Burch Fellowship Scholar – Burn Prevention in Malawi

– written by Marissa Bane, Health Policy and Management student and Burch Fellow

As a burn survivor, I had dreamed of working at the Kamuzu Central Hospital (KCH) burn unit in Lilongwe, Malawi for several years, and I was finally able to go this past summer as part of the Burch Fellows Program. The burn unit was founded in 2008 through a partnership with UNC Hospitals to help improve outcomes for burn patients. Because the unit is relatively new, they had no knowledge on burn prevention in Malawi, and they did not have the resources to research and fund a program. At first, I did not understand why it was important to research burn prevention strategies in Malawi. In the United States, we already know how to prevent burns – for example, we know not touch a hot stove or let children near a pot of boiling water. However, if we tried to implement our burn prevention strategies in Malawi, most would be completely useless and even confusing. The challenges Malawians face regarding burns are very unique, and burn prevention strategies need to be relevant to them.

Open flames are the cause of the majority of burns in Malawi.  Marissa's project aimed to educate Malawi's citizens on fire safety and burn prevention.

Open flames are the cause of the majority of burns in Malawi. Marissa’s project aimed to educate Malawi’s citizens on fire safety and burn prevention.

With the help of UNC surgeons, I created and translated a 35-question survey that was asked to the parent of each child at the burn center under eight years old. Prior studies have shown that children bear a disproportionate share of the burn injury burden, which is why this specific age range was chosen. The goal was to understand how serious burns occur for children, as well as the environment surrounding the accidents. To do this, it was important to assess other factors potentially affecting the burn accident, such as underlying health problems and bad weather. The survey consisted of five main sections, which included basic demographics of the burn patient, socio-demographics of the patient’s primary guardian, cooking style in the home of the patient, child care in the home of the patient, and information about the burn accident.

Marissa with a family in Malawi.

Marissa with a family in Malawi.

We discovered more than half the burns were cooking-related. Further, most people in Malawi are dependent upon fire for survival. They use open flames or unsafe traditional stoves several times a day for light, heat, cooking, bathing water, and manual labor. At the time of the burn, only 23 percent of mothers were with the patient. Further, 22 percent of patients had no one looking after them when they were burned. There were several other discoveries that were found to be extremely helpful when considering burn prevention in Malawi. Information collected from the study should be used to help create effective burn prevention strategies for those in sub-Saharan Africa, which is why I plan to present my findings from the study at Harvard University’s 2015 National Collegiate Research Conference, as well as produce a publication under the guidance of UNC surgeons.

I loved my time in the beautiful place I now call a second home. I learned so much during my time in Malawi and built some amazing friendships. My heart was broken by the poverty, especially the failing health care system. And while I know my research will not change everything, my hope is that I can change the life for at least one person. As a burn survivor, I know the pain and hardship a burn produces. Therefore, if I could prevent the burn of just one Malawian, I would consider my research a success. They call Malawi the “Heart of Africa,” and I now know why. I will never forget the people I met and the experiences I had.

SURF 2014 in Malawi

– written by Connor Belson, BS Biology and minor in Business Administration, Class of ’15

I arrived at the University of North Carolina in the fall of 2011 with a head full of ideas—plans for the future, places I wanted to see, experiences I wanted to create. But none of these plans involved Malawi. And none of these plans involved research. However, I now find myself entering my senior year of college in the midst of a life-changing research experience in Malawi’s capital city of Lilongwe. The development of my research experience at Carolina resulted from a series of relationships that have been growing since my freshman year. It began with a shadowing experience with a doctor at Walter Reed Hospital in Washington DC two summers ago, which led to a friendship first built between him and me over discovering that he had attended Ubelson 1NC for undergraduate and medical school, and then strengthened over sharing our love for Carolina basketball, Franklin Street, and lunch at Weaver Street on a Sunday afternoon. He then connected me with several UNC staff members back in Chapel Hill, who, after meeting with all of them in the fall, each connected me with several more. And then, two years and countless conversations later, I was offered the incredible opportunity to travel to Lilongwe, Malawi and work with the UNC Project Research Center for Infectious Diseases at the Kamuzu Central Hospital.

