Medicine and Health Commons^™

Digital Health Technologies For Peripartum Depression Management Among Low-Socioeconomic Populations: Perspectives From Patients, Providers, And Social Media Channels, Alexandra Zingg, Tavleen Singh, Amy Franklin, Angela Ross, Sudhakar Selvaraj, Jerrie Refuerzo, Sahiti Myneni

Faculty, Staff and Student Publications

BACKGROUND: Peripartum Depression (PPD) affects approximately 10-15% of perinatal women in the U.S., with those of low socioeconomic status (low-SES) more likely to develop symptoms. Multilevel treatment barriers including social stigma and not having appropriate access to mental health resources have played a major role in PPD-related disparities. Emerging advances in digital technologies and analytics provide opportunities to identify and address access barriers, knowledge gaps, and engagement issues. However, most market solutions for PPD prevention and management are produced generically without considering the specialized needs of low-SES populations. In this study, we examine and portray the information and technology needs …

Evaluating The Use Of Blood Pressure Polygenic Risk Scores Across Race/Ethnic Background Groups, Nuzulul Kurniansyah, Matthew O Goodman, Alyna T Khan, Jiongming Wang, Elena Feofanova, Joshua C Bis, Kerri L Wiggins, Jennifer E Huffman, Tanika Kelly, Tali Elfassy, Xiuqing Guo, Walter Palmas, Henry J Lin, Shih-Jen Hwang, Yan Gao, Kendra Young, Gregory L Kinney, Jennifer A Smith, Bing Yu, Simin Liu, Sylvia Wassertheil-Smoller, Joann E Manson, Xiaofeng Zhu, Yii-Der Ida Chen, I-Te Lee, C Charles Gu, Donald M Lloyd-Jones, Sebastian Zöllner, Myriam Fornage, Charles Kooperberg, Adolfo Correa, Bruce M Psaty, Donna K Arnett, Carmen R Isasi, Stephen S Rich, Robert C Kaplan, Susan Redline, Braxton D Mitchell, Nora Franceschini, Daniel Levy, Jerome I Rotter, Alanna C Morrison, Tamar Sofer

Faculty, Staff and Student Publications

We assess performance and limitations of polygenic risk scores (PRSs) for multiple blood pressure (BP) phenotypes in diverse population groups. We compare "clumping-and-thresholding" (PRSice2) and LD-based (LDPred2) methods to construct PRSs from each of multiple GWAS, as well as multi-PRS approaches that sum PRSs with and without weights, including PRS-CSx. We use datasets from the MGB Biobank, TOPMed study, UK biobank, and from All of Us to train, assess, and validate PRSs in groups defined by self-reported race/ethnic background (Asian, Black, Hispanic/Latino, and White). For both SBP and DBP, the PRS-CSx based PRS, constructed as a weighted sum of PRSs …

Strategies For Recruiting Underrepresented In Medicine And Sexual And Gender Minority Students To Emergency Medicine, Lauren T Wilson, Benjamin Weigel, Edgardo Ordonez, Navdeep Sekhon, Adedoyin Adesina, Anisha Turner, Aleksandr M Tichter, Sarah Bezek, Ynhi T Thomas

Faculty, Staff and Students Publications

BACKGROUND: Despite having well-described benefits, diversifying the physician workforce has been an ongoing challenge. Within emergency medicine (EM), multiple professional organizations have identified expanding diversity and inclusion as top priorities. The following is a description of an interactive session held at the SAEM annual meeting addressing recruitment strategies for underrepresented in medicine (URiM) and sexual and gender minority (SGM) students into EM.

METHODS: During the session, the authors provided an overview of the current state of diversity in EM. In the small-group portion of the session, a facilitator helped characterize the challenges programs face in recruiting URiM and SGM students. …

Examining The Use Of Expressive Arts Therapies In Neurorehabilitation Treatment Planning, Rebecca J. Horner

Expressive Therapies Capstone Theses

Those undergoing neurorehabilitation after stroke and traumatic brain injury report a diminished sense of overall wellness. This paper examines the conceivable benefits of introducing expressive arts therapies, which is the therapeutic use and combination of the visual arts, movement, drama, music, writing and other intermodal creative processes, into physical therapy and neurorehabilitation treatment planning. Expressive arts therapies have the capacity to engage with an individual’s physical, emotional, social and spiritual states concurrently. They simultaneously offer the ability to promote an increased sense of well-being, address mind-body disconnects, and process trauma non-verbally.

