Meharry Student Research Day

Meharry's Center of Excellence Student/Faculty Summer Research Program is designed not only to provide students with the opportunity to participate in a mentor relationship with Meharry researchers, but also to allow them to present their findings through abstracts, posters, and final papers during Meharry's Student Research Day held in March of each year.  For 2005, below are examples of presentations made by students who participated in the 2004 Student/Faculty Summer Research Program:

Patients Presenting to a Tertiary Care Chronic Pain Clinic Incite
New Considerations for the John Henryism Active Coping Strategy

Jordana M. Kincey, Meharry Medical College MS-II
Michigan Pain Outcomes Study Team, Dept. of Anesthesiology - Summer Research, 2004
University of Michigan Health System, Ann Arbor, MI

Abstract

The profound psychosocial impact of chronic non-malignant pain is well documented in the literature and the varied coping strategies (i.e. passive and active) used by chronic pain patients are well characterized. Generally, active coping strategies have been linked to positive adjustment to chronic pain.  However, John Henryism, a well-documented active coping strategy utilized predominantly by African Americans, has been associated with poor adaptation to pain in a manner that negatively impacts cardiovascular health (eg. elevated blood pressure) (8).  This somewhat paradoxical finding elicited further examination of John Henryism, particularly within the context of patients suffering from chronic pain. 

Questions concerning John Henryism, chronic pain and cardiovascular risks to African American chronic pain sufferers evolved from a descriptive study of patients presenting to the Pain Center at the University of Michigan, a tertiary care center.  Our study aimed to generate a sociodemographic profile for this population as well as to elucidate potential relationships between these sociodemographic factors, patients' pain characteristics and the John Henryism Active Coping scale (JHAC).  

Participants were asked to complete a battery of tests upon initial evaluation including the eight-item John Henryism Scale for Active Coping (JHAC-8).   Self-reported sociodemographic information (age, gender, ethnicity, education level, employment status) was obtained and pain characteristics (i.e., pain severity) measured by the well-validated West Haven-Yale Multidisciplinary Pain Inventory (WHY MPI) were also collected at the initial visit and used for analysis. 

The majority of patients (N = 134) were female (57.6%), currently unemployed (44.2%) and achieved a level of education greater than high school (63.8%). The mean age for this population was 38.2 years with ages ranging from 21 to 50 years.  The mean WHY MPI score was 3.7 ± 1.09 (range:1-6) and the mean JHAC-8 total score was 18.76 ± 2.71 (range: 11-24).   Both African-American and Caucasian-American patients had very similar sociodemographic profiles, pain characteristics and JHAC-8 total scores.  (Table I)  The univariate relationships between JHAC-8 total score and sociodemographic factors and that between JHAC-8 total score and pain severity (WHY MPI) scores were unremarkable, with the exception of education level and gender.  Higher education is negatively associated with JHAC-8 scores (p < 0.05) and female patients tended to report lower JHAC-8 scores as compared with men (p < 0.05).

Results from this study set the backdrop necessary to consider John Henryism, cardiovascular health risks and chronic pain management together in a way that may prove meaningful for the future pain management and counseling of African American patients suffering from chronic pain.  To our knowledge, no study has examined this coping strategy as it pertains to African Americans suffering from chronic pain.  However, it stands to reason that the predisposition for John Henryism, a measure of a person's tendency to constantly struggle against an unrelenting adversity in life, should be of utmost consideration for patients who suffer from pain that is unrelenting, or chronic. The results of this study, considered with previous studies of John Henryism afford an opportunity to discuss its relationship to chronic pain as well as how variations in coping strategies may have differential effects on cardiovascular health and hypertension.

Clinicians who treat these patients should certainly be aware that as the patient suffers and works through the constant stress inherent in chronic pain disorders, particular behavioral predispositions may cause the patient to cope with their pain in a way that is detrimental to their cardiovascular health.  These issues are not currently being addressed in the pain literature or in John Henryism hypertension studies, but clearly they are noteworthy for the treatment and wellbeing of this population of patients.

