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A FOOD BOX INTERVENTION FOR FAMILIES EXPERIENCING FOOD INSECURITY AND TYPE 2 DIABETES: A PILOT PROJECT
No full textThe negative impacts of type 2 diabetes (T2D) can be exacerbated by food insecurity (FIS), contributing towards overall familial stress, poor health outcomes, and difficulties with diabetes management. Food box interventions may reduce some barriers to healthy eating, including access to fresh produce, transportation, and food cost. The current pilot project was designed to examine the feasibility, acceptability, and satisfaction of a produce food box intervention for families impacted by T2D and FIS, as well as any changes in eating habits and perceived stress. The pilot project was shown to be acceptable to families and participants indicated that they were satisfied with the intervention. Study feasibility was negatively impacted by participant recruitment and retention. Participant eating habits did not change; however, perceived stress was shown to decrease mid-intervention before rebounding post-intervention. Barriers identified throughout the pilot study, as well as via participant response are highlighted
Sexual Dimorphism, Throat Coloration, and the Evolution of Gene Expression in Threespine Stickleback Brain Tissue
No full textElucidating the causes and mechanisms underlying variation in sexual dimorphism is a critical issue in evolution, medicine, and ecology. In the threespine stickleback (Gasterosteus aculeatus), the leading vertebrate model for evolutionary research, sexual dimorphism in color and morphology is known to vary dramatically among populations. Marine (anadromous) populations typically show greater morphological dimorphism and more consistent color dimorphism. Here I examine how sexual dimorphism of gene expression in the brains of stickleback fish varies with life history across populations and with color pattern. I studied one marine population that exhibits sexual dimorphism in throat coloration; two stream-resident populations that express intense red coloration in both sexes; one that exhibits much less coloration in females; and one stream-resident population that lacks red coloration in either sex. This gene expression data set was collected previously in my laboratory but had not been mapped to the most recent, substantially improved stickleback genome. Data was trimmed and remapped to the newest threespine stickleback genome (UGA_version5) using RNA sequence alignment with fastp and STAR. To measure the expression level, the number of reads associated with each gene from the reference genome was considered using featureCounts. Remapping of the reads to the newest stickleback genome and a principal component analysis (PCA) of the data shows a strong divergence in sex for all five populations on the first principal component and some differentiation by population on the second principal component. DESeq2 differential expression analysis of population interaction indicates a higher level of upregulation in males for significant genes in the marine populations as compared to the freshwater populations in both magnitude and frequency
Examining Loneliness and Social Anxiety in College Students Across Different Phases of the Pandemic
No full textIntroduction: Emerging adulthood (18-25) is a stage of development full of profound changes. Emerging adults attending college are vulnerable to mental health challenges, such as loneliness and social anxiety. The pandemic put students at greater risk with research showing loneliness and social anxiety levels increased pre-pandemic to pandemic onset (greatest health risk and social behavior restrictions period), but none has examined these levels as the pandemic continued and health risk and restrictions decreased. Research reveals a positive relationship between loneliness and social anxiety pre-pandemic, but none has examined their relationship during the pandemic.
Purpose: Aims include examining: 1) whether loneliness and social anxiety levels differ across three years following pandemic onset; and 2) if there are differences in the relationship between loneliness and social anxiety across these years. I hypothesize loneliness and social anxiety levels will be highest during the first year after onset and will be lowest during the third year after onset.
Method: Repeated cross-sectional study included undergraduate participants at a public southeastern university recruited through Introductory to Psychology courses and random sample during three years following pandemic onset (2020-2023). Participants completed a two-part online survey including the UCLA Loneliness Scale and Social Phobia Screener.
