A.T. Still University’s scholarly activity magazine

“A spark of fire will start the principles of powder into motion.”

– A.T. Still, DO

1 The strike zone p.26 Dr. Bruce Young zeroes in on neuromuscular control in rattlesnake strikes.

2 Vol. 1, No. 1 2017-18 ContentsA.T. Still University’s scholarly activity magazine

Features

Knowledge networks ATSU’s practice-based research networks help 19 healthcare professionals improve patient care. Social media and online education ATSU-CGHS faculty members seek to increase social 25 engagement in the online learning community. Snake reaction Dr. Bruce Young studies neuromuscular control in 26 rattlesnake strikes. Laser focus Laser-based dental treatments offer hope for patients 29 with chronic periodontal disease.

Departments

6 Faculty highlights 13 Student highlights 30 Behind the scenes: Ultrasound 32 Q&A: Plagiarism 35 Did you know? Tooth wisdom

ATSU Mission A.T. Still University of Health Sciences serves as a learning-centered university dedicated to preparing highly competent professionals through innova- tive academic programs with a commitment to continue its osteopathic heritage and focus on whole person healthcare, scholarship, community health, interprofessional education, diversity, and underserved populations.

ATSU schools and colleges The University comprises Kirksville College of Osteopathic Medicine (ATSU-KCOM), College of Graduate Health Studies (ATSU-CGHS), Missouri School of Dentistry & Oral Health (ATSU-MOSDOH), Arizona School of Dentistry & Oral Health (ATSU-ASDOH), Arizona School of Health Sciences (ATSU-ASHS), and School of Osteopathic Medicine in Arizona (ATSU-SOMA).

Notice of nondiscrimination A.T. Still University (ATSU) does not discriminate on the basis of race, color, religion, ethnicity, national origin, sex (including pregnancy),gender, sexual orientation, gender identity, age, disability, or veteran status in admission or access to, or treatment or employment in its programs and activities. Dating violence, domestic violence, sexual assault (e.g., non-consensual sexual contact/intercourse), stalking, harassment, and retaliation are forms of discrimi- nation prohibited by ATSU. Any person with questions concerning ATSU’s nondiscrimination policies is directed to contact Lori Haxton, vice president for student affairs (660.626.2236; [email protected]), Donna Brown, assistant vice president of human resources (660.626.2790; [email protected]), or by mail to either office at 800 W. Jefferson St., Kirksville, MO 63501. Any person with questions concerning ATSU’s Title IX compliance is directed to contact Joe Vincent, Title IX coordinator (660.626.2113; [email protected]), 800 West Jefferson St., Kirksville, MO 63501. 3 LEADERSHIP MESSAGE

Introducing Spark, ATSU’s strategic vision of scholarly activity

Writer/Editor Welcome to ATSU’s newest publication, Spark. This magazine is designed Katie Hubbard, MBA to celebrate and foster the University’s continued commitment to scholarly activity contributing to healthcare education, knowledge, and society. Contributing Writers Virginia Halterman, BA Laurie Trowbridge, MS As a teaching and learning university that values scholarly activity supportive of our heritage, mission, and vision, ATSU is fortunate to have Design a 125-year foundation of actively participating faculty and students. Gail Doss, BFA Photography Scholarly activity at ATSU encompasses Boyer’s definition allowing Kelly Rogers participation from all interested faculty and students. Forms of scholarly activity include scholarship of teaching and learning, engagement, Contributing Photographer discovery, application, and integration. Mitchell Faherty Editorial Adviser In Spark’s inaugural issue, learn how ATSU’s practice-based research Deborah Goggin, MA, ELS networks are bringing together clinicians and researchers to improve patient health. Also, discover current investigations involving novel Vice President for Research, Grants, & Information Systems technology, online learning, battling harmful pathogens, and much John Heard, PhD more. From rattlesnakes to dental lasers, faculty members are pushing boundaries to improve learning outcomes and community health. ATSU President Craig M. Phelps, DO, ’84 We hope you enjoy reading about our wonderful faculty and students who question and inspire scholarly activity leading to new knowledge. Please send us your comments or questions at [email protected]. Your feedback is welcome. Spark magazine A.T. Still University Yours in service, 800 W. Jefferson St. Kirksville, MO 63501 [email protected]

Craig M. Phelps, DO, ’84 Spark magazine highlights scholarly President activity across the University. It is published biennially by Communication & Marketing and Research, Grants, & Information Systems, A.T. Still University.

Published in winter 2017. John Heard, PhD Vice President Research, Grants, & Information Systems

4 MMXVII INFORMATION DISSEMINATION

ADVICE DEPARTMENT OF ASSISTANCE RESEARCH SUPPORT

DIRECTION GUIDANCE

SOLUTION COMPETENCE

ATSU Research Support benefits you! It often takes a team of experienced individuals to generate a successful research project. Whether you are a veteran or novice to research, Research Support staff offers guidance and services that can help you formulate and disseminate new research information.

Serving all ATSU schools and departments Contact Research Support today! ASDOH, ASHS, CGHS, KCOM, MOSDOH, SOMA, Jack Morris, MS, PMP Still OPTI, and ATSRI Director, Research Support 660.626.2444 Services offered [email protected] • Statistical consultation • Research coordinator assistance Visit Research Support through the • Scientific writing assistance ATSU portal • General research study advice Departments>Research and Sponsored • Research project management Programs>Research Support

5 HIGHLIGHTS

The finger-stick test

Patient safety is the No. 1 priority for ATSU-ASDOH faculty Why is your research important? members Seena Patel, DMD, MPH; Maureen Perry, DDS, A patient taking a medication, or who has a medical MPA; Ann Spolarich, PhD, RDH, FSCDH; and Rebecca condition that causes coagulopathy, is at risk for Schaffer, DDS. Together, they are studying a more effec- increased bleeding during and after an invasive tive way to assess a patient’s bleeding risk before an inva- dental procedure. A testing device that can be used sive dental procedure. The project, which began in 2013, at the point of care can provide an easy way to check examines how a simple finger-stick test can ensure patient a patient’s INR and determine if it is safe to proceed safety or determine the need for additional medical care. with the planned treatment. Assessing the efficacy of this testing device may be beneficial for clinical What are you investigating? practice because it is a convenient tool that promotes The research project investigates the potential for a patient comfort and convenience more than traditional portable, self-monitoring finger-stick testing device to laboratory assessments. Results of this test can prevent be used as a screening tool to assess the coagulation the need to reschedule a procedure when the patient’s status of patients taking the blood thinner medica- status is unknown. Furthermore, it can make the tion Coumadin (e.g., warfarin). In particular, we are patient aware of their current response to Coumadin evaluating the use of this device at chair side prior to a therapy so they seek medical care sooner if their INR dental procedure. is outside the therapeutic range. A patient who is on the medication warfarin, or has a suspected bleeding disorder related to coagulopathy, What do you hope to achieve? will undergo a finger-stick test at the point of delivery Currently, INR self-monitoring is not approved or of care, chair side, in the Advanced Care Center at intended for use as a diagnostic device. Our study ATSU-ASDOH to assess their international normal- examines the accuracy, and therefore the validity and ized ratio (INR). This value will indicate whether it is reliability, of this type of device compared with labo- safe to proceed with the planned dental procedure. It ratory standards. If both types of tests show the same will also be compared with the laboratory INR that result, discussions may be opened about whether its the patient was required to have done 24 hours before use could be extended to clinical settings. We hope the dental visit. this study shows our dental and medical colleagues that using a finger-stick device to assess INR at the point of care is simple, accurate, and reliable and provides for a more predictable risk assessment of the patient’s bleeding risk during and after an invasive dental procedure. In addition, we hope this device will replace the 24-hour INR order that is required of patients before every invasive procedure.

6 FACULTY

Robotic rehab

For almost 20 years, James Lynskey, PhD, PT, associate professor and director of research, physical therapy, ATSU-ASHS, has been investigating recovery after neurologic injury. In a current study, funded by ATSU, he takes a closer look at a novel technology used in rehabilitation of individuals with neurologic diseases and disorders, specifically a robotic device called Foot MentorTM.

What are you investigating? When using the Foot Mentor, which was orig- inally developed by a local Arizona company, stroke survivors play video games controlled by their foot and ankle movements. The device is intended to be used in the home and engage the patient by turning rehabilitation into a game. Previous research showed that 12 weeks of training with this device in the home improved Dr. Lynskey studies novel technology used in rehabilitation of leg strength by 28.6 percent and walking ability by stroke survivors. 20 percent in chronic stroke survivors. In the current follow-up study, I am collaborating with colleagues at the University of Illinois-Chicago and Arizona State University to determine if training with Foot Mentor in-home rehabilitation models may become more promotes neuroplasticity. Using transcranial magnetic common for improving lower extremity strength and stimulation, we are assessing changes in connectivity walking ability in stroke survivors. between the brain’s primary motor cortex and the ankle muscles after one session with the device and What is the next step? after the 12-week training program. For this area of research, larger scale studies are need- ed. Our current studies are fairly small, and a larger Why is your research important? randomized controlled trial would be great to validate The current treatments that promote recovery of leg our findings. After that, more real-world implementa- function and walking ability in stroke survivors are tions with stroke survivors as they are going through inadequate. Stroke survivors need continued care the rehabilitation process would be ideal. and rehabilitation, not just for a few months, but intermittently for the rest of their lives. The decreased reimbursement period and shortened time stroke survivors have in both inpatient and outpatient reha- bilitation necessitate the implementation of alternative strategies of treatment, especially those based in the home. If we can demonstrate that using Foot Mentor in the home promotes recovery and plasticity, then

