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Intensive Multidisciplinary Approach to the Prevention and Management of Metabolic Syndrome in a Primary Care Setting: A Pilot Study
No full textMetabolic Syndrome (“MetS”) is a spectrum of diseases characterized by obesity, insulin resistance, low HDL, hypertension, and hypertriglyceridemia that is estimated to affect at least 1/3 of Americans. Initial treatment for this condition is centered around comprehensive lifestyle change, which can be curative, but presents challenges to clinicians and patients alike. Evidence repeatedly demonstrates its proven baleful effects. Intensive interventions in the form of a multidisciplinary approach with frequent follow-up and group-based encounters have shown particular promise. Thus, we constructed a pilot study reviewing lifestyle interventions in the setting of an outpatient primary care family medicine residency clinic to add to this body of research, assess generalizability, determine possible benefits of such a program, and develop and improve the program’s methods. Our approach to reversing metabolic syndrome spanned over a 12-month period. The study’s components were designed during the first trial year, and included frequent physician visits, 90-minute monthly group sessions, and in-house consultations with dietetic students, behavioral health, and pharmacy. Patients were enrolled by recommendation from their primary care provider or patient request. Evaluations included pre- and post-intervention markers of MetS, including blood pressure, weight, and BMI. Pre- and post-intervention questionnaires were collected to compare subjective scoring of life function, motivations to make behavioral changes, and overall health. Findings from the pilot study noted weight and BMI trended up and blood pressure trended down. Due to a limited sample size of participants, participation rate, and sampling bias, this led to insufficient data to assess for statistical significance. However, qualitative data revealed an overall positive experience with the group visits. Future application of this program include improved recruiting and retaining of participants and the continued development of educational materials to expand topics for future sessions
Blood and Beauty: The Beautiful Dead Girl Trope in Literature and Beyond
No full textWomen throughout different forms of media are consistently assigned a value associated with youth and beauty. Throughout history, the aging of women has become a societal reasoning to devalue them as it seems to signify the gradual loss of beauty. However, the concept of the beautiful dead girl has risen as a means of combating this “unfortunate” loss of what society deems valuable. This concept identifies the beauty of dead girls and sees their death as not a tragic circumstance, but rather a gift to immortalize their youth, allowing them to remain beautiful forever, cemented in a state of value. This has extended beyond media and into real life by allowing fantasies to form in the minds of the people – fantasies which are then enacted against real women. By exploring how this trope is present in literature such as Edith Wharton’s novella Ethan Frome and Ottessa Moshfegh’s novel My Year of Rest and Relaxation, I was able to see the patterns that subsequently emerged as technology grew. As society evolved with the internet and film, so did the idea of the beautiful dead girl, taking on different forms in slasher films and pornography. The consistent presence of violence against women and women lacking agency, rooted in the beautiful dead girl trope, led to small implementations over time until full fledged fantasies were developed, resulting in violence against women. This paper calls attention to these patterns resulting in a solution that the media stop glorifying women’s deaths (such as pictures taken of women after jumping from the twin towers during 9/11 as mentioned in My Year of Rest and Relaxation). Until the media recognizes the harm within the trope, the beautiful dead girl will never be confined to media and entertainment, and will affect living women as much as metaphorical characters
PFOA administration in rats with chronic kidney disease leads to kidney and liver hypertrophy and decreases blood pressure
No full textPer- and polyfluoroalkyl substances (PFAS) are a type of nonbiodegradable, man-made chemical used in many industrial applications. Exposure to PFAS is associated with harmful health impacts including hypertension and chronic kidney disease (CKD). Moreover, exposure to PFAS may worsen preexisting CKD and hypertension because the kidney is the main route of PFAS excretion from the body. The goal of this study was to assess the effects of perfluorooctanoic acid (PFOA), a legacy PFAS, on exacerbating hypertension and CKD in Dahl Salt-Sensitive (SS) rats, a genetic model of hypertension and CKD. Male Dahl SS rats (10 to 13-weeks-old, n=15) were instrumented with a radiotelemeter (DSI) to assess arterial blood pressure (BP) and heart rate (HR). One week later, baseline BP (500 Hz, 24 hrs/day over 2 days) and proteinuria were assessed. Then, one group of rats was maintained on regular tap water (vehicle, n=5) or administered PFOA (10 mg/kg/day, n=10) for 4 weeks. BP was assessed weekly, proteinuria at 2 and 4 weeks, and organs were harvested at the end of the experiment. A two-way repeated measures ANOVA with Tukey post hoc analysis was used to assess differences between groups over time, and an unpaired t-test was used to assess differences in organ weights between groups. Data are mean±SE and P\u3c0.05 was considered statistically significant. Despite similar body weights, both kidney (13%) and liver (52%) weights were significantly greater in PFOA vs. vehicle groups. The percent increase in mean arterial BP (mmHg) over time was significantly attenuated in rats administered PFOA (3.3±1) vs. vehicle (9±2). There were no significant differences in HR or proteinuria between groups. Contrary to our hypothesis, PFOA administration for 4 weeks blunted the age-related increase in BP in Dahl SS rats. Current experiments in the lab are evaluating kidney and liver injury
Panniculectomy with Concurrent Incarcerated Incisional Hernia Repair: A Case Report
