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Diana Munera, BS
Clinical & Research Program Manager

Diana Munera joined Dr. Quiroz’ Lab in September 2019. She received her Bachelors of Science in Psychology in 2013 from Northeastern University. Before joining MAPP, Diana worked as a Practice Manager for the Psychology Assessment Center at MGH, where she worked closely with the MUNDOS program and Dr. Quiroz. Diana’s interest are: helping Latino families navigate the healthcare system. In her free time, she enjoys playing with her two toddlers, traveling and spending time with friends and family.

Daisy T. Noriega, BA
Clinical Research Coordinator II

Daisy joined the Multicultural Alzheimer’s Prevention Program (MAPP) as a Clinical Research Coordinator in 2021. She completed her bachelor’s degree in 2019 with a major in Biopsychology, Cognition, and Neuroscience (BCN) from the University of Michigan-Ann Arbor. Before joining MAPP, she worked as a Clinical Research Coordinator in the Scharf Lab at MGH. She is excited to contribute to understanding racial and ethnic disparities in cognitive disorders like Alzheimer’s Disease through her time at MAPP. In her free time, she enjoys picking up new hobbies and snuggling with her cat.

Alex L. Badillo Cabrera, BA
Clinical Research Coordinator

Alex is a bilingual (Spanish & English) Clinical Research Coordinator at MARC. He joined Dr. Quiroz’s group on February of 2021. He received his Bachelor of Science of Psychology and a second concentration in Multidisciplinary Art from the University of Puerto Rico in 2020. Alex is interested in neuroaesthetics and clinical psychology. In his free time, he enjoys baking and painting.

Eva Martinez, BA
Clinical Research Coordinator

Eva is a Clinical Research Coordinator of the Multicultural Alzheimer’s Prevention Program (MAPP), primarily working on the BLAST Alzheimer’s Project. She graduated from Bates College in 2021 with a Bachelor of Arts in Neuroscience, and a double-minor in French and music. She intends on attending medical school to become a surgeon so that she can serve in under resourced parts of the world where help is most needed. Eva enjoys anything having to do with nature and the outdoors, music and art, as well as discovering different parts of the world and learning new languages.

Gabriel Oliveira, BS
Clinical Research Coordinator

Gabriel graduated Boston University with a BS in Human Physiology. Gabriel has aspirations of becoming a physician, using both Portuguese and English to assess and support patients. He is a Fulbright fellow to Brazil for the 2021-2022 academic year. Outside of work, Gabriel enjoys hiking, listening to music, and playing video games.

Ana Paola Garza BS, MS
Clinical Research Coordinator II

Paola received her Bachelors of Science in Nutrition and Food Science in 2011 from Universidad Iberoamericana in Mexico City and completed her Master of Science in Health Communication in 2016 from Lasell University. Before joining Paola worked as a Program Coordinator for the Latin American Heritage Diet at Oldways, where she worked closely with the Latino and African American communities. She previously worked at Joslin Diabetes Center with Dr. Enrique Caballero coordinating outreach and research efforts for the Latino Diabetes Initiative. Paola joined the lab in February 2020 to work on the newly funded Spanish speaking cohort of the Harvard Aging Brain Study. Paola is interested in the lifestyle prevention programs and the relationship between nutrition and mental health across cultures. In her free time, she enjoys traveling, cooking, playing with her dog, and spending time with friends and family.

Ana Baena, BA, MA
Clinical Research Coordinator

Ana received her undergraduate degree with a major in psychology from the University of Antioquia (Colombia), and she completed her MSc in Neuropsychology from the University of San Buenaventura. She joined the Group of Neuroscience of Antioquia as a neuropsychology psychometrician right after graduation, in order to study cognitive impairment in patients with neurodegenerative diseases. Ana’s current research interests include the study of the personality traits, as risk factors of the cognitive impairment in Alzheimer’s disease. For the past five years, she has worked as research study coordinator in Colombia for Dr. Quiroz’s NIH grant on memory network dysfunction in preclinical Alzheimer’s disease. Ana is a full-time professional who passionately dedicates herself not only to her research, but also strives to maintain the well-being of patients and their families.

