Poster Day 2025: Abstracts: Population Health

David Brown, OMS-II; Michael Dever, OMS-II; Alicia Lai, OMS-II; James Larson, OMS-II; Koushik Murali, OMS-II; Emmalee Stephens, OMS-II; Laney Van Lenten, OMS-II   

Hemorrhagic shock is a cause of preventable death in pediatric trauma, and early resuscitation is critical for improving outcomes. While prehospital blood product administration has become more common in adult trauma care, its use in pediatric patients remains less standardized and inconsistent across states. Current prehospital protocols for pediatric transfusion vary markedly by state, and evidence comparing the outcomes of whole or component blood product therapy administration versus crystalloid in this population is limited. This review analyzes the prehospital administration of whole blood or component blood products in pediatric trauma patients in comparison to the administration of crystalloid and the resuscitation outcomes of these methods. This research was conducted through a literature review of articles on PubMed, JAMA Network, and Google Scholar. Searches within our selected databases included the terms “pediatric trauma,” “prehospital transfusion,” “prehospital blood administration,” “child hemorrhage,” and “blood product versus crystalloid”. Papers selected were either a retrospective propensity matched cohort, multicenter observational cohort, or expert consensus investigation. The participants in the majority of these papers were pediatric trauma patients between the ages of 0-17 years old, although two of the papers studied adult trauma patients as well. These papers found that the use of early, prehospital blood improved overall outcomes (reduced time spent in hospital, reduced ventilation, and reduced mortality) compared to using crystalloid products. Studies demonstrated that children receiving early whole blood had improved hemostatic stability, shorter ICU stays and decreased mortality. Across nearly all studies, early use of whole blood or balanced component therapy with a 1:1 ratio of PRBC to FFP was associated with better 6 and 24 hour survival. The studies also showed excessive crystalloid resuscitation was linked to worse outcomes, including dilutional coagulopathy, acidosis, and prolonged ICU stays. Within this literature review, the research indicates that whole blood products are more beneficial than crystalloid based fluids in improving patient outcomes, specifically regarding patient survival rates and hospital stay length. These improved outcomes did not change whether it was an adult or pediatric patient. The available research is limited by the fact that a large swath covers only adult patients rather than pediatric patients. Future studies should be aimed at evaluating pediatric outcomes and in the comparison of outcomes between different blood products. Further evaluation of blood product administration will help to identify the best protocol in prehospital trauma victims.

Andrea Gathercole, MS, OMS-II, Amber Nguyen, MS, OMS-II, Maria Pencu, OMS-II, Elizabeth Smith, OMS-II, Joshua Thomas, OMS-II, Thomas Wagner, OMS-II

The use of DDT, a synthetic organic insecticide used for agriculture and disease control, was banned in the 1970’s after discovering carcinogenic potential and deleterious effects on the central nervous system. In recent years, the use of organophosphates has been suggested to cause similar central nervous system damage upon direct or prolonged exposure. Alzheimer’s disease has increased in prevalence due to multiple factors such as an aging population and enhanced diagnostic practices. Given the ubiquitous use of organophosphate pesticides in agriculture and the rise in Alzheimer’s, this review investigated correlations between pesticides and Alzheimer's disease in the medical literature and suggest a possible mechanism for the rise in neurodegenerative disorders in the United States.

Due to the increasing prevalence of Alzheimer’s disease, it is crucial to determine if there is a correlation between pesticide use and disease incidence. A variety of different research publications assessed pesticide exposure and what role it plays in the development of Alzheimer's disease. This project tried to determine the degree of the relationship between exposure to different types of pesticides, methods of pesticide exposure, and length of pesticide exposure plays a role in the development of Alzheimer’s disease or declining cognitive function, as measured by a variety of different cognitive tests such as Mini Mental Status Exam and CERAD World Learning & Delayed Recall Test. The use of pesticides has been shown to have deleterious effects on the environment and human health.

Literature searches using the keywords “pesticides’ and “Alzheimer’s disease” were conducted using PubMed to identify peer reviewed journal articles that fulfilled the inclusion criteria. The participant population included patients with Alzheimer's disease compared to those without Alzheimer's disease. The intervention examined was pesticide exposure. The outcomes measured were rates of Alzheimer's disease and pesticide exposure. These parameters were used to create inclusion criteria for studies in this literature review. The inclusion criteria for studies included measuring or quantifying pesticide exposure and Alzheimer's disease rates. Results were filtered and selected by reading titles and abstracts and evaluating whether they were relevant based on the inclusion criteria.

A comprehensive analysis of the sources suggests that prolonged exposure to pesticides may have a significant correlation with early onset Alzheimer's as well as decreased cognitive function. While some studies did not find a statistically significant correlation between degree of pesticide exposure and the rate of Alzheimer’s disease, all studies found a clear link between exposure and decreased cognitive function. More research must be done in this area to determine a more conclusive relationship between pesticide exposure and declining neurocognitive functioning.

The findings indicate correlation between pesticide exposure and Alzheimer's disease, but the observational nature of the studies means that a causative link cannot be definitively established at this time. As such, further investigations should be conducted into the specific causative agents within pesticides that contribute to the development of neurocognitive diseases, the mechanism by which pesticides contribute to Alzheimer's disease development, and geographical differences in pesticide exposure and Alzheimer's disease. The scope of these deleterious effects of organophosphates are not limited to Alzheimer's disease. Additionally, further research should be conducted to determine if there are any significant correlations between pesticide use and other neurodegenerative diseases aside from central nervous system disease, such as any peripheral nervous system degeneration involvement.

Austin Brookshire OMS II, Gabriella Garas OMS II, Martha Lopez OMS II, Nolan Kaleel OMS II, Stephanie Consuegra OMS II, Walter Johnson OMS II

Background:

Mental health disorders among pediatric populations are a growing public health concern, especially within the underserved/rural communities. Local physicians not receiving the formal mental health treatment training, communities lacking resources for these treatments, and a decrease in perceived need for mental health treatment are all such catalysts that could lead to increased hospitalizations and complications for these pediatric populations. This study design was aimed at examining if pharmacologic or psychotherapeutic treatments led to quicker improvement of mental health symptoms in pediatric patients living in underserved/rural communities. The literature review examined different studies regarding pediatric mental health care, pharmacological and psychotherapeutic treatments, and disparities across underserved/rural populations.

Methods:

A comprehensive literature search was conducted using two primary databases: PubMed and ScienceDirect. For example, the National Health Interview Survey in 2019 provided data that was empirically studied and reported by the National Center for Health Statistics regarding children and their course of mental health treatments. The search strategy involved the use of keywords such as “pediatric”, “underserved”, “children”, “mental health”, “psychiatric disorder”, “pharmacological” “psychotherapy” and “interventions”. Difficulty showed up in two opposing ways. Searching with the keyword “psychiatric disorders” provided countless unnecessary studies. A specific disorder (ADHD, depression, anxiety, ect.) was used to narrow down the search. On the other hand, searching with the keyword “rural” provided sparse studies. Adding “underserved” and using national trend studies helped increase the amount of studies available.