SPARKMAGAZINE 7 HIGHLIGHTS

Caries prevention

Jaana Gold, DDS, PhD, MPH, CPH, is an associate What do you hope to achieve? professor at ATSU-CGHS for the Master of Public Health – I hope to promote awareness of the importance of oral Dental Emphasis (MPH-D) program. During her 25 years of health for underserved pregnant women and young teaching, research, and practice in dentistry, she has children. As I expand my research, the next step is focused her research on preventive dentistry, cariology, to research the effect of silver diamine fluoride on and dental public health. As a director of the Women, arresting dental caries in these populations. Silver Infants, and Children (WIC) Oral Health Program in Gaines- diamine fluoride (38 percent SDF) is a desensitizing ville, Florida, she recently completed a study titled and cariostatic agent that has been gaining attention “Oral Health Knowledge and Practices of WIC Staff at in the United States since it was approved by the Food Florida WIC Program.” and Drug Administration in 2014. SDF is an easy and low-cost application method with proven efficacy on What are you investigating? active caries, resulting in an inexpensive nonsurgical I am an online faculty member for the MPH-D treatment option for many Americans. Currently, most program, and in addition to guiding our residents’ studies of SDF have been conducted overseas, and we and students’ research projects, I conduct research have not established clinical evidence in the United locally in Florida. As a director of the WIC Oral Health States. Therefore, the investigation of SDF treatment Program, which serves underserved pregnant women has great potential to reduce oral disease burdens in and young children who are clients of the local WIC our underserved populations. program, I studied the knowledge and attitudes of WIC staff on oral health issues and dental care. Through my research, I found the WIC staff needs oral health training and education to provide oral health counseling for at-risk WIC populations. Specifically, the training should include oral health assessments and guidance on evidence-based prevention tech- niques, such as using fluoride toothpaste, tooth brush- ing, dietary counseling, and referrals to dentists.

Why is your research important? Uninsured and low-income populations have greater oral disease burdens and oral health disparities. However, dental caries and many dental conditions are preventable. Early prevention and education is effective, and we should target vulnerable popu- lations, such as pregnant women and families of young children. Because the oral health of pregnant women can affect the health of unborn children, it is important to educate pregnant women and prevent oral diseases early so the health of communities and underserved populations can be improved.

Dr. Gold promotes oral health awareness for underserved pregnant women and young children.

8 MMXVII FACULTY

Patent-approved research

Hamid Nurrohman, DDS, PhD, joined ATSU- MOSDOH as an assistant professor in January 2016 Dr. Nurrohman’s patented technology and is an assistant adjunct professor at the Univer- will improve fillings for dental patients. sity of California San Francisco (UCSF) School of Dentistry. With his research background in cariol- ogy and operative dentistry, he is specifically inter- ested in nano-controlled molecular interaction at adhesive interfaces for hard tissue reconstruction. His research interests have also branched into guided tissue remineralization as well as repair of caries-infected dentin and inherited dentin de- fects. In collaboration with Dr. Grayson W. Marshall from USCF School of Dentistry, Dr. Nurrohman most recently researched biomaterials that would provide better fillings for patients while restoring dentin within the teeth.

What did you investigate? The project spanned seven years and was funded by the National Institutes of Health. As the primary investigator or co-investigator of these studies, our early publications addressed laboratory-based biomaterials research, which is essential to the genesis and development of improved biomaterials for dentistry. We also investigated how nano-controlled molecular interaction at the biomaterial-hard tissue interface can improve bond durability and resist caries attacks. Moreover, our recent publication described investigations into the remineralization and repair of dentin resulting from the progression of caries or inherited dentin defects.

What were your results? As a result of our research, we invented a technology that provides the required ions and acidic polymers in dental fillings to fill cavities while repairing mineralization of the surrounding tooth. Additionally, the technol- ogy provides longer lifetimes for the fillings Why is this research important? and robust light- or auto-cured dentin repair. In March 2016, Dr. Marshall and I documented our Optimization of a biomimetic mineralization approach invention titled “Biomimetic and bioactive dental may open new pathways toward an in situ strategy restorative for in situ remineralization.” Recently, that can develop into clinically relevant biomedical the patent was approved through the U.S. Patent and applications for hard tissue repair and engineering. Trademark Office. Even with our approved patent, more funding and evidence is needed in this area.

SPARKMAGAZINE 9 HIGHLIGHTS

It’s in the genes

Vineet Singh, PhD, professor of microbiology/immunology proteins and how they help this bacterium resist at ATSU-KCOM, has spent 20 years studying Staphylococ- antibiotic stress. cus aureus, specifically methicillin-resistant Staphylococcus aureus or MRSA, a highly destructive, antibiotic-resistant Why is your research important? bacterium. In his pursuit to find an antibiotic to combat This research is important because MRSA is the damaging effects of this harmful pathogen, he re- everywhere. Approximately 50 percent of people in ceived funding from the National Institutes of Health (NIH) a community, particularly those who work in hos- to study the importance of many of the bacterium’s genes pital settings, have the bacterium on their skin and that may be regulated by the presence of antibiotics. in their nose. Nearly 90 percent of all skin infections are caused by this bacterium. Typically, this is not a What are you investigating? problem because skin infections are easy to control. My research began with studying how S. aureus However, if MRSA gets into the blood circulation, it responds when you add different antibiotics to it. I can consume bones, joints, and other tissues fairly found that when antibiotics were added the bacterial rapidly. Infected individuals need an effective cell produced large amounts of a few select proteins. antibiotic to immediately stop the damage caused So the question became, are these proteins somehow by this pathogen. helping protect the bacterium from antibiotics? I identified some of these proteins, and one of them was What do you hope to achieve? a methionine sulfoxide reductase (Msr). Subsequently, I’m hoping I will be able to identify and target a few I found that S. aureus makes four of these Msr proteins critical genes and find the means to completely control through four genes. One way to stop bacteria from the expression of these genes. If these genes are not making these proteins is by deleting the specific genes allowed to express and make proteins, the bacteria from the chromosome. After deleting the Msr encod- may not survive. Making these genes nonfunctional ing genes individually, I combined these deletions in is my long-term goal. The next step would be to find the chromosomes, resulting in an S. aureus bacterium a novel antibiotic that can shut down the expression that was not producing any of these four Msr proteins. of these genes during clinical infections and kill the With funding from NIH and through collaboration bacteria once it’s in the human body, ultimately pro- with Dr. Jackob Moskovitz from the University of viding a cure. Researchers have been trying to create Kansas, I am studying the importance of these a vaccine to prevent MRSA infections from occurring, but no one has been successful yet.

1 2 3

Battling Staphylococcus aureus infections

In the figure, the bacterium S. aureus is grown on a solidified 1) Degradation of RBCs is significant (observed by a larger circular medium mixed with sheep red blood cells (RBCs). Bacterial factors zone of clearing) near growth of S. aureus, which produces all (toxins) are causing degradation of the RBCs, which is evidenced Msr proteins. by the clearing of the red color in the plate. This is one of the many 2) Degradation of RBCs is reduced by MsrA-deficient S. aureus. ways S. aureus can cause damage to the cells in human body 3) MsrA1 protein is restored, again causing significant degradation tissues. The observation shown in the figure suggests that MsrA of RBCs by S. aureus. proteins are important for S. aureus to cause disease.

10 MMXVII FACULTY

The bioinstrumentation team

Through active collaboration, we are able Dr. Makin, Dr. Heath, and ATSU-SOMA to use precise instrumentation, photo pleth- students practice OMT techniques. ysmography, and laser Doppler flowmetry to assess peripheral blood flow changes resulting from OMT. The changes in blood flow parameters can have multiple underly- ing mechanisms, including modulated local sympathetic vascular tone. Our current studies have been conducted on clinically asymptomatic human partic- ipants, but future goals are to investigate the role of OMT on patients with compro- mised peripheral vascular status. Addition- al instrumentation techniques are being implemented to investigate the regional vasculature of the target region using spec- tral Doppler ultrasound and high-resolution ultrasound imaging. Several conference presentations have been made, and results from these studies will be published in early 2017. According to Inder Makin, MD, PhD, an associate professor at ATSU-SOMA and ATSU-ASDOH, collaborative and Why is your research important? interdisciplinary teams are key for successful and effective For clinical practices and procedures to be established, medical research. As a medical professional and bio- the corresponding clinical evidence must be demon- engineering scientist, Dr. Makin’s research background strated. Therefore, research conducted at ATSU-SOMA pairs nicely with that of Deborah Heath, DO, professor of that assesses quantitative physiological changes osteopathic principles and practice and assistant dean following OMT will augment the scientific literature for curriculum integration, and Chandhana Pedapati, MS, related to OMT and potentially enhance adoption research associate with expertise in biosignal analysis. of OMT as one of the options in practice to treat Since 2010, the group has studied changes in physiologic somatic dysfunction. parameters from osteopathic manipulative treatment (OMT), and they offer research opportunities to engineer- What is the next step? ing students from Arizona State University for specific Ultimately, we hope to advance the scientific under- technical tasks related to this research. standing of osteopathic medical principles by using sophisticated and appropriate instrumentation tools, What are you investigating? such as continuously monitored cerebral blood flow The research direction at ATSU-SOMA is to enhance measurements, measurement of segmental arterial the knowledge of functional and structural effects velocities, as well as time and frequency post-analysis following OMT. The goal of this research is to demon- of acquired physiologic signals. The next step of this strate changes in physiologic status at the cardiac research would involve the use of ultrasound instru- and peripheral blood circulatory levels following mentation to document spatially defined changes in osteopathic procedures performed along the vertebral blood flow and tissue morphology following OMT. column. The idea that OMT positively influences the Also, this research will be expanded to clinically body’s autonomic system, distant from the site of symptomatic patients. manipulation, through neural pathways along the spinal column was proposed by John Stedman Denslow, DO, ’29, and Irvin Korr, PhD, several decades ago.

SPARKMAGAZINE 11 to ATSU faculty, staff, and students engaged in scholarly activity during fiscal year 2015-16!