No full textSignificant weight loss after bariatric surgery often results in excess skin and subcutaneous tissue, leading to the formation of a pannus. This excess tissue pulls the abdomen downward, sometimes necessitating a panniculectomy. Additionally, the incidence of incisional hernia after a cesarean section is relatively low, ranging from 0.0% to 5.6%, with risk factors including obesity, smoking, diabetes, history of multiple C-sections, and the type of incision. We present a case of a patient who underwent an elective panniculectomy with concurrent incisional hernia repair, in which an incarcerated hernia was found within the pannus. Our patient presented with a grade 3 pannus covering her mid-thigh with a history of multiple cesarean sections, gastric bypass surgery, morbid obesity, diabetes mellitus and hyperlipidemia. She sought consultation for panniculectomy due to impaired daily function and had no signs of strangulation, nausea, vomiting, or bowel obstruction. After discussing treatment options, she opted for surgery. In the operating room, a transverse elliptical incision was made, and the skin and subcutaneous tissue were elevated off the underlying fascia and a fascial defect measuring 3 x 4cm, containing herniated omentum and small bowel, was noted. No evidence of strangulation or bowel compromise was found. A primary repair was performed using interrupted non-absorbable running sutures in a figure-of-eight technique, reinforced with a continuous suture. The excess pannus was excised en bloc, bilateral drains were placed, and the wound was closed in layers with an abdominal binder applied postoperatively. This case highlights an atypical presentation of an incisional hernia incarcerated within a pannus, emphasizing the importance of thorough preoperative evaluation and intraoperative vigilance in post-bariatric patients and those with multiple prior abdominal surgeries. To our knowledge, a case of an incarcerated hernia within a pannus has not been previously reported
Novel porous materials for adsorption of nitrates from water
No full textThe presented innovation addresses the critical environmental issue of elevated nitrate levels in water bodies, primarily due to excessive use of nitrogenous fertilizers and improper waste disposal. It leads to detrimental effects like eutrophication and health hazards. Focusing on the necessity to reduce nitrate concentrations in contaminated water to permissible levels, the effectiveness of hybrid organic-inorganic materials in nitrate adsorption was explored in this work. Mesoporous amino-functionalized silica materials were synthesized by grafting and sol-gel techniques. The surface amino groups of the materials were converted to amine hydrochlorides for easy ion exchange on nitrate cations. The chemical compositions and structural characteristics of obtained adsorbents with high BET surface area were examined by elemental analysis, FT-IR spectroscopy, porosimetry and particle size analysis. Batch adsorption tests proved high nitrate adsorption capacities of these materials. Sol-gel materials demonstrated the highest efficiency attributed to their abundant amino group contents. Among them, the surfactant-free sol-gel material was selected as the best adsorbent due to its ease of synthesis and cost-efficiency. The study of the effect of temperature on nitrate adsorption showed its high performance in the wide range of naturally occurring climatic conditions. Obtained adsorbents remained highly efficient in five adsorption/regeneration cycles. This study contributes significantly to the development of efficient methods for nitrate removal from water, presenting a promising approach for environmental remediation
Exploring Relationships Between Caregiver and Child Adversity and Parenting Style
No full textExtant literature reveals a robust association between caregiver adversity and that of their offspring. We explored how/if such associations were underwritten by intraclass correlations within adversity subtypes. Additionally, we were interested in whether parenting style mediated these associations. 327 caregivers provided anonymous data on themselves and their children via links posted on social media and listservs. We measured caregivers’ and children’s adverse childhood experiences (ACEs) using the Health-Resiliency-Stress Questionnaire. We divided ACEs into four subtypes: abuse, neglect, household dysfunction, and community violence. We also measured degree of authoritativeness, permissiveness, and authoritarianism using the Parental Attitudes Questionnaire. Pearson intra- and cross-class correlations were calculated between caregiver and child ACE scores. We found significant intraclass correlations for three subtypes: abuse (r=.248, p\u3c.001), community violence (r=.177, p =.005), and household dysfunction (r=.175, p=.002). The interclass correlation for neglect was not statistically significant. Two cross-class correlations also emerged, but they were weaker than the intraclass correlations. Parent abuse ACEs predicted children’s neglect ACEs (r=.146, p=.024) and their household dysfunction ACEs (r=.164, p=.004). The authoritarian parenting domain was most predictive of children’s ACEs. However, permissiveness was negatively correlated with child neglect ACEs (r=-.185,=.004). For the mediation analysis, we first regressed cumulative child ACEs on cumulative caregiver ACEs. The association was significant [F(1,324) = 8.126, p\u3c.01; B=.09, p\u3c.01]. We next tested whether any parenting styles mediated this association. In three independent analyses, we regressed caregiver parenting style scores and children’s ACE scores on caregiver’s ACE scores. In all three cases, the direct path remained significant, whereas none of the indirect paths achieved significance. Our hypotheses were partially supported. Significant interclass correlations were as predicted. Caregivers with ACEs in abuse or household dysfunction domains reported parallel categories of adversity for their children. However, these associations were not mediated by parenting style as we believed they might be
Disability Inclusion in Local Public Health Community Health Assessments and Community Health Improvement Plans
No full textIntroduction: Local health departments (LHDs) use community health assessments (CHAs) and community health improvement plans (CHIPs) to identify and address health needs of the populations they serve. People with disabilities experience health disparities, and there is limited information about how the health needs of people with disabilities are included in CHAs and CHIPs. The purpose of this study was to describe and quantify disability inclusion in LHD CHAs and CHIPs.
