Health

Fear-based experiences, such as those related to PTSD, have been shown to induce changes within regions of the brain involved in emotion and memory processing (hippocampus, amygdala, prefrontal cortex). However, because the mechanisms governing PTSD are not fully known, an effective protocol for inducing PTSD-like symptoms becomes necessary for accurately studying its mechanisms. We compared the effectiveness of two models of stress induction in rats - two days of single prolonged stress (SPS) with two weeks of chronic light, versus social defeat with two weeks of chronic light. SPS consisted of two hours of restraint, followed by 20 minutes of forced swim and loss of consciousness via isoflurane gas, twice over two weeks. Social defeat consisted of seven consecutive days of “beating” by an older, more aggressive rat for five minutes, followed by 25 minutes of “isolation” from the larger rat by a mesh divider. We used elevated plus maze and light-dark transition assays to test for anxiety-like and depression-like behaviors, and recorded fEPSPs (field excitatory post-synaptic potentials) from CA1 of the ventral hippocampus to detect differences in synaptic plasticity, specifically long term potentiation (LTP), to determine which model of stress was more effective in inducing PTSD-like changes. In the elevated plus maze and light-dark transition assays, both models significantly increased anxiety and depression-like behaviors compared to controls. However, because the social defeat model caused greater anxiety-like behavior than the SPS model in the behavioral assays, and significantly increased LTP at the ventral hippocampus, we concluded that the social defeat with chronic light model was more effective in inducing both PTSD-like behavioral and physiological changes.

About 1 in 6 adults in the US use antipsychotics, the vast majority of these being long-term users [1]. Much is known about how these drugs affect extrapyramidal and pathophysiological symptoms [2], however little to nothing is known about how they affect long-term synaptic transmission in task-dependent working memory areas. Antipsychotics alter long-range synaptic functions in a distributed brain system, and most efforts in the literature thus far have been focused primarily on attempting to understand pathophysiological synaptic dysfunction (with and without drugs) at a local level, typically involving one sub region of the brain [3]. We propose a biophysically plausible computational model that captures (a) the anti-correlation between default-mode and task-dependent states in a spiking neural network at a global scale and (b) allows for direct implementation of pharmaceuticals. Our validating computational model is a spiking neural network consisting of, but not limited to, the working memory (WM) and default-mode network (DMN) regions in the brain. The model was designed in part using the brian simulator [5], and our specified AMPA, NMDA, GABA, D1 and D2 cell types within the model. Each cell is defined by a differential equation which captures these channel’s unique features [6], and constant parameter values which do not change on input or output. Capacitance values were determined from voltage clamp data in the literature. For our work with schizophrenia, we use ketamine-like effects [7] to induce the pathophysiological brain. Our lab is currently using this model to understand the blood oxygen level dependent activation of WM areas for patients with schizophrenia who are taking antipsychotics. 1. Moore TJ (2016) Adult Utilization of Psychiatric Drugs and Differences by Sex, Age, and Race. Jama Internal Medicine 177(2):274-275 2. Singh KP, et al. (2016) Effect of in utero exposure to the atypical antipsychotic risperidone on histopathological features of the rat placenta. Int J Exp Path. 97(7):125-32 3. Bremner JD, et al. (1998) Measurement of dissociative states with the Clinician- Administered Dissociative States Scale (CADSS). J Trauma Stress 11:125–136. 4. Stimberg M, Goodman DFM, Benichoux V, Brette R (2014). Equation-oriented specification of neural models for simulations. Frontiers Neuroinf, doi: 10.3389/fninf.2014.00006. 5. Compte A. et al. (2000) Synaptic Mechanisms and Network Dynamics Underlying Spatial Working Memory in a Cortical Network Model. Cerebral Cortex 10:910-923 6. Kotermanski SE, Johnson JW (2009) Mg2+ imparts NMDA receptor subtype selectivity to the Alzheimer’s drug memantine. J Neurosci 29:2774–2779.

