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Navigating double burden: Community health workers in rural Dominican Republic living and working through the epidemiologic transition
Get PDFThe epidemiological transition postulates that over time, the burden of infectious disease declines and is replaced with non-communicable diseases (NCD). Community health workers (CHW) work on prevention and treatment of infectious and NCD in low-resource settings in the context of health transitions. We explored CHWs’ experiences working through the epidemiologic transition in rural Dominican Republic and how the transition impacted their roles and communities. We conducted two semi-structured interviews each with eight CHWs. We analyzed interviews using narrative summaries and thematic coding. CHWs described themselves as change makers that drove health improvements, including child mortality reductions and advancements in social determinants of health. However, more than a transition from infectious disease to NCD, participants described a current double burden of both, and a resulting expansion of their roles and responsibilities. Increased workloads and poor remuneration, layered on top of gendered roles and expectations, were identified as threats to CHW sustainability, efficacy, and well-being. CHWs need additional support to continue their essential role strengthening the health profile of communities in transition
Statistics and AI: A Fireside Conversation
Get PDFA 3-hour webinar titled “Statistics and AI – A Fireside Conversation” was held on Sunday, March 17, 2024, attracting an online audience of approximately 1,000. The event featured three sessions aimed at engaging the statistical community on key topics in the AI era: addressing statistical challenges and opportunities (Panel I), evolving the publication process (Panel II), and advancing next-generation statistical pipelines and resources (Panel III). Panel I examined issues such as dwindling talent, shifting funding landscapes, and AI's rapid rise, highlighting the need for statistical rigor, interdisciplinary collaboration, and innovative approaches to shape the future of AI. Panel II emphasized the importance of streamlining the publication process, fostering impactful research, and prioritizing workflows and data quality. Panel III focused on modernizing statistical education by integrating AI and deep learning, promoting interdisciplinary collaboration, and maintaining foundational principles such as uncertainty and reproducibility. These discussions collectively outlined a strategic roadmap for ensuring the relevance and advancement of statistics in the age of AI.
These discussions were organized by (in alphabetical order) Xihong Lin (Harvard University), Tracy Ke (Harvard University), Tian Zheng (Columbia University), Jing Zhou (University of California at Los Angeles), and Hongtu Zhu (University of North Carolina at Chapel Hill).
In the dynamic landscape of statistical science, the fireside chat organized by the Stats Up AI Alliance (https://statsupai.org/) and the International Chinese Statistical Association (ICSA) emerged as a seminal event, bringing together leading experts to explore the evolving role of statistics in the era of artificial intelligence
Getting to Full Open Access: Integrating Dimensions Into Hyrax
Get PDFIn 2016, the University of North Carolina at Chapel Hill Faculty Council passed the Open Access Policy, which facilitates free, public access to research authored at the University. The Carolina Digital Repository (CDR) is a Hyrax-based institutional repository whose mission supports the Open Access Policy. CDR staff have engaged in multiple projects to collect and provide access to open content, which has been challenging given the University’s lack of access to automated solutions such as a faculty activity tracker. In this presentation, we will discuss the CDR’s integration with Dimensions, a large-scale research system, which has enabled us to import over 50,000 works to CDR. We will describe the projects, the workflow and our results. We will reflect on the successes and challenges of the project and evaluate future directions, including our plan to integrate federal research sources
Youth Family Caregivers and the Geography of Childhood (NSF 1853260)
No full textThis project examined the childhood geographies of youth caregivers under the age of 18 years old. Every day in the United States, more than 5.4 million youth caregivers support family members who have a chronic illness, disability, or other health issue that requires help, supervision or support. Youth caregivers often assume responsibilities such as cooking and cleaning. They may also support basic activities of daily living such as assisting in mobility, dressing, feeding, and administering medication. Like adult caregivers, youth caregivers encounter a diversity of social, cultural, and geographic or spatial impacts which vary according to the type and intensity of care they provide to a loved one. However, unlike adult caregivers, youth in the United States tend not to be recognized for the care that they provide. Furthermore, there are few public programs that provide support for their distinct needs. As pressure upon family caregivers intensifies in the U.S. with the aging of the population and projected shortages of paid care workers, young people are likely to play a larger role in providing support, comfort, and assistance to family members. The project focused on three key objectives: 1) to understand the relationship between youth caregiver recognition, identity and place based emotions; 2) to explore how youth caregiving impacts childhood perceptions of time, space, scale, and place; and, 3) to identify ways to better incorporate youth caregiving into future research and policies of family caregiving in the United States. The research took place with young people who receive support from the Caregiving Youth Project, a nonprofit organization that works with school districts to provide services to youth caregivers in Palm Beach County, Florida. Though the work is limited to one geographic area in the United States, the findings are relevant to understanding the experiences of family caregiving by this largely hidden population. The theories and methodologies developed in this research will provide new insights and approaches to research on childhood geographies