Acknowledgements

Special thanks to Carmen R. Green, MD,  Khady Ndao-Brumblay, PharmD and the Michigan Pain Outcomes Study Team at the University of Michigan Medical School for outstanding guidance and support.

References

1. Dressler, WW et al. John Henryism, gender, and arterial blood pressure in an African American community.  Psychosom Med.  1998 Sep-Oct;60(5):620-4.
   
   
2. Geronimus et al.  Excess Mortality Among Blacks and Whites in the United States.  The New England Journal of Medicine.  1996  335:1552-8.
   
   
3. Green et al.  Patient Attitudes Regarding Healthcare Utilization and Referral:  A Descriptive Comparison in African- and Caucasian-Americans with Chronic Pain.  Journal of the National Medical Association 2004; 96:31-41.
   
   
4. Green et al.  The Unequal Burden of Pain:  Confronting Racial and Ethnic Disparities in Pain.  Pain Medicine  2003;  4:277-294
   
   
5. James et al.  John Henryism and Blood Pressure in Black Populations:  A Review of the Evidence
   
   
6. Keefe et al.  Psychological Aspects of Persistent Pain:  Current State of the Science.  The Journal of Pain 2004;  5:195-211.
   
   
7. Kenny et al.  Constructions of Chronic Pain in Doctor-Patient Relationships:  Bridging the Communication Chasm.  Patient Education and Counseling  2004; 52:297-305.
   
   
8. Light et al.  Job Status and High-Effort Coping Influence Work Blood Pressure in Women and Blacks.  Hypertension 1995; 25:554-559.
   
   
9. Markovic John Henryism and blood pressure among Nigerian civil servants.  J Epidemiol Community Health. 1998 Mar;52(3):186-90.
   
   
10. McKetney & Ragland.   John Henryism, education, and blood pressure in young adults: The Coronary Artery Risk Development in Young Adults Study (CARDIA). Am J Epidemiol. 1996 Apr 15;143(8):787-91.
    
    
11. Merritt et al.  Low Educational Attainment, John Henryism, and Cardiovascular Reactivity to and Recovery from Personally Relevant Stress.  Psychosomatic Medicine  2004; 66:49-55.
    
    
12. Novy et al.  Coping with Chronic Pain:  Sources of Intrinsic and Contextual Variability.  J. Behav Med  1998; 21:19-34.
    
    
13. Ramírez-Maestre et al.  Personality Characteristics as Differential Variables of the Pain Experience.  Journal of Behavioral Medicine  2004;  27:147165.
    
    
14. Wiist & Flack. A test of the John Henryism hypothesis: cholesterol and blood pressure.  J Behav Med. 1992 Feb;15(1):15-29.   
    
    
15. Carver et al.  Assessing coping strategies:  A theoretically based approach.  J. Person. Soc. Psychol  1989; 56:267-28

Introduction

The profound psychosocial impact of chronic pain is well documented in the literature.  The various coping strategies utilized by patients suffering from chronic pain are broadly classified under active or passive coping strategies. In general coping strategies allow patients to positively adjust to chronic pain. (5,6) However, John Henryism, an active coping strategy to which some African American patients are predisposed has been linked with higher systolic and diastolic blood pressures (3) and stronger cardiovascular responses(4) placing this population at a higher risk for hypertension and poor cardiovascular health.  There is a paucity of research that examines John Henryism in the context of chronic pain.  This study aims to assess socio-demographic relationships to John Henryism scores amongst chronic pain patients, presenting to a tertiary care clinic.

Methods

 

Participants

Secondary analysis of a clinical database was performed for this cross-sectional prospective study. African-American and Caucasian-American patients presenting to a tertiary care clinic for chronic non-malignant pain management were included.

Measures

Participants completed a battery of tests including the eight-item John Henryism Scale for Active Coping (JHAC-8).   Self-reported socio-demographic data (age, gender, ethnicity, education level, employment status) were obtained and pain characteristics (measured by the West Haven-Yale Multidisciplinary Pain Inventory, WHY MPI) were collected at the initial visit and used for analysis.