The production of renewable energy from biomass has been demonstrated using processes such as Fischer-Tropsch synthesis, direct fermentation of biomass sugars, biomass conversion to syngas followed by fermentation, and utilization of biomass carbohydrates in biofuel cells. Processes have been used to produce either electrical power, heat, liquid biofuels, or hydrogen. However, limitations and challenges for commercial viability still exist with all of these processes. Challenges inhibiting biofuel cell processes include low power output, low biological catalyst durability, and low carbohydrate conversion. Recently, a potentially transformative breakthrough has occurred with the discovery of a homogeneous non-biological viologen catalyst that facilitates carbohydrate conversion to electricity. The viologen catalyst serves as a mediator or “electron shuttle” to extract electrons from the carbohydrate to form a reduced viologen. The reduced viologen is then oxidized at the anode of a biofuel cell to generate power. The combination of homogeneous viologen reduction by the fuel coupled with oxidation of the viologen at the electrode provides a continuous electron shuttle, enabling energy to be extracted from carbohydrates. For a biofuel cell process, the viologen catalyst provides greater durability relative to that achievable with biological catalysts. Our initial studies have shown that viologens are effective in shuttling electrons from a wide variety of carbohydrates (C1 to C6 compounds). The homogeneous reaction rates and the efficiency of electron extraction were found to vary with reaction conditions such as pH, temperature, and reactant concentrations. Optimization of the reaction rates and efficiency are critical towards developing a viable biofuel cell using biomass carbohydrates as the feedstock. Studies were conducted to determine the homogeneous rate law that describes the reaction between the carbohydrate and viologen. Specifically, studies were performed using NMR and spectroscopic techniques to develop a mechanistic description of the reaction rate applicable for a wide range of conditions. Studies of viologen stability were also performed to quantify potential viologen decomposition conditions that could compromise carbohydrate conversion efficiency. This work will present the mechanistic model of the carbohydrate-viologen reaction and provide insights towards optimizing reactor conditions that enhance reaction rates and carbohydrate conversion efficiency.

According to the United States Department of Veteran’s Affairs, an average of 11-20% of deployed US soldiers return home with post-traumatic stress disorder (PTSD). In addition to this, 8% of the American population will develop this disorder at some point in their lives (ptsd.ne.gov). Because of these statistics, a cure for PTSD appears at the global forefront of modern research. PTSD induces memories that are aberrantly strong. This enhanced memory is measured physiologically as increased long-term potentiation (LTP), the primary cellular mechanism mediating learning and memory. These enhancements are noted in the hippocampus, the memory center of the brain, along with the amygdala and prefrontal cortex. It is thought that these increases are mediated by increased corticosterone and/or increased norepinephrine that occur by over-activation of sympathetic responses. Therefore, to help treat PTSD, physicians have employed an adrenergic antagonist or glucocorticoid receptor antagonist that can be administered to soldiers before deployment to help decrease the adverse effects of PTSD. Our goal is to examine whether these drugs can be used in a true prophylactic manner to prevent the onset of PTSD. To study this, we set up our research with control rats and stressed rats. We induced PTSD in the stressed rats by using seven consecutive days of social defeat and two weeks of chronic light. Through electrophysiology, we recorded LTP in the ventral prelimbic cortex (PrL) of the pre-frontal cortex, ventral hippocampus and lateral amygdala in both the stressed and control rats. Injections consisting of propranolol and mifepristone were administered to the rats before social defeat and subsequent experimentation. Our data shows that the levels of LTP in the ventral hippocampus were significantly higher for the PTSD rats compared to non-stressed controls and stressed rats with prophylactic injections. We also see a trend of increased LTP in the ventral PrL of the pre-frontal cortex of the PTSD rats. In the lateral amygdala, ventral hippocampus, and the ventral PrL of the pre-frontal cortex, the prophylactic injections were shown to decrease levels of LTP compared to stressed rats that did not receive injections. We have found that the adverse effects of PTSD can be altered with the use of propranolol and mifepristone. These results could prove important as a potential mechanism to prevent PTSD prophylactically for individuals, such as soldiers, who are entering stressful situations.