I am pursuing an undergraduate degree in Biology with a minor in Business Administration through the Kenan-Flagler Business School. Because of my interest in both the hard science and financial aspects of the healthcare world, the director of the UNC Project Research Center, Irving Hoffman, asked if I would like to join a team that was working on a new business proposal that would improve access to sufficient healthcare and diagnostic testing for the population of Lilongwe. Because many clinics and research centers in the country operate with a significant lack of resources and cannot provide all of the tests needed for their patients, a majority of individuals who come for diagnosis and treatment are not able to receive a comprehensive set of all possible causes of their illnesses and can risk missing the proper treatments. However, the University of North Carolina’s center at Kamuzu Central Hospital has a full laboratory with the resources to test its patients for any and all possible causes of their illnesses. In order to provide this to a wider portion of the population of Lilongwe, the UNC Project has offered to allow other clinics in the city—those without access to sufficient patient testing—to pay for samples from their patients to be tested in the UNC Project laboratories, ensuring that the patients receive a proper diagnosis. During both of the last two summers, I have traveled to Lilongwe, Malawi to conduct research on this process. In my first trip, I researched the feasibility of the patient sample exchange system. This involved performing a financial analysis of the UNC Project laboratory to ensure that it could handle an increased level of patient samples and conducting market research as a means of identifying potential partner clinics in the area. By the end of the summer, I had generated a final presentation that supported the feasibility of the proposal and that identified the UNC Project’s future partners who could benefit most from the commercialized system.

This summer, through OUR’s Summer Undergraduate Research Fellowship, I was able to travel back to Malawi and research the financial and cultural implications of the new partnerships as they were being implemented. The goal of the research was to identify any barriers that were met along the way and to record how they were resolved, in addition to tracking the additional revenues and expenses that were generated for the laboratory as a result. I designed and incorporated a computerized accounting program to replace the inefficient and unorganized handwritten receipting process, as a way of helping the staff handle an increased influx in work. In addition, a system of transporting the samples between clinics was created, and pricing system for all of the tests was created to make sure the lower-resource clinics would still be able to pay for any tests their patients needed. Thus far, the commercial system for patient samples has generated additional profits that the UNC Project has been using to support the free clinic it provides for patients. In addition, the partner clinics have successfully increased the array of diagnostic tests that they can deliver. Although several cultural issues have been encountered along the way, solutions have been found for all of them, indicating that this system is one that has potential to be incorporated in other low-resource areas as well.belson 2

Because I had never considered research before coming to Carolina, I did not seek out my initial research opportunities. However, I soon learned how integral research can be to other areas of work, like medicine, that had always interested me. And so when the opportunity for international research presented itself to me, I took it immediately, despite knowing very little about what experience I would have or how it would impact my future. Since then, my research with the UNC Project in Malawi has become a defining characteristic of my undergraduate experience at the University of North Carolina. I have used it to help reinforce my desire to work in a medical career. In addition, it has opened the doors of clinical and public health research as potential roads I may find myself traveling down in the future. It has given me countless memories, experiences, useful skill sets, and friendships, and I would now recommend undergraduate research to anyone, including those not currently considering the idea of research. It will provide ways to learn outside of the classroom, to discover hidden interests and passions, to expand important networks of relationships, to see the world, and to enjoy the entire process.

In With the New – OUR Welcomes New Ambassadors

UNC - Chapel Hill with Graham Memorial in the background

The University of North Carolina – Chapel Hill
with Graham Memorial in the background

written by Daijha J. Copeland

As nine ambassadors turned their tassels to officially become Carolina alumni in May, we welcome a new group of highly-qualified and enthusiastic undergraduate researchers. With experiences ranging in disciplines from Art History to Biology to Political Science, our new ambassadors offer a diversity of experiences to share with the Carolina community. These ambassadors have worked on timely projects such as: how specific RNA molecules distribute controls the division of zygotes, the role of suicide in the plays of William Shakespeare, further development in C. elegans, and the development of a thermoelectric vaccine cooler. Check out the ambassadors’ page to get to know all of our ambassadors and the other enriching projects that they have been a part of.

