Health Sciences – Page 21 – UROP Spring Symposium 2021

Health Sciences

The Effects of Out-of-Pocket Payments on Emergency and Trauma Surgery Patients’ Livelihoods

Every year, 3 million US residents suffer from injuries leading to needing medical care. The trauma care system has greatly improved saving lives from the time of injury, but many patients are left with out-of-pocket (OOP) payments whether or not they had insurance coverage. We do not know what the burden of these OOP payments are, including the long term financial, mental, and physical impact. The specific aims of this study are to 1) measure the OOP payments for patients who had an emergency surgical procedure, 2) quantify whether these OOP payments change on average by the type of insurance a patient has (private, Medicaid, Medicare, uninsured), and 3) understand the hardship caused by OOP payments for these emergency surgical procedures on the patient and their family. This study reports the findings from in-depth qualitative interviews of 30 patients =18 years of age sustaining a traumatic injury requiring treatment at the University of Michigan Hospital trauma center. We expect our mixed-methods analysis to elucidate the downstream effects of large OOP payments not otherwise able to be captured in available databases. Our findings will be one of the first to describe the long-term burden of trauma care and estimate the out-of-pocket payments trauma patients face from patient-level data.

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The Effects of Out-of-Pocket Payments on Emergency and Trauma Surgery Patients’ Livelihoods

Every year, 3 million US residents suffer from injuries leading to needing medical care. The trauma care system has greatly improved saving lives from the time of injury, but many patients are left with out-of-pocket (OOP) payments whether or not they had insurance coverage. We do not know what the burden of these OOP payments are, including the long term financial, mental, and physical impact. The specific aims of this study are to 1) measure the OOP payments for patients who had an emergency surgical procedure, 2) quantify whether these OOP payments change on average by the type of insurance a patient has (private, Medicaid, Medicare, uninsured), and 3) understand the hardship caused by OOP payments for these emergency surgical procedures on the patient and their family. This study reports the findings from in-depth qualitative interviews of 30 patients =18 years of age sustaining a traumatic injury requiring treatment at the University of Michigan Hospital trauma center. We expect our mixed-methods analysis to elucidate the downstream effects of large OOP payments not otherwise able to be captured in available databases. Our findings will be one of the first to describe the long-term burden of trauma care and estimate the out-of-pocket payments trauma patients face from patient-level data.

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The Relationship between COVID-19 Racial Discrimination and Mental Health among Asian Americans

Racism and discrimination is a persisting dilemma that has affected people of color in the United States on many levels, including employment, housing, and health. Specifically, there is multiple evidence that indicates cultural racism (including stereotyping) connected to an increased prevalence of mental health concerns and poor overall wellness. Since the beginning of the COVID-19 pandemic, there has been an influx of anti-Asian racism and violence towards Asian American populations. In addition to the implicit and explicit bias that Asian populations have been facing prior to the COVID-19 pandemic, this current anti-Asian sentiment has the potential to have a toll on their mental and physical health. This research project explores the relationships between encountered racism during the COVID-19 pandemic and mental state among Asian American populations. The method used in this study is a quantitative survey; data collected were based on online survey questions that include demographics, experiences related to racism and/or discrimination after the start of the COVID-19 outbreak, mental state, and actions taken as results of racism experiences. The results and conclusion of the survey are yet to be reviewed and determined. I expect to identify an association between negative COVID-19 racism encounters/heightened fear for one’s safety and worsened mental health. With these results, we can address the need for prevention and intervention strategies to eliminate acts of racism/discrimination and to provide safe and comfortable environments for Asian Americans.

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Vision Zero implementation and how to improve its effectiveness in underserved communities

The Center for Health Disparities Innovation and Studies (CHDIS) team at EMU has begun working with the city of Hamtramck, a predominately ethnic and minority city on the outskirts of Detroit, in a mission to address public health deficiencies and disparities in underserved communities through policy change, community outreach/education, and general health promotion.  A core part of their proposal to the city is the implementation of a Vision Zero (VZ) strategy to combat the growing numbers of traffic accidents that has disproportionately affected the pedestrians/civilians of Hamtramck. VZ requires a complete overhaul on the relationship shared between road/transportation infrastructure and pedestrians/.

