs (Orr et al., 2020). Therefore, preventing mental disorders development and reinforcing resilience in violence-exposed children is thus relevant to evade these negative consequences. The project aimed to identify the effects of family or domestic violence exposure on children, the protective and risk factors that influence the effects of violence exposure, and the intervention applicable to prevent violence-exposure effects for children aged below thirteen years. The project’s recommended intervention is a public health preventive approach at the primary, secondary, and tertiary levels to prevent violence-exposed children from developing mental health problems and disorders. Specifically, the intervention will include mindfulness training, cognitive behavior therapy, psychosocial fulfillment, and learning to regulate social and emotional responses to challenges faced, which will help prevent the development of mental health problems in children and teenagers. The reviewed literature suggests that the intervention should be evidence-based, and population-based, incorporate risk assessments and promotion of protective factors, integrate multisector and multilevel collaboration, and be operationalized within a socio-ecological framework (Carlson et al., 2019; Colizzi et al. ; Eriksson et al., 2022; Fong et al., 2019). Eventually, the intervention will reinforce resilience and positively 3 influence the mental health of at-risk and violence-exposed children to offer a better quality of life. Catering for children facing developmental adversity is essential to prevent negative consequences later in life. Future research should focus on how to best implement this intervention that specifically targets violence-exposed children and their mental health.
Effects of Distraction Techniques During Immunizations
(2023-05) Walker, April M.
Routine vaccine injections are some of the most common painful procedures during childhood especially when they are administered without adopting any pain management practice. According to the Center for Disease Control and Prevention (2022), an experience of pain is a biological component that makes some people react very strongly to the idea of procedures involving a needle. Pain from a needle is usually not severe but the brain still focuses on it. Therefore, managing the pain can reduce fear and avoidance of medical care during childhood related experiences of painful procedures such as immunizations. The purpose of this project is to determine if the use of distraction techniques vs. no distraction techniques during immunizations decrease pain levels. An Evidence Based Practice (EBP) conceptual framework will be used to provide evidence that distraction techniques during childhood immunizations decrease pain levels. The expected outcome of this project is to increase awareness of the use of distraction techniques vs. no distraction techniques while administering immunizations to children. The hope is that this study will prove effective for implementing distraction techniques for children receiving immunizations and provide education for healthcare facilities, healthcare providers, and parents to implement appropriate pain and distress management strategies during future vaccinations (Ouach et al., 2019).
Mindfulness-Based Intervention to Prevent Burnout in Healthcare Professionals
(2023-05) Richardson, Chester J.
Background: Burnout appears to effect two thirds of providers, and has been steadily rising among healthcare providers, with more than one third of healthcare providers meeting criteria for severe burnout, with nurses that have experienced burnout being 2 to 3 times more likely to leave their positions (Vells et al., 2021). The risk of burnout in healthcare providers is high, 78% of physicians, 44.2% of medical students, 45% of residents, and 50% of nurses in the United States reporting some type of burnout in their careers (Chemali et al., 2019). Purpose: The purpose of this review of the literature is to explore the current knowledge for the expected positive effects and the ability to implement a stress reduction intervention, such as mindfulness meditation, to prevent burnout in healthcare workers. Methods: Key words used for the literature search included: nurses, healthcare professionals, physicians, mindfulness, meditation, burnout, burnout prevention, mindfulness based stress reduction, MBSR, and stress. Studies required both a mindfulness based intervention and the testing of outcomes to assess for the correlation between the interventions and outcomes. Findings: The review of the literature showed a reduction in burnout symptoms, indicating that mindfulness-based interventions to reduce burnout among healthcare professionals in the hospital setting is promising. Conclusions: Mindfulness-based stress reduction interventions can be a promising tool to better the lives of those that give direct care to patients, families, and communities. Given the positive outcomes the research has shown in preventing and reducing burnout in healthcare professionals, MBSR therapies are a potential cost saving and quality of life improving intervention that can be provided to a wide reaching group of individuals.

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