The ambassadors program was created for undergraduate researchers to be used as a resource to advocate for undergraduate research to university leaders and to serve as peer mentors. Ambassadors frequently host meet-and-greets with fellow students and give presentations on research opportunities offered through OUR and the greater university. And of course ambassadors are here to provide information, make faculty introductions, or answer any questions, so feel free to contact them for any assistance navigating Carolina’s research filled world.

If you have research experiences that you would like to share with other undergraduates and would like to apply to be an OUR ambassador, look for the call to apply in early spring. Below are the OUR ambassadors for 2014-2015.

Lauren Askew Biology /Spanish for the Medical Professions Minorlaskew@live.unc.edu

Jordan Bishop Chemistryjwbishop@live.unc.edu

Emily Cerciello Health Policy and Management & Economicscerciello@live.unc.edu

Sarah Cooley Geoscience-Geophysics/ Math and Religious Studies Minorsswcooley@live.unc.edu

Clark Cunningham Chemistry & Biologychcunnin@live.unc.edu

Sarah Faircloth History & Art Historyscfaircl@live.unc.edu

Blake Hauser Environmental Health Sciences & Biologybmhauser@live.unc.edu

David Joyner Political Science & Englishdbjoyner@live.unc.edu

Sloane Miller Environmental Health Science & Engineeringskm0709@live.unc.edu

Rizul Naithani Clinical Laborarory Science/ Chemistry Minor

Layla Quran Global Studies/ Journalism Minorlaylaquran@gmail.com

Sam Resnick Biology/ Chemistry Minor sresnick@live.unc.edu

Jay Zhang Biostatistics & Quantitative Biology/ Chemistry Minorjczhang@email.unc.edu

Zijian (Larry) Zhou Chemistry/ Computer Science Minorzzhou1@live.unc.edu

 

Undergrads as an Asset in Neurobiology

written by Chris Smith

BS Neuroscience  Furman University From Greenwood, SC

Chris Smith
BS Neuroscience Furman University
From Greenwood, SC

I am a 6th year Neurobiology PhD student in the lab of Charlotte Boettiger in the Department of Psychology at UNC. During my time as a graduate student at UNC – CH, I have had the pleasure of working with 8 UNC undergraduate students whose interests ranged from psychology to biology. My role was to show them the various aspects (and challenges) of human subject research and how it can be used to understand the cognitive processes related to addictive behaviors we study in the lab. Specifically, I focus on understanding the neurobiology of decision making processes which may be altered in populations at risk for developing addictive disorders or populations already diagnosed with addictive disorders.

This academic year I have three undergraduates – Melisa Menceloglu, Michael Parrish, and Scott Oppler – working with me. Their projects demonstrate the range of approaches we use to understand human behavior. Melisa and Michael are assisting me on a neuroimaging project to understand neural circuit differences across individuals which may modulate the behavior we study. Scott, on the other hand, has been helping me investigate how genetic polymorphisms affecting dopamine levels in humans impact their behavior.

Michael Parrish  BS Psychology/ BS Biology

Michael Parrish
BS Psychology/ BS Biology

Scott Oppler  BS Psychology & Biology Melissa Menceloglu BA Psychology

Scott Oppler
BS Psychology & Biology
Melisa Menceloglu
BA Psychology

How UNC Undergraduate Students Are An Asset to My Work:

While working with UNC-CH undergraduate students, I have learned that they are all extremely bright, self-motivated, and eager to learn new things. They have assisted me greatly in the work I have been doing over the years. For example we have been looking at the role of age and genetic polymorphisms on human behavior. Specifically, a person’s age (emerging adult versus adult) appears to determine which particular genetic variations may be associated with a tendency to value the future less: a process we believe is implicated in promoting and sustaining alcohol use disorders. A total of 4 UNC-CH undergrads were      acknowledged in the paper (in Psychopharmacology) focused on this project.