Obesity has become a serious threat to nearly two thirds of the adults in the United States. The correlation of the gut microbiota to obesity has been extensively studied. Researches showed that lipopolysaccharide (LPS) endotoxin from Gram-negative opportunistic pathogens can trigger systemic inflammation and intensify inflammatory symptoms such as accumulation of excess adipose tissue and insulin resistance. In previous studies, LPS from bacteria was shown to be able to cause obesity in mice when injected subcutaneously. In 2013, by using Koch’s postulates, scientists were able to demonstrate that the gram-negative opportunistic pathogen Enterobacter. cloacae B29 has the ability to cause obesity and chronic inflammation in its host. Originally isolated from a morbidly obese patient’s gut, this bacteria induced obesity, insulin resistance, and inflammation when inoculated into germ-free mice that were on a high-fat diet; but when the mice were inoculated with Bifidobacterium animalis or simply placed on a high-fat diet without B29, they did not become obese. This shows that diet alone cannot induce obesity in the host, and not every strain of bacteria will interact with the diet to cause obesity. In this research, I propose a new strategy for treating obesity by using gut microbiota targeted bacteriophage therapy. Bacteriophages (phage) are viruses that infect bacteria by binding at specific and unique binding sites on the cell surface. Compared to broad-spectrum antibiotics, each phage only kills specific bacterium. Making it possible to only eradicate the pathogenic bacteria in the gut while leaving the probiotics to flourish, thus treating obesity. Phages were isolated from local sewage treatment-plants and characterized with EM pictures and DNA sequencing. The phages were also tested with their lytic activity, survivability in the host gut, and host range. So far we have isolated 9 different phages that lyse B29, have narrow host range, and are robust enough to transit through the mammalian gut. We are currently testing the phages in obese mice models, which are established by using antibiotic-treated mice that are colonized with B29. The efficacy of the treatment will be measured by mice weight, fat pads, glucose tolerance and inflammation in the adipose tissue. With these current findings and future expected results, we suggest that phage therapy may be used to be an effective treatment against obesity.

Purpose/hypothesis We investigated the difference in metabolic syndrome parameters among college students based on their individual caloric distributions. We hypothesize that meal calorie distribution consumption will be influential on the MetS parameters in both males and females. Methodology We assessed MetS parameters in 108 Weber State University student participants, ages 18-54 years. Two-day diet records for each participant were collected and analyzed using Diet and Wellness Plus. Participants were separated by gender (Male:33; Female:75) and by meal calorie distribution. Groups included high, medium and low % of calories in breakfast, lunch, dinner, and snacks. Correlations between MetS parameters and calorie consumption, as well as mean comparisons between meal calorie distribution groups and MetS parameters, were assessed using SPSS software. Results Significant correlations in MetS parameters and total calories were found among participants in the categories of weight (r=0.27, p=0.005), waist circumference (r=0.23, p=0.01) and systolic blood pressure (r= 0.39, p=0.0001). Women in the high calorie breakfast distribution group presented lower systolic blood pressure than women in the low or medium breakfast group (μ= 106.3 mm/Hg, μ= 113.2. mm/Hg, μ= 112.01 mm/Hg p - 0.05). Men in the high snack consumer group presented higher HDL than the low snack group (μ= 41.9 mg/dL, μ= 29.9 mg/dL p - 0.01). Men in the high snack consumer group also presented higher blood glucose than the low and moderate snack groups(μ= 98.9 mg/dL, μ= 92.9 mg/dL, μ= 91.5 mg/dL p - 0.05). Conclusion In this study, males with a higher snack calorie distribution presented higher HDL-C than the lower snack calorie distribution counterparts. It is possible that this observation is due to HDL-C promoting foods consumed as snacks. High snack consumption is linked to increased exercise which is known to increase HDL-C. In females, higher caloric intake distribution for breakfast resulted in lower systolic blood pressure compared to the medium and lower breakfast intake groups. Previous studies have shown that skipping breakfast increases cortisol levels, which may result in higher blood pressure. Furthermore, many breakfast associated foods such as milk and eggs have shown to exert blood pressure lowering effects. Consumption of such foods may play a role in the results observed in this study. Meal calorie distribution seems to have an effect on MetS parameters. Further, research elucidating possible mechanisms behind this observation such as common foods consumed for each meal and meal effects on appetite hormones are warranted.