Results: The ANCOVA examining AY sample differences in mean ULS score approached significance, F(2,2905) = .232, p = .098. Post hoc pairwise comparisons were examined and showed the AY1 sample had significantly lower mean ULS scores (19.75) compared to the AY2 sample (20.36), p = .039. The ANCOVA examining AY sample differences in mean SPS scores was significant, F(2,2915) = 19.18, p < .001. Post hoc pairwise comparisons showed the AY1 sample had significantly lower mean SPS scores (3.70) compared to the AY2 sample (4.92) and AY3 sample (4.77) (ps < .001). The AY2 and AY3 samples did not significantly differ. Partial correlations revealed significant positive correlations between the ULS and SPS for AY1 (r = .413, p < .001), AY2 (r = .445, p < .001), and AY 3 (r = .436, p < .001). These correlations did not significantly differ when compared using r to z Fisher transformations (AY1 compared to AY2 p =0.20; AY2 compared to AY3 p =.40; AY1 compared to AY3 p=.28).
Discussion: The results show that college students’ levels of loneliness and social anxiety may have been influenced by the chronicity of the pandemic and the social reintegration when social restrictions lessened. This study helps in understanding the trajectory of and relationship between loneliness and social anxiety across pandemic phases in college students. This study can help guide future research in efforts to understand reasons for changes in loneliness and social anxiety, and the causal relationship between loneliness and social anxiety in college students. The longer-term impact of loneliness and social anxiety in college students found in this study suggests the need to attend to student mental health, especially as crises become more chronic.
Feasibility and Acceptability of a Values-Based Telehealth Intervention to Promote Adherence in Cardiopulmonary Rehabilitation Patients
No full textBackground: Current research indicates an ongoing need to identify interventions to promote Cardiopulmonary Rehabilitation (CVPR) participation, as participation in CVPR remains low despite positive effects on health outcomes. Values-based interventions, such as Behavioral Activation and Acceptance & Commitment Therapy (ACT), have been shown to be effective for improving the quality of life of patients with a variety of chronic illnesses including cardiovascular disease. We hypothesized that a values-based intervention may be helpful to promote CVPR participation through reduced avoidance and exploration of intrinsically motivating factors that improve patients' willingness to engage in potentially unpleasant activities (e.g., physical activity) that are important for managing their diagnoses. The COVID-19 pandemic also provided the opportunity for more widespread implementation of telehealth interventions to increase access to psychosocial support, especially for marginalized patient populations who experience a high number of attendance barriers. Purpose: The purpose of this study was to assess the feasibility and acceptability of a novel telehealth intervention that is informed by ACT principles and focused on improving adherence to CVPR. Methods: Participants in this single-armed study could choose to participate in a 5-session ACT-informed telehealth intervention via live virtual meetings (at home) or self-guided pre-recorded videos (at home or onsite) featuring the same content. Feasibility was assessed by the number of participants enrolled (goal of 50), sessions attended, Ecological Momentary Assessment (EMA) response rates (measuring mood, experiential avoidance, values congruence), and rates of post-completion assessment. Acceptability was assessed through a qualitative interview following the five-week intervention period. Results: Feasibility of the study was hindered by low participation. Forty-four participants were consented and 21 did post-completion questionnaires. Only 8 participants attended > of the 5 live sessions. Twenty participants requested pre-recorded videos, and though exact numbers of views could not be determined due to our distribution method, only 6 reported watching > 1 videos. Participants often reported difficulty with the virtual meetings and EMA technology, despite staff demonstrating its use and a prior study's success with the same EMA program. Also, participants anecdotally reported exhaustion with virtual meetings across multiple settings. Fourteen participants dropped out of the study due to illness/hospitalization or time conflicts. Five participants completed the qualitative follow-up interview. Qualitative responses generally indicated a high acceptability of the intervention, though this small group included mostly those with high engagement; those who dropped out may feel differently. Discussion: Overall, our results indicate that major changes are needed to increase feasibility and better measure acceptability of this intervention. Participants provided helpful feedback regarding their preferences, challenges encountered, and suggestions for improvement that will be helpful for future repetitions of this research. The results especially highlight the potential benefits of developing a self-guided version that is modified to improve accessibility to the technology required to participate in the intervention