Results:

According to the National Health Interview Survey in 2019, male children were treated more often than female children, White children were treated more than Black and Hispanic children, and rural populations had higher rates of psychotherapeutic medication dispensing when compared to urbanized populations. This was in contrast to the following years, during the COVID-19 pandemic, when psychotropic medication prescriptions declined for pediatric patients. Interestingly, antidepressant prescriptions increased among adolescents during this same time frame, and have since continued to increase, especially amongst adolescent females. The Primary Care Mental Health Integration Program showed improvement to pediatric outcomes by combining primary care with specialty mental health services. In Kansas, the KSKidsMAP consultation hotline allowed rural primary care physicians (PCPs) access to expert opinion for treatment management. From this hotline, it was found that these PCPs lacked the training and/or knowledge to adequately and confidently treat pediatric mental health disorders. Pediatric patients in rural areas also reported a lesser amount of mental health needs being met within their communities, potentially due to a low perceived need for mental health treatment. In conjunction, rural hospitals, when compared to children’s hospitals or metropolitan non-children’s hospitals, had shorter lengths of stay for pediatric mental health crises but also had a higher risk of increased readmission rates.

Conclusion:

While existing literature addresses aspects of treatment access and intervention types, the comprehensive search revealed that no single study addressed the research question in its entirety. The studies emphasized how treatment accessibility and provider accessibility impacted mental health care across different populations. There remains a clear knowledge gap regarding how quickly children improve with pharmacological or psychotherapeutic care and how the outcomes differ for children belonging to underserved/rural communities. Future studies should focus on treatment type and symptom resolution with attention to the pediatric populations in underserved/rural communities.

Faraz Ahmed OMS-II, Joseph Budisak OMS-II, Amanda Geary OMS-II, Ruby Jewell OMS-II, John McCarus OMS-II, Mahathi Mula OMS-II, Skylar Nollenberger OMS-II

Abstract:

In the digital age, access to online resources and other digital media has vastly increased, making the dispersion of health resources to rural populations more feasible. The purpose of the current study was to identify the efficacy of digital health promotion media on overall community health outcomes in areas that were not previously receiving health promotion.

Using various peer-reviewed databases, academic journals were identified that examined the use of different online platforms and media delivery methods and their effect on a specific aspect of population health. Using recent studies from within the last ten years, various health behaviors such as health screening habits, health literacy, and interaction with health promotion materials were measured before and after the distribution of health promotion media.

The main form of media distributed was in the form of videos, as these can be easily accessed across almost all social media platforms, as well as in the form of DVDs, and they provide concise and engaging health promotion that can be easily understood by a wide range of age groups. Targeting various technological use demographics was achieved by implementing social media campaigns and creating YouTube videos, which generally reach an audience already accustomed to technology use, as well as distributing DVDs, which targeted groups who were new to technology.

The overall population health behaviors were then compared between communities that had access to health promotion media and those that did not to gauge the efficacy of transforming health habits in a community and improving overall population health. The keywords included health promotion videos; rural population; health literacy intervention; public health campaign; impact of health literacy video. The inclusion criteria included adolescents; elderly; low-income; rural population; video media; understanding healthcare; lower costs; accessibility; instructional content; English language; measured outcome. The exclusion criteria included purely entertainment reasons without educational intent; lack of health literacy focus; not English language; advertisements without public health relevance; and do not provide any quantifiable or qualitative-based outcomes.

The present research found that health promotion videos are an effective and accessible way to encourage healthier lifestyles. Establishing that videos engage viewers, promote active learning, and reach a broader audience more so than traditional printed materials. The use of video-based interventions was associated with improvements in health behaviors, medication adherence, and health literacy. While some outcomes varied depending on the population and topic, the overall trend showed positive behavioral changes and improved awareness of healthy practices. The video-based approach is especially valuable in regions with limited access to healthcare resources. In Southwest Alabama, where chronic diseases such as diabetes and heart disease are prevalent, health education videos could play an important role in improving prevention, self-management, and long-term health outcomes. The use of utilization of promotional videos is an effective tool to improve health literacy and health outcomes, particularly in low-resource regions.

Health promotion videos are engaging, cost-effective, and accessible sources of valuable health information. While the overall findings from the current review strongly concluded that the utilization of health promotion videos is an effective tool, there are a few limitations that must be included. First, much of the data was self-reported, which may limit standardization. Additionally, variations in the quality of the videos and data included may have varied across studies. Future directions for the current research would include developing standardized frameworks to better evaluate the use of videos and their effect on long-term health behavior modification. Collaboration with local health departments or public health organizations would be a great way to reach a wider audience and create greater change.

Breanne Wolfenbarger MS. OMS II, Jacob Gray OMS II, Nathan Oseen OMS II, Raheem Memon MS. OMS II, Jayden Ojah-Maharaj OMS II, Vivian Lerner MS. OMS II

Abstract:

Heart disease is the leading cause of death in the US, and as new emerging evidence is showing that oral health specifically - periodontal disease- may play a significant role in cardiovascular risk. Chronic inflammation and infection within the oral cavity is linked with vascular dysfunction and atherosclerosis- which puts patients at an increase of cardiac events. With this understanding, access to affordable dental care remains limited for many Americans. The following review examines the evidence of periodontal disease and cardiovascular disease, with a focus on access to health care and its potential impact on cardiovascular outcomes. This review looks at male and female adults in the United States. Data specific to dental care access and cardiovascular disease rates were retrieved from a public census focusing on the country’s south eastern region. Secondary data was also used for this research project, with a focus on the United States adult population as well.

The search strategy consisted of utilizing keyword searches that helped better understand the relationship between access to dental and reducing the risk of cardiovascular disease and what possible factors (cost of dental care, insurance availability, and medical spending) to the relationship being investigated. Some keywords used were “cardiovascular disease”, “dental access”, “dental insurance”, “dental hygiene" and "Periodontal disease”. There were some exclusions used to help narrow down the scope. To find articles that better suited the research questions there were excluded searches that included familial heart disease and included only periodontal health, access to dental care, and cardiovascular health. Data for the preliminary comprehensive literature review was sourced from PolicyMap, focusing on national-level statistics and information related to dental health and cardiovascular outcomes. Research was gathered from two key academic databases, Google Scholar and PubMed, using targeted search terms such as “dental disease + cardiovascular disease,” “periodontal disease+ cardiovascular health”, “oral hygiene + heart failure,” and “oral health + cardiovascular health.” Other reputable sources of studies include the Journal of the American Dental Association, the Journal of the American Heart Association, and the American Journal of Cardiology. Sources were selected to provide insights into the relationship between dental health status and cardiovascular disease in both pediatric and adult populations.

Strong evidence links oral health to cardiovascular outcomes. Recent studies show that regular dental visits are associated with lower blood pressure, and periodontal therapy can reduce LDL and HbA1c levels—major cardiovascular risk factors. A systematic review of 82 studies and NHANES data found a positive association between poor oral health and cardiovascular disease. Despite policy efforts, cost remains the main barrier to dental care, especially among uninsured and low-income adults, contributing to widespread periodontal disease. PolicyMap data from 2022 revealed that southeastern U.S. regions with fewer dental visits had higher rates of coronary heart disease, underscoring the importance of access to dental care. Overall, oral health strongly correlates with cardiovascular risk. Addressing financial barriers to dental care through coordinated efforts among policymakers, dentists, and physicians could help reduce CVD burden.

Further longitudinal research should control for confounders like socioeconomic status, education, and smoking. Additional longitudinal studies are needed to control for confounding variables such as socioeconomic status and education levels, as well as shared risk factors for both CVD and periodontitis, such as smoking.