Osteoarthritis (OA) of the tibiotalar joint is a major cause of ankle pain, and is currently treated using one of two methods: fusion of the tibiotalar joint (i.e. arthrodesis) and total ankle replacement (TAR). Although the ankle joint seems simple, it is actually comprised of two complex, articulating interfaces: the tibiotalar and the subtalar joint, which represent the interface between the tibia and talus and talus and calcaneus, respectively. While arthrodesis and TAR are able to relieve pain in the short-term, many patients develop complications from surgery that can be difficult to address. Furthermore, patients who have received a tibiotalar arthrodesis commonly develop OA in the subtalar joint, which is thought to be caused by the subtalar joint having to compensate for motion lost at the tibiotalar joint as a result of fusion. Due to the difficulties associated with measuring the motion of small bones in the foot and ankle, the precise joint kinematics of the ankle are not yet realized. This work will study the kinematic differences in the subtalar joint between subjects with non-pathological, native joints in one ankle and tibiotalar fusion in the other ankle. This will be done using dual fluoroscopy to image the ankle joints in vivo, while subjects perform a double-heel-rise activity. Computed tomography (CT) scans are acquired of each subject’s ankles and used to create three-dimensional computerized models of the tibia, talus, and calcaneus. These three-dimensional models of the ankle bones are then synced with the dual fluoroscopy images to determine the three-dimensional (3D) position and orientation of each bone throughout the heelrise activity. These bone positions are then used to calculate joint angles and translations (kinematics) throughout the activity. The kinematics of the fused ankle will be compared to the contralateral ankle to determine the effects of ankle fusion on subtalar mobility. It is expected that mechanistic differences between the subtalar joint of the contralateral and fused ankles will lend insight into the properties and motions of the joints. Specifically, it is hypothesized that tibiotalar arthrodesis will lead to compensatory hypermobility in the subtalar joint, since it is adjacent to the fused tibiotalar joint. Hypermobility of these adjacent joints may contribute to the development of OA in these joints, as observed clinically. Such findings will promote the development of improved surgical planning tools and novel techniques to treat tibiotalar OA.

The goal of this meta-analysis is to establish the overall comparative efficacy of culturally adapted mental health treatments. Mental health care given to ethnic minorities has been a central focus of those seeking to improve psychological and therapeutic care. Cultural values, ideas, and beliefs may affect the way an intervention is received and therefore its ultimate effectiveness. The influence of culture is present across all aspects of psychotherapy, impacting the theoretical conceptualization, delivery, and assessment of an intervention. Tailoring and modifying mental health treatments to better fit clients’ cultural needs is commonly known in the literature as cultural adaptations. Through the process of cultural adaptation, (1) the cultural and historical biases and assumptions that are inherently intertwined in psychotherapy are addressed and (2) empathic attunement to the client’s culture facilitate the successful reception of the mental health treatment. Although various cultural adaptations of mental health treatments have added to the existing literature, there is an impending need to examine these studies together in order to provide empirically supported recommendations to guide practice. To address this need, we conducted a meta-analysis to establish the relative effect of those mental health interventions that have been explicitly adapted to clients’ racial, ethnic, or cultural backgrounds. We conducted a number of searches through various electronic databases in an attempt to grasp the totality of the literature on this subject. We included studies that used experimental or quasi-experimental research designs comparing mental health treatments that were culturally adapted to those that did not contain cultural adaptations. We examined only interventions that explicitly intended to improve emotional or psychological well-being. Data was extracted from 99 studies, containing 13,183 individuals, and the aggregate random effects weighted effect size was d = 0.499 (se = .039, 95% CI = 0.42 to 0.58, p < .0001). The types of cultural adaptations reported in individual studies varied substantially, both in terms of the number of adaptations and in terms of the specific types of adaptations. In addition, Egger’s regression test (an estimate of effect size asymmetry) was statistically significant (p < .001), providing evidence of publication bias which was statistically accounted for in our overall results. We review the importance of this research in terms of its implications in training, therapeutic practices, and research construction. Ultimately, cultural adaptations to mental health treatments prove somewhat more effective than treatment as usual with clients of color in North America.

