Reducing Health Disparities In Communities of Color: Perspectives from Professions in Healthcare

While people of underrepresented ethnic groups (URGs) represent 40% of the nation\u27s population, less than 5% of admissions to PT, OT, and SLP programs are students from URGs. Suggestions for this disparity include lack of academic, social, financial, and mentoring support as barriers to enrolling URGs in health professions programs. Research indicates that health care providers who are from URGs are more likely to serve patients of color, indigent patients, and work in medically underserved communities. In addition, patients are more likely to report greater satisfaction with care from providers that share their racial/ethnic background. This presentation includes our initiative to address the lack of diversity in healthcare through a program we have developed named TRIUMPH- the Tennessee Recruitment to Increase Underrepresented Minorities into Professions of Health. This program is designed to serve as a UT system pipeline to increase URGs admissions from UT Knoxville into the University of Tennessee Health Science Center\u27s PT, OT, and SLP programs. This ultimately will assist in healing and health in communities of color. Presentation outline: The state of representation of persons of color in health care professions and its impact on communities of color Barriers that contribute to lack of representation in health care professions Explanation of the TRIUMPH program developed at UTHSC to increase the representation of URGs in PT/OT/SLP programs which will ultimately assist with health and healing in communities of color

Force Characterization and Manufacturing of a Dynamic Unilateral Clubfoot Brace

Clubfoot is a musculoskeletal birth defect characterized by an inward twisting of an infant’s feet. Currently, a series of casts are used to correct the clubfoot, and a boots-and-bar brace is used to maintain the correction. However, this method has concerns with compliance, comfort, and social stigma. Hope Walks and their clinic in Kijabe, Kenya are interested in implementing a new maintenance brace that addresses these concerns. Mr. Jerald Cunningham, CPO, designed and is utilizing a unilateral clubfoot maintenance brace called the Cunningham Clubfoot Brace. He asserts his brace reduces treatment time, lessens social stigma, and increases child mobility. However, to date, there is not enough published research on its biomechanics and patient success rates to confirm his findings. The Cunningham Clubfoot Brace Collaboratory project seeks to validate the effectiveness of the Cunningham design through biomedical testing and increase brace availability through sustainable manufacturing. To do this, the team is measuring the biomechanical forces applied by the brace with multiple force sensor systems and an infant foot model. The team is assisting Mr. Cunningham in his plans to use injection molding to increase brace production by scanning and creating CAD files of the brace. The team is also completing a failure and reuse analysis of the Cunningham Brace for the clinic in Kijabe. Furthermore, the ongoing clinical study at CURE International\u27s hospital in Kijabe, Kenya, and Dr. Emily Farrar’s research paper will provide greater insight into the effectiveness of the Cunningham Brace. These collaborative efforts will allow for further understanding of the effectiveness of the Cunningham Brace and its acceptance as an alternative clubfoot maintenance brace.https://mosaic.messiah.edu/engr2021/1001/thumbnail.jp

Force Characterization and Manufacturing of a Dynamic Unilateral Clubfoot Brace

Clubfoot is a musculoskeletal birth defect characterized by an inward twisting of an infant’s feet. Currently, a series of casts are used to correct clubfoot and the Steenbeek brace is used to maintain the correction. However, this method has issues with compliance, comfort, and social stigma. Mr. Jerald Cunningham, CPO, designed and is utilizing a unilateral clubfoot maintenance brace called the Cunningham Clubfoot Brace. He expects his brace to reduce treatment time, lessen social stigma, and increase child mobility. Hope Walks, in Kijabe, Kenya, is interested in implementing this new maintenance brace at their clinics. However, there is not enough published research on its biomechanics and patient success rates to confirm Mr. Cunningham’s findings. The Cunningham Clubfoot Brace Collaboratory project seeks to validate the effectiveness of this design through biomedical testing and increase brace accessibility through sustainable manufacturing. The team is measuring the biomechanical forces applied by the brace with multiple force sensors on the Cunningham and Steenbeek braces. Mr. Cunningham plans to use injection molding to increase brace production. The team is completing Finite Element Analysis to determine how the brace’s properties change with injection molding. The team is also completing fatigue analysis with the Cunningham Brace to quantify its reusability. Furthermore, the clinical study in Kenya and Dr. Emily Farrar’s retrospective research paper will contribute to the published research on the Cunningham Brace. The collaborative efforts of the team will increase further understanding of the Cunningham Brace and its acceptance as an alternative clubfoot maintenance brace.https://mosaic.messiah.edu/engr2022/1002/thumbnail.jp

