UVA Health Student Nurse Finds Renewed Personal Mission in the Pandemic

By Amy Preddy Hughes

Since May 2020, UVA Health, the University of Virginia’s medical school and hospital, has been providing hundreds of COVID-19 tests per week to members of the local community. Teams of UVA volunteers host events three or four times per week to bring testing to residents who otherwise may not have access.

As of March 31, 8,376 tests had been administered at these events.

“It has brought testing to the community in a way that’s accessible and safe,” said Trisha Durfee, who has been using her nursing skills to combat the pandemic for more than a year. “I think it gives people this sense of calm and comfort in the storm that there’s this resource to go get tested. There are so many communities across the country that have very limited testing.”

Durfee has emerged as a leader in UVA Health’s COVID-19 effort, even as she continued her nursing career in the Medical Center—and wrapped up the Bachelor of Science in Nursing program at the UVA School of Nursing. On Friday, she walked the Lawn for graduation, fulfilling a childhood dream.

Meanwhile in the background, Durfee has a family at home (a husband, four kids, two cats, a dog, and a bearded dragon).

Related: How a University of South Carolina Business School project could save lives in cancer clinical trials

The Testing Effort
At every testing event, there are at least four UVA volunteers swabbing, accompanied by four to six assistants. Several more volunteers support the effort by greeting, registering, helping with paperwork, explaining the process, answering general questions and directing traffic.

Multiply that crew by three or four events every week, and there are a lot of volunteer hours needed to provide this service to the community. To date, more than 200 UVA Health team members have participated in the community testing events.

The events are designed to primarily provide drive-through testing, but because they take place in neighborhoods, there is often walk-up traffic. Events are regularly held at Mount Zion First African Baptist Church on Lankford Avenue and at the Southwood Community Center on Hickory Street, both in Charlottesville, Va. They also rotate to other locations as needed. These organizations and other community partners have been vital to the operations by offering resources and space.

Durfee said the number of tests completed at a given event ebbs and flows, and usually, the size of the neighborhoods is reflected in the number of individuals requesting tests.

Southwood, for example, is primarily a Hispanic community, and it tends to be busier, with a lot of walk-up demand, she said. In general, the Hispanic community has had higher rates of COVID-19 compared to the rest of the region.

Related: Cancer survivor Haley Tyrrell teaches isolated patients how to write their own fight songs

One Nurse’s Journey
In her regular job, Durfee is the charge nurse in the UVA Dermatology clinic. At the beginning of the pandemic, the clinic suspended appointments and closed down. Durfee became one of the first nurses to volunteer in the COVID Clinic, which opened in March 2020.

As the COVID Clinic operations evolved and more became known about the coronavirus, Durfee was asked to do point prevalence testing, which is testing in congregate living facilities, like dorms, when there is an outbreak.

She embraced the work. Eventually, she found herself knee-deep in the testing environment. The community testing events began in May 2020; Durfee volunteered at the first event at Mount Zion and quickly became a crucial member of the team. Soon, she started recruiting colleagues to assist at the events. She felt there were many team members who wanted to help but weren’t sure how to contribute. She sent out an email to solicit volunteers and received an overwhelming response. Within two days, 70 team members signed up to help out, and all the volunteer spaces were filled.

“It’s been really inspiring to see the number of people helping,” Durfee said. “The whole team has just been working really hard, and I’m proud of them.”

When the Dermatology Clinic opened again and clinic appointments filled up, Durfee worked her regular shifts during the day, then helped at the testing sites a couple evenings a week. “For all of us who are doing the community testing, it really is a labor of love, because we all have our full-time positions and we’re doing this as well,” she said.

As time passed, a core group of team members emerged as regulars at the testing events, and Durfee grew close to them. “The number of people who I’ve met volunteering from the different areas of UVA Health and the community is amazing,” she said. Without COVID-19, “all of these people probably would never have had a chance to talk to each other. The fact that they all came together makes it a very humbling experience. If there is a silver lining to COVID-19 in any way, it’s the way that it has brought the UVA community together.”

In recent months, Durfee’s assistance was needed with the vaccination effort, so she pivoted once more to help at the vaccination clinics.

Related: Hollins University’s “Tick Lady” works to combat Lyme disease

Personal Growth
From the COVID Clinic to community testing to vaccination, Durfee has gone where she was needed most. She admitted she hasn’t slept a lot lately, but, to her, it’s worth it because she knows she is helping her neighbors.

Durfee said things have changed a lot in the past year, and so has she. “My perspective has changed from only patient care to a wider view of how we can—and do—impact health care,” she said. “It also taught me to think like a leader.”

Durfee has grown. She has given a lot of herself, and she is using that to become the best version of herself. She plans to take her whirlwind experience during the pandemic, her formal education and her desire to make a difference and use it all to lead the next generation of nurses, “which is not anywhere I had previously envisioned myself,” she said.

This article has been edited slightly from the original version appearing on the University of Virginia website.

How a School of Business Project Could Save Lives in Cancer Clinical Trials

By Marjorie Riddle Duffie

A team of operations and supply chain students at the University of South Carolina’s Darla Moore School of Business learned during the spring semester how they could save a life—without ever stepping foot in a hospital.

Team members were focused on reducing the time it takes Hollings Cancer Center at the Medical University of South Carolina (MUSC) to activate industry-sponsored cancer clinical trials. Their recommendations for more efficient processes could get a patient started on a trial before their cancer becomes terminal, and the treatment could be approved faster by the Food and Drug Administration for eligible patients, thus saving many more lives.

“The stakes are really high. If a trial isn’t approved in time, the patient unfortunately could pass away,” said TJ McCoy, a recent operations and supply chain graduate who will work with Bell Helicopter in Dallas this summer. “With our recommendations, we have the ability to reduce the likelihood of the outcome, which is someone dying. The project is one of the coolest things I’ve done in school.”

Related: Cancer survivor and musician Haley Tyrrell teaches isolated patients how to write their own fight songs

The project was part of the new Operations and Supply Chain Humanitarian Initiative to improve operations, business processes and supply chains at nonprofit organizations and, ultimately, make their work more impactful. Students and faculty members partner with for-profit companies, who will sponsor semester- and yearlong projects for the nonprofit organizations.