Femoroacetabular impingement (FAI) is one of the most prevalent causes of osteoarthritis of the hip. Cam FAI is an orthopaedic pathology characterized by abnormal bony growth on the femoral head-neck junction. Cam FAI is thought to limit range of motion, which may result in chondral lesions and extensive labral tears. The purpose of this project was to quantify the variance in kinematics and the location of the hip joint center (HJC) between hip joints with cam FAI and asymptomatic controls using dual fluoroscopy (DF). For this DF study, 6 cam FAI patients and 11 control subjects were recruited. For each subject, hip joint kinematics were determined using DF. First, computed tomographic (CT) images were obtained for each subject. The images were segmented to delineate the bony surfaces and converted to 3D digitally reconstructed radiographs (DRRs). For the capture of bone movement, subjects performed activities in the combined field of view of two fluoroscopes, which collect x-ray video data. Specifically for identification of the HJC, subjects performed the StarArc pattern with their leg. This activity provided a large range of motion that allowed accurate determination of hip joint kinematics and the HJC location. After data capture, the DRR was matched to the DF data during the markerless tracking process. The data was processed in Matlab to provide visualization of the kinematics using subject-specific bone reconstructions in Postview. Abnormal, aspherical morphology of the femoral head in patients with cam FAI may cause the femoral head to translate more within the joint while also limiting the range of movement. Therefore, patients with cam FAI are expected to display a greater degree of translational motion of the HJC and a lower degree of rotational motion than control subjects. DF techniques provide arthrokinematics of the hip, which is how the joint moves in vivo relative to subject-specific bone anatomy. Using this data as a gold standard, errors in the calculation of the hip joint center using standard motion capture techniques can be measured. This method can be applied to help us better understand the kinematics of cam FAI and how the asphericity of the femoral head can cause pain and cartilage erosion which is associated with osteoarthritis.

Title: The Fox Anger Inventory: A New Way to Measure State Anger Author: Logan Ashworth, Mentor: Michelle Grimes Affiliation: Southern Utah University Poster Presentation Introduction Tests that purport to measure anger most often measure trait anger as opposed to state anger. There are few measures of state anger available in the public domain. The purpose of the current study was to construct a new measure of state anger, the Fox Anger Inventory (FAI), which records state anger by presenting respondents with a series of items that include emotionally-valenced words as response options. The words chosen for the FAI were taken from the Affective Norms for English Words (ANEW) database (Bradley & Lang, 2017). We hypothesize the FAI will demonstrate adequate internal consistency and construct validity. This project is currently in the IRB approval process, data collection is projected to be complete by December, 2017. Methods Approximately 60 participants will be recruited from Southern Utah University PSY 1010 classes. Participants complete the FAI and the the State Trait Anger Expression Inventory (STAXI-2; Spielberger, 1988). The order of completion will be chosen at random. Participants will receive course credit in their PSY 1010 class for completing the survey. Results We predict the FAI will demonstrate internal consistency with cronbach’s alpha estimates of .80 or higher. Further, we predict the FAI will demonstrate construct validity through a positively correlated to the STAXI-2. Conclusion If our hypothesis is supported, this will provide evidence that the FAI is a reliable and valid measure of state anger. Specifically, adequate internal consistency estimates will provide evidence of reliability. A strong positive correlation between the FAI and the STAXI-2 will indicate construct validity. If our hypothesis is not supported our measure will not be a viable tool to measure state anger. Implications for the project, as well as future directions will be discussed.

The incidence of cervical spine surgeries has been steadily increasing over the last 20 years. Most of the recipients are older than 65 years old, a population projected to reach 83.4 million in the United States by the year 2050. Previous studies show that hospital readmissions from posterior cervical spine surgeries in particular occur at the highest frequency in this age group and have multidimensional contributing factors. The most common factors in 30-day and 90-day hospital readmissions are post-operative infections and wound dehiscence, which are largely preventable. Peripheral but significant contributing factors include payer status, facility type, comorbidity status, etc. Analysis of these factors on a systems level is critical to constructing a singular statistical model to reduce readmissions for the purposes of optimizing patient outcomes and hospital resource management. We propose structural equation modeling (SEM) as a novel approach to comprehensively evaluate hospital readmissions. Data was collected from the National Readmissions Database (NRD) in the year 2013, which is an all-payer database of inpatient care and represents almost half of the total US hospitalizations. Adults 18 years and older were included and outliers, missed data, redundancies, and inconsistencies were addressed. Predictive factors included in the model were patient demographics, diagnostic and procedural information, as well as hospital characteristics. Outcome variables include hospital mortality, 30-day readmissions, and 90-day readmissions. A more complex analysis of direct and peripheral contributing factors for readmissions from posterior cervical spine surgeries is imperative to create a comprehensive predictive model. This new model can be used to implement administrative changes and changes in procedural protocol, including post- and pre-operative prophylaxis. SEM has been applied previously for assessment of atrial fibrillation readmissions and it stands to reason that our model could be extrapolated to readmissions in other surgical specialties or specific types of inpatient complications. If our model is successful in optimizing resource management for hospitals, it would be possible to clearly understand the allocation of funding within the hospital which could lead to targeted decreases in costs of healthcare for the hospital, insurance company, and patient. In anticipation of the possible changes in health policy climate which may restrict funding for state healthcare programs in states which have the largest populations, efficient utilization of hospital resources and patient outcomes is of utmost priority.

