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If You Breathe You Should Care
No full textMany years ago, I worked in the Mott Haven section of the South Bronx providing social services to underserved populations. This was at the height of the HIV crisis in New York and this area was particularly affected because of the high rates of drug use. The families mostly hailed from Latin America, the Caribbean and Africa. However, they all had one thing in common, asthma. Almost every family had a child or an adult with asthma. We sought to address the high rates of asthma by helping families to find housing that was free of roaches, rats and mold. And when that failed, we took their landlords to court to force them to make the necessary repairs. After I left the job, I maintained communication with some of the families and colleagues who touched my life and whose life I became a part of.
My quilt draws attention to the environmental injustice in the South Bronx. One of the things I learned in subsequent years was that asthma is not only caused by mold and vermin infestation but by environmental inequality. Your ability to breathe clean air should not be determined by your zip code, the color of your skin or your socio-economic status. The area referred to as “asthma alley” is the 3rd poorest in the city and is 97 percent Latino and Black.
According to New York City community health profiles, the South Bronx has the highest levels of PM2.5, the most harmful air pollutant - 10.0 micrograms per cubic meter compared with 8.6 citywide. Other sources of air pollution include the excessive amounts of diesel-intensive industries that serve other communities. The Fresh Direct warehouse, and the printing press of The Wall Street Journal are both located in the South Bronx. Hunts Point Food Distribution center, the largest in the country, is also part of the steady stream of truck traffic. Although the area is home to only 6.5 percent of the population of the city, the South Bronx has one third of the city’s waste treatment plants.
Other sources of pollution include the exhaust fumes from a network of highways. There are ten highways running through the Bronx and four of those surround the South Bronx. In contrast there are only two highways running along the outskirts of Manhattan. This pollution causes asthma and other respiratory illnesses, leading to health complications and premature deaths for residents of the South Bronx. The asthma rate in the South Bronx is so high it was nicknamed asthma alley. The Guardian reported that asthma hospitalizations in the South Bronx are five times the national average and at rates 21 times higher than other NYC neighborhoods. Not surprisingly, city data also suggest that this area was among hardest hit by the coronavirus. Research confirmed that air pollution is associated with COVID-19 death.
Every New Yorker has a right to the city including equitable use of the services and resources that the city has to offer, participation in the decision making of how space is utilized and the right to a habitat that is clean, safe and life affirming. To achieve these goals, we need more equitable environmental regulations that offer protection for all forms of life in ways that ensure a responsible relationship between individuals and nature and promote the dignity and humanity of individuals, families and communities.https://digitalcommons.liu.edu/community_usquilt_2023/1007/thumbnail.jp
Tick-Talk: Human Babesiosis
Get PDFBackground: Human babesiosis is a parasitic infection caused by species of the protozoan Babesia, most commonly B. microti. The organism invades the erythrocytes causing them to lyse. The infection is transmitted through the Ixodes tick, which is commonly found on white mice and white tailed deer. Outbreaks of this disease most commonly occur in the Northeastern region of the United States, specifically New England and Long Island, New York, during spring and summer months, due to the greater proximity of vectors to humans. Patients who are infected can have a range of symptoms from asymptomatic to severe manifestations, including hospitalizations and mortality.
Methods: Information was gathered through the use of the PubMed search engine. The search terms: (a) human babesiosis, (b) prevalence, (c) prevention, and (d) manifestations were used. To narrow the results the article types were limited to clinical trials and reviews. Other limitations included: (a) full text, (b) publication dates from 2008-2018, and (c) human species. This search provided 102 results.
Results: According to the Centers for Disease Control and Prevention, in 2014 the highest incidence of babesiosis was in the found in: (a) New Jersey (159), (b) Rhode Island (172), (c) Connecticut (205), (d) New York (437), and (e) Massachusetts (537). A total of 1,744 incidences reported in the United States in 2014. Between 2011 and 2014 it was reported that roughly 2,165 cases of babesiosis required hospitalization. The highest rates per state in 2014 were found in: (a) Rhode Island (16.3), (b) Massachusetts (8.0), (c) Connecticut (5.7), (d) Maine (3.2), (e) New Hampshire (3.2), (f) New York (2.4), and (g) New Jersey (1.8). Immunocompromised patients, such as those who are: (a) asplenic, (b) HIV-infected, or (c) fighting malignancy, are more likely to experience severe symptoms and death as a result of babesiosis. In a recent study, those with more than one immunosuppressive condition were more likely to experience a prolonged disease state and despite multiple rounds of therapy, 20% of those patients died.