Number of publications Number of grant awards received • 92 faculty publications • 33 external grant awards totaling $2,628,294 • 33 faculty and student/alumni publications • 14 internal grant awards totaling $706,413 • 14 student publications

Number of presentations • 117 faculty presentations • 61 faculty and student/alumni presentations • 19 student presentations

Quartile Summer 2016

Submit your research

for the ATSU Research Presentations and Edwin Land a.”bstracts, ~ continued newsletter! “It is a curious property of research activity that after the problem has been solved theBroussard solution A [student], seems DeChant obvious A [student], Gorell E [student], Hartford A [student], Hua CJ [student], [student], Mika A [student], Millhouse R [student], Sylvia J [student], Whiting A [student], Yang E [student],

Simmons K , Lewis JH . Venom peptides Loofburrow S Publications HealthPoint Community. HealthEvaluating Center the population. receptivity Posterof patientsAhmad presented regarding Z at: National text messages Association-251. for healthcare of Community Health Centers Community Health Institute and Expo; August 28 Michaelis R, The ATSU Research newsletter is ATP synthase. Int J Biol Macromol. 2016;87:246 -related reminders in Escherichia coli -30, 2016; Chicago, IL. the

published quarterly by the Azim S [student], McDowell D [student],Cardenas Cartagena J, Valovich A [student], McLeod Rodriquez TC R, Laughlin TF, Department of Research Support, cathelicidin and lycotoxin cause strongAthletic inhibition Trainers’ of Association 67th .Clinical Emergency Symposia; preparedness June 22 of seco Link. Train. 2016;51(6 suppl):S125. -570. Link. ndary school athletic programs. Presented at: National Park JH. Vertical eruption patterns;86(4):565 of impacted mandibular-25, 2016; third Baltimore,molars after MD. the Abstract published in: J Athl and it features peer-reviewed journal Baik UB, Kook YA, Bayome M, ParkCha JU,C [student], Conley L [student], Geiger M [stude publications, oral and poster mesialization of second molars using[student], miniscrews. Salibay Angle [student], Orthod.-based Tingle 2016practice R [student], beliefs Wyand TJknowledgent], [student], Gunawan of physical L [student], therapy Hasan clinical A [student], Ogino J [student], Pyo G , Shaw DK. The evidence Link. Leafman J program: establishing 2016;14(3):10. a student presentations, and research abstracts. National Association of Community-led walking Health Centersgroup to Community supplement Health diabeNavarro Institute I, Whelihan and Expo; K August 28 Bierwas DA [alum], , Lewis JH. Walk to Wellness instructors. Internet J Allied Health Sci Pract. tes management support groups. Presented at: . . The effectCoffey of J kinesio[student], taping on anterior-293. Link knee pain consistent with patellofemoral pain syndrome: a Valier AR Crutchfield P, Frei W [student], Hatch D [student], Kaminski A. Reducin -30, 2016; Chicago, IL. Campbell SA, topic. J Sportcommunity Rehabil. 2016;25(3):288health centers: a controlled study. Poster presented at: National Association of Community Health Centers critically appraised Community Health Institute and Expo; August 28-68. Link. g dental no Link. -shows in -30, 2016; Chicago, IL. -126. For more information or to submit Coelho KR [student], Belden CCummings [adjunct]. R A [student], systematic Erickson review Aof [student],the literature Hora on the relationship between caste membership and health-related risk factors[student], in India. IntMatsushita J Med Public S [student], Health. Morris 2016;6(2):61 C [student], Padakanti S [student], Sadiqi A [student], th C [student], LinkHuntley. J [student], Imayanagita B [student], Kurtz J JH. The influence of patient education on colorectal cancer sc-396. research, contact . Decoded neurofeedback is unlikely to enhance moral capacities. AJOB Neurosci. 2016;7(2):125 Crutchfield P of Community Health Centers Community Health Institute and Expo; August 28 reening Linkcompliance.. Poster presentedMeek at: BNational, Sivakoff Association M Deborah Goggin, MA, ELS -33. , Lewis . The epistemology of moral bioenhancement. Bioethics. 2016;30(6):389 Crutchfield P Erickson CD [alum], Kay MC [alum], Weber ML [alum], -30, 2016; Chicago, IL. Scientific Writer, ATSU Research Support -back pain: a Cochrane systematic perceptions of the academic management team for -studentspecificValovich low McLeod TC DePalma SM [student]. ManagingNational atrial Athletic fibrillation Trainers’ in Association primary care. 67th JAAPA. Clinical 2016;29(6):29 Symposia; June 22 , Welch Bacon CE 660.626.2397 SJ. Muscle energy technique for non -athletes following a sport . School Athl Trai -related concussion. Presentednurses’ at: , Ostelo R, Kampern. 2016;51(6-52. Link suppl):S225.. [email protected] Franke H, Fryer G -25, 2016; Baltimore, MD. Abstract published in: J review. Int J Osteopath Med.Fick 2016;20:41 J , Dishman L, Adler K hospital CEOs? Presented at: Association, Williams L of University Programs in Health Administration 2016 Annual Meeting; S. Oral health knowledge and practices of WIC staff. What at Florida leadership WIC competencies program. J Community of health. Expadministration Health. Parasitol. graduates matter most to Gold JT, Tomar 24,. 2016; Kansas City, MO. Trichomonas tenax -618. Link -1 macrophages to 2016;41(3):612 Cytokine response of human THP June 22 StuartFilali MK N, Valovich. McLeod TC - Govro EJ [student], among Italian youth soccer athletes., Welch Presented Bacon at: CE American Academy of Neurology 2016 Sports Concussion -80. Link. hygiene:, Bellini creating G, Ammaddeo new oral P, healthcare Cornali C. paradigms. Concussion J Evid reporting attitudes To view the latest newsletter, visit Academic 2016;169:77 July 8-10, 2016; Chicago, IL. . The doctoral degree in dental Spolarich AE 149. Link. . Publishing News on iconnect.atsu.edu. Gurenlian JR, Rogo EJ,Gallegos suppl):144 DM [alum],- -13. Link Conference; Lam KC mplification protocol (TRAP) activity upon Based Dent Pract. 2016;16(who diagnose acromioclavicular, Snydersprains: Valiera report AR from the Athletic Training Practice Hansen JL. Telomerase repeat, Huxel a Bliven KC National Athletic Trainers’ Association 67th Clinical Symposia; June 22. Use of orthopedic special tests by athletic trainers 12 Hansen DT, ThiyagarajanAthl Train. T, Larson 2016;51(6 AC, suppl):S207 -Based Research Network. Presented at: recombinant expression and purification of human telomerase-S208. in a bacterial system. Protein- Expr25, 20 Purif.16; Baltimore, 2016;123:6 MD. Abstract published in: J Goldstein LB. Improving Arizona rural health through clinical training at community health centers. Presented at: 43rd Annual Arizona Rural Health Conference and 11th Annu AZ. al Performance Improvement Summit; July 26

-27, 2016; Flagstaff, Gorman NT, Mayhew JL, aged women. Presented at:Brechue American WF College. Bilateral of Sports deficit Medicine during the 63rd squat A jump is not affected by training state in college

Govro EJ [student] nnual Meeting; June 1 - Stuart MK -4, 2016; Boston, MA. Trichomonadidae). Poster presented. Cytokine at: 68th response Annual of Midwestern human THP Conference of Parasitologists; June 9 -1 macrophages to IL. Trichomonas tenax (Trichomonadida:

-11, 2016; Carbondale, Gurenlian JR, Spolarich AE. Stats, facts, myths and downright lies. Presented at: American Dental Hygienists’ Association Center for Lifelong Learning 93rd Annual Session; June 8

-14, 2016; Pittsburgh, PA. Han D, Young BA. The r Annual Joint Meeting of Ichthyologistsoot of audition and in snakes.Herpetologists; Poster presented July 6 at: Society for the Study of Amphibians and Reptiles

-10, 2016; New Orleans, LA.

HIGHLIGHTS STUDENT

Ketogenic diet effects

ATSU-ASDOH student Austin Shackelford investigates the ketogenic diet’s effect on oral health at the Barrow Neurological Institute.

Presentations and At the Barrow Neurological Institute, third-year dental bacterial byproduct lipopolysaccharide. Then, I give abstracts, continued student Austin Shackelford is investigating the ketogenic the cells ketone bodies and measure the inflammatory

Broussard A [student], DeChant A [student], Gorell E [student], Hartford A [student], Hua CJ [student], diet to determine if the molecules produced by the diet markers that the cells produce using immunohisto- [student], Mika A [student], Millhouse R [student], Sylvia J [student], Whiting A [student], Yang E [student], have an effect on inflammation in the oral cavity. With Simmons K chemistry imaging, gene expression techniques, and , Lewis JH Loofburrow S HealthPoint Community. HealthEvaluating Center the population. receptivity Posterof patients presented regarding at: National text messages Association for healthcare of Community Health Centers funding provided by the institute and ATSU, he hopes to protein expression techniques. Community Health Institute and Expo; August 28 Michaelis R, -related reminders in produce clear and meaningful data that will expand his -30, 2016; Chicago, IL. the