An intraoperative detection of malignant cells in the margins of excised tissue during the breast conservation surgery (BCS) is critical for patient survival. Traditionally, the surgeon removes malignant breast tissue and pathology analysis is performed subsequently in the lab searching for residual malignant cells on the margins of excised tissue. If such cells are present, a second, and sometimes a third, surgical procedure is needed to remove them. The multiple procedures are time consuming, painful, and costly. Further, malignant tissue that remains in the breast has the potential to continue growing and metastasizing to other body parts. Ideally, the boundaries on an incision should be free of malignant tissue after the initial surgery. A software for breast cancer data acquiring and analysis is presented. The main objective of the presented work is improving the BCS surgical outcomes by having pathology analysis inside the operating room. Such a technology would enable real time malignancy detection and removal during the initial surgical procedures. Our software is an interface for high frequency ultrasonic technology. It communicates with an oscilloscope and ultrasound generator device to acquire, analyze, and store breast tissue data generated using high frequency ultrasound waveforms. The developed system implements pioneering data analysis techniques to determine breast tissue malignancy. The system has been tested using phantoms and breast tissue specimens collected at the Huntsman Cancer Institute (HCI). Our software has delivered high-accuracy data collection and analysis procedures when compared with the pathology results. Additionally, it is significantly faster than the old procedure of manual data collection and storing methods used by our team at the HCI. The software interface is user friendly, does not require any knowledge in programming and can be used by the medical team in the operating room. The system is a prototype for a commercial product that could be used for in vivo tissue examination to assist surgeons with cancer detection in soft tissue organs such as the breast.

Although heart failure continues to be the leading cause of death in the U.S., research into safer and more reliable methods for replacing dead cardiac cells has become more promising. Instead of a human donor transplant, we can engineer a patient-specific heart to be used in the transplant that will lower risk of rejection by the receiver. Our research at BYU has focused on strengthening the beating function of engineered cardiac tissue and layering the engineered tissue to create transplantable patches to be inserted on damaged hearts. Beating human heart tissue was created in vitro using non-immunogenic scaffolds generated from decellularized porcine hearts combined with cardiomyocytes (CMs) derived from human induced pluripotent stem cells (hiPSCs). Whole porcine hearts were decellularized to create 3D scaffolds capable of supporting the human cells mechanically and biochemically. From the left ventricle of the decellularized hearts, 300 µm thick, 10 mm round slices were prepared and mounted on glass coverslips. Human iPSCs were differentiated into cardiac progenitors and 4 days after differentiation, these cells were seeded onto the decellularized tissue samples. Ten days after recellularization, clusters of differentiated CMs started to beat spontaneously. Immunofluorescence images showed confluent coverage of CMs on the decellularized slices and the effect of the scaffold was evident in the alignment of the CMs in the direction of the collagen fibers. A resazurin-based viability assay showed attachment and survival of 75% of the seeded cells up to 14 days after recellularization. The clusters continued to beat for 60 days. To improve the beating function of the CMs implanted in the tissue scaffold, we will use mechanical, electrical and pharmacological stimulation. By combining mechanical stimulation through a mechanical stretching device, electrical stimulation through transmitting electrical frequencies ranging from 1 to 1.6 Hz, and pharmacological stimulation through drugs, such as epinephrine, we hypothesize that we will increase the beating function of the cardiac tissue from 10 beats per minute (current rate) to 60 beats per minute. We will also layer sheets of CMs into a patch, and insert them onto hearts of induced-infarction rats on top of the dead cardiac tissue. By using these strengthened CMs and layering them through chemical binding factors and centrifugation, we hypothesize that the CM patch will attach securely to the patch of dead cardiac tissue in the rats and replace it in function without being rejected by the host.