Relationship-centered care and diversity, equity, inclusion, and belonging in action
Get PDFNursing practice focused on health equity, social justice, and DEIB (diversity, equity, inclusion, and belonging) provides a lens through which nurses can support the advancement and achievement of optimal health for everyone. This article discusses the importance and strategies for incorporating DEIB into nursing education
Protocol for a Randomized Controlled Trial to Determine if Biomarkers Predict Response to a Pediatric Chronic Pain Symptom Management Program
Get PDFBackground/Objectives: Disorders of gut–brain interaction (DGBI), characterized by chronic abdominal pain and significant disability, affect 15–20% of children and adults and continue into adulthood in ~60% of cases. Costs for adults reach USD 30 billion per year, yet effective management strategies are elusive. Studies support using cognitive behavioral therapy (CBT), but abdominal pain only improves in ~40% of patients. Dietary management (low FODMAP diet; LFD) has also shown promise but it is effective in only a similar percentage of patients. Studies suggest that biologic factors (biomarkers) contribute to CBT response. Similarly, gut microbiome composition appears to influence abdominal pain response to the LFD. However, no previous CBT trials in children or adults have measured these biomarkers, and it is unclear which patients respond best to CBT vs. LFD. Methods: Children aged 7–12 years with DGBIs (n = 200) will be categorized as having/not having Autonomic Nervous System imbalance and/or abnormalities in gut physiology. We will randomize these children to either CBT or a LFD to compare the effectiveness of these treatments in those with/without abnormal physiologic biomarkers. We hypothesize that CBT will be more effective in those without abnormal physiology and LFD will be more effective in children with abnormal physiology. Primary outcome measures include the following: (1) Symptom improvement (abdominal pain frequency/severity) and (2) improvement in health-related quality of life. Conclusions: This innovative multidisciplinary study is the first to identify physiological characteristics that may moderate the response to two different management strategies. Identification of these characteristics may reduce the burden of these disorders through timely application of the intervention most likely to benefit an individual patient
Automated self-service cohort selection for large-scale population sciences and observational research: The California teachers study researcher platform
Get PDFOBJECTIVE: Cohort selection is ubiquitous and essential, but manual and ad hoc approaches are time-consuming, labor-intense, and difficult to scale. We sought to automate the task of cohort selection by building self-service tools that enable researchers to independently generate datasets for population sciences research. MATERIALS AND METHODS: The California Teachers Study (CTS) is a prospective observational study of 133,477 women who have been followed continuously since 1995. The CTS includes extensive survey-based and real-world data from cancer, hospitalization, and mortality linkages. We curated data from our data warehouse into a column-oriented database and developed a researcher-facing web application that guides researchers through the project lifecycle; captures researchers' inputs; and automatically generates custom and analysis-ready data, code, dictionaries, and documentation. RESULTS: Researchers can register, access data, and propose projects on the CTS Researcher Platform via our CTS website. The Platform supports cohort and cross-sectional study designs for cancer, mortality, and any other ICD-based phenotypes or endpoints. User-friendly prompts and menus capture analytic design, inclusion/exclusion criteria, endpoint definitions, censoring rules, and covariate selection. Our platform empowers researchers everywhere to query, choose, review, and automatically and quickly receive custom data, analytic scripts, and documentation for their research projects. Research teams can review, revise, and update their choices anytime. DISCUSSION: We replaced inefficient traditional cohort-selection processes with an integrated self-service approach that simplifies and improves cohort selection for all stakeholders. Compared with manual methods, our solution is faster and more scalable, user-friendly, and collaborative. Other studies could re-configure our individual database, project-tracking, website, and data-delivery components for their own specific needs, or they could utilize other widely available solutions (e.g., alternative database or project-tracking tools) to enable similarly automated cohort-selection in their own settings. Our comprehensive and flexible framework could be adopted to improve cohort selection in other population sciences and observational research settings
Making strides in doctoral-level career outcomes reporting: a review of classification and visualization methodologies in graduate education