The Importance of Undergraduate Research Experiences:

 Getting experience with scientific research is the best way to know whether or not pursuing a career in science is right for you. I was able to take advantage of undergraduate research at Furman University while I pursued my Bachelor’s Degree in Neuroscience. My early work, looking at the impact of alcohol and the neuropeptide beta-endorphin on stress and anxiety behavior in mice, was critical in inspiring me to apply to PhD programs focused on the neurobiology of drug abuse and behaviors associated with problem drug use. Conducting original science is a difficult enterprise and nothing prepares someone more for understanding the process better than doing it firsthand, which is the value of pursuing research opportunities early.

I encourage anyone remotely interested in the scientific process to think about volunteering in one of the hundreds of labs at UNC-CH. This is a great place to explore a vast array of research topics and areas. In labs affiliated with the Neurobiology Curriculum, for instance, one can experience the various approaches researchers take to understanding the brain and behavior from animal models to humans, from intracellular signaling in individual neurons to widespread neural activity as measured by functional magnetic resonance imaging.

Links to publications of my work (containing acknowledgements to many UNC undergraduate students that have helped out over the years):

Smith CT, Boettiger CA (2012) Age modulates the effect of COMT genotype on delay discounting behavior. Psychopharmacology (Berl). 222: 609-617.

http://www.ncbi.nlm.nih.gov/pubmed/22349272

Smith CT, Swift-Scanlan T, Boettiger CA (2013). Genetic polymorphisms regulating dopamine signaling in the frontal cortex interact to affect target detection under high working memory load. Journal of Cognitive Neuroscience, in press.

http://www.ncbi.nlm.nih.gov/pubmed/24144248

Other papers of Interest from our lab:

http://www.ncbi.nlm.nih.gov/pubmed/16385186

http://www.ncbi.nlm.nih.gov/pubmed/18160646

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Community-Based Research: An Approach, not a Methodology

On November 7, the Office for Undergraduate Research and the Carolina Center for Public Service offered a workshop on Community-Based Research (CBR). Dr. Beth Moracco from the Gillings School of Global Public Health talked to over 50 students about what CBR is and what it isn’t, why it’s an extremely important and relevant approach to research, and the challenges involved in doing CBR. She was also clear that there are research projects and situations where CBR would not be appropriate or effective. CBR is not about getting feedback on something you’ve already decided to do or findings you’ve already developed.  It is about “conducting research with people, not on people.”Moracco agenda

Dr. Moracco learned some of the basic principles embedded in CBR, like mutual respect and listening to community members, during her time as a Peace Corps volunteer. Other principles of CBR include engaging multiple stakeholders in all phases of the research, shared decision-making, commitment to long-term relationships and more. CBR believes in “bidirectional” learning–both the researchers and the community have knowledge and should learn from each other; however, it’s also necessary to acknowledge power and privilege differentials. CBR is rooted in an ethos of social justice; it makes explicit its goal to engage in inquiry and discovery that results in social change for the good.

Conducting CBR is not without its challenges. It is time-consuming to build relationships and trust with communities. There can be conflicts between the researchers’ agendas and the needs and desires of the community members — and community members themselves may differ on what takes priority or has the most salience for their lives.

Dr. Moracco traced the history of the development of participatory research and CBR and noted that increasingly funders expect CBR approaches to research questions; CBR can also help build capacity and develop the sustainability that funding agencies demand. Although the gold standard of CBR is to involve the community from the very beginning of the project, it is also possible to employ CBR in specific aspects or components of a project. Dr. Moracco said that you can use CBR “anywhere or everywhere in the research process.” She shared many examples from her own research experiences, both locally and globally, as well as telling us about CBR projects undertaken by students in the School of Public Health. According to Dr. Moracco, there is a substantial body of evidence demonstrating that interventions and policies developed using CBR are more effective.

Thanks to everyone who attended the workshop and to our colleague Dr. Beth Moracco for taking the time to share her knowledge and expertise.