The sections of this narrative literature review focus on …

Analytical Approach For Monitoring The Behavior Of Patients With Pancreatic Adenocarcinoma At Different Stages As A Function Of Time, Aditya Chakaborty Dr, Chris P. Tsokos Dr

Biology and Medicine Through Mathematics Conference

No abstract provided.

The Last Of Us In Therapy: How Mind-Controlling Fungi And Gut Bacteria Affect Your Mental Health, Anastasia Lyon

Journal of Pharmacology & Nutritional Sciences

The "psilocybiome" represents the mutually beneficial relationship between ourselves, our bacteria, and psychedelic drugs. This short review briefly discusses the benefits and limitations surrounding the potential for psychedelic therapy to synergize with gut bacteria to help regulate and maintain proper balance in the immune system, diet, and stress levels. Psychedelic therapy is a novel treatment strategy that has the potential to improve patient mental health, and, by identifying the types of gut bacteria present in patients, it can aid in personalizing medicine by determining how well their "psilocybiome" may respond.

Attitudes Towards Gluten Free Foods And Celiac Disease In Italy, Joellyn Speredelozzi

Senior Honors Projects

This project addresses the perception and realities of living with Celiac’s Disease in Italy. I combine a literature review with my own anecdotal experiences as an individual with Celiac’s Disease who has lived and studied in Italy. In my paper, I first describe the high awareness of gluten-free living that I noted the first time I studied abroad, being the impetus of this project. I follow this with the history and science of Celiac’s Disease for those who may be unaware of this serious chronic medical condition. I then continue to describe personal experiences I had while living in Naples, …

Biocultural Diversity Of Medicine In Tsum Valley, Ashira Weinreich

Independent Study Project (ISP) Collection

Health is intrinsically connected to biodiversity in the Himalayan mountains of Tsum Valley. Medicinal plants have historically been integral to primary health care in this region. The main objectives of this paper are to explore the role of biocultural diversity on perceptions of health and to demonstrate that medicinal plant knowledge contributes to health sovereignty in times of cultural and environmental change. The nutritional and medicinal significance of plants were examined in the daily lives of villagers. Semi-structured interviews were conducted from April to May 2023. Preliminary results are analyzed ethnographically. Interviews and participant observation will provide a rich understanding …

Exploring Anterior Cruciate Ligament Tears And Athletic Identity As Predictors Of Disordered Eating Behaviors In Female Collegiate Soccer Players, Niondina M. Nyström

Masters Theses

Research has consistently established the relationship between injury occurrence and subsequent mental health concerns within the athletic population (Brown et al., 2014; NCAA, 2021). Specifically, negative mental health outcomes such as anxiety, depression, and social isolation have followed the occurrence of an anterior cruciate ligament (ACL) tear (McGinley et al., 2022; Töyrä & Bergström, 2017). Similarly, because of high levels of athletic identity (AI), the inability to participate in a sport due to injury has been associated with disordered eating (DE) (Gusfa et al., 2022). Despite this, no studies have examined disordered eating and the role of athletic identity after …

Development Of Competency-Based Online Genomic Medicine Training (Cogent), Susanne B Haga, Wendy K Chung, Luis A Cubano, Timothy B Curry, Philip E Empey, Geoffrey S Ginsburg, Kara Mangold, Christina Y Miyake, Siddharth K Prakash, Laura B Ramsey, Robb Rowley, Carolyn R Rohrer Vitek, Todd C Skaar, Julia Wynn, Teri A Manolio

Faculty, Staff and Student Publications

The fields of genetics and genomics have greatly expanded across medicine through the development of new technologies that have revealed genetic contributions to a wide array of traits and diseases. Thus, the development of widely available educational resources for all healthcare providers is essential to ensure the timely and appropriate utilization of genetics and genomics patient care. In 2020, the National Human Genome Research Institute released a call for new proposals to develop accessible, sustainable online education for health providers. This paper describes the efforts of the six teams awarded to reach the goal of providing genetic and genomic training …