Conclusions & Recommendations: It is recommended that those who detect a tick bite seek medical attention to remove the tick, and undergo lab testing. Most patients who are asymptomatic do not require treatment. Ill patients are treated for 7-10 days with a combination of two antibiotics. The two options include atovaquone and azithromycin or clindamycin and quinine for severely ill patients. Supportive treatment such as antipyretics and vasopressors may also be helpful. Preventative measures can be taken to lower the risk of babesiosis infection such as: (a) avoiding areas of high grass and shrubbery, (b) frequently mowing the lawn, (c) wearing long clothing when spending time outdoors, (d) checking oneself, children, and pets after spending times outdoors, (e) avoiding going off trails in wooded areas, and (f) wearing long pants that are tucked into socks if planning on spending time in areas where ticks are present. Additionally, many of the areas plagued with high incidence of infection are taking action by educating the public on ways to prevent further infections
The Phylogeny Predicts Potential New Sources of Antibiotics from Plants
Get PDFThe evolution and spread of antibiotic resistance has been the greatest threat to successful antibiotic treatment, and hence the driving force behind the search for new therapies. None of our modern pharmaceutical antibiotics have been developed from plants, albeit plants have been used since antiquity in traditional medicine to fight bacterial infections. We phylogenetically analyzed 138 plant species with antibacterial activity and found 5 plant families that are disproportionately important, with confamilials exerting similar antibacterial mechanisms, as expected due to common ancestry. Myrtaceae (guava family) was shown to inhibit quorum sensing, disrupting bacterial communication implicated in pathogenicity, due to its flavonoids. The unrelated families Fabaceae (bean family), Lamiaceae (mints), Lauraceae (laurel), and Zingiberaceae (ginger family) possessed phytochemicals, mostly essential oils, that affected bacterial cell membrane integrity. Species in these plant families may offer unique natural products that could be developed into new antibiotics. Our study reinforces the utility of the plant phylogeny in drug discovery
Protective effect of Memantine and Bacopa Monnieri on LPS-induced SHSY5Y cells via amyloidosis, anti-inflammatory and intrinsic apoptotic pathways
Get PDFBackground:
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by the extracellular accumulation of Amyloid-β (Aβ) plaques, causing neurotoxicity and leading to neurodegeneration. Amyloid precursor protein (APP) is processed into various Aβ isoforms. It has been shown to contribute to mitochondrial dysfunction and oxidative stress, activating mitochondrial apoptotic pathways and pro-inflammatory factors and leading to neuronal cell death. Memantine (MN) and Bacopa Monnieri (BM) are postulated to have neuroprotective effects, most likely via anti-amyloidogenic and anti-apoptotic mechanisms. The in vitro models suggest a potential for further development of biologically based adjuvant therapeutics for neurodegenerative diseases. However, more precise identification of the bioactive metabolites in these extracts and their mechanisms of action in vitro is required to achieve this goal.
Objective:
The present study investigated the neuroprotective effects of Memantine (MN), an FDA-approved drug, and the Ayurvedic nootropic drug Bacopa Monnieri (BM) on the amyloid precursor protein (APP) expression and the apoptotic and inflammatory pathways in the lipopolysaccharide (LPS)-induced SHSY5Y cells toxicity. Specifically, we investigated the effect of MN and BM on the expression of APP for the anti-amyloidogenic pathway, NF-kB for the anti-inflammatory pathway, and BCL-2, cytochrome C (Cyt C), and caspase-3 for the apoptotic pathway.
Methods:
SHSY5Y cells were pretreated with varying concentrations of Memantine (0.01 μM, 0.5 μM, and 1 μM) and Bacopa Monnieri (1μg/ml,10 μg/ml, and 20 μg/ml) for 2 hours prior to lipopolysaccharide (50 μg/ml) exposure for 24 hours. Cell viability, amyloidosis, inflammation, and apoptosis in LPS-induced SHSY5Y cell death were assessed. Cell viability was analyzed by MTT assay. Anti-amyloidogenic, antiinflammation, and anti-apoptotic effects were analyzed using western blot.