Cardenas J, Valovich McLeod TC project and generate interest from other dental research- Why is your research important? Athletic Trainers’ Association 67th .Clinical Emergency Symposia; preparedness June 22 of seco ers in this specialized field. Train. 2016;51(6 suppl):S125. ndary school athletic programs. Presented at: National Inflammation is at the center of periodontal disease. -25, 2016; Baltimore, MD. Abstract published in: J Athl This disease affects many people, and while clinicians Cha C [student], Conley L [student], Geiger M [stude What are you investigating? [student], Salibay [student], Tingle R [student], Wy TJnt], [student], Gunawan L [student], Hasan A [student], Ogino J [student], Pyo G do all they can to stop the disease, it still progresses. program: establishing a student I am researching the ketogenic diet, which is a high- National Association of Community-led walking Health Centersgroup to Community supplement Health diabeNavarro Institute I, Whelihan and Expo; K August 28 This progression may be due to the body’s inflamma- , Lewis JH. Walk to Wellness tes management support groups. Presented at: fat, low-carbohydrate, and moderate-protein diet. This tory response to bacterial pathogens in the mouth. If Coffey J [student], Crutchfield P -30, 2016; Chicago, IL. community health centers: a controlled, Frei study.W [student], Poster Hatchpresented D [student], at: National Kaminski Association A. Reducin of Community Health Centers diet causes the body to produce ketones instead of car- my research can find a way to lessen that inflamma- Community Health Institute and Expo; August 28 g dental no-shows in bohydrates to fuel its energy needs. Current evidence tory response in a patient with periodontal disease, -30, 2016; Chicago, IL. Cummings R [student], Erickson A [student], Hora suggests this diet can reduce inflammation in certain then dental professionals would have a useful tool for [student], Matsushita S [student], Morris C [student],th PadakantiC [student], S [student],Huntley J Sadiqi[student], A [student], Imayanagita B [student], Kurtz J areas of the body – especially the brain. Through healing this disease. JH. The influence of patient education on colorectal cancer sc of Community Health Centers Community Health Institute and Expo; August 28 my research, I would like to bridge the gap between reening compliance. Poster presentedMeek at: BNational, Sivakoff Association M , Lewis neuroscience research and oral health research by What is the next step? Erickson CD [alum], Kay MC [alum], Weber ML [alum], -30, 2016; Chicago, IL. determining if the ketogenic diet affects the mouth as perceptions of the academic management team for student Valovich McLeod TC The next step in this research would be to validate National Athletic Trainers’ Association 67th Clinical Symposia; June 22 , Welch Bacon CE -athletes following a sport . School nurses’ much as it does the brain. the in vitro results in animal models. If that research Athl Train. 2016;51(6 suppl):S225. -related concussion. Presented at: -25, 2016; Baltimore, MD. Abstract published in: J Specifically, I am performing in vitro cell culture progresses, then human trials could follow. After Fick J , Dishman L, Adler K hospital CEOs? Presented at: Association, Williams L of. WhatUniversity leadership Programs competencies in Health ofAdministration health administration 2016 Annual graduates Meeting; matter most to experiments using human gingival fibroblasts. These human trials, delivery of treatment would be the last 24, 2016; Kansas City, MO. cells make up a majority of the gum tissue. Once the step in the process. cells have grown, I stimulate inflammation with the Filali N, Valovich McLeod TC June 22- , Welch Bacon CE among Italian youth soccer athletes. Presented at: American, Bellini G,Academy Ammaddeo of Neurology P, Cornali 2016 C. Concussion Sports Concussion reporting attitudes July 8-10, 2016; Chicago, IL.

Gallegos DM [alum], Conference; Lam KC, Snyder Valier AR who diagnose acromioclavicular sprains: a report from, Huxel the Athletic Bliven TrainingKC Practice National Athletic Trainers’ Association 67th Clinical Symposia; June 22. Use of orthopedic special tests by athletic trainers Athl Train. 2016;51(6 suppl):S207 -Based Research Network. Presented at: SPARKMAGAZINE 13 -S208. -25, 2016; Baltimore, MD. Abstract published in: J Goldstein LB. Improving Arizona rural health through clinical training at community health centers. Presented at: 43rd Annual Arizona Rural Health Conference and 11th Annu AZ. al Performance Improvement Summit; July 26

-27, 2016; Flagstaff, Gorman NT, Mayhew JL, aged women. Presented at:Brechue American WF College. Bilateral of Sports deficit Medicine during the 63rd squat A jump is not affected by training state in college

Govro EJ [student] nnual Meeting; June 1 - Stuart MK -4, 2016; Boston, MA. Trichomonadidae). Poster presented. Cytokine at: 68th response Annual of Midwestern human THP Conference of Parasitologists; June 9 -1 macrophages to IL. Trichomonas tenax (Trichomonadida:

-11, 2016; Carbondale, Gurenlian JR, Spolarich AE. Stats, facts, myths and downright lies. Presented at: American Dental Hygienists’ Association Center for Lifelong Learning 93rd Annual Session; June 8

-14, 2016; Pittsburgh, PA. Han D, Young BA. The r Annual Joint Meeting of Ichthyologistsoot of audition and in snakes.Herpetologists; Poster presented July 6 at: Society for the Study of Amphibians and Reptiles

-10, 2016; New Orleans, LA.

HIGHLIGHTS

Autism intervention

Occupational therapy (OT) students Hannah Maynard, and sensory perceptual skills. As a result, children Deborah Walker, Samantha Cao, Melinda Holder, Elena with ASD may be challenged by the performance of Stone, and Fonta Wenger have teamed up with ATSU- daily activities and school-related activities. Since ASHS OT faculty research adviser Rachel Diamant, PhD, sensory processing behaviors and VPM skills have the OTR/L, BCP, and community research partner Brynn potential to influence performance and participation Nealon, OTR/L, to create an autism-focused research in school-related activities, an investigation of how group. Specifically, the group is investigating the rela- these constructs are interrelated in children with ASD tionships between sensory processing behaviors and is warranted. visual-perceptual-motor (VPM) skills on school-related Successful study of the interrelationships between functions in school-aged children with a diagnosis sensory processing behaviors and VPM skills could of autism. inform OT clinical practice and school-based OT practice. Therefore, results from our study may suggest how these behaviors and skills can be addressed during clinical intervention to increase functional abilities for school-related activities, such as handwriting, in school-aged children with ASD.

What results have you found? During the first year of our study, 17 children and their parents participated. Inclusion criteria for this study were children who were enrolled in grades 1-4, had a diagnosis of ASD, were attending general education classes, and could speak and understand English. Participants were excluded if they had cognitive delays or a neuromuscular or physical limitation that inhibited the ability to hold a pencil and sit independently. The children participants completed standardized assessments that involved pencil and paper activities, and parents of the children were interviewed about their children’s sensory-based behaviors. Preliminary analysis of the data suggests a statistically significant correlation between auditory sensory processing behaviors, VPM skills, and copy- ing skills for handwriting.

What do you hope to achieve? We hope to achieve a greater understanding of the relationships between sensory processing behaviors and VPM skills and how knowledge of these relation- ships can assist OTs who work with children with ASD on functional school-related skills. Published Why is your research important? papers about the relationships between these behav- A child’s ability to integrate sensory processing behav- iors and skills are limited; thus, this project may build iors and VPM skills is critical for skill development a foundation for future research investigating this that supports participation in school-related activi- topic area. ties. Children with autistic spectrum disorder (ASD) often have difficulties with social and communication skills, emotional self-regulation, motor skills, praxis,

14 MMXVII STUDENT

Persistent bacteria

First-year medical student Ally Loveland is studying a phenomenon called persistence in Staphylococcus aureus bacteria. According to Loveland, persistence is increased bacterial cell survival that cannot be explained by the acquisition of genetic material. In other words, it is a perceived change in phenotype that occurs without an accompanying change in genotype, unlike what is often seen in resistant bacterial strains.

What are you investigating? Through an internal research grant, I am working with Neal Chamberlain, PhD; Vineet Singh, PhD; and Timothy Geisbuhler, PhD. Although William Brechue, PhD, and William Sexton, PhD, are not directly ATSU-KCOM student Ally Loveland presents a research poster at involved in the research, they play important roles the American Society for Microbiology Microbe 2016 Conference through grant writing and project support. in Boston, Massachusetts. We focused our research efforts on characterizing the role of the dnaK gene as it pertains to the onset of persistence. We obtained a bacterial strain that was What is the next step? mutated in the region of the dnaK gene, which effec- In the short term, we hope to identify which genes tively knocks out production of this protein. We then have a major impact on persistence. In the long term, treated this strain, and the unmutated parent strain, we hope to find areas of bacterial genomes that we can with antibiotic to determine the survival percentag- target to eliminate chronic infections. We found some es at different stages of growth. By comparing these effect with our mutant strain; our results suggested results, we can determine whether the dnaK gene plays the dnaK gene played some role in persistence. Howev- a significant role in persistence at multiple growth er, the metabolic processes of cells are incredibly com- phases or when different antibiotic classes are used plex and often cannot be attributed to a single gene. for treatment. For this research, additional antibiotic classes and Why is your research important? different antibiotics within previously tested classes should be tested to determine if results vary within a This research really boils down to eradicating chron- class. Future research should focus on longer growth ic bacterial infections. Many pathological bacterial phases, different treatment lengths, and other genes species share this trait of increased survival, and in that are similar to dnaK. A better understanding many cases, they have similar genetic attributes. If of persistence will help researchers develop more we can identify the important players in persistence, effective treatments for patients who have we can knock them out and reduce bacterial survival. recurrent infections. Clinically, recalcitrant infections are often the product of persistence in bacterial species that cause difficulty for patients and doctors when it comes to treatment. Extensive antibiotic therapy to treat recalcitrant infections can lead to problems, but so can letting a bacterial population run rampant.

SPARKMAGAZINE 15 HIGHLIGHTS

Uganda to Peru

Through ATSU’s Global Health Honors Society, Capacidad, fourth-year ATSU-SOMA student Daniel Ebbs, MS, FP-C, society co-founder, is part of a team conducting interna- tional research through health worker training programs in the Peruvian Amazon and northern Uganda. The team focuses its research on three areas: baseline, community utilization of community health such as workers (CHWs) after pretraining and how often posttraining program implementa- randomly tion, retention of medical skills with surveyed com- innovative methodology, and munity mem- osteopathic manipulative bers utilize trained treatment (OMT) interest CHWs. Additionally, we and utilization by CHWs. are finding positive retention rates for medical skills Currently, based on the use of mHealth applications, which were the developed for our training program. These education applications are used for training and provide health information for each community the CHWs represent. Why is your research important? This research is important because we are attempt- ing to establish innovative, low-cost, and sustainable methods to help rural underserved communities de- velop their own medical training programs that also include research. CHW retention is critical for provid- ing emergency skills and recognizing dangers signs when, for example, an infant needs rapid transport to a hospital that requires more than a day’s travel. By including OMT in this research, we support an area of interest and continued learning while providing sustainable medical treatment that also helps CHWs learn basic anatomy.