Yesica Zuluaga, BA
Clinical Research Coordinator

Yesica Zuluaga, completed her bachelor’s degree in psychology at the University of Envigado and completed her master’s degree in neuropsychology at the University of San Buenaventura in Medellin. She currently works in the Neurosciences Group of Antioquia (Colombia) and teaches neuropsychology and neurophysiology at the Grancolombiano Polytechnic. Her main interest is the investigation of neurodegenerative diseases, especially Alzheimer’s disease. In recent years, it has been approached and motivated by cerebrovascular diseases, mainly of autosomal dominant origin caused by mutation in the Notch3 gene, such as CADASIL.

The Importance of Maintaining Mental Health as a Caregiver

By: Adrianna Fusco 


In society, it is expected of you to take care of your loved ones when they get sick. If you choose not to, you’re seen as cold, heartless, and ungrateful. However, should loved ones really take care of their sick relatives when there are professionals who are experts? In this article, we are going to look into how taking care of sick family members can have adverse effects on the caretakers and how to avoid burnout. 

What does Caregiving Entail? 

Taking care of sick people can involve many important tasks, like making sure they are 

eating, practicing good hygiene, and more. These aren’t just little tasks, these are things that are needed for survival and good health. Therefore, there is a lot of pressure on these caregivers to make sure that they are giving their sick family member or patient the best care possible. This can lead to the caregiver suppressing their own needs to meet the needs of others. Once the caregiver starts ignoring their own needs, they become susceptible to mental health issues and health issues which not only puts themselves in danger, but also may affect how they take care of their patient. 

What is burnout? 

Burnout is the medical term used to describe when a person is physically, mentally, and emotionally exhausted. Signs of burnout are less energy, low immunity, feeling exhausted, and poor self care. Along with burnout, there is caregiver stress which is anxiety and stress due to taking care of someone else. The symptoms of caregiver stress are anxiety, depression, exhaustion, difficulty sleeping, extreme reactions, new or worsening health conditions, outlets such as drinking or smoking, neglecting responsibilities, and issues concentrating. Untreated caregiver stress can build up and lead to burnout or other mental issues.

How to Deal with Caregiver Stress and Burnout: 

When dealing with stress and burnout, it’s important to be able to cope. There are different ways to go about treating burnout, but one of the solid ways is therapy. Talking to someone about your issues and having someone to help you talk through your problems is a good way to deal with the emotional

responses that come with dealing with a sick loved one. Therapy is an extremely good option when taking care of someone who is not getting better and is projected to only get worse. 

Another form of treatment is thinking positively about the situation and finding someone to support you. When caregiving, it’s important to highlight why you are helping and to find the positive things you are getting out of caregiving. As mentioned, caregiving can be hard when the person seems to not be getting 

better, but looking for positives such as how your loved one would react if they were healthy, can help you get through it. It is also important to make sure you take time for yourself. To do that, you can accept help when it’s offered and reach out if you need help. 

The most important way to make sure you are coping is taking care of yourself first. Make sure that you are keeping on top of doctors appointments to make sure you are in good health. Being healthy can help you be able to deal with the strain of caregiving and makes it easier to focus on the person who is sick. On top of this, make sure that you are eating properly and getting enough sleep, as a lack of either of these can lead to decrease in mood, energy, and productivity. Before you worry about anything else, you need to make sure that you are okay. 


Caregiving is hard no matter what the situation is. With Alzheimer’s disease, caregiving is especially hard if you are the caregiver for your loved one. Alzheimer’s disease is vicious and causes people to forget main parts of their life. In many cases, people with Alzheimer’s forget their loved ones by the end and forget how to complete basic tasks. This makes it very hard for loved ones to take care of them because it is painful to see your loved one forget who you are and lose the skills they need to survive. It’s hard to see them struggle and be unable to take away their pain. That’s why it is so imperative to make sure you are taking care of your own mental health. Joining a support group, going to therapy, or even talking to friends can help you deal with the loss of your loved one. Dealing with your mental health not only benefits you, but also benefits your loved one. As when you are healthy mentally, physically, and emotionally you can be the best caregiver possible and put all your energy into helping your loved one. 