Statistical Analysis

Descriptive statistics including socio-demographics and pain characteristics were computed.  Continuous data (eg. age and WHY MPI score) were evaluated for their relationship to JHAC-8 scores via univariate linear regression analysis.  Categorical data (eg, education level, ethnicity, gender, employment status) were assessed using the one-way ANOVA and the Mann-Whitney U non-parametric tests.  Multivariate analysis for all variables was performed using a multiple linear regression model.  Statistical significance was evaluated using two-tailed tests (p < 0.05). All statistical analyses were conducted using SPSS v.11.5 for Windows.

Results

The majority of patients (N = 139) were female (57.6%), unemployed (44.2%) and achieved an education greater than high school (63.8%). The mean age was 38.2 years, the mean WHY MPI score was 3.7 ± 1.09 and the mean JHAC-8 total score was 18.76 ± 2.71. African-American and Caucasian-American patients had similar sociodemographic profiles, pain characteristics and JHAC-8 total scores. Higher education is negatively associated with JHAC-8 scores (p < 0.05) and female patients tended to report lower JHAC-8 scores as compared with men (p < 0.05).

Discussion

John Henryism is an active coping mechanism that is frequently utilized by African American patients as a means of enduring through prolonged periods of struggle or psychological distress.  Previous studies associate John Henryism with increased blood pressure, hypertension and poor cardiovascular health.  Presumably, African American patients who suffer from chronic pain and who utilize John Henryism as a coping mechanism may be placed at a higher risk of poor cardiovascular health

John Henryism has mainly been discussed in the context of African Americans with hypertension.  To our knowledge, no study has examined this coping strategy as it pertains to African Americans suffering from chronic pain. 

The results of this descriptive study support findings from previous John Henryism studies, but more importantly, this research presents a new vantage point from which to consider John Henryism and chronic pain. The current literature on coping strategies for chronic pain patients and John Henryism cardiovascular studies are robust and continue to expand within their respective fields.  However, the health implications of the John Henryism active coping strategy as they relate to chronic pain and cardiovascular health are at odds and warrant further consideration.

References

1. Green et al.  The Unequal Burden of Pain:  Confronting Racial and Ethnic Disparities in Pain.  Pain Medicine  2003;  4:277-294
2. James et al. John Henryism and Blood Pressure in Black Populations:  A Review of the Evidence.
3. Light et al.Job Status and High-Effort Coping Influence Work Blood Pressure in Women and Blacks.
   
4. Merritt et al.  Low Educational Attainment, John Henryism, and Cardiovascular Reactivity to and Recovery from Personally Relevant Stress.  Psychosomatic Medicine  2004; 66:49-55.
   
5. Novy et al.  Coping with Chronic Pain:  Sources of Intrinsic and Contextual Variability.  J. Behav Med  1998; 21:19-34.
   
6. Ramírez-Maestre et al.  Personality Characteristics as Differential Variables of the Pain Experience.  Journal of Behavioral Medicine  2004;  27:147-165.

____________________

Oxidative Stress and Endothelial Dysfunction:  Keith Perkins¹ Jr., Lipi Saha¹, S. K. Das² and S. Mukherjee^{1 1} Department of Pharmacology, ² Department of Biochemistry, Meharry Medical College.

 

Abstract

Direct and passive smoking has been implicated in the pathogenesis of atherosclerosis and coronary artery disease.  However, how smoking damages the arterial wall and leads to the progression of atherosclerosis is still unknown.  With many factors, chemicals, and substances within the smoke and the cigarettes themselves, finding the pathophysiological events and the mechanisms in itself is very difficult.  Cultured endothelial cells produce reactive oxygen species spontaneously which is often augmented by hypoxia/reoxygenation as well as environmental pollutants.  In this study, we looked at the effects of mainstream(MS) and sidestream(SS) cigarette smoke on bovine aortic endothelial cell proliferation, morphology, and oxidative stress, which are relevant to endothelial dysfunction.  Cultured endothelial cells were exposed to MS and SS smoke at different doses and time. After the cells were exposed, they were isolated and cell mortality was determined. Then we measured the activity of catalase, SOD, and nitric oxide.  Cell proliferation was decreased in dose and time.  Activities of SOD increased upon acute exposure in both MS and SS cigarette smoke but both chronic and higher dosage decreased their activities.  Our research indicates that exposure of MS and SS cigarette smoke to endothelial causes oxidative stress resulting in cell proliferation and endothelial dysfunction.  (Supported by NIH grant 2S06GN-08037Army Gant DAMD 17-03-2-0054, and COE Grant)