First Measurement of the Helicity Asymmetry E in ƞ Photoproduction on the Proton

Results are presented for the first measurement of the double-polarization helicity asymmetry E for the ƞ photoproduction reaction ɣp -\u3e ηp. Data were obtained using the FROzen Spin Target (FROST) with the CLAS spectrometer in Hall B at Jefferson Lab, covering a range of center-of-mass energy W from threshold to 2.15 GeV and a large range in center-of-mass polar angle. As an initial application of these data, the results have been incorporated into the Jülich-Bonn model to examine the case for the existence of a narrow N* resonance between 1.66 and 1.70 GeV. The addition of these data to the world database results in marked changes in the predictions for the Eobservable from that model. Further comparison with several theoretical approaches indicates these data will significantly enhance our understanding of nucleon resonances

Prosthetic Knee

Amputations, specifically lower limb amputations, are common in Sub Saharan Africa and across the broader global community largely due to infection and disease. Our project, The Prosthetic Knee Team, partners with the orthopedic workshop at the CURE International Hospital in Kijabe, Kenya to create a prosthetic knee design for a specific type of amputation known as a Knee Disarticulation (also called through-knee). Currently, the orthopedic workshop is only able to provide one very expensive prosthetic knee option for these patients, and they often elect to undergo a second surgery, a trans-femoral amputation, because the cost of the second surgery and trans-femoral prosthesis combined is less than the currently available through-knee prosthetic. The goal of our project is to provide the orthopedic workshop with a manufacturable prosthetic knee design that provides through-knee amputees with a cheaper prosthetic option and removes the need to have a second amputation above the knee. Throughout the past two semesters, our focus was on organizing collected data, researching knee-disarticulations, and communicating with our client to more fully understand the scope of our project. After determining that moving forward our project will be manufacturing the prosthetic knees at Messiah College’s machine shop and shipping them to CURE Kenya to be fit on patients, we began to brainstorm potential design ideas. We are presently working on modifying and improving our chosen design to best meet all of the specifications laid out by our partner. Those specifications include minimized thigh-lengthening, low weight, maximized stability and durability, and aesthetically pleasing.https://mosaic.messiah.edu/engr2020/1017/thumbnail.jp

Assessment of bulbar function in amyotrophic lateral sclerosis: validation of a self-report scale (Center for Neurologic Study Bulbar Function Scale).

BACKGROUND AND PURPOSE: Impaired bulbar functions of speech and swallowing are among the most serious consequences of amyotrophic lateral sclerosis (ALS). Despite this, clinical trials in ALS have rarely emphasized bulbar function as an endpoint. The rater-administered Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) or various quality-of-life measures are commonly used to measure symptomatic benefit. Accordingly, we sought to evaluate the utility of measures specific to bulbar function in ALS. METHODS: We assessed bulbar functions in 120 patients with ALS, with clinicians first making direct observations of the degree of speech, swallowing and salivation impairment in these subjects. Clinical diagnosis of bulbar impairment was then compared with ALSFRS-R scores, speech rate, time to swallow liquids and solids, and scores obtained when patients completed visual analog scales (VASs) and the newly-developed 21-question self-administered Center for Neurologic Study Bulbar Function Scale (CNS-BFS). RESULTS: The CNS-BFS, ALSFRS-R, VAS and timed speech and swallowing were all concordant with clinician diagnosis. The self-report CNS-BFS and ALSFRS-R bulbar subscale best predicted clinician diagnosis with misclassification rates of 8% and 14% at the optimal cut-offs, respectively. In addition, the CNS-BFS speech and swallowing subscales outperformed both the bulbar component of the ALSFRS-R and speech and swallowing VASs when correlations were made between these scales and objective measures of timed reading and swallowing. CONCLUSIONS: Based on these findings and its relative ease of administration, we conclude that the CNS-BFS is a useful metric for assessing bulbar function in patients with ALS

Nuclear transparency and effective kaon-nucleon cross section from the A(e, e'K+) reaction

We have determined the transparency of the nuclear medium to kaons from $A(e,e^{'} K^{+})$ measurements on $^{12}$C, $^{63}$Cu, and $^{197}$Au targets. The measurements were performed at the Jefferson Laboratory and span a range in four-momentum-transfer squared Q$^2$=1.1 -- 3.0 GeV$^2$. The nuclear transparency was defined as the ratio of measured kaon electroproduction cross sections with respect to deuterium, ($\sigma^{A}/\sigma^{D}$). We further extracted the atomic number ($A$) dependence of the transparency as parametrized by $T= (A/2)^{\alpha-1}$ and, within a simple model assumption, the in-medium effective kaon-nucleon cross sections. The effective cross sections extracted from the electroproduction data are found to be smaller than the free cross sections determined from kaon-nucleon scattering experiments, and the parameter $\alpha$ was found to be significantly larger than those obtained from kaon-nucleus scattering. We have included similar comparisons between pion- and proton-nucleon effective cross sections as determined from electron scattering experiments, and pion-nucleus and proton-nucleus scattering data.Comment: 7 pages, 5 figure