What do you hope to achieve? After five years, we intend that all programs will transition to completely community-run training program’s programs with autonomous research efforts. We hope CHWs in Uganda reach more than 30,000 community our programs will continue to flourish and represent members who have little to no access to healthcare. In more surrounding communities. We hope reassess- Peru, CHWs reach more than 1,500 community members. ments of vital skills and community knowledge of diseases, such as HIV, will change dramatically based What is the goal of your project? on our interventions. We hope OMT becomes a valued part of each training program. Finally, we hope to This research project is multifaceted. Our ultimate have a large data set on mHealth to assess its use goal is to help CHWs develop their own research into and retention. best practices for training by transitioning them from a community participatory training and modified research model (using community participation to The research team includes ATSU-SOMA’s Deborah Heath, DO; guide outside researchers) to community participatory Joy Lewis, DO, PhD, FACP; Jeffrey Morgan, DO, FACOI; Saikiran research (equal research participation by community Earasi, OMS IV; Julian Hirschbaum, OMS IV; Stanton Jasicki, OMS members and outside researchers). We have a five- IV; Jenni Adams, OMS III; Starr Matsushita, OMS III; and Amanda year research goal to assess outcomes related to our Mika, OMS III.

16 MMXVII STUDENT

Early detection

Olawunmi Obisesan, DHEd, ’16, is a recent ATSU-CGHS Middle East. The results also identified statistically graduate who completed her dissertation on the preva- significant associations between the lifetime uptake lence and predictors of cervical cancer screening among of the Pap test and specific predictors, namely, level of African immigrants living in the United States. With education and healthcare provider’s recommendation. research assistance from faculty members Donna Allen, PhD, and Meg Sheppard, PhD, Dr. Obisesan’s study was What do you hope to achieve? accepted for presentation at the American Public Health This research is important because early detection Association’s 2016 annual meeting in October. of cervical cancer in female African immigrants can reduce the incidence and mortality rates associated What did you investigate? with cervical cancer and improve health equity in this Cervical cancer screening is less common in female population. At 87 percent participation, the uptake immigrant populations compared with females born prevalence of the Pap test in this population is still in the United States. The purpose of our research proj- six percent below the Healthy People 2020 target of ect was to examine the lifetime uptake of the Pap test 93 percent. in female African immigrants, a subset of the general Healthcare providers are vital for the reduction of black female population, and compare that uptake health disparities among immigrant populations in prevalence with other female populations. We also the United States. Through our research, we hope to examined the influences of cervical cancer predictors, increase awareness of the pivotal role of healthcare such as age, level of education, socioeconomic status, providers to improve cervical cancer screening marital status, perceived health status, and healthcare behaviors in the female African immigrant popu- provider’s recommendation on the lifetime uptake of lation. We also hope to increase awareness of the the Pap test. need for innovative and culturally and linguistically appropriate health education materials that encourage What results did you find? them to be screened. Because education level was a Our results indicated the prevalence of the lifetime predictor of cervical cancer screening in our study, the uptake of the Pap test was lower in female African development of illustrated health education materials immigrants (87 percent) compared with females born is needed. in the United States, Europe, South America, and the

Cervical cancer cell

17 HIGHLIGHTS STUDENT

Oral immunity

ATSU-MOSDOH’s Josh Coffey spent a summer performing research at the National Institutes of Health-National Institute of Dental and Craniofacial Research in Bethesda, Maryland. He worked with several periodontists and became interested in how the microbiome shapes the immune system. For his research project, he investigated the species and quantities of bacteria present in the oral cavity of mice.

What did you investigate? My project specifically involved classifying the oral microbiome of a particular strain of mice used in the laboratory. This research required delicate collection techniques and culturing and isolating bacteria, followed by purifying, amplifying, and sequencing the DNA. Third-year dental student Josh Coffey (third from left) investigates Why is your research important? immune function in the oral cavity at the National Institute of Once the oral microbiome can be clearly defined and Dental and Craniofacial Research. bacterial samples stored, then repopulation studies can be conducted. These studies would require using germ-free mice and introducing known mixtures of bacteria. This type of investigation allows for the study of antibiotic therapy and may result in deter- mining the protective mechanisms of certain bacterial species.

What do you hope to achieve? Bacteria play a fundamental role in establishing health. The more we learn about the interactions between bacteria and the host, the more we can utilize that relationship. This is where the research gets really interesting because certain bacterial interactions enhance immunity and resist colonization of bad oral bacteria, like gram-negative bacteria. Once bacterial interactions are more clearly understood, probiotic treatment for oral bugs is certainly on the table. Imagine if we could prophylactically eliminate, or greatly reduce, Streptococcus mutans in the mouth without any antibiotics.

WANT MORE RESEARCH? For more information on research published by ATSU faculty, staff, and students, visit Academic Publishing news at iconnect.atsu.edu and check out the Grants & You and ATSU Research newsletters.

18 MMXVII Healthcare professionals have one shared goal: improve patient health. Through the use of prac- tice-based research networks (PBRNs), clinicians and researchers are joining together and think- ing critically to improve patient care. These networks provide the infrastructure and constructs that allow healthcare providers to link relevant research findings with everyday practice.

By Katie Hubbard

19 Composed of researchers and practicing would be asked by a practicing physical thera- clinicians, PBRNs help train clinician members pist or athletic trainer,” says Dr. Heard. “Thus, to follow the scientific method of reasoning each area has their own domain of interest and while also increasing their critical thinking procedures, which require processes to analyze ability. Consequently, they become better prob- them that may be specific to their disciplines.” lem analyzers, improving their ability to diag- nose complex patient conditions. Additionally, the questions they help answer are general in The University’s PBRNs nature and carry a practical value that is relevant and immediately applicable to routine AT-PBRN patient care. ATSU’s first PBRN is the Athletic Training “Practicing clinicians develop the questions Practice-Based Research Network (AT-PBRN), as well as help discover the answers,” says developed in 2009. Striving to improve the John Heard, PhD, vice president for research, quality of care and outcomes for patients grants, and information systems at ATSU. “Both treated by athletic trainers, AT-PBRN received the questions and answers are relevant to the recognition from the Agency for Healthcare practicing clinician – those who are part of the Research and Quality (AHRQ) in 2010 and is PBRN and those who are not.” the only athletic training PBRN recognized by AHRQ. It is headquartered within the Athletic Training program at ATSU-ASHS and includes Scholarly activity at ATSU more than 100 clinicians and 75 clinical practice Prior to the late 1990s, the University’s most sites across 23 states. notable era of scientific research came in the Compliant with the Health Information late 1940s and 1950s with the work of John Portability and Accountability Act, the infra- Stedman Denslow, DO, ’29, and Irvin Korr, structure of AT-PBRN includes a custom-made, PhD. Throughout the years, some researchers practice-oriented electronic medical record received private and federal funding and pub- (EMR) system. CORE-AT EMR provides lished their findings in peer-reviewed journals, clinicians access to an athletic training-specific but toward the turn of the century, ATSU as EMR via laptops, tablets, and smartphones. The a whole renewed its focus on research. This pro- use of a custom-made EMR allows the regular vided a favorable environment for researchers patient documentation done by athletic trainers attempting to produce valid clinical outcomes. to be a means of data acquisition. The EMR In 1998, the University launched the Interdis- includes complete patient records, from initial ciplinary Research Committee, which promoted evaluation through discharge, and includes a culture of research and facilitated key collabo- patient-reported outcome measures that link to rations and internal research mentorships. Later a diagnosis to record the patient’s perspective that year, the Board of Trustees approved the on their injury, treatment, and recovery. Strategic Research Initiative, today termed as “As the only athletic training EMR to offer the Strategic Research Fund. During the follow- built-in, patient-reported outcome measures, ing year, the Department of Research Support the CORE-AT EMR can facilitate whole person, was created to provide expertise in clinical patient-centered care and support investiga- research design and data analysis as well as tions aiming to identify effective treatment support for publications of research results. interventions,” says AT-PBRN Director Tamara To formalize the rejuvenated research culture Valovich McLeod, PhD, ATC, FNATA. and infrastructure, the A.T. Still Research According to Dr. Valovich McLeod, investiga- Institute was established in 2001. The institute tions within the PBRN have generally focused combined many of the University’s clinical on characterizing routine athletic training and interdisciplinary research activities and practice. For instance, through retrospective components under one overarching entity. Soon analyses of CORE-AT EMR data, AT-PBRN afterward, the University began to focus on found the injured body part most commonly PBRNs. The University’s gamut of health pro- reported was the ankle. This information was fessions programs required multiple networks, based on 5,595 reported sport-related injuries, each with their own area of expertise. and ankle sprains accounted for the majority of “The questions that would be asked by a prac- the ankle injuries. Of the 4,510 athletic training ticing physician may or may not be the same as services provided for ankle sprains, the most