Results:
The results showed that the pretreatment with MN of LPS-induced toxicity in SHSY5Y cells significantly increased cell viability and decreased APP expression, thus limiting further neurotoxicity. In parallel, the apoptotic pathway triggered by LPS was reduced, as represented by a dose-dependent increase in the expression of BCL-2, an anti-apoptotic marker, and a decrease in the expression of cytochrome C and caspase-3, as well as a decrease in the expression of the inflammatory marker NF-kB. On the other hand, pretreatment with BM also protected the cells from LPS-induced neurotoxicity by significantly increasing cell viability and decreasing APP expression. In addition, BM also prevented apoptosis by decreasing the expression of cytochrome C and caspase 3. It also prevented neuroinflammation by reducing the expression of NF-kB. Both MN and BM show anti-amyloidogenic, anti-inflammatory, and anti-apoptotic effects in LPS-exposed neuronal cells.
Conclusion:
The present study suggests that BM can be considered a potential adjuvant therapy for preventing or delaying the progression of neurodegeneration in AD
Postpartum Depression
Get PDFBackground: Postpartum depression (PPD) affects 10-20% of women in the US. It is a condition in which mothers’ experience depression during pregnancy or within 4 weeks postpartum. Numerous physiological, socio-economic, and psychological factors have been linked to postpartum depression. Mothers with postpartum depression can experience feelings of (a) extreme sadness, (b) anxiety, and (c) exhaustion that may make it difficult for them to complete activities of daily living for themselves or for others. PPD in its severest form can lead to suicide and acts of harming the newborn.
Methodology: Information was gathered using the search engines: (a) Pubmed, (b) PubMed Central, and (c) Google scholar. The terms used in the search were: (a) Postpartum Depression AND Risk Factors, (b) Postpartum Depression AND Epidemiology, (c)Postpartum Depression AND Pathophysiology, and (d) Postpartum depression treatment, specifically articles published between the years of 2013 and 2018, in English.
Results: The literature search on postpartum depression yielded information on the (a) risk factors, (b) epidemiology, (c) pathophysiology, and (d) treatment options relating to this population. Significant risk factors include: (a) women over the age of 30, (b) psychological, physical, or sexual abuse, (c) low socioeconomic status, and (d) unplanned pregnancy. PPD has also been linked to physiologic changes in new mothers including (a) altered maternal brain responses (b) hormonal fluctuations, and (c) effects on immunity. Additionally, women with (a) poor marital relationship, (b) stressful life events, and (c) poor physical health/body image have been found to be of greater risk for PPD. Signs and symptoms of PPD include: (a) mood swings, (b) suicidal thoughts, (c) thoughts of harming the newborn, (d) insomnia, and (e) feelings of helplessness. PPD prevalence varies by state and can be as high as 1 in 5 women. PPD may resolve spontaneously within weeks after its onset; however, about 20% of women will continue to have depression up to one year following delivery, and about 13% after 2 years. Approximately 40% of women will have a relapse of their symptoms with subsequent pregnancies. Within the population of those identified at risk for PPD, only about half had undergone previous screening by a clinician since the birth of the child. Screening tests found to be valid for identification of at-risk mothers include the Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire-9 (PHQ-9). Effective treatments have been found to include counseling, such as Cognitive Behavior Therapy, and antidepressant medication.
Conclusion: Without treatment, PPD can have detrimental effects on the health and welfare of the mother and child. Immediate family should be educated on the signs and symptoms of PPD. New mothers should be assisted with childcare activities and housekeeping responsibilities. Clinicians should screen and frequently follow up with patients that have established PPD. Assessments should include: (a) past psychiatric problems, (b) social stressors, and (c) biochemical changes. Treatment options include: (a) counseling, (b) group therapy, (c) hormonal therapy, (d) antidepressant medications, or (e) any combination therapy. These interventions have the potential to improve the detection and management of PPD
Pica: The Mysterious Eating Disorder
Get PDFBackground. ‘Pica’ is the Latin word for magpie, a bird that ingests inedible substances. The DSM-V defines pica as a disorder of persistent eating of nonnutritive, nonfood substances over a period of at least one month. Although pica is a disorder that affects a widespread population, it is seen as a social anomaly which prevents patients from admitting their behavior. As the behavior continues unnoticed and untreated, patients will experience the adverse effects of ingesting foreign materials. Thus, healthcare providers and family members should educate themselves on pica’s etiologies and manifestations to prevent complications and avoid unnecessary hospitalizations.