Led by faculty mentors Sanjay Ahire and Jack Jensen, the student team that worked on the cancer trial project also included Julia “Lane” Herlong, Shang-Yi Peng, Scarlett Pho and Trent Stroup. They recently presented at the 2021 Industry Summit their 23 strategic recommendations to improve the cancer trials’ overall time to activation by about 30 percent—solutions that could ultimately keep patients from dying.

Faster activation of cancer trials at the Medical University of South Carolina could save countless lives.

High Stakes for Cancer Trial Activation
With the current administrative time MUSC invests before trials even begin, about 50 percent of the trials they tried to launch in recent years didn’t have a single patient enrolled in them. By the time they were ready to begin the trial, the patients’ cancer had progressed too far, they had already moved on to a different trial or they had died, said Herlong, a recent operations and supply chain and international business graduate who will begin working with Deposco in Atlanta this summer.

With industry trials, if MUSC didn’t get the trial underway in a more expedited manner, the trial could end up going to a bigger city, which not only takes funding away from the school but also forces South Carolina patients to go farther away to participate in the lifesaving trials.

“The students and our faculty applied the same principles of agile process design on this project that were implemented in the highly effective Operation Warp Speed COVID-19 vaccines development initiative that saw the vaccine development timeline compressed from years to months,” said Ahire, a professor and co-director of the Moore’s Operations and Supply Chain Center.

While the students learned a great deal about analyzing a complex process, the recommendations they made could make a real difference by decreasing the patients’ clinical trial wait time by a third.

“While we have completed numerous process improvement projects with Fortune 500 firms, the MUSC project has been both challenging and valuable to mentor. Students came away with a sense of mission, and we helped with useful recommendations to flow the clinical trial studies quicker through the activation process,” said Jensen, a clinical professor of operations and supply chain management who has led projects alongside Ahire over the past 10 years.

Related: Ole Miss pharmacy professor helps the underserved in the Mississippi Delta

MUSC’s Patrick Flume said he admired the way the students grasped the complexities of clinical trials across several universities. Flume, an M.D., directs MUSC’s Adult Cystic Fibrosis Center and is the Powers-Huggins Endowed Chair for Cystic Fibrosis.

“Helping us improve our processes to speed up the startup time is essential because time matters to everyone: to the study drug sponsor and to our teams where there are financial considerations, but also especially for the patients, where time, and more of it, is what they want,” Flume says.

Learning the Intricacies of Clinical Oncology Trials
Most students who participate in the senior capstone projects through the Moore School’s center must get up to speed with the company’s business challenge. For the MUSC cancer trials project, the students also had to familiarize themselves with the clinical oncology trials that includes an intricate multi-step process to match patients with trials that best fit their situation.

The Moore School team analyzed multiple data sets from various clinical trials and had detailed conversations with MUSC staff and affiliates to inform their 460-point operations data map.

Through interviews with various groups associated with the clinical trials within MUSC and across eight universities—including Dartmouth College, the University of Rochester and the University of North Carolina—the team conducted internal and external benchmarking for MUSC’s current processes.

Pho, a senior operations and supply chain, finance and Honors College student who will graduate in December, said the group learned valuable skills beyond the scope of the project. For example, the team presented a 200-plus-slide report to more than 20 research and administration leaders from MUSC.

Dr. Sanjay Ahire co-led a team of business school students in developing more efficient processes for activating cancer clinical trials.

Ahire and Jensen closely oversaw the MUSC group’s project because of the high stakes for the possible outcomes as well as the organization being one of the first to take part in the center’s Operations and Supply Chain Humanitarian Initiative.

In recent years, Ahire’s undergraduate courses have focused on projects that help socially missioned nonprofits become more efficient.

This service sparked an idea for Ahire to create a pipeline for socially missioned nonprofits to participate in the Industry Summits, which since 2008 have partnered teams of students and Moore School faculty with business executives to increase efficiency. These partnerships have amounted to more than $280 million in recurring cost-savings measures. Companies pay to participate in the projects; with the initiative, some nonprofits are now being sponsored by larger corporations.

Ahire created the Operations and Supply Chain Humanitarian Initiative to give back to community organizations in three ways. A partnering organization or individual donor sponsors a nonprofit of their choice or one chosen by Ahire and his colleagues. Or a nonprofit with a social mission pays for their project.

In each instance students serve organizations that provide vital services like the MUSC cancer trials, Harvest Hope food bank and United Way Association of South Carolina, which has 25 branches that serve vulnerable populations across the state.

Ahire sees these nonprofit projects as an opportunity to give back to the community.

“The capstone course has completed more than 290 projects for the for-profit companies. In the next five years, such an initiative will be even more impactful,” Ahire says. “For nonprofits, it won’t just be savings in dollars but savings in lives and dignity for vulnerable populations, right? That’s the idea.”

This article has been edited and condensed from the original version appearing on the University of South Carolina website.

Cancer Survivor Haley Tyrrell Teaches Isolated Patients How to Write Their Own Fight Songs

By Lynn Adams Wilkins

When it comes to facing life’s battles, Haley Tyrrell, a senior at the University of Mississippi, knows everyone needs their own fight song. And she helps them write it.

Tyrrell’s journey began in Ridgewood, N.J., where she grew up, and took her through a battle with cancer before leading her to music and to Ole Miss, a Sullivan Foundation partner school.

At Ole Miss, Tyrrell’s opportunities expanded to match her boundless spirit. From solo recitals to choral performances to her work with Pi Beta Phi and the Living Music Resource, Tyrrell has used each experience to end up right where she wants to be: teaching in the classroom with the Fight Song Project, which uses music to connect students who are isolated—by hospital stays, as she once was, or even by COVID19, as everyone has been.

Related: This Algernon Sydney Sullivan Award recipient beat breast cancer and helps other black women do the same

Tyrrell said she created the Fight Song Project to help people connect and stay strong by writing their own fight songs. “Fight can mean many things,” she said. “We all have obstacles we need to battle, things we need to overcome.”

A fight song expresses those battles and energizes the singer to keep going. “I am a cancer survivor and an amputee,” said Tyrrell, whose experience taught her a lot about staying strong. “I lost my leg to cancer in 2009, and music played a huge role in my recovery.”

A serious athlete as a child, Tyrrell discovered she had bone cancer when a broken leg took her to the hospital. The hospital ward was a pretty lonely place, she learned, but music was always an escape. Afterward, she got involved with theater and discovered a love for music and for performing. “That’s why I’m a music education major today,” she said.

Haley Tyrrell launched the Fight Song Project, which uses music to connect students who are isolated, in the Oxford and Lafayette County, Miss. school districts.