Thank you for reading! For more information about Alzheimer’s disease, brain structure, and more check out the other blog posts and our social media!


“Caregiver Health.” Caregiver Health – Family Caregiver Alliance 

“Emotional Signs of Caregiver Stress.” Caregiver Stress, 11 Apr. 2010, 

“Mental Health of Caregivers.” American Psychological Association, American Psychological Association, 2011, . 

Smith, Melinda. “Caregiver Stress and Burnout.”, Oct. 2020,


Cheat Sheet to Brain Health

By Rachel Kimball 


The brain is one of the most vital organs. From thoughts and tasks to involuntary actions, your brain doesn’t just make you, you, it keeps you alive. Many neurological diseases are in-part caused by habits that lead to worsened brain health. By keeping your brain healthy through various habits and routines, neurological disorders can be prevented, increasing your quality of life. So what can we do to improve brain health?

Brain Health Overview: 

Brain health is determined by genetics, environmental factors, and lifestyle. We’re going to focus on lifestyle, and  the role of physical activity, sleep hygiene, nutrition, mental stimulation, music, and substance use on your brain.

Physical Activity:

“We know that physical exercise, and aerobic exercise in particular, is very beneficial for maintaining brain health, even in people who are at risk for developing dementia and Alzheimer’s disease (AD) …You can make a major difference in terms of how your body is functioning and, as a result, how your brain is functioning.” says neuropsychologist Aaron Bonner-Jackson, PhD. 

So how does physical activity promote brain health? Physical activity promotes cardiovascular health and helps your brain get the blood supply it needs. Blood delivers oxygen and glucose to the brain, and although your brain is a small part of your body’s total weight, it requires a lot of energy to function. 

In a recent study, researchers found that achieving 7,500 steps or more daily was associated with higher total brain volume that was equivalent to approximately 1.4 to 2.2 years less brain aging. 

Whether it’s going on a run or dancing, getting in those extra steps and making your heart rate rise is a great way to make your brain healthier.

Sleep Hygiene:

Two thirds of teenagers report getting less than 7 hours of sleep a night! We need at least 8 for the brain to function properly and stay healthy. Restorative sleep helps with executive function, reward sensitivity, regulation of emotions,  and learning. Sleep actually helps us form memories, as our brain replays moments from the day. Chronic sleep deprivation can put you at higher risk for stroke, and shuts down the production of essential brain proteins. 

Cellular timekeepers naturally prep synapses in the brain before sleep through the production of proteins. However, in the absence of a regular sleep schedule, neurons begin to curtail their own protein-making cycles, making it harder to get into the routine of restorative sleep, worsening the problem.

Sleep also enables the brain to do some “housekeeping” and clean up waste. The brain cleans out toxins that accumulate during the daytime hours. The space between the brain cells increases during sleep which enables all of those toxins to be flushed out. 

Make sure you get those 8 hours a night to keep your brain young and healthy!


Nutrients are absorbed through the cells lining the intestine and transported through blood vessel walls into the bloodstream. They travel in the blood through the liver, and must cross small blood vessels into brain tissue. This transport mechanism from the blood to neurons is restricted by the blood brain barrier which keeps many substances out. However, nutrients pass this barrier to reach your brain! 

Why do we need nutrients? 

Energy and nutrients from the food you eat help the brain perform its daily functions, as this is how the brain gets the glucose it needs. Lacking certain nutrients can be toxic, as they affect development, mood, cognition, disease, and aging. 

Here are 5 nutrients that are great for the brain: 

→ Omega 3 Fatty Acids: found in fish, flax seeds, walnuts, chia seeds, brussel sprouts, avocadoes

→ B Vitamins: found in meat, seafood, poultry, eggs, dairy, legumes, leafy greens, seeds, fortified foods

→Vitamin E: found in nuts, seeds, avocados, tofu, leafy greens

→ Lycopene: found in red fruits and vegetables such as tomatoes, strawberries, bell peppers, red carrots 

→Zinc: found in pumpkin seeds, dark chocolate, potatoes, lamb, seafood 

Mental Stimulation:

Mental activity increases blood flow to the brain, which increases the brain’s supply of oxygen and important nutrients. Mental activity also acts as a signal to promotes brain-derived neurotrophic growth factor (BDGF), a protective chemical which promotes growth and survival of neurons. Many older adults are encouraged to stimulate their brains, but doing this at any age is super beneficial! 