Abeer Saeddin MS OMS II, Alexis Cochran OMS II, Olufemi O'niyi OMS II, Ryan Patipa OMS II, Thomas Owens OMS II, Yasemin Fidan OMS II

Abstract:

Antimicrobial resistance (AMR) has become a critical public health concern worldwide, with a profound impact on morbidity, mortality, and healthcare costs. This issue disproportionately affects low-income communities and racial minorities, who experience higher rates of antibiotic misuse and limited healthcare access. As conventional antibiotics lose effectiveness against multidrug-resistant organisms, there is an urgent need to explore and evaluate other successful alternative therapies. This study investigates the effectiveness and challenges of non-antibiotic antibacterial alternatives including bacteriophages, antimicrobial peptides, and monoclonal antibodies while also examining the relationship between socioeconomic factors and AMR prevalence in the state of Alabama.

A structured literature review was conducted using the PICO framework. The reviewed articles were identified through PubMed, utilizing keywords such as “antimicrobial-resistant bacteria,” “antibiotic alternatives,” “bacteriophages,” “peptides,” and “monoclonal antibodies.” Articles were selected if they directly compared the inhibition of resistant bacterial species by traditional antibiotics and non-antibiotic alternatives. The review focused on known drug-resistant bacterial species, such as Clostridioides difficile, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa. To assess correlations between demographic factors and AMR, socioeconomic data for Alabama, including estimated per capita income and hospital locations, were obtained from PolicyMap. Metrics included reduction in bacterial growth, disruption of resistance mechanisms such as efflux pump activity and biofilm formation, and successful eradication of bacterial colonies.

The findings demonstrated that AMR rates are higher in low-income groups and minority populations, largely as a result of the increased antibiotic misuse and the lack of available healthcare resources. Non-antibiotic alternatives have shown promise in laboratory settings. For example, bacteriophage therapy effectively eliminated resistant pathogens, disrupted biofilm formation, and reduced overall bacterial loads. Moreover, antimicrobial peptides, particularly when combined with antibiotics, improved bacterial killing and mitigated resistance mechanisms such as efflux pumps and biofilms, as seen in Klebsiella pneumoniae. Also, monoclonal antibodies that target bacterial virulence factors accelerated pathogen clearance, which was especially beneficial in immunocompromised patients. Studies also revealed that combining alternative therapies with standard antibiotics could further reduce bacterial viability and lower the minimum inhibitory concentrations (MICs) needed for effective treatment. Despite these promising results, significant issues remain. Challenges with stabilizing and producing phages at scale, limited evidence from clinical trials, and ongoing concerns about the potential for bacteria to develop resistance to these new modalities are all pressing issues in current research. 

Overall, this research highlights the need for a dual approach to address antimicrobial resistance. This includes developing innovative non-antibiotic therapies and prioritizing targeted public health interventions in high-risk communities. Alternatives mentioned above, such as bacteriophages, antimicrobial peptides, and monoclonal antibodies, have shown significant potential. However, further research is required to ensure their safety, efficacy, and practical application in clinical care. Overcoming socioeconomic disparities is essential as well, as they remain a driving force behind AMR. Integrating scientific advances in antibacterial therapy with equitable healthcare strategies, such as improving access, education, and resource distribution, can effectively reduce the burden of antimicrobial resistance and protect vulnerable populations. Furthermore, continued investments in research, clinical trials, and public health infrastructures will be crucial for realizing the potential of these emerging therapies.

Alis Mullen OMS-II, Tyler Martin OMS-II, Melissa Fadini OMS-II, Madelyn Debski OMS-II, Tarun Cherukuri OMS-II, and Naheed Wallizada OMS-II

Background:

Gestational diabetes mellitus continues to be a growing global health issue that affects millions of pregnancies every year. The condition not only increases the risk of complications during pregnancy and childbirth but also contributes to long term health problems for both the mother and child. With rising rates of obesity, sedentary lifestyles, and limited access to prenatal care in many parts of the United States and even the world, the burden of gestational diabetes mellitus and complicating comorbidities gestational diabetes mellitus continues to increase across both developed and developing countries. The current review aimed to explore lifestyle modifications such as diet and exercise using both maternal and neonatal outcomes as indicators. The current research also examined how social determinants of health influence maternal and neonatal outcomes, highlighting the need for community and policy-level support to improve health equity.

Design:

Data was gathered through PubMed and Policy Map databases utilizing the ACOM library access portal. To ensure timely information was gathered, only studies that were published between 2011 and 2024 were included in the review. The key terms first utilized were gestational diabetes mellitus, pregnancy, and lifestyle interventions. The review of articles was then narrowed using the terms of diet, exercise, pharmacological management, and maternal outcomes. The articles selected for further review included randomized control trials, systematic reviews, and meta-analyses that measured outcomes related to glycemic control, maternal complications and neonatal health. Journals referenced include Frontiers in Global Women’s Health, Diabetes Care, Communications Medicine, Nutrients, Journal of Diabetes and its Complications, Journal of the ASEAN Federation of Endocrine Sciences, and Pregnancy Hypertension. Policy Map further provided data with the additional context on how geographic and socioeconomic differences influence access to maternity care and essential health services. The Policy Map search conducted utilized data from both the Health Resources and Services Administration and the Centers for Disease Control to depict maternity care target areas.

Results:

The current review found that dietary and lifestyle modifications effectively improved outcomes of mothers and their newborns, reducing instances of gestational diabetes mellitus. While these modifications were found to have favorable outcomes, medications were noted to still be required for more severe cases. One of the most important insights from the current review is that effective gestational diabetes mellitus prevention and management extend far beyond clinical interventions. Social determinants of health, including socioeconomic status, education level, access to nutritious food, reliable transportation, and quality healthcare, play a powerful role in shaping maternal and neonatal outcomes. Women that are living in areas with food insecurity or limited healthcare resources face major healthcare resources face major barriers to maintaining health diets, following exercise regimens, and adhering to medical care. In contrast, access to community-based support systems and educational resources was strongly associated with better adherence to treatment plans and improved outcomes.

Conclusion:

To effectively address extant and also prevent potential gestational diabetes, implementing integrated health education, long-term sustainable dietary modifications, and involvement in exercise programs must be supplemented with local and federal community and policy efforts that address all of the social determinants of health, such as food deserts, healthcare provision areas, and the overall quality of social services plus efforts to address unequal access to the same. Potential future research avenues include focusing on the specific effects of dietary guidelines and the systemic impact of COVID-19 on healthcare for at-risk mothers, thereby furthering efforts toward health equity.

Michelle Volis OMS-II, Noah Gawthorp OMS-II, David Boose OMS-II, Huda Faiz OMS-II, Jimmy Fung OMS-II, Roshni Patel OMS-II

Low-income adults face disproportionate rates of metabolic dysfunction due to limited access to affordable, nutritious foods and greater reliance on ultra-processed options. Federal nutrition assistance programs, such as the Supplemental Nutrition Assistance Program (SNAP), help alleviate food insecurity by improving caloric adequacy but do not directly address dietary quality. As a result, participants often continue to consume diets high in ultra-processed foods, contributing to increased risk for obesity, diabetes, and hypertension. Evidence from emerging “food-as-medicine” and produce-prescription programs suggests that targeted subsidies for fresh produce can improve diet quality and cardiometabolic outcomes. This study aims to bridge clinical outcomes of metabolism with the social determinants of health by evaluating how access to subsidized healthy food programs impacts metabolic function. This investigation compares subsidized versus non-subsidized diets to determine effects on metabolic markers of chronic disease in low-income adults with metabolic syndrome over a 6–12-month period.