Tyrrell piloted the Fight Song Project this spring. Children met via Zoom to express themselves and socialize with others in a nurturing and creative environment. They worked together with Tyrrell to develop content, write lyrics, compose music and record it.

“All the lyrics came from poems that they wrote,” Tyrrell said. The resulting song celebrated the love and support the students get from their families. “Now they have a song they can return to, to empower them to get through whatever they’re dealing with in their own lives.”

The idea for the project crystallized when Tyrrell learned about Carnegie Hall’s Lullaby Project, a songwriting initiative that pairs pregnant women and new parents in correctional facilities, foster care and homeless shelters with professional artists to write and sing personal lullabies for their babies.

“That was a huge inspiration for me,” she said. “I thought how helpful it would have been for me to be able to express myself through music during my experience with cancer. This process of expression is great for kids because they are dealing with so much. Through the Fight Song Project, they get to take control and create their own song.”

Related: Furman University professor co-creates mobile app for parents of children with cancer

As a student, Tyrrell worked as an undergraduate assistant for the Living Music Resource (LMR), which connects students to real-world experience in music professions and arts-based community service. She learned about the Lullaby Project when LMR participated in the 2018 International Teaching Artist Collaborative Conference hosted by Carnegie Hall, Lincoln Center and Dreamyard.

“Through LMR, I was also able to gain professional experience in the music industry, collaborate with my peers and take ownership for projects I was a part of,” she said. “One highlight was being the student director of LMR’s first-ever cabaret competition. I coordinated auditions, selected acts, created a program and arranged rehearsals for performers.”

Being part of the cabaret competition gave Tyrrell skills she needed to start the Fight Song Project and the confidence to know she could do it. She was supported by her voice professor, Nancy Maria Balach and assisted by LMR colleague Alexis Rose and UM music alumnae Hannah Gadd Ardrey.

“Students absolutely loved participating in the Fight Song Project,” said Ardrey, choral director at Lafayette High School in Oxford, Miss. “They enjoyed working with Haley because she was funny and personable. She made the project easy to understand and a fun process.”

In the future, Tyrrell sees herself teaching music and continuing to develop the Fight Song Project, eventually taking it to pediatric hospitals, where she has been volunteering on and off since she was a patient herself. After graduation, she’ll start working right away in New York City, teaching with Teach for America and attending graduate school.

Tyrrell (right) celebrates completing her senior recital with Nancy Maria Balach, her voice professor.

“In creating the Fight Song Project, Haley drew on her personal background, her music education training and career development opportunities to create something unique,” said Balach, professor of music and artistic director of LMR. “She even successfully adapted her idea to a virtual formal due to the pandemic. Her ability to connect with people helped build trust with her Fight Song students.”

“Haley is an inspiration because she embodies how you define who and what you want to be, and she demonstrates that in all areas of her life,” Balach added.

Thomas Ardrey, choral director at Oxford High School, agreed. Tyrrell did student teaching in his classroom during the spring 2021 semester. “Haley’s vibrant, outgoing personality allowed her to quickly build a relationship with our students,” he said. “I know that, with her personality and high level of musicianship, she will become a valued member of our profession.”

Student teaching provided valuable experience and feedback, Tyrrell said. “The students are so excited to learn and make music,” she said. “Everyone welcomed me with open arms, and I am definitely going to miss them when I graduate.”

With a college career packed with rehearsals, performances, music classes, studio lessons, recitals, special projects in music through LMR and, in the spring of 2021, student teaching, Tyrrell still had energy to spread across campus. She served as a team captain for RebelTHON, a College of Liberal Arts Student Council member and an active member of both Lambda Sigma and Order of Omega honor societies and the American Choral Directors Association.

“As part of my Miss Ole Miss campaign, I hosted Ole Miss’s first-ever ‘Gold Out,’ where I encouraged the student body to ‘Go Gold’ in order to raise money and awareness for pediatric cancer research,” Tyrrell said.

“All of these organizations and experiences enriched my college career, but the most memorable and impactful experience was serving as chapter president of Pi Beta Phi fraternity for women.”

As president, Tyrrell met the responsibility of leading 400 women, ensuring positive and productive chapter life, and overseeing all aspects of the chapter. “Leading through the uncertainties of the pandemic taught me important communication, problem-solving and team-leading skills,” she said.

“From implementing COVID-19 protocols to coordinating socially distanced and virtual events, my term was not what I expected, but I learned more about myself and grew more than I had in my entire college career,” she added. “I wouldn’t change it for the world and would do it over again in a heartbeat.”

This article has been edited from the original version appearing on the University of Mississippi website.

UA Nursing Student Focuses on Taking Care of the Underserved in Birmingham

For LaDarryl Banks, a nursing student at Sullivan Foundation partner school University of Alabama, being a nurse is more than caring for individual patients—it’s about serving the community.

“We need people who are passionate and invested in our communities and making positive changes in health care,” Banks said. “We are making progress, slowly but surely.”

Banks will graduate from UA’s Capstone College of Nursing RN Mobility (RN to BSN) program in May. As an RN and office manager at Cahaba Medical Center’s West End location, a nonprofit healthcare center in Birmingham, he not only provides care to historically underserved populations but also works to improve their community, which he, too, calls home.

Related: Ole Miss pharmacy professor helps the underserved of the Mississippi Delta

One of his biggest areas of impact has been assisting his colleagues in securing grants for school-based health centers and COVID-19 mobile clinics in west Birmingham.

“One of my favorite parts of being a nurse is going beyond providing someone the healthcare resources they need and teaching them how to manage or treat their condition,” Banks said. “By going to our schools and using the mobile clinic, we can reach those who can’t come to us.”

Banks said he decided to pursue a career in nursing because he has always been a natural empath and caregiver.

“I learned compassion as the middle child in my family and also watching my grandmother and her nurses during her time in hospice care,” he said. “Nursing is my calling and my passion—it’s always my goal to not make my work about me, but, rather, the impact that we can all make when we work together.”

Banks began his nursing education at Lawson State Community College, where he received his Associate of Science degree in nursing. After obtaining his registered nursing license in Alabama, he knew he wanted to attend UA’s RN to BSN program, he said.

“I always recommend the UA program to my colleagues. The faculty and staff at CCN understand the challenges we have faced in health care throughout the pandemic and beyond,” he said. “They understand the stress related to our jobs, and they go above and beyond to help students be successful.”