Methods. The data was obtained using the Google search engine. Search terms used were: (a) history of pica, (b) diagnosing pica, and (c) treating pica for the years 1990-2018. The DSM-V was referenced for the medical definition of pica.
Results. The few studies done on pica have drawn inconclusive data. While the percentage of the population that suffers from pica is unknown, common risk factors are: (a) nutritional deficiencies such as iron-deficiency anemia, (b) low socioeconomic status due to the inaccessibility of nutritious foods, (c) nondiscriminating oral behaviors in those with intellectual disabilities, and (d) an underlying biochemical behavior. No specific laboratory tests are indicated to evaluate pica. Providers have found success in diagnosing pica through: (a) dietary history, (b) interviewing family members, and (c) a high index of suspicion. Without verbal admittance, the only way to evaluate pica is to test for nutrient deficiencies and identify ingested materials using: (a) abdominal radiography, (b) barium enema, and (c) upper GI endoscopy. Although this disorder is seen most frequently in children and the developmentally disabled, it is also observed in pregnant women who ingest starch to quell morning sickness. Pica patients have been reported to ingest a variety of substances including, but not limited to: (a) clay, (b) dirt, (c) stones, (d) cigarette butts, and, (e) lead paint and soil. Lead poisoning affects the central nervous system and leads to irreversible neurological damage; it is also associated with decreased renal function and hypertension.
Conclusions and Recommendations. Serious complications of pica include obstruction or perforation of the gastrointestinal tract, and lead poisoning. Early detection of lead toxicity is vital to prevent systemic complications. There is no definitive management for pica but current therapies include (a) nutrient replacement, (b) behavioral therapy, and (c) dopaminergic function enhancing medications such as olanzapine. Since very little is known about pica, it would be beneficial to perform longitudinal studies to observe and educate the general public on the long-term effects of pica so they understand that this behavior is more than a habit but one with serious consequences. Pica is a condition that requires a multidisciplinary approach utilizing physicians, psychologists, and social workers and it is recommended that healthcare providers treating high-risk patients ask appropriate primary and exploratory questions during physical exams. While many may be discouraged at the lack of data on pica, it should be seen as an opportunity to promote its clinical importance through awareness and education
Pharmaceuticals from natural products: The utility of the phylogeny
Get PDFAbout 60% of approved drugs during the last 30 years are either directly or indirectly from natural products. Previous studies have shown that the phylogeny has predictive utility in drug discovery. In this study the pharmacological applications of various naturally-derived drugs were mapped on the phylogeny reconstructed from DNA sequences of the source organisms to decipher phylogenetic patterns that may facilitate drug discovery. A multi-step approach was employed starting with a literature search to compile a comprehensive list of pharmaceutical drugs derived from natural sources. A phylogeny was reconstructed from the source organisms and their pharmacological uses mapped on the phylogeny as “traits” based on the organ-system targeted, with the goal of finding clades with a predominant pharmacological application, such that a member within that clade missing such application may be hypothesized to also possess this use/“trait” due to common ancestry. Unexplored taxa belonging to six clades may be good sources of novel pharmaceuticals based on phylogenetic patterns: Kingdoms Bacteria (100%) and Fungi (67%) with many of its investigated taxa with antibiotic effects and therapeutic against infectious diseases; K. Animalia: Subphylum Vertebrata (67%)—for endocrine applications, K. Animalia: Class Ascidiacea (100%)—for oncological applications. K. Plantae: Fabids subgroup (62.5%)—nervous/ psychopharmacological uses, and K. Plantae: Solanaceae family—gastrointestinal uses (50%) as well as nervous applications (67%). These findings underscore the pharmacological utility of the phylogeny shedding light on new avenues for pharmaceutical research and innovation
Shared Screens: A Qualitative Study of Therapist Self-Disclosure Over Telehealth