Here are some ways to do this: 

→ Jigsaw puzzles

→ Listening to music

→ learn or teach a new skill

→ build your vocabulary 

→ Use your non-dominant hand

Listen to Music:

Did you know that listening to music can have major positive effects on your brain?! Listening to music is associated with decreased stress, reduced pain, better memory, and improved sleep quality. 

Music has a unique link to our emotions. When we’re happy, we tend to listen to upbeat music, and when we’re sad, we tend to listen to songs at slower tempos or in minor keys. Listening to music reduces levels of cortisol, a hormone that causes increased feelings of stress and anxiety. Additionally, according to researchers at Stanford, listening to music causes brainwaves to match those we experience during meditation, making us feel relaxed. Listening to music also triggers our brain to produce dopamine. 

Enjoyable music can trigger the release of opioids in the brain, the body’s natural ‘morphine’. This may explain why music decreases the need for pain-killers in those with pre-existing conditions. Researchers at McGill University in Montreal found that listening to music increased the body’s production of immunoglobulins, a natural antibody that fights off viruses, including those that cause pain. By listening to music we are increasing the release of natural opioids and immunoglobulins, decreasing pain!

Imagine this: you’ve been studying for hours but can’t remember anything. This may be caused by the stress you’re experiencing, so put on your favorite songs, relax (as it reduces stress,) and you’ll be able to remember a lot more. Also, in patients with dementia, many memories fade, but emotional and physical memories never do. By learning new things with music,  those with dementia are much less likely to forget those memories.  However, this is applicable to everyone. Learning new things in the presence of music enables us to engage our emotional memory, helping us remember them long-term.  

There’s a reason why babies listen to lullabies before bed, and music can make it easier for older youth and adults to fall asleep, as well. According to the NIH, adults who listened to music for 45 minutes prior to bed reported better sleep quality beginning on the first night.  In another group of participants with insomnia, time spent falling asleep decreased from 27-69 minutes to 6 -13 minutes when music was played in the background. So why does this happen? In addition to decreasing cortisol, music soothes the autonomic nervous system, making us feel relaxed and ready to go to sleep.

The Effects of Substance Use:

Drugs interfere with the way neurons send, receive, and process signals via neurotransmitters. Some drugs activate neurons because their chemical structures are similar to neurotransmitters that naturally occur in the body, so drugs can attach onto and activate neurons. This includes marijuana and heroin.  However, they don’t activate neurons in the same way as a natural neurotransmitter, so they can have huge negative impacts.

Our brains are wired to increase the odds that we will repeat pleasurable activities through the release of endorphins, such as dopamine, that make us happy. Drugs cause this cycle to continue, leading to addiction. 

Photo from NIH


Physical activity, sleep hygiene, nutrition, mental stimulation, music, and substance use have major effects on your brain. In order to keep your brain healthy, we recommend following these tips and finding more information online from the NIH and CDC. Remember, brain health is in your hands, and it starts with YOU. 


Bates, Mary. “A Dose of Music for Pain Relief.”,

Collingwood, Jane. “The Power of Music To Reduce Stress.” Psych Central, Psych Central, 17 May 2016,

Corliss, Julie. “Music and Heart Health.” Harvard Health Blog, 29 May 2018,

Linnemann, Alexandra, et al. “The Effects of Music Listening on Pain and Stress in the Daily Life of Patients with Fibromyalgia Syndrome.”

Frontiers in Human Neuroscience, Frontiers Media S.A., 30 July 2015,

“Sleep Deprivation.” Department of Neurology, 18 Aug. 2020,

“Sleep Deprivation: Causes, Symptoms, & Treatment.” Sleep Foundation, 11 Dec. 2020, Tarokh, Leila, et al.