20 MMXVII common treatments were cryotherapy, taping, and therapeutic exercises or activities. In a more recent study that included 36,245 daily patient encounters, network researchers found the Director of ankle was still the most commonly reported AT-PBRN body part, and more importantly, that athletic trainers spend a fair amount of time working to Director: prevent injuries. Tamara Valovich McLeod, AT-PBRN has also begun to focus on describ- ing value characteristics of athletic training PhD, ATC, FNATA practice. Researchers estimated the cost of athletic training services related to lower and Title: upper extremity injuries and described changes Professor and Director, in patient-reported outcomes over time for a Athletic Training, ATSU-ASHS wide range of injuries, such as concussions, Research Professor, ATSU-SOMA musculoskeletal injuries as a whole, knee John P. Wood, DO, Endowed Chair for sprains, and ankle sprains. In a recent study, Sports Medicine researchers investigated changes in self- With ATSU since 2002 reported function during the first two weeks following an ankle sprain and found patients Research area: with ankle sprain injury generally reported significant and meaningful improvements in Sport-related concussion function during the first two weeks post-injury. However, most patients continued to experience self-reported deficits in general and sport function at two weeks post-injury. While these findings provide support for rapid improvement in self-reported function by patients under the care of an athletic trainer, ac- cording to Dr. Valovich McLeod, little is known about the effectiveness of specific treatments on DO-Touch.NET long-term outcomes and recurrent injury risk. Created in 2010, DO-Touch.NET is the A.T. Still Because most studies have been retrospective Research Institute’s inaugural PBRN. It is also in nature, researchers within AT-PBRN are the first PBRN focusing on osteopathic ma- making efforts to conduct prospective studies. nipulative medicine (OMM) and osteopathic These studies will strive to identify outcomes of manipulative treatment (OMT). With a mission the care provided for injuries treated by athletic to evaluate and advance the practice of OMM, trainers, determine the comparative effective- its purpose is to create and sustain a network of ness of athletic training interventions, and clinicians engaged in the assessment of the conduct point-of-care clinical trials. clinical usefulness of OMM. DO-Touch.NET “To our knowledge, these efforts are the first values and promotes the advancement of to use an EMR to collect clinical data in support osteopathic medicine by supporting clinicians of point-of-care investigations in athletic train- who integrate OMT into their patient care and ing,” Dr. Valovich McLeod says. “Ultimately, whose practice promotes health and optimizes these types of efforts should help enhance clin- the inherent healing capacity of humans. Any ical practice and improve the care provided to practicing clinician who provides osteopathic patients who suffer sport-related injury, which manipulative services to their patients is eligi- reflects the mission of AT-PBRN.” ble to be a member of DO-Touch.NET. The network is comprised of more than 200 members from 30 states and 11 countries. Currently, about 65 of those members have contributed to its research studies. The Network Coordinating Center on the Kirksville, Mis- souri, campus serves as its headquarters, and in 2015, the PBRN established its first Regional

SPARKMAGAZINE 21 collection tools to evaluate patient-reported outcomes following OMT. A manuscript titled “Preliminary Findings on the Use of Osteopath- Director of ic Manipulative Treatment: Outcomes During DO-Touch.NET the Formation of the Practice-based Research Network, DO-Touch.NET” presented results of the pilot study and was published in the March 2014 issue of The Journal of the American Osteo- Director: pathic Association. A follow-up study, known Brian Degenhardt, DO as the OMM Utilization Study, was funded by the American Osteopathic Association along Title: with support from ATSU and expanded the Director, scope of the pilot study in number of patients A.T. Still Research Institute and research sites. It was designed to document Associate Professor, how OMM is used in clinics and how patients ATSU-KCOM respond to this form of treatment. Additionally, With ATSU since 1993 data on potential side effects from OMT was collected to guide future studies on the safety Research area: of OMT. “In 2014, the American Academy of Osteop- Osteopathic manipulative medicine athy and the ATSU Strategic Research Fund provided funding to conduct the largest study of patient-reported adverse events from OMT to date,” says Dr. Degenhardt. “The goal of this study is to collect data from more than 1,000 patients from 50 DO-Touch.NET members.” An independent, interdisciplinary event adjudication committee was established to help Coordinating Center in Germany. In addition to determine the likelihood that the adverse event the A.T. Still Research Institute’s External Board is caused by OMT. To date, more than one-third of Scientific Counselors and ATSU’s institution- of the data has been collected. al support, the Network Coordinating Center is guided by its Executive Committee that consists of DO-Touch.NET members who review all ATSU-SOMA PBRN proposed research studies, publications, and Building on the unique relationship between presentations to ensure research integrity ATSU-SOMA and the National Association and accurate representation of the network’s of Community Health Centers (NACHC), the activities. ATSU-SOMA PBRN was established in 2011 “A Community Advisory Board of patients following discussions with NACHC leadership. and other stakeholders advises the Executive Focusing on the healthcare needs of America’s Committee regarding the value and refinement underserved populations, the PBRN conducts of current and proposed research activities,” clinically relevant research to develop and says Brian Degenhardt, DO, director for share sustainable programs to improve DO-Touch.NET. “By involving members, healthcare access and quality. It is housed patients, and other stakeholders, results from within the A.T. Still Research Institute and DO-Touch.NET research activities have in- includes 12 sites. creased applicability for practitioners of OMM Since the network’s main focus has been and their patients.” addressing health disparities and social deter- According to Dr. Degenhardt, DO-Touch.NET minants of health, much of the work has been has focused on research that addresses the need integrated into the ATSU-SOMA curriculum. for evidence regarding the efficacy and safety All OMS II students enroll in the Epidemiolo- of OMT. The PBRN’s pilot study, “Establishment gy and Biostatistics & Preventative Medicine of the OMM Practice-based Research Network,” courses to learn the fundamentals required for resulted in preliminary data characterizing community-based participatory research. modern OMT practice and refinement of data

22 MMXVII According to ATSU-SOMA PBRN Director and includes an active component that enables Joy Lewis, DO, PhD, FACP, students are taught the youth to act out what they learn via playful to conduct needs assessments and to design exercise. The children are encouraged to share and implement community projects addressing these lessons with family and community the social and economic determinants of health. members and report back what they were Equipped with detailed instructions, tools, and taught. Parents or guardians are then surveyed support, students then work with the School’s on what they learned from the lessons. At the faculty members and regional directors of end of the year, teams hold a ceremony that medical education at their assigned community recognizes and rewards children for their health centers to develop, execute, and evaluate efforts, and ATSU-SOMA students evaluate the their research, service, and quality improve- impact of the educational project. ment projects. In addition to supporting community “The goals and objectives of the PBRN are projects, ATSU-SOMA PBRN is part of an to promote and support student, resident, and interdisciplinary team that provides concus- practicing clinician community-oriented prima- sion and traumatic brain injury education to ry care projects,” Dr. Lewis says. “Furthermore, University-affiliated community health centers. PBRN members focus on improving knowledge Funded by the ATSU Community Health Grant, related to the use of technology-enhanced the program titled “Traumatic Brain Injury active learning for medical education.” Education: Enhancing Knowledge and Collabo- One example of a public health education ration for Community-Based Youth Concussion collaborative that fosters student participatory Management” is implemented at participating research occurs at Waianae Coast Comprehen- community health centers that have at least sive Health Center on Oahu, Hawaii. At the one school-based health center. This design center, which serves a population with high furthers the program’s reach into the com- rates of diabetes, obesity, poverty, and home- munity through school personnel and lessness, interdisciplinary teams of OMS II and community members. nursing students deliver health and wellness education to elementary school children. Each lesson focuses on a different aspect of health

Director of ATSU-SOMA PBRN

Director: Joy Lewis, DO, PhD, FACP

Title: Chair, Public Health, ATSU-SOMA With ATSU since 2011

Research area: Community-oriented primary care

SPARKMAGAZINE 23 Network for Community Oral Health nity health centers. Researchers established an Research intervention for scheduling procedures at the ATSU’s newest school, ATSU-MOSDOH, hosts Northeast Missouri Health Council, which re- the University’s fourth PBRN: Network for sulted in a 50 percent reduction in its no-show Community Oral Health Research (NCOHR). rate. In addition, the study determined the pop- Created in 2014 and housed within the A.T. Still ulation most at risk for no-shows was Medicaid Research Institute, NCOHR aims to improve patients under age 18. This is an intriguing the oral health of underserved populations result, considering the state of Missouri pays through practice-based research and is the for coverage of this group. only PBRN in the country composed entirely of The third study, currently in the planning federally qualified health centers (FQHCs). The phase, will investigate the effectiveness of a tar- member FQHCs are also ATSU-MOSDOH af- geted referral of patients who visit the emergen- filiated sites where fourth-year dental students cy room for dental conditions to the local FQHC complete their clinical education. Currently, for treatment. the four member FQHCs represent the “The three studies were proposed by commu- Springfield, Sikeston, Kirksville, and St. Louis, nity dentists and are designed to solve the oral Missouri, areas. health needs of their local populations,” says Although NCOHR is continuing to develop, it Parker Crutchfield, PhD, director for NCOHR. is conducting three studies. One study, now in “All research activities are designed and carried the dissemination phase, looked at the adverse out by ATSU-MOSDOH dental students under event rates of community health center patients. faculty supervision.” The project helped establish processes and pro- cedures related to the internal conduct of the PBRN and how to create and maintain research Knowledge is power relationships with FQHCs. As PBRNs gained momentum in the past A second study, which is in the data collec- decade on a national level, so have PBRNs at tion phase, is a controlled experiment testing ATSU. Although each of the University’s PBRNs various interventions designed to reduce focuses on different areas of healthcare, each no-show rates among dental patients at commu- has shared values and promotes improved clin- ical practice. Each also advances the principles and practices of their respective fields by pro- ducing research that is applicable to clinicians and by translating the latest evidence into rou- tine practice. With all the knowledge available through PBRNs, healthcare providers across Director of the country and around the world are empow- ered to enhance their clinical decision-making NCOHR skills and ultimately improve the care of their patients. “Our PBRNs bring together practitioners Director: from diverse settings to meet the needs of Parker Crutchfield, PhD fellow clinicians and the needs of patients,” says Dr. Heard. “As ATSU expands its program Title: offerings, I would not be surprised to see a new PBRN emerge.” Research Director, ATSU-MOSDOH With ATSU since 2013