Banks recently received the 2021 Outstanding RN Mobility Student award given by the CCN Epsilon Omega Chapter of Sigma Theta Tau International nursing honor society. This award recognizes a student who demonstrates outstanding achievement and ability in scholarship, professional involvement and leadership.

Related: Dr. Sarah Imam of The Citadel teaches the human side of medicine

In addition to working fulltime and being active in the community, Banks adds home health visits on the weekends and plans to pursue advanced nursing education.

“I plan to continue my education and apply to UA’s Master of Science in Nursing degree program with a specialization in the Dual Nurse Practitioner Concentration in Psychiatric Mental Health and Family Nurse Practitioner,” said Banks. “I realize I am just a dent in the universe, but my calling and focus remain to learn more about how to not only treat but manage addictions and diseases continuing to plague our area.”

Banks added, “I am a firm believer in treating a patient’s mind, body and soul for recovery.”

This article has been edited slightly from the original version appearing on the University of Alabama website.

These Mercer University Student Volunteers Have Administered Thousands of COVID-19 Vaccines

By Jennifer Falk

Students at Sullivan Foundation partner school Mercer University are playing a major role in administering COVID-19 vaccines to the Atlanta community.

Over the past three Saturdays, March 6, 13 and 20, students in the physician assistant program in the College of Health Professions have given thousands of vaccinations at a site located at Mercedes-Benz Stadium.

“Being part of the vaccination site was like being part of something that’s bigger than yourself,” said Sara Kaplan, a second-year student in the physician assistant program. “Every shot that goes in an arm is, hopefully, one less person that ends up in the hospital … This disease has really torn the fabric of America, and it’s just really, really powerful to be part of the process that is helping end this pandemic.”

Related: Mercer University partners with Real Impact Center to get girls excited about STEM

As of March 15, Georgia had administered nearly 2.8 million doses of the COVID-19 vaccine, with about 16% of the population receiving at least one dose, according to the Centers for Disease Control and Prevention’s COVID Data Tracker.

Many Mercer students have wanted to help since the beginning of the pandemic but were unable to do so, said Arlene Salmon, a clinical assistant professor in the Department of Physician Assistant Studies. “They were just in a unique position because they were getting all this medical training, but there wasn’t an opportunity because they weren’t fully qualified,” she said.

Then, when the vaccines came out, they were “uniquely positioned” to be able to administer them, said Salmon.

Arlene Salmon, a clinical assistant professor in the Mercer University College of Health Professions Department of Physician Assistant Studies, shows Sara Kaplan, a second-year student, how to prepare a COVID-19 vaccine.

The students already knew how to give intramuscular injections, which is required for the three COVID-19 vaccines available in the U.S., as it was a core lab skill that they learned during their first year in the physician assistant program.

Salmon reached out to Fulton County officials to see if the students could help. In addition to giving shots at the mass vaccination site, plans are in the works for students to go out in mobile units to vaccinate underserved populations.

Related: New Mercer University center could provide millions with access to clean water

“Our program is very service-oriented, and we felt a little bit like a fish out of water when we weren’t able to go out there and help with the pandemic,” said Dr. Jill Mattingly, chair and clinical associate professor in the Department of Physician Assistant Studies. “We supported from behind the scenes, but now, with this, the students feel empowered to be part of the effort across the country.”

Students jumped at the chance to help, quickly filling the 20 volunteer slots available each Saturday at the mass vaccination site. They work 8 a.m.-4 p.m. at tables of two set up in the concessions area of Mercedes-Benz stadium.

“It’s just a stream of people coming in, and it’s really like one after another after another,” Kaplan said.

Not only do students give the shots, but they also prepare the vaccine for injection. This involves bringing the main portion of the vaccine from frozen to room temperature, reconstituting it with a diluent and drawing single doses of the vaccine out of the vial, said Tyler Fredlund, a second-year student who helped with the process.

“It just feels really rewarding to be able to know that the vaccine that you’re giving these people is really going to make a big difference,” Fredlund said.

The students have met all sorts of people at the site, from the grandfather eager to see his grandchildren for the first time in a year to the hesitant woman whose daughter made her come.

“I’ve given so many shots, but I’ve never given a shot that made me feel like I was actually, really changing lives,” Kaplan said.

This article has been edited slightly from the original version appearing on the Mercer University website.

Ole Miss Pharmacy Professor Helps the Underserved of the Mississippi Delta

By Patrick Smith

For Meagan Brown, a clinical associate professor of pharmacy practice at Sullivan Foundation partner school University of Mississippi, serving the underserved has been the driving force in her career.

Since joining the UM School of Pharmacy faculty in 2011, Brown has been involved in the Mississippi Delta Health Collaborative. The project, funded through a grant from the Mississippi Department of Health and the Centers for Disease Control and Prevention, focuses on providing clinical pharmacy services in the Mississippi Delta.

Many residents in the Mississippi Delta face high levels of chronic disease, exacerbated by high poverty and health disparities in the region. Brown and her colleagues sought to improve health outcomes and show that pharmacists can make a difference for patients dealing with cardiometabolic diseases such as diabetes, hypertension and dyslipidemia.

Related: University of Mississippi’s Lauren Graham honored as one of the nation’s top veteran students

Meagan Brown

Brown, in particular, conducted her work at a federally qualified health clinic in Yazoo City. The work has made her a better pharmacist and educator, she said.

“Being in the Mississippi Delta, there were a number of socioeconomic barriers that existed,” Brown said. “It really teaches you the balance of what we teach our students in school versus what they’re really able to do when they’re out in the real world. Ideally, we would pick the best therapy for a patient. But if it’s an expensive drug and the patient doesn’t have insurance or even a ride to the pharmacy to pick it up, that presents another set of challenges.”

Brown said this work has been invaluable to her students as well. Ole Miss students and residents working alongside her not only get hands-on experience, they also receive preparation for a future in serving patients who may be facing challenging circumstances.

“It has helped them experience and navigate those socioeconomic barriers that patients have,” Brown said.

According to the researchers, significant improvement in the health of patients was observed over the course of the grant. And though the funding ended in 2019, Brown has continued her work in the Delta, working at the clinic two days a week.

Related: Sullivan Award winner Neely Griggs of the University of Mississippi keeps puppy tails wagging for pet rescue organizations

Her work extends to other areas. In 2020, Brown and Justin Sherman, an associate professor of pharmacy practice at UM, received one of the university’s inaugural Achieving Equity Grants. Brown is serving as co-principal investigator with Sherman, exploring health inequities stemming from the use of vaping and other electronic nicotine delivery systems.