________________________

 

Generation of the Syntaxin 1B SNARE Motif for Inhibition of Choline Cotransporter Recruitment
Janelle Dennis, Yilun Wang, James Townsel
Department of Physiology, Meharry Medical College, Nashville, TN 37208

 

Abstract

Syntaxin 1A an 1B, presynaptic target (t) soluble N-ethylmaleimide-sensitive factor attachment protein receptors (SNARE), are well established as mediators serving in exocytosis to fuse vesicles with the plasma membrane (Chen, Y.A. & Scheller, R.H., 2001, Nature Rev. Mol. Cell Bio. 2:98-106).  The combination of syntaxin with its partners, a 25-kDa plasmalemmal protein (SNAP-25) and vesicle-associated membrane protein (VAMP, synaptobrevin) to form SNARE complex is central to the fusion process.  At the cholinergic synapse, it has been shown that choline cotransporters (ChCoT) are recruited to the terminal membrane by antecedent depolarizing levels of KCl.  The purpose of this study is to generate syntaxin1B, in order to examine whether syntaxin 1B is required for ChCoT cargo vesicle recuitment to the plasmalemmal membrane of Limulus brain tissue.  To assess the syntaxin 1B participartion in ChCoT recuitment, two peptides of Limulus syntaxin lB (Lim-syn 1A) were generated.  One peptide contains the SNARE motif, 191-265 aa (syn/SM).  The second is the complete peptide from the syntaxin N-terminus 2-190 aa (syn/NT) to the SNARE motif, excluding the transmembrane domain.  Both were expressed as fusion peptides with the poly-His tag at N-termini.  Fusion peptides were purified using NTA-Ni affinity method, followed by a two-step dialysis to remove a high concentration of imidazole in the purified products, and subsequently changed to a calcium-free Chao's buffer.

Meharry's Center of Excellence sponsors student/faculty research opportunities each summer.  The goal is to increase the number of students who participate in basic science or clinical research projects related to health issues or diseases that disproportionately affect African Americans.  For the summer of 2004, the following students participated with Meharry and/or Vanderbilt mentors:

 

2004 Medical Research Students	2004 Medical Research Faculty
Abdulbaaqee, Nailah	John T. Clark, Ph.D
Allen, Derron	Alvin C. Powers, Vanderbilt
Arthur, Rebecca	Maciej Buchowski, Ph.D.
Britt, Earl, Jr.	Alvin C. Powers, Vanderbilt
Brown, Michael	Maciej Buchowski, Ph.D.
Cadogan, David	Maciej Buchowski, Ph.D
Crow, Adrienne	Gerard ShuTangyie, MD
Dennis, Janelle	James G. Townsel, Ph.D.
Hill, JaHanna	Maciej Buchowski, Ph.D
Kincey, Jordana	Carmen R. Green, MD, University of Michigan
Lamar, Cory	Michael Hill, Ph.D.
Leighton, Joshua	Maciej Buchowski, Ph.D.
Manns, Melantha	Pilar Aguinaga, Ph.D.
Naeem, Mohammed	Mace L. Rothenberg, MD
Newson, Nicole	Sakina E. Eltom, Ph.D.
Perkins, Keith, Jr.	Salil K. Das, Ph.D.
Poulos, Steve	Ana Grau, Ph.D.
Rudinski, Michelle	Maciej Buchowski, Ph.D
Stewart, Zanetta	Frederick A. Ernst, MD
Thompson, Letitia	Steen N. Wolff, MD
Welch, Shenika D.	Pilar Aguinaga, Ph.D.
Woods, Rashida H.	Valerie Montgomery-Rice, MD

Students who participate in the research effort during the summer are encouraged to participate in Student Research Day at Meharry held in March of the succeeding year.