Exome Array Analysis Of 9721 Ischemic Stroke Cases From The Sign Consortium, Huichun Xu, Kevin Nguyen, Brady J Gaynor, Hua Ling, Wei Zhao, Patrick F Mcardle, Timothy D O'Connor, O Colin Stine, Kathleen A Ryan, Megan Lynch, Jennifer A Smith, Jessica D Faul, Yao Hu, Jeffrey W Haessler, Myriam Fornage, Charles Kooperberg, On Behalf Of The Trans-Omics For Precision Medicine Topmed Stroke Working Group, James A Perry, Charles C Hong, John W Cole, Elizabeth Pugh, Kimberly Doheny, Sharon L R Kardia, David R Weir, Steven J Kittner, Braxton D Mitchell, Sign Consortium

Faculty, Staff and Student Publications

Recent genome wide association studies have identified 89 common genetic variants robustly associated with ischemic stroke and primarily located in non-coding regions. To evaluate the contribution of coding variants, which are mostly rare, we performed an exome array analysis on 106,101 SNPs for 9721 ischemic stroke cases from the SiGN Consortium, and 12,345 subjects with no history of stroke from the Health Retirement Study and SiGN consortium. We identified 15 coding variants significantly associated with all ischemic stroke at array-wide threshold (i.e., p < 4.7 × 10-7), including two common SNPs in ABO that have previously been associated with stroke. Twelve of the remaining 13 variants were extremely rare …

A Cross-National Comparison Of The Linkages Between Family Structure Histories And Early Adolescent Substance Use, Haley Stritzel, Michael Green, Robert Crosnoe

Faculty, Staff and Student Publications

Family structure can influence adolescent health with cascading implications into adulthood. Life course theory emphasizes how this phenomenon is dynamic across time, contextualized in policy systems, and grounded in processes of selection and socialization. This study used data from the U.S. (National Longitudinal Survey of Youth 1979 Child and Young Adults, n = 6,236) and U.K. (Millennium Cohort Study, n = 11,095) to examine associations between a single mother family structure between ages 0-14 and early adolescent substance use at age 14 across time and place, using inverse probability of treatment weighting to explore how results varied by selection into …

Covid-19, Nutrition, And Gender: An Evidence-Informed Approach To Gender-Responsive Policies And Programs, Anna Kalbarczyk, Noora-Lisa Aberman, Bregje S M Van Asperen, Rosemary Morgan, Zulfiqar Ahmed Bhutta, Bianca Carducci, Rebecca Heidkamp, Saskia Osendarp, Neha Kumar, Anna Lartey

Department of Paediatrics and Child Health

In addition to the direct health impacts of COVID-19, government and household mitigation measures have triggered negative indirect economic, educational, and food and health system impacts, hitting low-and middle-income countries the hardest and disproportionately affecting women and girls. We conducted a gender focused analysis on five critical and interwoven crises that have emerged because of the COVID-19 crisis and exacerbated malnutrition and food insecurity. These include restricted mobility and isolation; reduced income; food insecurity; reduced access to essential health and nutrition services; and school closures. Our approach included a theoretical gender analysis, targeted review of the literature, and a visual …

Chemical Relaxers And Hair-Straightening Products: Potential Targets For Hormone-Related Cancer Prevention And Control, Adana A. M. Llanos, Jasmine A. Mcdonald, Dede K. Teteh, Traci N. Bethea

Health Sciences and Kinesiology Faculty Articles

"Emerging data show that use of permanent hair dyes, chemical relaxers, and straightening products might contribute to increased risk of hormone-related cancers (1-5) and potentially breast tumors with features indicative of more aggressive phenotypes (6). Given the wide use of these products globally, they are an important source of exposure to potentially harmful chemicals, including endocrine-disrupting chemicals—to which we are ubiquitously exposed (7)—and mutagenic and/or genotoxic compounds. The unequal burden of exposure across populations plausibly contributes to cancer inequities as the groups with the greatest exposure also experience poorer cancer outcomes (8). …

A Case Study Investigating Perceptions Of The Covid-19 Vaccine In Cato Manor And Chesterville, Caitlin Chan

Independent Study Project (ISP) Collection

Despite countries all over the world transitioning to life post COVID-19, there are still many aspects of the pandemic that remain controversial and hot topics of debate. Perhaps among one of the most debated subjects is the question of whether vaccinations are necessary and if they truly had an impact on eliminating the virus. The concept of vaccine hesitancy has become a growing concern and threatens the health of communities around the world.