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Computational design of Raf-based protein binders to inhibit mutant Ras-Raf interactions

Designing proteins in an attempt to create treatments for illnesses is a cutting-edge area of research and has limitless possibilities in the field of medicine. One particular area of illness that could benefit from the protein design is cancer. Cancer occurs when there is a mutation in the genetic sequence that codes for a protein and, when produced by a cell, this mutated protein behaves abnormally in the form of loss of function, a gain of a new function, or hyperactivity. One of the leading ideas for treating cancer is the specific targeting of misbehaving proteins in an attempt to eliminate or correct their behavior. To accomplish this, new programs need to be developed to predict and design the structure of a folded protein and isolate protein-protein interactions that can be used to target the protein in question. This research project uses newly developed prediction programs, EvoDesign and EvoEF2, to design the novel structure of one of the proteins in a protein-protein interaction relevant to cancer and found in nature. The programs aim to accomplish this using energy functions and evolutionary patterns. For this study, an analysis was done on an oncogenic Ras mutant, and novel interacting partner protein sequences based on the native Raf scaffold were designed using EvoEF2. The designed protein partners were then compared to the native one. The analysis showed that the designed partners of this study had greater binding affinities for the mutant Ras sequence than the native partner did, and all protein-protein interactions with the designed partners were more energetically favorable than the native protein-protein interactions. Wet lab testing would be required to test the feasibility and binding of some of the best (most favorable) designs.

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Identification of Cell Types in scRNA-seq Data Using Machine Learning Algorithm

Adam Tisch Research Mentor(s): Fadhl Alakwaa, Research investigator Research Mentor School/College/Department: Neurology Department, Michigan Medicine Presentation Date: Thursday, April 22, 2021 Session: Session 2 (11am – 11:50am) Breakout Room: Room 17 Presenter: 4 Event Link Abstract For privacy concerns this abstract cannot be published at this time. Authors: Adam Tisch, Fadhl Alakwaa, Stephen Blough Research

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Identification of Cell Types in scRNA-seq Using Machine Learning Algorithms

Stephen Blough Research Mentor(s): Fadhl Alakwaa, Research investigator Research Mentor School/College/Department: Neurology Department, Michigan Medicine Presentation Date: Thursday, April 22, 2021 Session: Session 2 (11am – 11:50am) Breakout Room: Room 17 Presenter: 4 Event Link Abstract For privacy concerns this abstract cannot be published at this time. Authors: Fadhl Alakwaa, Adam Tisch, Stephen Blough Research

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Understanding the Social Determinants of Health in Medical and Surgical Care

Although the term social determinants of health (SDOH) has been in the social science literature for several years now, SDOH are a relatively new concept in the field of medicine, and more specifically, in surgery. Researchers are just beginning to develop an understanding on how SDOH applies to surgical patients. This literature review aggregates known research on what has already been published on SDOH in surgical care by way of a systematic literature review. Multiple peer-reviewed journal aggregation sites, including PubMed, were used to gather our results. We are currently solidifying our search terms and will be embarking on the systematic literature review process. Finalizing our search terms has provided our team valuable information on how to better narrow our research question, but also it has allowed us to be thoughtful in methods and structure. As a literature review of this type has not been published prior, it is critical that the finalized search terms capture the pertinent articles discussing SDOH within surgical care. By better understanding how SDOH impacts surgical patients, clinicians and policy makers will have more tools in their toolbox to improve patient outcomes to those most affected.

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The effects of Covid-19 on essential workers’ mental health

The topic of my research is to examine symptoms of anxiety and depression in participants from The Study of Adolescent to Adult Neural Development (SAND) during Covid-19. My research question is has mental health deteriorated among SAND participants since the start of Covid-19, and if so for what groups (ex. groups that have previously exhibited symptoms for depression)? For my UROP research project, I compared the mean depression scores from the Beck Depression Inventory II (BDI) for young adults and primary caregivers (PCGs) during the Covid-19 pandemic. In the UROP research project, I examined the depression scores of young adults and PCGs that are categorized as essential workers and comparing them to the depression scores of non-essential workers. In this context, an essential worker’s job is defined as first line work such as grocery store workers or nurses. The hypothesis I tested was whether among employed young adults and PCGs, young adults and PCGs who are essential workers will have worse symptoms for depression (which means a higher score on the BDI scale). This question aims to test whether this hypothesis is true in the context of the SAND study.

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MyVoice- Examining the Relationship between Youth Health and spending time in Nature

Purpose: Both physical and mental health issues among youth have been on the rise, yet there still is a challenge in how to combat this growing problem that is damaging the overall health of the younger generation. Methods: In order to get youth’s perspectives, the MyVoice team fielded a series of 4 open ended text message questions designed to gauge the opinions of the youth (ages 14-24) on the impact of nature on their health. Once the data was collected, it was coded and frequency of codes were summarized. Results: From this, it was found that 51.6% of youth stated that being in nature helped them feel at peace or more calm (“I always feel calm when I am in nature”) while 22.1% stated that it improved their mental state by calming their anxieties or stress (“It reduces my anxiety”); however, the data also showed that over 20% of youth claimed that they were unable to spend as much time in nature due to other engagements that limited their ability to go into nature as much as they would have liked (“My busy schedule doesn’t allow me.”) Overall, the youth polled agreed that being in nature improved both their physical and mental health. Conclusion: Using this information, policy makers can help youth spend more time in nature by promoting accessible and safe outside areas for recreation.

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