She and Sherman will seek, through a series of focus groups, to get thoughts from students about their perceptions of the dangers associated with tobacco products, particularly around vaping.

Brown pointed out that there is a disproportionate health burden on disadvantaged racial and ethnic groups for smoking-related diseases. However, not much literature exists focusing on usage by youth and young adults, particularly for vaping. Her research will seek to remedy that.

Besides her work as a faculty member, Brown also has served as a member of the National Pharmaceutical Association since 2017. She was asked to serve on the organization’s board of directors and previously served as the clinical initiatives chair. As the association’s convention chair, she is planning the group’s national convention set for July in Los Angeles.

Founded in 1947, NPhA is an organization that seeks to elevate the voices of minority pharmacists and bring attention to issues facing underserved communities. Brown said the organization aligned perfectly with her career goals.

“We’re a small but mighty group,” Brown said. “I think, especially this year, NPhA has risen to the top as an organization that really can help folks identify some areas for improvement and serve as a resource in the area of diversity, equity and inclusion.”

Lakesha Butler, immediate past president of NPhA, praised Brown’s work for the organization. Butler pointed to Brown’s work as the clinical initiatives chair, where she led the collaborative efforts between NPhA and VotER.org as the organizations celebrated Civic Health Month by providing members with resources to assist in signing patients up to vote.

Related: University of Mississippi researchers seek new ways to help people who stutter

Brown also took the lead in NPhA’s initiatives on chronic kidney disease, diabetes and cardiovascular disease.

“I have known Dr. Brown for close to 10 years as a mentee, colleague and friend,” Butler said. “Her passion for underserved communities, work ethic, leadership, tenacity and overall great personality made her the ideal candidate as I identified individuals to serve on the NPhA board of directors during my presidency.”

“I wanted individuals who would be ready to work hard and be committed to the vision I set forward,” Butler added. “Meagan was all of that and more.”

This article has been edited slightly from the original version appearing on the University of Mississippi website.

Nursing Students at Tennessee Wesleyan University Volunteering to Boost Vaccination Efforts

As the coronavirus pandemic continues and demand for vaccinations rises nationwide, Dr. Kellee Vess, an associate professor of nursing at Tennessee Wesleyan University’s Fort Sanders Nursing Department, has never seen a time like this. Recognizing the need and a unique opportunity to help, Dr. Vess, her colleagues and TWU Fort Sanders Nursing students have volunteered in recent weeks to administer COVID-19 vaccines all over the Knoxville, Tenn. area.

According to the National Council of State Board Nursing (NCSBN), high volume in populated areas and nurse shortages in rural areas have created a problem for the COVID-19 vaccine. There simply aren’t enough nurses to administer the vaccine at the rate that is needed. As a result, partnerships with nursing education programs are being encouraged so that nursing students who have been taught the principles of the COVID-19 vaccine can help administer it.

TWU Fort Sanders Nursing, in its ongoing partnership with Covenant Health, answered this call. To this point, the nursing school has provided more than 30 student and faculty volunteers who have given more than 250 hours of service at five different Covenant Health locations. And the numbers keep climbing as Covenant Health, a network of hospitals in Knoxville, continues to utilize TWU volunteers.

Related: How Warren Wilson College stayed COVID-free in the fall 2020 semester

“It was a great experience,” said Dr. Vess of her time volunteering at Fort Sanders Regional Medical Center. “It was just humbling. And I was so proud to be a nurse. I’m so proud to be a nurse [and] that I could go into the hospital, help give the immunizations to people that are caring for COVID patients day in and day out. It felt like such an honor to be able to help them in that small way.”

The vaccines are largely being administered to Covenant Health’s frontline workers.

Nursing student Michael Dalton administers a COVID-19 vaccination.

“How many people are actually frontline that we don’t think of as frontline?” said Michael Dalton, a senior nursing student at TWU Fort Sanders. “Of course, we think of the ER and ICU. But what about the people that are actually behind the scenes that we’re helping? It was just amazing. I had such a great experience with that. It made me proud that I’m continuing on with this career.”

“We gave 700 vaccines in three hours,” said senior Carol Stiles of one of her shifts at Parkwest Medical Center. “Those 700 people were almost all Covenant Health employees. Everyone seemed to know everyone and were all genuinely happy to see each other. People were saying, ‘Happy Vaccination Day,’ as if it were a celebration. There were smiles all around. I got a sense of pride, unity, and family being around this bunch.”

Members of the TWU Fort Sanders Nursing family have worked as teams in Covenant Health facilities in Roane County, Morristown, Loudon, Oak Ridge, and Fort Sanders Regional in downtown Knoxville. No matter the location, the students and faculty have seen the impact of the vaccines.

“I really felt like the people were hopeful,” added Dr. Vess, when asked about the morale at Fort Sanders. “People were very energized getting their vaccines. Lots of people talked about what the future is going to look like after they get their second vaccine.”

“I have volunteered three times so far and plan to continue as my crazy schedule will allow, because it is the most important and rewarding thing I have done in a long time,” Stiles said. “I am part of history in doing this. I am literally helping to stop this terrible pandemic.”

Related: Entrepreneur honors black-owned businesses threatened by COVID-19 pandemic

Outside of the service opportunity, the experience has also served as an invaluable learning opportunity for the TWU Fort Sanders students. Despite the pandemic, students have been able to remain in clinical settings, providing a chance for hands-on training in an unprecedented situation.

“This is a rare opportunity for students to directly learn about population health, participate in a public health program, gain clinical experience and ultimately save lives,” said Dr. Maryann Alexander of the NCSBN in a letter sent to nursing programs.

“Any opportunity that students have to practice their technical, communication and patient teaching skills is beneficial to forming their identity as a professional nurse,” said TWU Assistant Professor of Nursing Dianna Vermilyea. “It also allows students to network and interact with other nurses and managers at Covenant and to showcase the knowledge and abilities gained through our nursing program.”

“[The Covenant Health employees] had open arms for us nursing students, they were so excited for us to come and help them,” Dalton added. “That alone, just everyone working together, let me know in my heart that this is the path that I need to be on, to have that group effort. And for everyone working together as a team, it touches you inside to let you know that this is what God is wanting you to do.”