Sierra Murri, SN, Mara Thomas, SN, Sondra Heaston, MS, NP-C, CEN, CNE, Sheri Palmer, RN, DNP, CNE Background: In May 2017 a group of students and instructors from Brigham Young University’s College of Nursing visited Guayaquil to assess malnutrition and anemia rates in school-aged children. The study found that more than 76% of all 581 children measured (ages 4-17) suffered from anemia (below 11g/dl 12 yrs as per WHO guidelines). The adverse effects of anemia for these children may include: weakness, fatigue, shortness of breath, and poor concentration. Anemia results from deficiencies of iron, B12, folic acid, and may also be the result of intestinal parasites. A nutritional survey conducted among these same school children showed that daily intake of iron, B12, and folic acid were below recommended levels. Intervention: Shortly after obtaining measurements in May, Hogar de Cristo (HDC), a non-profit organization located in Guayaquil and a long-time partner of BYU, began a nutritional intervention distributing eight ounce bottles of fortified soy milk to pre-selected local schools to be served as a complimentary snack to the students. For our study, two schools were selected receiving the soymilk intervention, one school receiving albendazole (400 mg), and one not receiving the intervention to compare. Fortified soymilk is affordable, available in the region, and made on site by Hogar de Cristo, making the intervention sustainable. Schools A and B will receive the soymilk 3-5 times per week. School C received the Albendazole in August 2017. School D will be the control group. The purpose of this research will be to determine the effectiveness among the different interventions, thus identifying whether the fortified soymilk or the Albendazole is most effective in reducing anemia levels. By so doing, we aim to help HDC more effectively distribute the fortified soymilk and/or Albendazole to provide evidence that fortified soymilk and/or Albendazole can be effective in raising hemoglobin to healthy levels. Results: Results of this sustainable intervention will be presented at UCUR. Our research group will be traveling back to Ecuador in November 2017 to do follow-up measurements of the children receiving the different interventions and the control group. The data will be entered into a statistical program and results will be available by mid-December 2017.

Recent research suggests that individuals who use religious coping in a negative fashion are prone to high levels of stress and depression. Religious missions require strict adherence to religious standards. Other research on returned and actively serving LDS missionaries has indicated that many suffered from mission-related stress. Some mission-related stress is thought to be associated with inappropriate weight gain and negative body image. Though under stress, some research indicates that LDS missionaries can learn positive life skills and gain confidence which leads many to successful lives. We wanted to examine the relationship between religious missionary service and the self confidence of returned LDS missionaries. We also wanted to learn if these returned missionaries were prone to significant feelings of guilt and shame for their eating choices and physical appearance. We hypothesized that returned LDS missionaries would have higher levels of self confidence and body comfort when compared to the control population. We also hypothesized that returned LDS missionaries would be subject to significantly higher feelings of stress and guilt when compared to the control population. In order to study these factors, we collected data from a convenience sample of 1008 participants who responded to an online survey distributed by means of social media. Of these participants, we recorded responses from 164 returned missionaries of the LDS church. Participants responded to questions by rating levels of self confidence and body comfort. Questions related to guilt, stress, and eating were also measured. Measures taken from returned LDS missionaries and other participants were compared in regards to both body comfort and self confidence. Measures of guilt and stress in regards to eating were also compared. On average, returned LDS missionaries reported higher levels of confidence and body comfort than other participants. In contrast to our hypothesis, returned LDS missionaries reported fewer instances of feeling guilt or shame due to eating habits. Results showed no significant relation between missionary service and eating as a response to stress. Though there is little available literature on the health of returned missionaries, the results seem to contrast findings from existing research on missionaries. The findings could aid in understanding the relation between the missionary lifestyle and the resulting positive self image. Further research will be needed to understand how LDS mission service impacts confidence and health. Perhaps future findings could aid in the discovery of factors which may lead to higher levels of confidence and body comfort.