A comprehensive literature review was conducted to examine whether subsidized, healthy food programs led to improved metabolic outcomes in low-income adults suffering from metabolic dysfunctions. Using PubMed, ClinicalKey, and ScienceDirect, keywords such as ‘ultra-processed foods (UPFs),’ ‘food insecurity,’ ‘subsidized food programs,’ and ‘farmers’ markets’ were included to address the research question. PolicyMap data were extracted via the USDA Food Access Research Atlas to uncover links between chronic health conditions and the limited access to healthy foods geographically. Inclusion criteria consisted of empirical studies within the U.S. pertaining to low-income adults with metabolic dysfunctions that reported pre- and post-intervention outcomes with respect to metabolism. These interventions included fresh fruit and vegetable prescription programs, subsidized foods, and ‘food as medicine’ initiatives by providing vouchers and/or produce allotments, and some treatments were combined with education in nutrition. Experimental groups included individuals receiving food subsidies and were compared with those not receiving these interventions. Overall outcomes included HbA1c, fasting glucose, blood pressure, triglycerides, BMI, and quality of diet. 

This research demonstrated that incorporating EBT and subsidized healthy food programs aimed at increasing fruit and vegetable access in low-income communities effectively lowered cardiometabolic risk factors, including HbA1c, fasting glucose, waist circumference, BMI, and blood pressure. Programs offering vouchers at farmers’ markets or specific produce allotments led to greater fruit and vegetable consumption than general EBT initiatives. The observed improvements in these cardiometabolic parameters highlight the role of EBT and similar programs in enhancing diet quality and reducing risks such as hypertension, hyperlipidemia, diabetes, and obesity; ultimately decreasing the prevalence of metabolic syndrome among low-income adults. Overall, these findings underscore the potential benefits of expanding subsidized healthy food programs and improving access to fresh, high-quality foods in low-income communities.

Subsidized healthy food programs appear to improve metabolic outcomes such as HbA1c, blood pressure, and BMI among low-income adults with metabolic dysfunction. Findings support integrating produce prescription models into SNAP or Medicaid preventive health frameworks to reduce cardiometabolic burden and advance nutrition security. However, while short-term benefits are reported, the long-term sustainability of these programs remains uncertain. Future research should focus on standardizing subsidy amounts, extending durations, and assessing the cost-effectiveness. These efforts could enhance public health outcomes by addressing both food insecurity and the physiological factors that contribute to metabolic syndrome. 

Coleman Gatlin, OMS-II, Nader Kamel, OMS-II, Emilee Middleton, OMS-II, Rayauna Nolan, OMS-II, Ian Perdue, OMS-II, Miller Roberts, OMS-II, Calyne Sayoc, OMS-II, Alexandra Schneiderhahn​, OMS-II

Type 2 diabetes and prediabetes are an increasingly prevalent chronic metabolic condition characterized by an inability to effectively use insulin. These conditions are an independent risk factor for multiple comorbidities, including stroke, kidney disease, and heart disease, which means that effective identification, management, and prevention are critical to improve health outcomes. Within the United States, medically underserved areas with limited access to preventive care - also known as healthcare deserts - have higher rates of type 2 diabetes. These areas often experience systemic barriers to healthcare access, nutritional education, and preventive screenings, all of which contribute to accelerated disease progression. As such, finding low-cost, sustainable, and efficacious interventions is critical for the management of these conditions to prevent long-term adverse effects. One management to be considered is nutritional counseling for both diabetic and prediabetic patients to help prevent the development of complications from type 2 diabetes. The goal of this literature review was to determine if providing patients with dietary information through nutritional counselling has a long-term impact on their progression toward developing chronic medical conditions. \

The information and findings utilized were obtained through the use of database searches in PubMed and Google Scholar to find relevant journal articles pertaining to the impact of nutritional education and nutritional counseling on nutritional and lifestyle factors. The studies evaluated varying factors correlated with diabetes risk, including HbA1c levels, BMI, lipid levels, fasting blood glucose, and blood pressure. PolicyMap was also utilized to create an overview of geographic prevalence of diabetes risk and areas with reduced access to medical care.

Across all articles, there was a consistent trend that nutritional counseling was effective in reducing both HbA1c levels and diabetes progression rates in patients. Lifestyle modifications, including the incorporation of exercise three or more times per week, also yielded a significant reduction in HbA1c levels - often comparable to diabetic pharmacological intervention. Additionally, combined lifestyle modifications and pharmacological intervention (in the form of Metformin) had a cumulative synergistic effect in terms of glycemic and metabolic risk factor control.

In adults with prediabetes, medical nutrition therapy provided by a dietitian resulted in significant improvements in glycemic control, with meta-analysis showing reductions in HbA1c and fasting blood glucose compared to standard care (Parajuli et al., 2022). Additional benefits included statistically significant reductions in weight, body mass index, waist circumference, total cholesterol, LDL, HDL, and both systolic and diastolic blood pressure. Nutritional counseling was also shown to lead patients to have better dietary adherence, enhanced self-efficacy, and higher patient satisfaction.

Some barriers discovered to this treatment plan included a lack of trained dietitians, high program costs, and inconsistent insurance reimbursement. Additionally, there were barriers to access, follow-up, and program adherence. These barriers are most pronounced in underserved geographic areas - underscoring a structural gap in equitable prevention strategies. Long-term outcomes across the literature suggest that the success of nutritional counseling depends on program intensity, cultural adaptation, and the presence of follow-up reinforcement.

Community-based and telehealth platforms have demonstrated promise in sustaining lifestyle changes, particularly when paired with technology-driven self-monitoring and personalized feedback. Overall, it can be seen that nutritional counseling has a significant long-term impact on reducing the risk of progression to chronic medical conditions such as type 2 diabetes. As such, nutritional counseling should be incorporated into the routine care of prediabetic and diabetic patients as a low-cost, sustainable, and efficacious part of their health plan.

Kaitlyn Bateh, OMS-II; Stefania Cardenas, OMS-II; Harrison Labanowski, OMS-II; John Mcteague, OMS-II; Alexander Peterson, OMS-II; Sydney Saunders, OMS-II; Milin Vira, OMS-II; Reshma Zehra, OMS-II

Type 2 Diabetes is a significant morbidity affecting many patients in the United States. Increased glycemic control within diabetics is key to preventing disease progression and secondary comorbidities.

Mobile health systems such as mHealth telemonitoring programs include virtual primary care and specialists consultations, continuous monitoring, and integrated digital platforms that may be customized to the patient’s needs, are fundamentally transforming Type 2 Diabetes Mellitus management, as demonstrated by consistent empirical evidence.

To determine the main research question for this study, the population, intervention, comparison, outcome (PICO) method was utilized. The population encompassed adults over the age of 18 years old diagnosed with Type 2 Diabetes Mellitus. The intervention was defined as telehealth intervention through online monitoring, coaching, advising, and support. The target population was compared with populations receiving traditional in-office monitoring. Lastly, the potential outcomes included improved compliance of Type 2 Diabetes management and therefore clinical outcomes as evidenced by clinical markers. The final research question for this study was the following: In adults over the age of 18 years old diagnosed with Type 2 Diabetes Mellitus, does telehealth intervention via online monitoring, coaching, advising, and support, compared to traditional in-office monitoring, improve patient compliance and overall clinical outcomes as evidenced by clinical markers?