“Just being in the hospital setting and practicing a hands-on skill is very beneficial to my education,” Stiles added. “We gave so many vaccines in such a short period of time. I am very comfortable talking with clients and confident in giving IM (intramuscular) injections now. During my time volunteering, I made some connections that will help my future career too. The experience was pretty incredible. Everything about it was positive. I felt truly proud to be part of making a difference.”

This article has been edited slightly from the original version appearing on the Tennessee Wesleyan University website. TWU is a Sullivan Foundation partner school.

UVA Pediatric Team Works to Bring Fresh, Healthy Foods to Families in Need

The question, “What are you going to do in your community?” had been swirling in Dr. Jeffrey Gander’s mind ever since he attended a pediatric conference more than two years ago.

During the COVID-19 pandemic, the answer came to him.

In November, Gander, a pediatric surgeon with University of Virginia Health, spearheaded the launch of a UVA food insecurity project, which partners with Local Food Hub’s Fresh Farmacy to bring regular deliveries of fresh produce to pediatric patients and in-need families.

Related: UVA faculty, alumni lead effort to combat food insecurity during pandemic

“All of us are in a profession to help people and care for people—a healing profession,” Gander said. “We owe it to our patients, as part of our care for them, to make sure that they have nutritious food. That may be even more powerful than some of their medications. Think about this fresh, healthy food as a way to treat their diseases.”

In the following Q&A with Whitelaw Reid of UVA’s Office of University Communications, Gander and Tegan Medico, a pediatric nutritionist at UVA Health, discussed how the program has been going.

Q: Dr. Gander, can you tell us about the “a-ha” moment you had at the conference in which you realized you needed to launch something like this for the community?

Gander: I had attended a conference at the American Academy of Pediatrics in 2018 and listened to several speakers talk about how physicians can have an impact on your community. One particular speaker was Adam Foss, an advocate for criminal justice reform, who really stood out to me. I was fortunate to attend a symposium led by him about six months later where he challenged everyone to find a problem in your community, find like-minded individuals who are working on it and work together.

I started to learn about the almost 20% incidence of food insecurity in Charlottesville, Va., and in particular how people had little access to fresh healthy food, given that it was so expensive.

At the beginning of COVID, I volunteered to deliver meals to students in an underserved community in Charlottesville through a not-for-profit called Cultivate Charlottesville. It was through them that I learned about a partner not-for-profit called Local Food Hub that was partnering with farmers in Virginia to bring healthy food to people who desperately needed it with their Fresh Farmacy program.

Q: Can you give us a snapshot of what childhood obesity looks like in this country and also here in Charlottesville? How big of a problem is it?

Gander: For childhood obesity, it is estimated to be 18% in the Blue Ridge Health District. I do see a fair number of obese teens in my surgery clinic. In speaking to some of them, they often talk about [how] most of their nutrition is from the school lunches, which are not always healthy.

Medico: Childhood obesity rates in the United States have been rising in a relatively consistent pattern over the past few decades. Most recent data shows that 18.5% of children ages 2 to 19 years met the clinical definition of obesity, which is based on body mass index at the 95th percentile or higher. In Virginia, the overall childhood obesity rate is slightly lower, at 13% for 10- to 17-year-olds as of 2018-19, based on data from the National Survey of Children’s Health.

When you break down this BMI data by family income, there is a clear relationship: the lower the family income, the higher the childhood obesity rate.

Dr. Jeffrey Gander (center), Dr. Amy Wrentmore (left) and pediatric nutritionist Tegan Medico (right) hope to expand the food program to every family throughout the UVA Health medical center who cannot afford fresh, healthy food. (Photo by Kay Taylor)

Q: How does your program work?

Gander: We are identifying families who are food-insecure through our Battle Building Pediatrics Clinic. One of our social workers, Lashanna Hicks, has a list of families that have responded “yes” to a two-question screening tool. We are hoping to expand this questionnaire to every family that has a clinic visit.

After the families are identified, they are asked if they would be willing to receive fresh food delivery to their house every other week. At that point, we contact Local Food Hub, and they work with their farmers and deliver a bag of produce, typically eight different foods.

Related: Wofford College makes free nutrition education resources available across South Carolina

Q: How has the program been going? What have been your takeaways so far? Does it feel gratifying to be helping the community like this?

Gander: So far, so good with the program. We have seven families that we have been delivering to. We initially were going to start in the spring, but when we recognized the urgent need, we started right away.

Medico: It has been remarkably smooth sailing. Charlottesville’s Local Food Hub deserves much credit here. We just gave them names and addresses, and they took care of the rest.

In fact, one of my biggest takeaways from the project thus far has been how easy it was to do something real, particularly by way of partnerships. While it might be somewhat new to UVA Children’s to focus on food insecurity broadly, it’s not new to many local organizations who are already doing this important work. They know that it starts on the ground.

As a single clinician or a single citizen, it’s easy to feel overwhelmed by a big, complex, societal-level problem like food justice. We can fall into the trap of asking, “How can we solve it all for everyone?” and overlook the validity of starting small, with our own neighbors. While the scope may be small, it is still significant.

Q: What are the long-term goals for the program?

Gander: Long-term, we would love to expand this to every family throughout the medical center who cannot afford fresh, healthy food. We are starting in Charlottesville, but as this program expands, would love to use it in other counties in the area.

Medico: We want the program to expand to reach more families and for the partnership with the Local Food Hub to be sustainable. That will require ongoing funding and probably some justification that a program like this not only is the right thing to do, but also supports the health and well-being of our patients. We hope to demonstrate as much.

We also recognize that the problem of food insecurity is much larger than we are capturing, so we are brainstorming about how to broaden screening efforts and ensure we don’t overburden community partners’ capacity.

Related: Lincoln-Memorial University medical student gives best friend a lifesaving Christmas gift

Q: Is there anything else you’d like to add?

Medico: Childhood obesity is a complex problem with overlapping dimensions. There isn’t one single cause. It’s a symptom of environmental and sociocultural shifts in response to changes in food production technology, food supply chains, agricultural policy, transportation, neighborhood design, technology and other factors. We cannot and should not blame children. Instead, we can and should work on creating environments in which they can be the healthiest and happiest versions of themselves.

A piece of this task is access to foods associated with good health outcomes, of course. Another important piece, however, is fostering a lifelong curiosity about food. What I love about this particular program is that children will be exposed to a wide variety of quality items. Each delivery will be a bit of a surprise.