Methods: This cross-sectional, mixed methods study used the CHAs and CHIPs of accredited local health departments, data about LHDs and populations served, and interviews with LHD staff and community partners engaged in CHA and CHIP processes that considered disability. Characteristics of disability inclusion in the CHAs and CHIPs were assessed through bivariate and multivariate analyses. A qualitative analysis of the interviews was conducted to describe factors that influenced disability inclusion in the CHIP.
Results: Less than one-quarter of CHIPs included a goal, objective, or activity that specifically included people with disabilities. In the multivariate regression, CHAs and CHIPs that were conducted by a mixed group of community partners were associated with greater odds of having a CHIP goal, objective, or activity that included people with disabilities (adjusted odd ratio (aOR)= 5.40, CI: 1.53-19.14) as well as CHA and CHIP steering committees that included at least one disability partner (aOR=5.65, CI: 1.96-16.32). In the qualitative analysis of the CHA free-text, disability was commonly written as a negative outcome focused on preventing disabilities. The two most common interview themes for building disability inclusion into CHAs and CHIPs were including disability partners throughout the CHA and CHIP process and using disability-inclusive data.
Discussion: Disability inclusion in LHD CHAs and CHIPs is limited. Factors such as who conducts the CHA and CHIP and who participates on the steering committee are correlated with disability inclusion in the CHIP. Understanding the characteristics that support disability inclusion in CHAs and CHIPs and the perspectives of those engaged in disability-inclusive CHAs and CHIPs may help to inform more inclusive CHAs and CHIPs in the future and ultimately to address the health disparities experienced by people with disabilities
Immersive Influence: Examining the Impact of Virtual Reality on Brand Perception Among the Innovation Generation
No full textNow more than ever, brands must create innovative and engaging experiences to enhance perception and build consumer trust. Virtual reality (VR) offers an opportunity for brands to achieve these goals by providing immersive, interactive experiences that, when done right, can strengthen key brand metrics. Despite the growing use of VR in experiential marketing, research on VR’s effectiveness in shaping brand perception and influencing authenticity remains limited. Grounded in media richness theory, this study examined how VR impacts brand perception and whether media richness influences authenticity.
Using a mixed-methods approach, 20 participants engaged with the “Wendyverse,” a branded VR environment. Pre-, post-, and follow-up surveys, along with interviews, assessed directional shifts in several perceptual metrics. The findings highlight VR’s potential to enhance brand perception, trust, and engagement while contributing to VR marketing literature by offering insights into immersive branding strategies and providing recommendations for brands seeking to create impactful, immersive experiences
Narcissistic Personality Traits and the Perception of Potential Romantic Relationship Partners
No full textDue to the difficulty of meeting potential dating partners in the modern age, many people have resorted to using dating apps to meet potential romantic partners. The ubiquity of dating app use in the U.S. led Bisio & Blackhart (2025) to examine how dating app users perceive potential romantic partners as opposed to those engaging in more traditional dating behaviors. They found that individuals higher in narcissism were significantly more likely to dehumanize potential romantic partners than those lower in narcissism, regardless of whether they used dating apps or not. The purpose of the present study was to explore this finding further, examining whether specific aspects of narcissism, as well as different aspects of the dark tetrad of personality, predicted dehumanization of potential romantic partners. The results indicated that individuals that scored higher in Contingent Self-Esteem and Self-Sacrificing Self-Enhancement, from the Pathological Narcissism Inventory, as well as those who scored higher in the sadism dimension of personality, were more likely to dehumanize potential dating partners