Literature studies were collected from PubMed and the Journal of Medical Internet Research to investigate if telehealth monitoring improved patient compliance and clinical outcomes within Type 2 Diabetic patients, as compared to traditional office monitoring. PolicyMap was also utilized as well as compiled data from the Center for Disease Control and the United States Census Bureau to depict Diabetes prevalence and management within the tristate area, which include the states of: Alabama, Georgia, and Florida.

Ten literature articles were compiled for this project with a variety of study designs, including meta-analyses, case-control studies, and clinical trial pilot studies. Across the different studies, digital tools achieved moderate-to-significant improvements in glycemic control, self-management behaviors, and overall clinical outcomes. Mobile applications show meaningful reductions by increasing patient engagement and providing individualized feedback with Electronic-Medical-Record-integrated applications. Furthermore, telemedicine improved knowledge within the field of Diabetes in older adults via modules and improving patient’s involvement in their day to day care. Integrated strategies, such as virtual clinics combining continuous glucose monitoring with specialist oversight and remote monitoring programs using connected meters, that provided real-time information to both patients and care providers, showed sustained glycemic improvements and enhanced patient satisfaction. This was often linked to improved patient-provider communication. Moreover, beyond core diabetes metrics, some studies showed that digital health was effective in managing other chronic conditions and comorbidities such as hypertension and improving medication adherence through culturally adapted interventions, which is crucial for addressing health disparities. The combination of evidence confirms that the strongest effects are observed in interventions that prioritize personalization, frequency of real-time feedback, and direct linkage to healthcare providers. While heterogeneity in study designs and challenges related to technology literacy and connectivity exist, these technologies offer a scalable, patient-centered approach to care.

In conclusion, mHealth, customized individualized care, and remote telemonitoring represent a crucial, evidence-based advancement, necessitating future focus on establishing long-term sustainability, cost-effectiveness, and equitable integration into routine care pathways.

Coleigh Mangham, OMS-II; Dalton Harris, OMS-II; Destiny Johnson, OMS-II; Joseph Kim, OMS-II; Katherine Narciso, OMS-II; Larry Crango, OMS-II; Sharno Amin, OMS-II

Abstract:

Rates of preventable hospitalizations are a rising concern among United States residents, although the contributing factors for this issue are not certain. Preventable hospitalizations often arise from conditions that could be managed in an outpatient setting with consistent primary care. Prior research suggests that limited access to healthcare could contribute to increased hospital admissions for conditions of this nature. The current review serves as an investigation to determine a relationship between the density of primary care providers in a region and the resulting rates of preventable hospitalizations. For information concerning healthcare disparities, articles from peer-reviewed academic journals indexed in PubMed were used to ensure credible research. The search involved key words to identify relevant articles including “avoidable hospitalizations”, “preventable hospitalizations”, “primary care provider density”, and “primary care supply”. A total of ten studies met inclusion criteria and were used to draw conclusions on the research topic. Selected articles focus on United States residents, but include population subtypes such as Medicare and Medicaid beneficiaries, individuals in healthcare maintenance organizations (HMOs) versus non-HMOs, elderly populations, and those with chronic conditions. Data collected from participants to determine rates of preventable hospitalizations include hospital records and discharge data, cross sectional surveys, state-administrative data, and Medicare claims. In addition to peer-reviewed articles, PolicyMap served as a resource to visualize the distribution of primary care physicians across the United States, specifically the ratio of primary care physicians per 1,000 residents, to better understand how provider density correlates with healthcare accessibility and hospitalization rates.

Research reveals that provider distribution and healthcare accessibility directly influence healthcare outcomes. As a result, studies show that increasing access to primary care and practicing physicians results in an overall decrease in preventable hospitalizations. This can be accomplished through various means, including utilizing the nurse practitioner workforce and improving community health-care center (CHC) densities. Furthermore, there are many barriers to healthcare access, including cost, geographic location, physician population, insurance coverage, etc. Recognizing impediments to healthcare access is a primary determinant in improving the quality of healthcare in the United States. Studies reveal that there are continual efforts to expand access to quality care. This includes federal programs such as the Affordable Care Act (ACA) and Health Center Program, which both attempt to increase the CHC densities and expand insurance coverage to underserved populations. Also, to correct the geographic inequalities in primary care providers incentive programs such as loan repayment plans and rural residency tracts have been instituted in hopes of increasing the number of physicians in rural communities. This also includes expanding the scope of primary care to include nurse practitioners (NPs) and physician assistants (PAs). Research especially reveals that older uninsured patients are most vulnerable to the effects of primary care shortages. Therefore, the introduction of accommodations such as transitional care homes addresses this targeted demographic. Overall, compared to other contributing factors, the primary care shortage in rural and underserved populations is the chief driver of avoidable hospitalizations. Thus, a continual effort to strengthen primary care facilities is necessary to reduce preventable hospital admissions in the United States.

Mateo Rojas OMS-II, Kayleigh Lunsford OMS-II, Tone Deinema OMS-II, Gabriella Mazzarona OMS-II, Fadi Berryane OMS-II, Bailey Shaffa OMS-II, Maneesh Yalamanchilii OMS-II, Sandhya Devi OMS-II

Background:

Sugar-sweetened beverages (SSBs) are a major contributor to excess caloric intake and have been strongly associated with obesity, type 2 diabetes, and cardiovascular disease. Their reinforcing effects on brain reward pathways are thought to promote habitual consumption and impaired appetite regulation. Artificially sweetened beverages (ASBs), which provide sweetness without calories, are frequently marketed as healthier alternatives; however, their long-term effects on neural, metabolic, and behavioral outcomes remain unclear. This review examines current evidence on how regular consumption of SSBs and ASBs influences brain reward activation, appetite control, and risk for chronic metabolic diseases in adults.

Methods:

A structured literature review was conducted using PubMed, ScienceDirect, and JSTOR. Boolean operators were used to refine searches with combinations of the following terms: “artificial sweeteners AND brain reward pathways,” “sugar-sweetened beverages AND obesity or diabetes,” and “non-nutritive sweeteners AND appetite regulation.” Articles published in English within the past 20 years were screened for relevance. Eleven peer-reviewed studies were included, representing randomized controlled trials, neuroimaging research, animal studies, and large epidemiological reviews. Study populations primarily consisted of healthy young adults, overweight or obese individuals, and animal models. Interventions involved exposure to caloric sweeteners such as glucose, fructose, and sucrose, compared with non-nutritive sweeteners including sucralose, saccharin, and allulose, or with unsweetened controls. The selected studies measured a range of neural, behavioral, and physiological outcomes, including blood oxygen level–dependent (BOLD) activity on functional magnetic resonance imaging (fMRI), subjective hunger and satiety ratings, insulin sensitivity, and long-term changes in weight or cardiometabolic health. Together, these data provided complementary perspectives on both short-term neural responses and chronic health effects.