Can food be good for you and fun? I may be biased as a dietitian, but I think definitely think so.

This article has been edited and condensed from the original version appearing on the University of Virginia website.

New Research Division at Duke University Merges AI With Medical Science

By Ken Kingery, Duke University

Sullivan Foundation partner school Duke University has created a new research entity that will combine leading-edge artificial intelligence with medical science to better diagnose diseases and improve patient outcomes. The Division of Artificial Intelligence and Computational Pathology will be a joint project between Duke’s Pratt School of Engineering and School of Medicine.

Researchers at Duke have been merging AI with health care for the better part of two decades. From making cochlear implants deliver purer sounds to the brain for the deaf to finding hidden trends within reams of patient data, the field spans a diverse range of niches that are now beginning to make real impacts.

Related: Hollins University’s “Tick Lady” works to combat Lyme disease

Among these niches, however, there is one in which Duke researchers have always been at the leading edge—image analysis, with a broad team of researchers teaching computers to analyze images to unearth everything from various forms of cancer to biomarkers of Alzheimer’s disease in the retina.

The Division of Artificial Intelligence and Computational Pathology will push the envelope in this field, the university said.

“Machine learning can do a better job than the average person at finding the signal in the noise, and that can translate into better outcomes and more cost-effective care,” said Michael Datto, associate professor of pathology at Duke. “This is one of the most exciting times I’ve seen in pathology, and it’s going to be exciting to see what we can do.”

The new division will support translational research by developing AI technologies for image analysis to enhance the diagnosis, classification, prediction and prognostication of a variety of diseases, as well as train the next generation of pathologists and scientists in the emerging field.

The division is led by Carolyn Glass, assistant professor of pathology, and Laura Barisoni, professor of pathology and medicine, and operates with the partnership of AI Health, directed by Lawrence Carin, professor of electrical and computer engineering and vice president for research at Duke, and Adrian Hernandez, professor of medicine and vice dean for clinical research.

Duke engineers have developed a new type of smart microscope for disease diagnosis. It uses a bowl studded with LED lights of various colors and lighting schemes produced by machine learning.

“Duke has taken the lead at the national level in establishing a division in the Department of Pathology in partnership with AI/Health with the goal of developing and establishing new models and protocols to practice pathology in the 21st century,” said Barisoni, who is also director of renal pathology service at Duke.

AI Health is also a new initiative, launched as a collaboration between the Schools of Engineering and Medicine and Trinity College of Arts & Sciences, with units such as the Duke Global Health Institute and the Duke-Margolis Center for Health Policy. AI Health aims to leverage machine learning to improve both individual and population health through education, research and patient-care projects.

“For what everyone has envisioned for AI Health, we see pathology paving the way,” Hernandez said. “AI Health is a catalyst and spark for putting cutting-edge machine learning development and testing into real-world settings. In pathology, we have image-intensive data streams, and COVID-19 has really emphasized the need for the timely processing of patient samples.”

Related: Dr. Sarah Imam of The Citadel teaches students the human side of medicine

Applying machine learning image analysis to pathology processes, however, is easier said than done. Figuring out how to process extremely large image files and train AI algorithms on relatively few examples is part of the focus of Carin’s laboratory, in partnership with Ricardo Henao, assistant professor of biostatistics and bioinformatics as well as electrical and computer engineering.

Current AI algorithms, such as convolutional neural networks (CNN), were originally designed for the analysis of natural images, such as those captured on phones. Adapting such algorithms for the diagnosis of biopsy scans, however, is challenging due to the large size of the scans—typically of tens of gigabytes—and the sparsity of abnormal diagnostic cells they contain. Led by David Dov, a postdoctoral researcher in Carin’s laboratory, Duke engineers are working to overcome these challenges to design AI algorithms for the diagnosis of various conditions, such as different types of cancers and transplant rejection.

“Designing algorithms that make a real impact on clinical practice requires close collaboration between AI researchers and pathologists,” said Dov, who joined Duke after completing his PhD in electrical engineering at The Technion – Israel Institute of Technology. “A key challenge in these collaborations is gaining a deep understanding of the gaps in medical practice and then ensuring that clinicians fully understand the capabilities and limitations of AI in bridging these gaps. The new Division of Artificial Intelligence and Computational Pathology plays an important role in facilitating such collaborations.”

Related: Auburn University’s Rural Medicine Program helps provide future doctors throughout Alabama

In a virtual kickoff meeting this fall, the new division’s leadership spoke to the potential it holds to improve patient health outcomes, and several researchers delved into projects they already have underway in the field. For example, Danielle Range, assistant professor of pathology, spoke of efforts to use AI in diagnosing cancer; Roarke Horstmeyer, assistant professor of biomedical engineering, described his efforts to create a “smart microscope” to better diagnose disease; and Glass detailed her work on the use of machine learning in diagnosing transplant rejection.

“In the last couple of years, we have seen an exponential increase in AI pathology interest, from Duke undergraduates to medical students applying for Pathology residency positions,” said Glass. “I think continued development of a solid, integrated curriculum and educational program will be critical to train these future leaders.”

Hollins University’s “Tick Lady” Works to Combat Lyme Disease

Elizabeth Gleim, an assistant professor of biology and environmental studies at Sullivan Foundation partner school Hollins University, is a disease ecologist. But a lot of people simply know her as the “Tick Lady.”

Gleim’s research centers on the study of zoonotic diseases (those that can be directly transmitted between animals and humans) and vector-borne diseases (infections that require transmission through vectors such as ticks or mosquitoes). Ever since she was pursuing her Ph.D. at the University of Georgia, Gleim, who is also a Hollins alumna (class of 2006), has investigated tick-borne diseases. It’s an especially relevant topic because Southwest Virginia, home to Hollins University, is also a hotspot for Lyme disease. And Gleim and her team of student researchers want to know why.