This project employed a mixed-methodology research design to investigate attitudes towards the COVID-19 vaccine constructed by community members living in the townships of Cato Manor and Chesterville. …

Active Consideration Of Health And Nutritional Quality Of Food Choices, Christopher R. Gustafson

Cornhusker Economics

Everyone can be positively influenced by effective interventions promoting healthier food choices. A handful of recent papers have documented positive impacts on dietary quality resulting from interventions that remind people to consider health through prompt messages or subtle priming in supermarkets and in controlled, online experiments. These studies have focused on the impact of reminders on nutritional quality rather than explaining how reminders work. An exception, Arslain, Gustafson, and Rose (2021), collected data on multiple elements of individuals' choice processes to trace the impact of reminders on decisions, showing that reminder messages led people to consider a healthier set of …

Benefits Of, Barriers To, And Needs For An Artificial Intelligence-Powered Medication Information Voice Chatbot For Older Adults: Interview Study With Geriatrics Experts, Meghana Gudala, Mary Ellen Trail Ross, Sunitha Mogalla, Mandi Lyons, Padmavathy Ramaswamy, Kirk Roberts

Faculty, Staff and Student Publications

BACKGROUND: One of the most complicated medical needs of older adults is managing their complex medication regimens. However, the use of technology to aid older adults in this endeavor is impeded by the fact that their technological capabilities are lower than those of much of the rest of the population. What is needed to help manage medications is a technology that seamlessly integrates within their comfort levels, such as artificial intelligence agents.

OBJECTIVE: This study aimed to assess the benefits, barriers, and information needs that can be provided by an artificial intelligence-powered medication information voice chatbot for older adults.

METHODS: …

Making Forests, Making Communities: An Ethnography Of Reforestation In Monteverde, Costa Rica, Megan Brown

Anthropology Theses and Dissertations

Reforestation is not just planting trees in the ground. More than net increase in forest cover, reforestation is a complex political endeavor undertaken by both humans and non-humans and a popular climate change mitigation tactic. However, little research has examined the dynamics between selection of specific reforestation strategies, health, and community resilience, particularly with attention to entanglements between the lives of both human and non-human forest dwellers. This ethnographic work, based on six months of in-person fieldwork and six months of digital ethnography, examines reforestation and forest relations in Costa Rica’s Monte Verde zone, a region which experienced widespread deforestation, …

Microplastics, The Environment, And Reproductive Health: How Is The Accumulation Of Microplastics In Our Environment And Bodies Impacting Reproductive Health?, Katherine Hayward

Independent Study Project (ISP) Collection

As global trends in both production and consumption of plastics continue to evolve, the bioaccumulation and biomagnification of microplastic particles in our everyday lives follow suit. This increasingly relevant problem has only recently been explored in the context of global health, and more specifically, reproductive health. Along with this steady increase in plastics and our exposure to them, researchers have separately observed adverse patterns in reproductive health. The chemicals involved throughout the microplastic life cycle may be playing a key role in these simultaneous patterns. With the aid of previous studies and publications on microplastics, exposure pathways, endocrine disruptors, and …

Rethinking Public Health Risk Mitigation Strategies: Recognizing The Biosocial Nature Of Covid-19, Grace Savard

CSB and SJU Distinguished Thesis

The SARS-CoV-2 virus has rippled throughout every aspect of society and influenced how we live, breathe, and interact with one another. The purpose of this thesis is to explore the interdisciplinary biosocial impacts of the SARS-CoV-2 virus and the resulting disease, COVID-19. In order to understand the complexities of caregiving during COVID-19, we conducted 75 semi-structured interviews with 55 healthcare providers across 18 states over a span of two years. This research assesses how COVID-19 risk mitigation strategies were designed with the primary intention to stop the spread of the virus rather than account for the longer-term social and biological …