Results:

Across neuroimaging studies, SSBs consistently produced robust activation of mesolimbic reward regions such as the ventral striatum, ventral tegmental area, and prefrontal cortex, confirming their strong hedonic and reinforcing properties. This heightened neural response was accompanied by greater behavioral disinhibition toward sweet stimuli and increased caloric intake over time. In contrast, ASBs elicited weaker or inconsistent activation in reward-related regions and sometimes produced responses similar to water. This blunted activation may interfere with the brain’s learned association between sweetness and caloric content, potentially leading to dysregulated appetite control and compensatory overeating. Metabolic studies revealed that chronic SSB consumption contributes to impaired insulin sensitivity, weight gain, and increased risk of obesity, type 2 diabetes, and cardiovascular disease. Each daily serving of an SSB has been associated with a measurable rise in long-term cardiometabolic risk. Findings regarding ASBs were more variable. When consumed in isolation, ASBs often produced neutral metabolic outcomes; however, when combined with carbohydrates, some studies observed reduced insulin sensitivity and altered hypothalamic activity, suggesting complex interactions between sweeteners and nutrient context. Epidemiological reviews confirmed strong associations between habitual SSB intake and increased incidence of obesity, diabetes, and cardiovascular events, whereas associations for ASBs were weaker and less consistent. Although ASBs may offer short-term benefits through calorie reduction, they do not appear to provide the same regulatory feedback on appetite and energy balance that natural sugars elicit.

Conclusion:

Current evidence demonstrates that SSBs strongly activate brain reward pathways, reinforcing high-calorie consumption and contributing to adverse metabolic outcomes. Artificially sweetened beverages, while lower in calories, may influence appetite signaling and metabolic sensitivity through altered neural processing of sweetness. The collective literature highlights substantial differences in how caloric and non-caloric sweeteners engage reward and homeostatic mechanisms. Limitations in the existing research include small sample sizes in neuroimaging studies, brief intervention durations, and variability in study design. Future investigations could consider long-term randomized controlled trials that integrate neuroimaging, behavioral, and metabolic assessments across diverse populations. Continued examination of both SSBs and ASBs may improve understanding of their respective roles in appetite regulation, energy balance, and chronic disease prevention.

Alexandria Cummings OMS - II, Elie Bachour OMS - II, Thomas Hart OMS - II, Nahian Khan OMS - II, Yasmin Haddadi OMS - II, Sean Joffe OMS - II, Chris Vo OMS - II​

Food insecurity, defined as the limited and uncertain access to nutritious and adequate food, has been linked with the prevalence and severity of many mental health conditions in children and adolescents, including stress, anxiety, depression, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD). Previous studies have found a significant deficit in many vitamins and minerals in individuals with ADHD, and further studies have shown that supplementation can reduce symptom severity. However, studies associating food insecurity with ADHD prevalence are limited and those associating it with ADHD severity are varied in their approach. The purpose of the current review is to identify the associations between food insecurity and ADHD, while proposing future studies that could further our knowledge in these associations. Literature for the current review was pulled from PubMed with a focus on attention deficit hyperactivity disorder (ADHD) and food insecurity. Results were refined by selecting observational studies such as cross-sectional and retrospective analyses, which were the most suitable for identifying associations between food insecurity and ADHD in pediatric populations. Overall, both the prevalence of ADHD and severity of symptoms were linked with higher levels of food insecurity. However, the data related to prevalence is limited and those concerning symptom severity vary in methodology, making it difficult to make clear comparisons. Some studies used self-reporting of ADHD diagnoses, while other studies used individuals who were diagnosed with ADHD by clinicians. With regard to symptoms of ADHD, many different screening tools were used to assess for inattention, hyperactivity, and other mental disturbances. Furthermore, food insecurity was analyzed using various screens, ranging from two question screens that gave results of positive for or negative for food insecurity, with others using screens that stratified severity of food insecurity. The inconsistent methodology points to a need to standardize methods for screening food insecurity and evaluating ADHD with the intention of clarifying the impact that food insecurity has on ADHD and creating potential interventions. More studies should evaluate ADHD prevalence in association with food insecurity to explore whether food insecurity may have an impact on the pathogenesis or diagnosis of ADHD. Furthermore, studies pertaining to ADHD severity should be expanded to adults, as information regarding food insecurity and ADHD in adults is very limited. Future research should also include the impact of food insecurity on the parents of children with ADHD, noting the psychological effect of food insecurity on the parents’ wellbeing and whether the effects can explain the impact of food insecurity on children diagnosed with ADHD. Lastly, research regarding food insecurity can be expanded to autism spectrum disorder (ASD). Vitamin and mineral deficiencies have also been found in individuals diagnosed with ASD and other studies have demonstrated that supplementation can reduce symptom severity in individuals with ASD as well. However, data regarding ASD and food insecurity is even more limited than those concerning ADHD. Overall, future studies will aid clinical interventions aimed at mitigating the broad impact of nutritional deficits in those impacted by food insecurity.

Alicia Lai OMS-II, Dinasha D Navindi MD, Raslina Shrestha MBBS, Kiran Nakarmi MBBS, Shankar Rai MBBS, Changiz Mohiyeddini PhD

Background:

Burn injuries in medically underserved areas often lead to lasting physical and psychological burdens. However, many survivors demonstrate post-traumatic growth (PTG), a process of positive psychological adaptation and a sense of renewed purpose following adversity, despite limited medical resources. This study explores how Nepali burn survivors achieve PTG through their lived experiences and coping mechanisms to better understand effective psychosocial recovery and rehabilitation frameworks.

Methods:

A qualitative, phenomenological approach was used to analyze eight narrative accounts from burn survivors treated at the Nepal Cleft and Burn Center. Narratives, originally collected through semi-structured interviews and published on a digital storytelling platform, were thematically examined using Braun and Clarke’s six-phase framework. Coding was guided by five domains of PTG and ATLAS.ti software supported analysis. Ethical approval was obtained for the original interviews, with participants providing consent for public sharing of de-identified narratives.

Results:

Analysis of 8 narrative accounts revealed eight psychosocial themes: (i) social support and connection, (ii) cognitive reappraisal and acceptance, (iii) spiritual and existential coping, (iv) problem-solving and adaptation, (v) post-traumatic growth, (vi) forgiveness and letting go, (vii) meaning-making and purpose, and (viii) avoidance and distraction. Survivors reported persistent challenges, including stigma, isolation, and limited access to mental health services. Recovery was shaped more by cultural, spiritual, and relational frameworks than by clinical severity of injury, as meaning-making, family support, and advocacy often transformed suffering into PTG.

Conclusion:

Nepali burn survivors achieve post-traumatic growth despite limited medical resources through recovery grounded in diverse cultural, spiritual, and social frameworks. Strengthening psychosocial care in burn rehabilitation and developing culturally sensitive, community-based interventions including peer-support and survivor-centered programs are priorities to foster resilience and long-term healing in resource-limited settings.