Get PDFThe following qualitative study explored how psychodynamic clinicians approach and use self-disclosure with patients over telehealth platforms. There is an abundance of research on therapist self-disclosure, with discussion of this topic dating back as early as Freud (1912) and Ferenczi (1933), and since spanning the spectrum of theoretical orientation and practice. There is some literature on psychotherapy over telehealth, with a recent surge in research as a response to the COVID-19 pandemic. There is less research on psychodynamic therapy or psychoanalysis over telehealth (Wolson, 2021), and to the author’s knowledge, no research on therapist self-disclosure and telehealth. This study aimed to uncover what clinicians are actually doing on the other side of the screen and will hopefully inform future therapists working over telehealth, as teletherapy appears to be a wave of the future. For this study, 11 doctoral level clinical psychologists and psychoanalysts participated in individual interviews with the author via online video conferencing. Individual interviews were conducted to: (a) investigate whether clinicians’ use of self-disclosure changes when using telehealth, (b) explore whether telehealth creates greater opportunities for both deliberate and inevitable disclosures, and (c) better understand the way clinicians process the impact of self-disclosure. Using a grounded theory approach to qualitative research (Auerbach and Silverstein, 2003), all interviews were transcribed, coded, and analyzed to extrapolate themes and theoretical constructs, and to create a narrative. Results yielded five theoretical constructs, 12 themes, and 56 repeating ideas that combine to create the narrative. Discussion contextualizes the data using aspects of relational theory, particularly mutuality in psychoanalysis (Aron, 1996)
Guidance and Support for One-to-One Paraprofessionals: A Multiple Regression Analysis
Get PDFResearch has focused on methods to support, train, and prepare one-to-one paraprofessionals from perspectives of administrators and teachers. This quantitative study extended research by investigating perspectives of one-to-one paraprofessionals on preparation, support, communication, feedback, and involvement in planning. These variables were investigated using 20 statements on a Likert-scale survey. Demographic information of participants include age, gender, age level of student, passage of the Assessment of Teaching Assistant Skills (ATAS), years of experience in education, type of class student is in, and professional preparation were surveyed as well. A convenience sample of 50 participants responded to the survey. Pearson’s correlation coefficients were determined for each Likert-scale statement variable to measure the strength of their associations. After a strong association was determined, composite scores for each variable measuring each hypothesis were created. A multiple linear regression analysis was run for each research question. Results from these analyses created highly statistically significant models (p(F)\u3c.05). These models indicated that perceived preparation, support, communication, feedback, and planning all contribute significantly to the overall role of one-to-one paraprofessionals working in public schools in Long Island, New York. Averaged perceived support had the most influence on average perceived preparation (β=.40) and average perceived communication (β=.49) had the most positive influence on average perceived feedback. Preparation methods such as providing one-to-one paraprofessionals with a job description or establishing meeting times for those involved are small changes that can promote positive change. This information will help administrators prioritize support for one-to-one paraprofessionals working in public schools in Long Island, New York
Aggression, avoidance, shame and narcissism in fragile masculinity
Get PDFThe overwhelming representation of males in physically aggressive acts and violent crime suggests that masculinity contributes to the gender discrepancy. Fragile masculinity, a term denoting the cultural mandate and the individual’s perception that manhood is precarious, has been posited as particularly meaningful in understanding the etiology of aggression and relational avoidance in men. Empirical work suggests that there is a link among these constructs (Vandello, 2013), but the literature has not fully explored variables that may inform or impact these connections. Based on psychodynamic theories of narcissism, shame and aggression, this study aimed to empirically test their impact. Mediation and moderation analyses were conducted to better understand the role of fragile masculinity, narcissism, and shame in contributing to enactments of aggression and avoidance of relationships, and they proved to be significant. In a random sample (n = 302) of males in the United States, strong evidence demonstrated a mediating effect of narcissism, including grandiose and vulnerable narcissism as well as entitlement rage, between fragile masculinity, and trait aggression, state aggression, as well as relational avoidance. A bootstrapping procedure confirmed the significance of mediation effects. Further, half of the male participants (n = 153) listened to a shame inducing audio scenario, and the other half (n = 149) listened to a neutral scenario to determine if those who are currently experiencing state shame would endorse higher state aggression. State shame moderated the association between entitlement rage and state aggression. Results suggest that the combination of fragile masculinity with narcissism and state shame is critical to consider in prevention and treatment of aggression and relational avoidance