Research area: Biomedical ethics

24 MMXVII “Social presence in online learning

By Laurie Trowbridge „

Online learning has become a standard form of anonymous online survey. Of the 94 faculty members education in the last few decades. For full-time profes- who completed the survey, most reported being sat- sionals, learning remotely provides a flexible alterna- isfied with the level of interaction in the LMS. Those tive to expand knowledge because location limitations same faculty members, however, indicated interac- no longer exist. Establishing a learning community in tions with students tended to be impersonal and the a Learning Management System (LMS), rather than LMS did not allow for more casual, personal discus- in a traditional classroom, is a challenge for faculty sions. The reported limitations of communication tools who must use email and the LMS discussion board as in an LMS suggested that faculty should consider us- primary methods for communication. ing alternative tools, such as social media, to improve Between 2010-12, Joan Leafman, PhD, and Kathleen social presence. Mathieson, PhD, CIP, associate professors at ATSU- More than 90 percent of surveyed faculty members CGHS, along with initial contributor Helen Ewing, owned a social media account, with Facebook being DHSc, former health sciences chair and associate the most common, and one-third indicated feeling professor, explored faculty perceptions of communica- comfortable using social media. Despite owning tions tools in an LMS and the use of social media tools accounts, many did not use such tools outside the LMS outside an LMS to increase social engagement in the to communicate with their students. Common factors learning community. In their research, Drs. Leafman that could contribute to avoiding social media in an and Mathieson applied the Community of Inquiry online classroom include legal and ethical concerns framework, which describes the factors that affect and lack of familiarity with when to use social media the online learning experience: teaching presence, and what type of content is appropriate to share. cognitive presence, and social presence. While social media tools may create a stronger social “We were interested in social presence, which presence between faculty and students, using social includes emotional expression, open communication, media to enhance online learning has no clear path. and group cohesion – factors that are challenging to Drs. Leafman and Mathieson note that without guide- incorporate in an online learning environment,” said lines faculty members are unsure how to proceed Dr. Mathieson. successfully, so they avoid using these dynamic tools Social presence aims to decrease transactional in online learning. Both Drs. Leafman and Mathieson distance, that is, the cognitive space between facul- plan to expand their research by evaluating specific ty and students in online education. The lower the elements that affect social presence. transactional distance the stronger the relationship “Our interest in this area is fueled by our commit- between faculty and students, which leads to a better ment to providing a high-quality online learning learning environment. experience for our students,” Dr. Mathieson says. Drs. Leafman and Mathieson invited full- and “Creating a sense of community and connectedness part-time ATSU online faculty to participate in an enhances their learning.”

SPARKMAGAZINE 25 By Katie Hubbard

“Would you like to meet them?” says Bruce Young, “This is our colony of rattlesnakes,” Dr. Young says. PhD. “Each snake is used in our controlled trials.” Making his way up six floors from the Anatomy He cautiously handles the snake and describes the department to the top of the Timken-Burnett Research care involved in using these reptiles for his research. Building, the ATSU-KCOM associate professor enters a These snakes are part of a rotation, which ensures each secluded research laboratory. The laboratory’s atmo- one has several days’ recovery between tests. He also sphere is a balmy 85 degrees. Its open workspace and makes sure to use appropriate experimentation mate- two small rooms are built to exact specifications with rials, such as soft pads for snake strikes. His concern no gap larger than one-half inch. One interior room for their safety and well-being demonstrates his strong serves as a soundproof space for recording experi- work ethic and enthusiasm for this research matter. ments. The second lodges a dozen western diamond- Make no missnake, Dr. Young is passionate about back rattlesnakes. more than just herpetology. His area of interest is ex- As he opens the door to the snake den, the rattles perimental biophysics to determine how morphological crescendo. He turns on the light and slowly slides systems interact with physical forces. Specifically, he out a plastic, opaque drawer from a tall storage rack. studies musculoskeletal systems and issues with Skillfully maneuvering a long-handled hook, he snags gravity, torque, acceleration, and sensory systems. a 3-foot snake. For this particular research project, he examines

26 Dr. Young has studied experimental biophysics for 25 years. With each project, he hopes to zero in on irregular neuromuscular integration.

neuromuscular control in rattlesnakes and the neuromuscular integration is associated with multiple precision of their strikes. debilitating human conditions and diseases. To help “Snake strikes have been studied, but we still don’t conduct his trials and analyze data, he gathered a know the underlying mechanics,” says Dr. Young. research team consisting of two undergraduate interns “How much control does the snake have? Is it just and one graduate student from Truman State a lunge?” University as well as a first-year DO student from In his early research, he studied puff adder strikes. ATSU-KCOM. Puff adders, which are found in Africa, are one of “The finger-to-nose test is frequently used to assess the largest venomous snakes in the world and are neuromuscular control in humans,” says Dr. Young. remarkably quick. He found that puff adders tense “That’s essentially the test we performed, but we took their muscles, using them as a spring to strike. That it up several notches in complexity.” discovery prompted him to determine if the spring The team was particularly interested in patterns recoil model of neuromuscular control translated to of muscle activation that are associated with snake rattlesnake strikes. strikes. To assess these patterns accurately, they stan- Despite his choice of research organism, the core of dardized the variable factors within their controlled Dr. Young’s study is neuromuscular integration, which trials. Each snake was approximately the same length, is critical to human health. Disruption of normal

27 and all experiments were performed in a small glass “The snake begins a strike by holding part of his cage, making each strike about 1 foot long. body off the ground, contracting its back muscles,” Dr. A snake’s strike is faster than the human eye can see, Young says. “The snake also has its body curved, with so the team had to use high-speed video to quantify one side of the curve elongated and the other contract- body posture and strike accuracy. To discern patterns ed. To launch a strike, the snake pulls one side more of muscle activation, Dr. Young had to perform electro- than the other.” myography (EMG). This required implanting micro- With the project nearly complete, Dr. Young plans to scopic wires – about half the size of human hair – into take this research to the next level, literally. He wants the snake’s spinalis/semispinalis muscle complex. to repeat the same experiments with arboreal vipers, Each test took approximately two and a half hours which are closely related to western diamondback rat- and included anesthetizing the snake, surgically im- tlesnakes. The vipers strike prey in a similar fashion, planting EMG wires, and recording the snake’s move- but they add another layer of complexity because they ment. Keeping fragile wires in an active rattlesnake strike while hanging from tree branches. was a challenge for the team. Many times a snake “Performing a strike in a tree top involves different flexed too aggressively and pulled out the wires, caus- risks,” says Dr. Young. “If a viper overshoots, it will ing the test to stop. However, the wires were designed fall out of the tree. If my rattlesnakes miss, they are to slip out easily to prevent harm to the snake. already on the ground.” With all the experiments complete, the team com- Dr. Young is going the distance to study snake piled the data and video images and began analyzing strikes. He supports ATSU-KCOM’s commitment to the information. Their preliminary results indicated research as he learns more about these different reptile asymmetric muscle activation, meaning the snake species. Ultimately, he hopes to have a better under- monitors its body posture during a strike. It also standing of neuromuscular control in snakes and shed means neural control of the activation is based on the some light on neuromuscular integration in humans. curvature of its body.

A snake has hundreds of joints that add complexity to understanding neuromuscular control.

28 Laser focus By Katie Hubbard

Laser-based treatments are the newest trend in emerg- The research team developed a prospective con- ing dental technology. Compared with traditional trolled, randomized, and double-blind protocol for methods, lasers offer a minimally invasive approach their 18-patient pilot study. They assessed clinical to oral healthcare. They also offer the potential of and microbial population improvement in patients portability and affordability for patients lacking access undergoing SRP procedures compared with patients to care. receiving diode laser treatments in addition to SRP While lasers have become popular in dental settings, procedures. As part of this research to understand the insufficient systematic clinical research has limited tissue effects and potential efficacious effects from la- their role in most disease treatments. To learn more ser treatment, they characterized the radiated energy about lasers and their application in dental diseases, from their laser system as well as its tip temperature. ATSU-ASDOH faculty members Inder Makin, MD, “So far, we have refined the techniques of genomic PhD, bioengineer; Marc Shlossman, DDS, MS, analysis of critical periodontal bacteria,” Dr. Makin periodontist; and Robert Levine, DDS, laser clinical says. “We have been successful in differentiating specialist, are focusing their research efforts on the bacterial profiles of gum pockets in individuals periodontal disease. diagnosed with chronic gum disease from individuals “According to scientific literature, periodontal having no periodontal disease.” disease affects up to 14 percent of the general popula- Taking an interdisciplinary approach, they gained tion,” says Dr. Makin. “It has significant public health an understanding of the pathophysiology of chronic implications such as associations with heart disease periodontal disease, clinical bioeffects and assessment and pre-term pregnancies.” approaches, and precise laser-soft tissue interactions. Chronic periodontal disease in particular is a The team’s motivation to advance scientific knowledge problem that typically affects underserved, aging, and enhance public health keeps a laser focus and special needs populations. At the root of the on addressing patient needs. With the pilot study to disease are bacterial colonies resident in gum pockets. be completed by mid-2017, they hope their results These bacteria become virulent under adverse health will confirm laser-based treatments improve conditions, like smoking and tobacco use, or through patient outcomes. systemic diseases, like diabetes. The harmful bacteria then destroy surrounding tissue, leading to gum tissue and bone loss, bleeding gums, and loosening and loss of teeth. Currently, scaling and root planing (SRP) procedures are the most common treatments to remove plaque buildup and diseased tis- sue. However, SRP procedures are time con- suming and require substantial skill by oral healthcare providers. Even after treatment, the disease can return. In addition, regular, long-term intake of systemic antibiotics may lead to drug resistance and cause some patients to become immune to treatment. Dr. Levine and an ATSU- ASDOH student treat a “Patients with this disease need effective, patient. Since the team’s low-cost approaches that are widely accessi- research project began in ble,” says Dr. Makin. “In our project, we pro- 2010, eight dental students pose additional use of laser-based treatment from ATSU-ASDOH have of the periodontal pocket, which can reduce participated in project tasks frequency of SRP procedures and also pro- to gain research experience. vide a response to antibiotic-resistant cases.”