ASSESSING BIAS IN PERSONAL EXPOSURE ESTIMATES WHEN INDOOR AIR QUALITY IS IGNORED: A CASE STUDY OF EASTERN NORTH CAROLINA AND RALEIGH/DURHAM
No full textExposure to outdoor air pollution can cause adverse health issues. Indoor air pollution can be more dangerous due to indoor activities such as cooking, painting, smoking, and heating systems, and can worsen the burden associated with air pollution. Neglecting indoor air quality in an exposure assessment may generate bias and erroneous conclusions regarding the association between exposure and health outcomes. Accurately assessing levels of exposure to air pollution helps advance our understanding of the health effects associated with air pollution and identify effective strategies to address public health concerns. Previous exposure studies have utilized outdoor air quality to assess individuals' exposure to air pollution in their residential locations. These studies neglect the significant amount of time people spend indoors and other activity places. Some other studies assessed exposure to air pollution by measured only indoor air quality inside homes, but they overlook outdoor and other indoor environments where people are exposed to air pollution. Therefore, it remains unknown whether neglecting indoor air quality would generate negligible or non-negligible bias. Likewise, environmental justice studies have also focused only on outdoor air quality to understand exposure disparities among social groups. It remains unknown whether the degree of disparities in exposure becomes larger when indoor environments are considered compared to when only outdoor air quality is considered in exposure assessments. This study aims to assess bias in personal exposure by comparing estimates derived from two different air pollution datasets: outdoor air quality data and data collected in both indoor and outdoor environments. It also investigates whether exposure disparity between different social groups would be more prominent when indoor air quality is considered in exposure assessments. For data that contains both indoor and outdoor pollution measurements, this study used 3-day mobile sensing air quality data of 100 research participants living in eastern North Carolina (ENC), which was collected using GeoAir2.0 portable monitors for a previous pilot project conducted by Park's research team. The GeoAir2.0 data includes GPS location data as well as particulate matter (PM) measurements in a 1-minute interval. For outdoor air quality data, publicly available PM2.5 data measured every minute were downloaded from 213 PurpleAir monitors across ENC for the corresponding times the GeoAir data were collected. Using a geostatistical method, a Python algorithm was developed to estimate PM2.5 from PurpleAir data for 129,600 minutes over 90 unique days of the entire data collection period. Participants' PM2.5 values were averaged for each dataset to obtain GeoAir2.0- and PurpleAir-based exposure estimates. Next, paired-sample t-tests were performed to examine whether there was a significant difference between the two exposure estimates. Lastly, to assess the degree of gender and economic disparities in exposure among different income groups, Welch's t-tests and analyses of variance (ANOVA) were performed. Game-Howell post hoc tests were used to assess whether the difference in exposure estimates among pairs of the income groups was significant. This study identified that the PurpleAir-based exposure estimates were consistently higher than the GeoAir-based estimates in overall exposure, activity places, and days of the week. The paired-sample t-test result revealed a statistically significant difference between the two estimates (t = 5.94; p < 0.001). This indicates that PurpleAir estimates overestimate the actual exposure to air pollution. Exposure levels in different microenvironments also showed significant variations between the two estimates, with home exposure generating the most significant difference (t = 5.74; p < 0.001), revealing that PurpleAir data overestimated the level of exposure in indoors when outdoor air pollution concentration is high and underestimates indoor air quality when outdoor air quality is low. Also, the socioeconomic disparities in exposure estimates were evident among the three income groups when indoor air quality was integrated into exposure assessment compared to when only outdoor air quality was utilized. The study emphasizes the significance of integrating indoor air quality data in exposure assessments to mitigate bias. It also underscores the importance of personal air sampling data in environmental justice studies to provide a more accurate representation of exposure disparities among different social groups
Signature Honors Project Thesis Paper: Towards an Efficiency Analysis of Division I Womens Basketball