Paayal Desai, OMS-II, Abigail Hunter, OMS-II, Sahith Kasireddy, OMS-II, Pranjali Rajalakshmi, OMS-II, Tyler Smith, OMS-II, Sara Thomas, OMS-II, Jayant Yagnick, OMS-II

Cleft lip and palate (CLP) congenital abnormalities are some of the most common deformities affecting children globally, occurring in nearly 1 in 700 births. Infants affected by CLP require specialized feeding support, and definitive management involves surgical interventions aimed at restoring normal function and facial form. Postpartum depression (PPD) is a common mental health concern among mothers and is exacerbated further when the birth and/or baby experience complications or abnormalities. The added stress the mothers face in these circumstances increases the risk of developing PPD. The specific relationship between the development of children born with CLP to mothers with PPD still shows great potential for future research. The study aims to explore the impact of PPD in mothers of infants with CLP and its potential long-term effect on the child’s development. A systematic review of peer-reviewed literature was conducted across various databases, including PubMed, Google Scholar, and Policy Map, to select for comprehensive coverage of key medical and demographic data regarding “postpartum depression,” “cleft lip and palate,” “child development,” etc. Furthermore, reference lists of relevant articles were reviewed to further widen the study’s research parameters. PolicyMap was specifically utilized to examine demographic patterns related to CLP cases across a wide geographic distribution. The inclusion criteria focused on maternal mental health, particularly PPD, and child development outcomes in the context of CLP. The review also considered the socioeconomic status of mothers, the presence or absence of CLP in infants, and the long-term outcomes for both mother and child.            Mothers of infants with CLP were consistently found to be at a higher risk for developing postpartum depression compared to mothers without cleft abnormalities. Mothers with CLP infants had higher levels of self-harm thoughts at one and six months postpartum. Lack of caregiver support, history of adverse pregnancy outcomes, and elevated parental stress further exacerbated the risk of developing postpartum depressive symptoms.

The developmental outcomes of children born to mothers who had prolonged postpartum depression were found to be significantly affected, especially in the early years of life. Persistent maternal depression was linked to an increased risk of internalizing problems, and delays in motor skills, communication, and social functioning. Additionally, mothers who were still experiencing depressive symptoms into children's adolescence reported increased problematic behavioral issues in their children. Research found that untreated CLP significantly impaired speech, physical, academic, and social outcomes. The study highlights that surgery, when performed before age five, significantly improves speech and inclusion. This highlights the importance of early interventional surgery to reach normal developmental milestones. The research collectively suggests that while maternal postpartum depression can affect the child’s development, the severity and chronicity of the depression, as well as crucial factors like surgical intervention for the child, are key to predicting long-term outcomes. The study that was conducted highlights the synergistic impact of CLP on maternal mental health and child development. Mothers of CLP infants are at an increased risk for PPD, with variables such as infant health complications, lack of support, and stress contributing to this vulnerability. This association between PPD and adverse child outcomes underscores the importance of integrated care that can address both maternal and child health needs, such as early mental health screenings for mothers and surgical intervention for CLP children. Mothers of infants with CLP face elevated risks of PPD, which in turn may significantly affect the long-term developmental outcomes of their children. Early surgical intervention for CLP infants can improve developmental outcomes, but maternal mental health support is equally critical. Addressing both maternal and child health holistically through early interventions and integrated care models is vital for optimizing outcomes in this vulnerable population.

Abbie Smith- OMS II, Areesha Charania- OMS II, Arjun Suresh- OMS II, Ryuma Naito- OMS II, Sandhya Yerra- OMS II, Sean Beggan- OMS II, Yvens Alerte- OMS II

The research presented addresses the critical interplay between area-level socioeconomic deprivation, access to healthcare resources, and subsequent diabetes outcomes among adults residing in rural communities throughout the southeastern United States. The central research question guiding the analysis is: How do area-level socioeconomic deprivation and access to healthcare resources influence the quality of diabetes care and clinical outcomes among adults with diabetes in rural southeastern U.S. communities?

The primary resource consulted was the PubMed database, which was selected for its comprehensive coverage of biomedical, social sciences, and life sciences publications relevant to diabetes, healthcare disparities, and social determinants of health (SDoH). The review specifically drew upon peer-reviewed academic journals, including Diabetes Care, The Journal of Rural Health, and Primary Care Diabetes.

Studies had to focus on Type 2 Diabetes Mellitus, discuss income level or socioeconomic status (SES), be set in the rural southeastern U.S. (including states like Alabama, Florida, Georgia, and others), and measure a clinical outcome or quality of care. Keywords included "diabetes," "socioeconomic status," "rural health," and "healthcare access."

The synthesis incorporated secondary data from 14 different studies, framed using the PICO (Participants, Intervention, Comparison, and Outcome) structure. Participants were defined as adults with diabetes in rural southeastern U.S. communities, encompassing diverse populations such as Medicaid-recipient individuals and various ethnic groups (e.g., African American, American Indian, and White adults). The examined intervention (or exposure) was a higher level of socioeconomic deprivation and/or reduced access to healthcare resources. Methodologies across the reviewed studies were varied, including the analysis of medical records and Medicaid data, the use of validated questionnaires, focus groups, and advanced statistical techniques like latent profile analysis (LPA). Comparison involved evaluating outcomes between adults in more deprived areas versus those in less deprived areas or comparing intervention versus control groups. The measured outcomes spanned quality of care metrics (e.g., compliance with recommended care such as eye and foot exams), clinical measures (glycemic control, BMI), health events (diabetes-related hospitalizations), and patient-reported outcomes (adherence, diabetes distress, and quality of life).

The collected research consistently highlights that socioeconomic deprivation and restricted healthcare access in the rural southeastern U.S. significantly compromise diabetes care and clinical outcomes. Socioeconomic status directly impacts the quality of care received.

Geographic location and neighborhood characteristics present substantial barriers. Rural residency was linked to a significant lack of diabetes knowledge and a deficiency of essential self-management equipment among older adults. However, the synthesis also revealed that neighborhood characteristics can mitigate risk: better access to healthy food and stronger social support were significantly associated with improved self-care behaviors. Adverse SDoH were strongly correlated with heightened levels of diabetes distress in low-income patients.

The identification of distinct social risk profiles via latent profile analysis demonstrated that individuals facing the highest overall risk across socioeconomic, psychological, and behavioral domains experienced the worst clinical outcomes, including poorer glycemic control. Study findings indicate that targeted interventions show promise for improvement.

The literature review confirms that socioeconomic deprivation and restricted healthcare access are critical factors that negatively influence the quality of diabetes care and clinical results for adults in the rural southeastern U.S. The major finding underscores the interconnected roles of SDoH, geographic challenges, and psychological factors in shaping health equity and outcomes. The success of focused interventions, such as peer coaching, suggests that future research and public health efforts must directly address these underlying social determinants. The next steps in research should focus on implementing and evaluating community-based interventions that explicitly target SDoH—such as improving food access and strengthening social support networks—to effectively reduce the psychological burden of diabetes and enhance patient self-management.

Vincent Boutsioukos, OMS-II; Corrinne Hickman, OMS-II; Nastassja Kowalski, OMS-II; Dhruv Patel, OMS-II; Reagan Shults, OMS-II; McKenna Williams, OMS-II; and James Winland, OMS-II

Medical students experience unique stressors as they advance through the various levels of their academic and clinical training. These stressors have the potential to influence their dietary habits, physical activity, and overall wellness. Creating an understanding of how dietary quality and nutritional behaviors evolve during medical training may help identify opportunities to improve student health and long term professional well being. A review of current literature was conducted using Google Scholar and PubMed to identify peer-reviewed studies from the past ten years that evaluated eating behaviors, dietary quality, and related lifestyle factors among medical students and residents. Keywords for the search included “medical students”, “medical school”, “eating habits”, “weight changes” to relate to the question, “How does the diet and meal quality of medical students change through the course of their studies?”. The studies included were selected based on inclusion of medical student cohorts and use of validated measures such as the Eating Attitudes Test (EAT-26), SCOFF questionnaire, Perceived Stress Scale, Rapid Eating Assessment for Participants—Short Form (REAP-S), and Beck Depression Inventory. The studies were synthesized to compare dietary behaviors by educational stage (preclinical, clinical, or residency), gender, and body mass index (BMI). Additional data from PolicyMap, CDC PLACES, and U.S. Census reports were used to further integrate these findings within broader population health trends. Consistent trends regarding dietary habits and lifestyle were observed across diverse populations.. Most medical students maintained a BMI within the normal range, however, dietary quality often declined with progression through training. Skipping meals, particularly breakfast, was a commonality and was linked to increased stress, time constraints, and economic pressures. Female and financially disadvantaged students reported higher stress and were more likely to skip meals. Several studies noted increased consumption of processed foods, meat, soft drinks, and alcohol among students with higher BMI. Alternatively, certain interventions such as nutritional education and online training modules were associated with improvements of the dietary quality and adherence to national nutrition guidelines in these students. Overall, physical activity levels were low, and sedentary behavior was prevalent across cohorts.