 “Sleep in Adolescence: Physiology, Cognition and Mental Health.” Neuroscience and Biobehavioral Reviews, U.S. National Library of 

Medicine,Nov.2016, Urrila, Anna S, et al. 

“Sleep Habits, Academic Performance, and the Adolescent Brain Structure.”

Scientific Reports, Nature Publishing Group, 9 Feb. 017,

Advanced Neurotherapy, PC. “6 Essential Nutrients to Promote Brain Function.” Advanced Neurotherapy, 

Gómez-Pinilla, Fernando. “Brain Foods: the Effects of Nutrients on Brain Function.” Nature Reviews. Neuroscience, U.S. National Library of Medicine, July 2008, 

“Nutrition and Brain Health.” HealthEngine Blog, 21 Mar. 2019, 

Drugs and the Brain,

Reynolds, Susan. “Have You Fed Your Brain Today?” Psychology Today, Sussex Publishers, 7 Sept. 2011, 

Your Brain: An Introduction to Its Anatomy

By: Rachel Kimball


Your brain is one of those things many of us take for granted. As the site of human consciousness, the coordinator of voluntary movement, and the regulator of nonconscious processes, your ? can do it all. The brain is not just a blob of cells in your skull, and the anatomy of the brain is quite complex. However, it is also very interesting to learn about.

Let’s start with some fun facts about the brain. Did you know… 

  • The average person has 12,000-60,000 thoughts a day
  • The human brain triples in the first year of life and in adulthood, it gets smaller as we get older
  • Headaches are caused by a chemical reaction 
  • There are one hundred billion neurons in the average brain 
  • 75% of the average brain is made of water 

Let’s first dive into each lobe of the brain. Each lobe has its own set of distinct functions, and together, the lobes of the brain make you, you. Damage to the brain can result in serious complications, and learning the function/location of each lobe enables us to understand the consequences of brain damage.

Frontal Lobe: 

Anatomy: The frontal lobes are located directly behind the forehead, and they are the largest lobes in the human brain. Located in the frontal lobe is Broca’s area, which controls the muscles in the mouth used for speech.

Function: The frontal lobe is responsible for speech & language production, motor skills, understanding & reacting to the feelings of others, forming personality, maintaining a sense of motivation, and managing attention. 

Damage: The frontal lobes are the most common area for damage in the brain. It can result in paralysis, Broca’s Aphasia (inability to express language,) inability to focus, Adynamia (reduced motivation,) changes in personality, mood fluctuations, and difficulty controlling impulse.

Parietal Lobe:

Anatomy: The parietal lobe is located near the back/top of the head, directly behind the frontal lobe, and separated by the parieto-occipital central sulcus

Function: The parietal lobe is responsible for sensations, such as touch, pressure, pain, heat, and tension, navigating and controlling the body through spatial awareness, understanding written language, and solving math problems 

Damage: Damage to the parietal lobe can result in difficulty in distinguishing left from right, spatial disorientation, alexia (problems with reading,) dyscalculia (difficulty with mathematics), and apraxia (difficulty with complex movements).

Occipital Lobe:

 Anatomy: The occipital lobes are in the rear part of the upper brain. The central cerebral fissure divides the 2 lobes, and the tentorium cerebelli separates them from the temporal lobe and cerebellum. It contains the primary visual cortex, which sends and interprets information through our eyes

Function: The occipital lobe is responsible for depth perception, color determination, distance perception, face recognition, object recognition, and combing the images from both eyes into one image

Damage: Damage to the parietal lobe can result in blindness and difficulty understanding basic colors & shapes, recognizing familiar faces, detecting moving objects, recognizing words, hallucinations, Riddoch syndrome (can’t see stationary objects,) and epilepsy

Temporal Lobe:

Anatomy: The temporal lobes sit at the bottom middle portion of the brain, just behind the temples. Key structures include the auditory cortex and Wernicke’s area. The auditory cortex performs basic and higher functions of hearing and Wernicke’s area interprets written and spoken speech

Function: They temporal lobe is responsible for long term memory, emotion, understanding and giving meaning to voices and sounds, and is an essential part of the limbic system

Damage: Damage to the parietal lobe can result in impaired verbal memory, impaired musical skills, trouble with direction, deafness, auditory hallucination, impaired learning, life-threatening bleeding, dyslexia, Pick’s disease, and aphasia.