Endocrine-Disrupting Chemicals And Breast Cancer: Disparities In Exposure And Importance Of Research Inclusivity, Ashlie Santaliz Casiano, Annah Lee, Dede Teteh, Zeynep Madak Erdogan, Lindsey Trevino

Health Sciences and Kinesiology Faculty Articles

Endocrine-disrupting chemicals (EDCs) are known contributors to breast cancer development. EDC exposures commonly occur through food packaging, cookware, fabrics, and personal care products as well as through the environment. Increasing evidence highlights disparities in EDC exposure across racial/ethnic groups, yet breast cancer research continues to lack the inclusion necessary to positively impact treatment response and overall survival in these socially disadvantaged populations. Additionally, the inequity in environmental exposures has yet to be remedied. Exposure to EDCs due to structural racism poses an unequivocal risk to marginalized communities. In this review, we summarize recent epidemiological and molecular studies on two lesser-studied …

Cost Of Care For Asylum Seekers And Refugees Entering The United States: The Case Of Volunteer Medical Providers In El Paso, Texas, Rigoberto I Delgado, Manuel De La Rosa, Marlon A Picado, Lisa Ayoub-Rodriguez, Celia E Gonzalez, Leopold Gemoets

Faculty, Staff and Student Publications

BACKGROUND: Between October 2018, and February 2020, the United States saw an unprecedented increase in the number of asylum seekers and refugees arriving unexpectedly at international crossings along the US-Mexico Border. Many of these migrants needed proper medical attention, and consequently created significant pressure on local health systems. In El Paso, Texas, volunteer clinicians, collaborating closely with religious organizations and non-governmental organizations, provided outpatient medical care for the new arrivals; the county hospital provided in-patient care at local tax payers' expense. The objective of this study was to estimate costs of healthcare services offered by these volunteers in order to …

Desired Resources For Changing Diet Among Persons With Multiple Sclerosis: Qualitative Inquiry Informing Future Dietary Interventions, Stephanie L Silveira, Emma V Richardson, Robert W Motl

Faculty, Staff and Student Publications

BACKGROUND: There are approximately 1 million adults in the United States with multiple sclerosis (MS). Persons with MS are interested in diet as a second-line therapy for improving MS symptoms and disease progression. Examination of desired resources regarding diet among persons with MS is necessary for supporting behavior change.

METHODS: Twenty-five adults with MS completed 1-on-1, online semistructured interviews. An inductive, 6-phase, semantic thematic analysis was applied to identify themes associated with participant preferences for dietary behavior change.

RESULTS: The research team crafted 4 key themes from the data that encompassed participants' desired resources for dietary behavior change. Theme 1, …

Exploring Factors Associated With The Eating Behaviours And Influences On Food Choice In Irish Teens, Aisling Daly

Doctoral

Aim The aim of this research was to understand the eating behaviour traits and food choice motivations of Irish teens, and to investigate the social, psychological, and attitudinal determinants of these eating behaviour traits and influences on food choice.

Methods Mixed methods were used in this research, using quantitative analysis of data from the National Teens’ Food Survey II (NTFSII), a cross-sectional study of teens aged 13-18 years old (N=428). Data predominantly came from the TFEQ-r18 and VARSEEK tools for eating behaviour traits, and the FCQ tool for food choice motivations, as well as socio-demographics, anthropometrics, behaviour/attitudes and dietary intakes. …

The State Of Animal- Assisted Interventions In France: Is The Iahaio Model Relevant?, Alice Mignot, Gérard Leboucher, Véronique Servais, Karelle De Luca

People and Animals: The International Journal of Research and Practice

Animal- assisted interventions (AAI) became more generalized in health care settings and their development in Europe is increasing. In France, the practice has grown in the absence of official recognition and regulation. In this context, we aim to identify the main characteristics of the French practice of AAI that can influence the establishment of a local regulation. Second, we aim to question the relevance of the model proposed by the International Association of Human- Animal Interaction Organizations (IAHAIO) distinguishing animal- assisted therapies (AAT) and (AAA) animal- assisted activities from the French practice of AAI. We interviewed 111 French handlers in …