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“There are three main areas on which my research questions focus,” she explained. “The first is identifying ways to better control and prevent tick-borne diseases, especially in the human population but also in domestic animals. I also do a lot of work in vector and disease dynamics, which can vary dramatically based on the ecosystem or the region of the country, and even just from year to year. The other piece is trying to better understand anthropogenic drivers, which is how humans are affecting tick-borne disease risk with their actions or behaviors, and then understanding environmental drivers of disease risk, which can include changes in weather, forest management practices, wildlife population changes and other factors.”

this photo shows Dr. Elizabeth Gleim peering into a microscope as part of her research in Lyme disease

Dr. Elizabeth Gleim is shown here at Emory University (Oxford campus) conducting research for her Ph.D. in Forestry. (Photo by Nancy Evelyn)

One of Gleim’s major research projects, which was published in the July 10, 2019, edition of Scientific Reports, examined the impact of a process known as “prescribed fire” on the risk of tick-borne disease. Over the past several decades, the emergence and incidence of tick-borne diseases, such as Rocky Mountain spotted fever and Lyme disease, have risen dramatically. The challenge for scientists and disease ecologists has been to find ways to reduce and control tick populations and mitigate the risk of tick-borne disease, especially in humans. For years, prescribed fire has been used to successfully manage forests, grasslands, wetlands and other types of landscapes.

The first phase of Gleim’s research looked at how fire impacts tick abundance and seasonality. The second phase, which she brought to Hollins, focused on whether fire might also affect the pathogens that circulate in the ticks. It was the first study ever done to examine the effects of prescribed fire on tick-borne pathogens themselves. Gleim spent two years doing field work in Southwest Georgia and Northwest Florida.

Along the way, she said, she “collected a whole lot of ticks—50,000 of them. I then tested almost all of those ticks for all known tick-borne pathogens.” She determined that prescribed fire affects some pathogens but not all of them. Furthermore, fire greatly reduced the density of ticks infected with pathogenic bacteria in an area and showed a 98% reduction of encounter rates with infected ticks.

Related: Auburn University and other Sullivan Foundation partner schools are developing rural pharmacies in the Southeast

“The findings here were exciting and promising and led to some interesting questions that I hope I can explore in the years to come,” Gleim said. “First, would we get the same types of dramatic reductions in ticks that we observed if we did this work in other ecosystems or other regions of the country or even the world? Second, could prescribed fire reduce Lyme disease risk specifically? Where I did this work in Georgia and Florida, Lyme is not endemic (e.g. does not occur). It’s at least possible that [prescribed fire] could affect the pathogen that causes Lyme.”

The dynamics of Lyme disease in the United States have evolved considerably over the past two decades. As recently as 2001, Lyme disease cases were seen primarily on a limited basis in New England and the Midwest. However, just 16 years later, Lyme was common everywhere in the Northeast and had begun to spread to other parts of the country.

“By 2017, the western region of Virginia was at the leading edge of what would probably be considered a Lyme endemic area with a distinct hotspot developing in Southwest Virginia,” Gleim said.

Jory Brinkerhoff, a professor at the University of Richmond, collected black-legged tick nymphs, the life stage particularly associated with Lyme cases in humans, at four sites on an east/west gradient across the state. He found the greatest number of nymphs at his western-most site and the highest level of the Lyme pathogen there, but it was just one site. “We all know in science that you can’t draw any firm conclusions from just one place,” Gleim said. Along with Hollins Professor of Biology Morgan Wilson and then-senior Ciera Morris, she set out to understand black-legged tick dynamics in the region, particularly in Southwest Virginia’s hotspot.

For Morris’ senior honors thesis, the team established 12 sites around the Roanoke Valley area to collect ticks on a monthly basis for an entire year. They collaborated with an Old Dominion University tick ecologist, collecting the critters in the eastern part of the state that same year. “We found a significantly higher number of black-legged tick nymphs and larvae in the Roanoke region versus the Norfolk area,” Gleim said. “What’s notable, though, is that we do not have significantly more adults. It seems to indicate that we don’t necessarily have more black-legged ticks in the western portion of the state.” However, they are more forcefully engaging in a particular kind of behavior.

“It turns out ticks don’t jump or fly. The only way they get on a human or animal host is to physically brush up against them. For a tick to get on a host, they crawl up to the tops of vegetation, grass or low-lying plants, and they wait for something to brush up against it. We call that behavior ‘questing.’”

Gleim cited previous studies that demonstrated ticks in the Northeast area quest much more aggressively than those in the Southeast. “Ticks in the Southeast tend to stay down in the leaf litter and therefore are unlikely to come into contact with humans. Thus, a migration of ticks from the north into Virginia via the Appalachian Mountains is a possibility.”

Leemu Jackson, a recent Hollins University graduate, conducted genetic analysis to verify whether black-legged ticks are migrating into Southwest Virginia from the northeastern U.S.

Using some of the groundwork laid by Morris and current student Shravani Chitineni and in collaboration with Gleim, Brinkerhoff and Hollins Professor of Biology Rebecca Beach, Leemu Jackson performed her senior honors thesis last year doing a genetic analysis to compare Roanoke-area black-legged tick populations to those elsewhere in order to verify whether migration was occurring.

“We did what we call a phylogenetic analysis, which is sort of a fancy way of saying we created a family tree of all the different ticks we were testing from Roanoke as well as the state of Virginia and the entire eastern U.S.,” Gleim said. “That analysis compared the DNA sequences of all these ticks and showed how similar those sequences are and thus how related they are to one another. What we discovered was a really high genetic diversity here in the Roanoke area, more so than what we’re seeing in the eastern part of the state. This does not definitively prove that ticks are migrating into Virginia, but it certainly provides some evidence to support that hypothesis.”

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Another factor that Gleim believes may be contributing to the prevalence of Lyme disease in the Roanoke Valley involves human dynamics. “In a lot of urban or suburbanized areas, people don’t spend a lot of time outside. But that’s simply not the case here. We have an outdoor-centered lifestyle, so there’s a large number of people who are spending a lot of time outdoors in an ideal tick habitat.”

The “Tick Lady” emphasizes there is still much work to be done. She hopes to submit Morris’ senior thesis for publication in the next month or two. “She’ll be first author on that paper, which is really exciting,” Gleim noted.

Hollins student Shravani Chitineni is exploring methods to effectively control Lyme disease risk.

In addition, Gleim said, “Shravani has picked up where Ciera and Leemu have left off—she’s a senior who is doing her thesis with me right now. She’s getting to do what she really loves, biostatistics, and she’s working on a Lyme simulation model with an ecological mathematician at Old Dominion University and myself. We’re examining different control methods that might be used to effectively control Lyme disease risk, particularly in different regions of the country.”

“My hope is that over the next six months or so, we can get published the work that Leemu and Shravani have been doing,” Gleim added. “And down the line, we may begin to examine other tick species and pathogens in addition to further exploring our questing behavior work.”

This article has been edited and condensed from the original version appearing on the Hollins University website.