SPARKMAGAZINE 29 Ultrasound:

ATSU-KCOM’s ultrasonography program is More and more hospitals are expecting phy- making waves across the osteopathic profes- sicians to use ultrasonography in emergency sion. As a leader in ultrasound education, the situations, such as FAST exams. Because ATSU- College’s robust curriculum affords students KCOM students have developed proficient the opportunity to develop point-of-care ultra- ultrasound skills while in medical school, they sound skills. In addition, ultrasound tools and are garnering the respect of attending physi- resources provide students with experience in cians and residents when demonstrating their osteopathic research. skills in a clinical setting. “We have 25 ultrasound machines, which “While on an ‘audition rotation’ at my first allows us to have three to four students per ma- choice residency site, I was asked to perform chine so each student gets the best hands-on ex- OB ultrasound on several patients,” says Brent perience possible,” says Tatyana Kondrashova, Pickett, OMS IV, who is completing rotations at MD, PhD, associate professor, family medicine, ATSU-KCOM’s Provo, Utah, site. “I was able to preventive medicine, and community health. find the vital structures and measure the fetal “During their initial exposure to ultrasound, heart rate using M-mode. It earned me high students are anxious about working with the praise from my preceptors.” machines, but quickly become more confident “I’ve done about half a dozen FAST exams and comfortable in identifying anatomical without assistance, which is about half a dozen structures and pathology.”

Above: Medical students Sierra Dickey, Megan Reidy, Daniel Brannen, and Adam Benchendorf practice ultrasound techniques.

Right: ATSU-KCOM’s ultrasound curriculum earned a commendation from the American Osteopathic Association’s Commission on Osteopathic College Accreditation.

30 MMXVII Making waves in osteopathic research By Virginia Halterman

more than almost every other auditioning studying the characteristics of the temporo- medical student,” says Richard Thomas, OMS mandibular joint. Faculty from ATSU-KCOM’s IV. “They have little to no experience or comfort Physiology department and Truman State with ultrasound.” University are working on ultrasound evalua- Integration of ultrasound into courses at tion of cardiac structure-function and aerobic ATSU-KCOM and ATSU-MOSDOH has allowed capacity in college athletes. In addition, OMM for educational research as well as interdisci- faculty members are evaluating the effects of plinary teamwork. Collaboration with anatomy, osteopathic manipulation on sacral dysfunction osteopathic manipulative medicine (OMM), using ultrasound. and physiology instructors has resulted in Ultrasonography has become an important the presentation of six posters at national and tool for fulfilling ATSU’s mission of preparing international conferences, two poster awards, highly competent professionals. The ultra- and publications in The Journal of the American sound curriculum has opened new avenues for Osteopathic Association, Medical Science Educator, research and collaboration in educational and and Clinical Anatomy. clinical studies. As these educational endeavors Clinical ultrasound research at ATSU improve student learning, the University better includes several collaborative projects. prepares future healthcare professionals to ATSU-MOSDOH faculty and students are improve patient care.

31 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?32 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? Drs. Tamara Roehling and Adrian Anast ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?weigh in on plagiarism By Katie Hubbard

A few years ago, a small group of ATSU-ASHS What results did you find? faculty came together to address academic 1. We found no statistical difference ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?integrity in the School’s online courses. The ad between student and faculty self-rated hoc committee was led by Helen Ewing, DHSc, knowledge about University plagiarism former chair, doctor of health sciences, and standards. Self-rated knowledge of comprised faculty members including Tamara University plagiarism standards was Roehling, PT, DPT, director, transitional doctor higher among online students and ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?of physical therapy, and Kathleen Mathieson, faculty compared with campus-based PhD, CIP, associate professor, doctor of health students and faculty. sciences. After the committee was formed, Adrian Anast, PhD, director, University Writing 2. While students perceived that plagiaris- Center at ATSU-CGHS, was asked to develop a tic behaviors were relatively common ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?remediation program for students who plagia- among their peers, few self-reported rize parts of their assignments. Together, the they had personally engaged in such group began tracking program participation behaviors. The most common perceived and researching student and faculty percep- behavior among students was citing tions of plagiarism on campus. and referencing a full-text source when ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? only the abstract was read. This was also the most common self-reported behav- ior among students. The next highest self-reported behaviors were submitting What is the most common form of work prepared for a different course plagiarism? (self-plagiarism) and working with ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?The most common form of plagiarism we another student when not authorized by see is poor paraphrasing. It’s important the instructor. to note that most plagiarism, for a first occurrence, is unintentional. Some students 3. Compared with students, faculty per- simply do not know the rules of scholarship. ceived plagiaristic behaviors to be much ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?This is particularly the case in programs more common. Seventy-five percent where the emphasis is on clinical experience of faculty thought students cited and – not writing papers. referenced a full-text source after only reading the abstract, and 70 percent What did you investigate? thought students copied content and ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?Our research project assessed student and did not quote or cite correctly. Working faculty perceptions of plagiarism. We used closely with another student on assign- a cross-sectional survey design, and sepa- ments without instructor authorization rate surveys were developed for students was more common among campus-based and faculty. students than online students.

? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?Why is this research important? What further steps have you taken? Policy, protocol, and practice should be In early 2016, we published a case study in based on facts. It’s too easy to assume every- Assessment & Evaluation in Higher Education, one is plagiarizing, no one is plagiarizing, which outlined how our programs or everyone else’s students are plagiarizing. implemented best practices to detect and ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?Therefore, basing practice on data from stu- respond to plagiarism. When we imple- dents is better than relying on assumption. mented these best practices three years ago, the incidence of plagiarism decreased 50 percent overall. It decreased 75 percent among the student population for whom ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? English is a second language. ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? SPARKMAGAZINE 33 Established in 2001, A.T. Still Research Institute’s (ATSRI) purpose is to advance whole person healthcare and wellness through the development and support of premier clinical and translational research.

ATSRI’s infrastructure and culture promotes interprofessional research relevant to whole person healthcare. The institute collab- orates with strategic external research centers and entities, both nationally and internationally. In addition, it provides research training and mentoring to develop preeminent clinician researchers.

Get involved with ATSRI: • Become a scientist or intern • Enroll in a course • Volunteer for a study • Participate in the annual Interdisciplinary Biomedical Research Symposium

For more information, contact ATSRI. Phone: 660.626.2026 Toll free: 866.626.2878, ext. 2026 atsu.edu/research

Missouri campus: Arizona campus: Brian Degenhardt, DO J. Michael Menke, DC, PhD, MA Director Associate Director [email protected] [email protected]

34 Many older adults lack a dental home and need assistance managing their oral Did you know? health issues. Tooth wisdom By Katie Hubbard

Ann Spolarich, PhD, RDH, FSCDH, director of Dr. Spolarich is thrilled by the interest and response research at ATSU-ASDOH, has partnered with Oral from her pharmacist participants. She is planning Health America to conduct research for the national to offer the training electronically to better reach Tooth Wisdom Project. Her specific research project, pharmacists across North America. She is building “Tooth Wisdom for Pharmacists,” is an interpro- relationships with pharmacy organizations and major fessional training program for community-based industry partners to develop oral health educational pharmacists. materials for use at the pharmacy counter. In addi- According to Dr. Spolarich, many older adults do tion, she is developing a pharmacist resource toolkit not regularly visit a dentist and need help finding that will be available on toothwisdom.org, the project resources to improve their access to oral healthcare. website for Oral Health America. Once the toolkit Pharmacists are well positioned to assist with this di- is complete, she will assess its use and influence on lemma since they see this population more frequently pharmacists’ practice behaviors. than other healthcare providers do. Additionally, older “I am excited to be working with pharmacists in this adults often seek the advice of pharmacists about interprofessional endeavor,” Dr. Spolarich says. “This managing acute oral health problems, selecting appro- partnership will enable us to reach many older adults priate products, and understanding their use. to help improve their overall health and quality “Hundreds of medications on the market cause ad- of life.” verse oral health effects,” says Dr. Spolarich. “Pharma- cists need assistance with knowing how to locate and recommend appropriate oral health interventions.” Pharmacists are moving toward the role of prima- ry care providers, and the scope of their practice is changing accordingly. Pharmacists now give vaccines and offer health advice. Dr. Spolarich believes oral health education should be a natural extension of their practice. Currently in her “Tooth Wisdom for Pharmacists” project, she is studying the types of oral health ques- tions and concerns that older adults ask practicing pharmacists. She is also testing pharmacists’ dental knowledge and level of comfort and preparedness with counseling on oral health issues, accessing reli- able oral health information, and knowing how and where to refer for dental care. “The training curriculum has been tested with pharmacists in Florida and North Carolina,” says Dr. Spolarich, who has presented her findings nationally and internationally. “Results of the educational inter- vention have been remarkable.”

Dr. Spolarich plans to pursue more initiatives with “Tooth Wisdom for Pharmacists,” including developing a curriculum model for pharmacy schools.

SPARKMAGAZINE 35 In 1938, John Stedman Denslow, DO, ’29, joined the faculty of the Kirksville College of Osteop- A look back athy and Surgery (KCOS), known today as A.T. Still University. Through his interest in research, support from President George M. Laughlin, DO, 1900, and $5,000 from the College’s general fund, Dr. Denslow established the first research program at KCOS. He focused his studies on the osteopathic lesion using electromyographical methods and opened the door for future investi- gators, such as Irvin M. Korr, PhD, and the Drs. Gutensohn, to contribute to scientific knowledge and validate osteopathic principles.

Dr. Denslow dedicated his career to research and the College, serving in various capacities from 1938-82. Museum of Osteopathic Medicine, Kirksville, Missouri [2010.02.876]

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