The reviewed evidence suggests that medical training is associated with significant and measurable declines in meal consistency and dietary quality which is largely influenced by stress, time constraints, and access to healthy food options. Despite global and cultural variance, similar patterns emerged across settings, indicating that these issues may be systemic, and related to medical training, rather than cultural. Research methods including REAP-S scores and lipid profiles, provide support that the overall health of students may be affected by the transition to clinical phases of training. Raising awareness and addressing these challenges through nutritional education, focused wellness plans, and elevated institutional food options may help mitigate long-term health risks associated with the previously mentioned barriers to healthy dietary habits in medical trainees. Medical students are at increased risk of developing poor dietary habits as they progress through training. This carries many implications for both personal health and future patient counseling behaviors. Future research should focus on longitudinal studies that track individual cohorts across all years of their medical training. Additionally, research should evaluate targeted interventions that promote consistent meal timing, dietary quality, and stress management techniques. Incorporating nutritional education and wellness resources within students’ medical training may promote, as well as foster, healthier lifestyles to enhance future physicians’ capacity to model healthy behaviors.

Anis Asljafari OMS-II, Brianna Cinneus OMS-II, William Crain OMS-II, Caleb Frey OMS-II, Brenda Nelson OMS-II, Laura Weatherford OMS-II

Depression represents a growing global health concern affecting diverse populations. Although antidepressant medications remain a cornerstone of treatment, increasing evidence suggests that treatment efficacy may not be uniform across ethnic groups. Differences in therapeutic response have raised questions regarding the relative influence of genetic variations, socioeconomic determinants, and disparities in access to care. A literature review was conducted using PubMed, Google Scholar, and Open Evidence to examine antidepressant efficacy among different ethnic groups. PolicyMap was used to evaluate population-level mental health treatment utilization, which was cross-referenced with racial demographic data. Evidence indicates variability in antidepressant treatment response across ethnic populations. Several studies suggest that genetic polymorphisms influencing drug metabolism, transport, and receptor sensitivity may contribute to differential pharmacological outcomes. Additional findings highlight socioeconomic determinants including financial instability, medication adherence barriers, limited prescription access, and early discontinuation of treatment as major contributing factors. Other studies demonstrate that when treatment is individualized to patient-specific clinical, genetic, and environmental factors, observed differences in efficacy across ethnic groups are substantially reduced or absent. Antidepressant efficacy varies across populations due to a combination of pharmacogenetic and socioeconomic influences. Structural barriers such as medication cost, inconsistent healthcare access, prescription refill limitations, and cultural stigma toward pharmacologic treatment may exacerbate disparities in therapeutic outcomes. Evidence suggests that personalized antidepressant therapy including tailored dosing, pharmacogenetic consideration, side-effect mitigation, and continuity of care may reduce variability in treatment response. Current research remains limited by small sample sizes and insufficient studies evaluating individualized treatment approaches across diverse populations. Further large-scale research is needed to clarify genetic contributors to antidepressant response, optimize personalization strategies for pharmacologic therapy, and evaluate interventions addressing structural barriers to medication adherence. Continued investigation into culturally informed and patient-centered approaches to depression treatment is essential to ensure equitable and effective mental health care.

Jake Crawford OMS-II, John Sullivan OMS-II, Nancy Truong OMS-II, Nicholas Russo OMS-II, Sayeed Shahriar OMS-II

Background:

Opioid Use Disorder (OUD) is a crippling affliction that can affect quality of life, and exacerbate a wide range of pre-existing problems (health-related or otherwise), not only for patients but also family members, friends and even communities as a whole. The prevalence of opioid over-prescribing, and ease of access to unregulated or illicitly obtained opioid substances have expanded the prevalence of this disorder and elevated it into a major public health crisis affecting communities across the country. Given the widespread effects, it is reasonable to infer that those negatively affected by social determinants of health feel these effects disproportionately as compared to their more advantaged counterparts. This project sought to describe this relationship, specifically focusing on economic instability and lack of healthcare access and quality, in order to understand and address it at the source. Better approaches to fighting the opioid crisis (and thus OUD) will not only improve individual health outcomes, but also reduce healthcare burden/cost and improve quality of healthcare delivery.

Methods/Findings:

This retrospective cross-sectional study utilized PubMed and Google Scholar search engines to explore peer reviewed literature from 2016-2023. PolicyMap was used to isolate geographical populations. Selected literature focused on opioid use in vulnerable groups including adults (18 years or older), rural residents, low-income populations, racial and ethnic minorities, and individuals with adverse childhood experiences. Their access to healthcare quality and economic instability were compared to the same populations with access to healthcare quality and improved economic stability. Healthcare quality metrics included prescription rates, in-hospital mortality, and access to buprenorphine therapy. Economic metrics included employment, disability, and social isolation. Specific exclusion criteria were applied to secondary searches because terms such as “hallucinogens” and “opioid anesthesia” were included.

Results/Discussion:

Overall, the project revealed a relationship that economic instability most directly affected outcomes of those affected by OUD morbidity and mortality. This was directly illustrated in unemployed populations (Aram et al., 2020) and had a compounding effect on in-hospital mortality in those affected by disability. Expanding this claim to broader populations, the study found an elevated opioid use disorder burden, even when adjusted for Medicaid populations unilaterally (Doogan et al., 2022). There is a direct link between economic instability and an increased risk of opioid overdose.

Interestingly, findings pertinent to lack of quality healthcare access indicated greater association with in-hospital over-prescribing (Weiss et al., 2018) and a general failure of prevention efforts. Additionally, minority populations affected by OUD had reduced access to timely buprenorphine therapy, an important tool in treating withdrawal symptoms that often prevent opioid cessation in affected patients (Miles et al., 2020).

Conclusion:

Ultimately, this research has drawn a link between Economic Instability and Lack of Healthcare Access within vulnerable populations to increased risks associated with opioid use and mortality. Through this project, vulnerable populations such as adults, the elderly, low income populations and racial and ethnic minorities have shown inadequate access to healthcare and increased mortality. Bringing awareness to these social determinants and these disparities is the first step and can increase the odds of developing long-term solutions. Some strategies to mitigate these issues include telehealth. While there is evidence supporting telehealth as an important prevention tool that has the potential to improve treatment retention, broader efforts to address these social determinants are needed to address these opioid-related harms and improve health outcomes regardless of population vulnerability.