No full textAs the pressure to win and generate revenue and as the allegations of out-of-control spending continue to increase, there exists many interests in intercollegiate athletics. College sports represent a multibillion-dollar industry. Division I institutions reported spending over & Women’s Sports’”, no previous studies have attempted to evaluate these factors simultaneously in the context of National Collegiate Athletic Association (NCAA) Division I women’s basketball. The value of the proposed methodology to decision makers is discussed and evaluated in my research
Changing the Model of Care for Home-Based Primary Care
No full textThis is an executive summary in partial fulfillment of the DNP.D.N.P
An Introduction to Categories and Homological Algebra: A Tale of Four Functors
No full textWe assume familiarity with group theory and discuss the technical background necessary
to construct and understand the functors Hom, Ext, T or and tensor on the category of
abelian groups, with special attention paid to Hom and Ext. In doing so, we hope to provide
an introduction to the study of category theory and homological algebra understandable to
an undergraduate with 1-2 semesters of abstract algebra
Investigating the anoxic protective effects of sex hormones and EphrinA1
No full textCardiovascular disease is the most prevalent and debilitating disease in the US and globally. There is no cure, and its devastating socioeconomic impact continues to progress. Studies have shown that the occurrence of myocardial infarction (MI) differs by age, sex, and physical well-being, but little is known about the specific mechanism behind these discrepancies. Researchers hypothesize that these differences may be partly due to the varying expression of the predominant sex hormones estradiol (E2) in females and testosterone (T) in males, which change with age. Both hormones are linked to cardioprotection, and the decreased expression of them in elderly and obese populations likely contributes to their increased risk of MI.
Our lab has shown that healthy mouse and human heart cells (cardiomyocytes) express ephrinA1. Administration of recombinant ephrinA1-Fc to the ischemic heart during injury onset reduces tissue damage and preserves cardiac function in acute and chronic mouse models of MI. In vitro treatment of human inducible pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) with ephrinA1-Fc preserved 84% of cells subjected to 24 hours of anoxia. One mechanism by which sex hormones may influence cardioprotective outcomes is by modulating the expression of the protein EphrinA1 and its cognate EphA receptors in cardiomyocytes.
To test this hypothesis, we investigated the effects of varying levels of testosterone or estradiol on ephrinA1/EphA expression to determine if they have a role in modulating ephrinA1-Fc-induced protection from anoxic injury. Specifically, human inducible pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) will undergo anoxia by treatment with Oxyrase to remove all oxygen, simulating an ischemic event. These cells were treated with ephrinA1-Fc in the presence of either 0, 0.1, 1.0, 10, 100, or 1,000 M of T or E2, respectively. Cell survival and Western blotting for proteins involved in protective response (anti-apoptosis, autophagy, and metabolism) were used to determine the effects of the varying sex hormone concentrations on the molecular mediators of apoptosis, metabolism, and autophagy
Application Program Interface Implementation for the Intercommunication of Prescription Information
No full textMedication errors are a significant problem related to mortality in the United States. When patients
present to a healthcare facility without accurate knowledge of their home medication regimen,
unintentional, harmful, and costly consequences can ensue, such as extra healthcare services related to
a medication reaction to an unreported medication mistaken for an unknown disease process. The
project site is a non-profit 501 3 c primary care facility that does not utilize the electronic health record
(EHR) medication list for medication reconciliations (MedRec) but uses the pharmacy-generated list. The
research project compared medication lists to the site's pharmacy list using pre-implementation and
post-implementation Application Program Interface (API) groups. A Plan Do Study Act (PDSA) cycle on
each audit day was completed to ensure consistency of the auditing process and chosen inclusion and
exclusion criteria. API intervention connected to the pharmacy software, thus allowing interoperability
between the site's pharmacy software and the EHR. Post-implementation results denote a 13% decrease in medication inaccuracies between the pharmacy list and other healthcare facilities' EHR medication lists. Improved medication accuracy can improve patient outcomes, decrease healthcare costs, increase healthcare workers' job satisfaction, and increase patient satisfaction and trust within the healthcare community.D.N.P