Covid-19 Vaccine Diplomacy In West Africa: Empathetic Soft-Power Or Neocolonial Intentions?, Mary Sperrazza

Independent Study Project (ISP) Collection

With the impending roll-out of COVID-19 vaccines, many questions have been raised concerning the roll-out of the vaccines beyond the Global North. While some countries across the Global South have been able to purchase limited numbers of vaccines; many countries in the Global South remain highly or entirely dependent on various programs for the distribution of vaccines, such as the COVID-19 Vaccines Global Access (COVAX) program. Another means of distribution is of individual countries of the Global North that have either higher purchasing power or are producers of one or more vaccines that have begun donating an allocated amount of …

Associations Of Hair Dye And Relaxer Use With Breast Tumor Clinicopathologic Features: Findings From The Women’S Circle Of Health Study, Rohan Rao, Jasmine A. Mcdonald, Emily Barrett, Patricia Greenberg, Dede K. Teteh, Susanne B. Montgomery, Bo Qin, Yong Lin, Chi-Chen Hong, Christine B. Ambrosone, Kitaw Demissie, Elisa V. Bandera, Adana A.M. Llanos

Health Sciences and Kinesiology Faculty Articles

Background

Building upon our earlier findings of significant associations between hair dye and relaxer use with increased breast cancer risk, we evaluated associations of select characteristics of use with breast tumor clinicopathology.

Methods

Using multivariable-adjusted models we examined the associations of interest in a case-only study of 2998 women with breast cancer, overall and stratified by race and estrogen receptor (ER) status, addressing multiple comparisons using Bonferroni correction.

Results

Compared to salon application of permanent hair dye, home kit and combination application (both salon and home kit application) were associated with increased odds of poorly differentiated tumors in the overall …

Black And White Health Disparities: Racial Bias In American Healthcare, Yasmeen Almomani

Bridges: An Undergraduate Journal of Contemporary Connections

This paper explores the historical implications of race in American society that have led to implicit racism in the healthcare system. Racial bias in healthcare against Black people is a factor in the health disparities between Black and white people in America, such as the gap in life expectancy, infant death, and maternal mortality. Black people are more likely to report racial discrimination from healthcare providers, which is a reason for the decreased quality of care received. The past justifications of slavery, the Tuskegee syphilis study, and the medical experimentations on Black women are horrifying but were considered acceptable in …

Understanding The "Social" In "Social Media" An Analysis Of Twitter Engagement Of Pulmonary And Critical Care Fellowship Programs, Sheetal Gandotra, Nancy H Stewart, Dina Khateeb, Puneet Garcha, W Graham Carlos, Christopher L Carroll, Viren Kaul

Faculty, Staff and Students Publications

Background: Social media is ubiquitous as a tool for collaboration, networking, and dissemination. However, little is known about use of social media platforms by pulmonary and critical care medicine fellowship programs.

Objective: We identify and characterize pulmonary and critical care fellowship programs using Twitter and Instagram, as well as the posting behaviors of their social media accounts.

Methods: We identified all adult and pediatric pulmonary, critical care medicine (CCM), and combined pulmonary and critical care medicine (PCCM) programs in the United States using the Electronic Residency Application Service. We searched for Twitter profiles for each program between January 1, 2018, …

The Association Between Type-2 Diabetes Pathophysiology & Exercise Adherence, Sydney Raymond

Senior Honors Projects

According to the American Diabetes Association, 1 in 3 Americans will be diagnosed with diabetes. While some of these individuals will be prescribed medications as part of their treatment, most will also be advised to begin an exercise program to assist with blood glucose control. Additionally, while regular exercise is associated with lower HbA1C and decreased insulin/medication dependence, it is estimated that only about half of those diagnosed with diabetes will adhere to their exercise plans. Social, psychological, and physiological factors all play roles in affecting ones ability to adhere to an exercise regiment, and individuals with Type 2 Diabetes …