Get PDFThe recent movement underscoring the importance of career taxonomies has helped usher in a new era of transparency in PhD career outcomes. The convergence of discipline-specific organizational movements, interdisciplinary collaborations, and federal initiatives has helped to increase PhD career outcomes tracking and reporting. Transparent and publicly available PhD career outcomes are being used by institutions to attract top applicants, as prospective graduate students are factoring in these outcomes when deciding on the program and institution in which to enroll for their PhD studies. Given the increasing trend to track PhD career outcomes, the number of institutional efforts and supporting offices for these studies have increased, as has the variety of methods being used to classify and report/visualize outcomes. This report comprehensively synthesizes existing PhD career taxonomy tools, resources, and visualization options to help catalyze and empower institutions to develop and publish their own PhD career outcomes. Similar fields between taxonomies were mapped to create a new crosswalk tool, thereby serving as an empirical review of the career outcome tracking systems available. Moreover, this work spotlights organizations, consortia, and funding agencies that are steering policy changes toward greater transparency in PhD career outcomes reporting. Such transparency not only attracts top talent to universities, but also propels research progress and technological innovation forward. Therefore, university administrators must be well-versed in government policies that may impact their PhD students. Engaging with government relations offices and establishing dialogues with policymakers are crucial steps toward staying informed about relevant legislation and advocating for more resources. For instance, much of the recent science legislation in the U.S. Congress, including the Creating Helpful Incentives to Produce Semiconductors (CHIPS) and Science Act, significantly impacts federal agency programs influencing universities. To ensure sustained development, it is imperative to support initiatives that enhance transparency, both in terms of legislation and resources. Increased funding for programs supporting transparency will aid legislatures and institutions in staying informed and responsive. Many efforts presented in this publication have received support from federal and state governments or philantrophic sources, underscoring the need for multifaceted support to initiate and perpetuate this level of systemic change
Engineering a platform for increased BEST4+ cell differentiation and potential function
Get PDFBEST4+ cells (BPCs) are a newly identified human-specific intestinal epithelial cell type with largely unknown functions. This study aims to optimize BPC differentiation in vitro and investigate their role in ion transport, particularly zinc handling. Using human intestinal epithelial stem cells (hIESCs), we found that traditional transwell cultures contain low BPC numbers, but BPC differentiation can be enriched for through air-liquid interface (ALI) culture and a more acidic medium indicating pH sensitive differentiation. NOTCH and TGFB signaling and the overexpression of transcription factor BARX2, previously suspected to influence BPC differentiation, had no effect. To explore BPC function, we assessed their potential role in metal handling. BPCs highly express CNGA1, a nonspecific divalent cation channel, and metallothioneins, which are involved in metal homeostasis. Functional assays using a CNGA1- overexpressing HEK293 model showed increased intracellular zinc accumulation, demonstrating a role for CNGA1 in zinc transport. Furthermore, BPC-enriched ALI cultures exhibited elevated apical to basal zinc transport, supporting their involvement in epithelial metal handling. Finally, to facilitate real-time tracking of BPC differentiation, we generated a BEST4-iRFP reporter cell line, enabling live-cell visualization and fluorescence-based sorting. Collectively, our findings establish a robust method for BPC enrichment, demonstrate their pH sensitivity, and provide support for a potential function in metal ion transport. This work lays the foundation for future studies into BPC function and their potential contributions to gut homeostasis and disease.Bachelor of Scienc
How Does Age Affect Fascicle Length-Dependent Changes in Local Muscle Fatigability?
Get PDFAge-related declines in Achilles tendon stiffness have been linked to shorter calf muscle operating lengths, which may lead to higher excitations and earlier onset of muscle fatigue, though this relationship has not been systematically studied. This study examined how calf muscle length, manipulated by ankle posture (15° plantarflexion [PF15] vs. 15° dorsiflexion [DF15]), and age affect fatigue onset during repeated fixed-end contractions in younger and older adults. Moving from DF15 to PF15 shortened fascicle lengths by 12.4%, doubled EMG activity, and reduced time to task failure by 49% (p<0.01), regardless of age. Older adults exhibited shorter resting fascicle lengths, 40–70% higher excitation for the same relative ankle moment (p<0.01), and smaller posture-dependent fascicle length changes (p=0.035), aligning with reduced Achilles tendon stiffness. Surprisingly, older adults had longer times to task failure (p=0.027), likely due to 33% smaller normalized force targets (p=0.019). These findings have clinical relevance for mechanisms associated with mobility impairment among older adults, who often operate their calf muscles at shorter lengths, and may have practical implications for rehabilitation and training strategies to refine ways to enhance fatigue resistance in older adults.Bachelor of Scienc