Anatomy: The cerebellum is found at the back & bottom of the brain, right behind the brainstem and under the occipital lobe.

Function: The cerebellum is responsible for maintaining balance, coordinating movement, assisting in vision and coordinates eye movements, motor learning & muscle memory, researchers think the cerebellum has some role in thinking and emotions

Damage: Damage to the brain stem can result in lack of muscle control and movement, abnormal eye movements, headaches, slurred speech or difficulty talking, difficulties with walking and mobility, ataxia, and dysmetria (inability to judge distance and know when to stop).


Anatomy: The brainstem is divided into 3 sections: the midbrain (mesencephalon), the pons (metencephalon), and the medulla oblongata (myelencephalon)

Function: The brainstem is responsible for swallowing, breathing, vasomotor control (blood pressure) the senses – taste, smell, hearing, touch, sight, and controlling heartbeat

Damage: Damage to the parietal lobe can result in speech disorders,vestibular disturbance, dysphagia (difficulty or pain in swallowing) abnormal consciousness, demyelination (multiple sclerosis),infections, respiratory disturbance, vision problems, problems with other senses, and difficulty with vasomotor control.


We hope you enjoyed using your brain to learn about your brain! Every part of the brain serves a different purpose which is why it is important for them to work effectively together. Damage to even just one lobe can lead to a decrease in performance and ability to perform certain tasks. We’ll be posting about brain injuries soon, so you can learn about ways to keep your brain safe and healthy. 


“Brainstem.” Encyclopædia Britannica, Encyclopædia Britannica, Inc.,

Johnson, Jon. “Hypothalamus: Function, Hormones, and Disorders.” Edited by Daniel Murrell , Medical News Today, MediLexicon International, 22 Aug. 2018,

“Medical and Health Information.” Medical News Today, MediLexicon International,

Stamps, Caroline. Human Body. DK Publishing, 2013.

Healthcare Disparities: An Improvement in Equity Starts With Us

By: Rachel Kimball


After going to the emergency room, did insurance cover your bills? Have you had access to vaccines? Access to affordable prescribed medications? Have you been eligible to participate in clinical trials? Have you had access to affordable, safe housing and non-polluted air? Have you had access to nutritious food and clean water? Have you had a doctor listen to your symptoms thoroughly to provide an accurate diagnosis?

Unfortunately, these are questions that many Americans cannot say yes to. Having access to quality healthcare should be the norm, but why isn’t it? 

Now, it’s possible this isn’t a problem that you personally face. However, you can play a role in combating it. The issues regarding healthcare disparities are the result of lack of compassion  and a lack of education around these issues. Healthcare is vital for our survival, crucial for our existence. Yet, many of those who have access to it don’t care about the fact that others don’t! Ending this problem begins with acknowledging it, so let’s learn a little about healthcare inequity, so we can better educate ourselves and our peers.

Healthcare Disparities Overview: 

The definition of healthcare disparities is “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group, religion, socioeconomic status, gender, age, mental health, cognitive, sensory, or physical disability, sexual orientation or gender identity, geographic location, or other characteristics historically linked to discrimination or exclusion ” (2020 Healthy People). 

It is important to note that healthcare disparities are not something that happen by chance, and as mentioned in this definition, healthcare disparities statistically affect marginalized groups of people more than others. Joan Quinlan, Vice President of Community Health at Massachusetts General Hospital states that “80% of one’s health status is attributable to a set of social and economic issues” (MGH Charged).

Examples of these attributable issues include a lack of the following: high-quality education, nutritious food, decent and safe housing, reliable public transportation, culturally sensitive healthcare providers, health insurance, clean water, and non-polluted air. 

Preventing the factors that cause healthcare disparities is a start to ending the inequity surrounding healthcare. Although they may not seem related, things such as improving quality of education or providing affordable housing can greatly improve the healthcare of many. 

Lack of trust in healthcare: 

Harriet Washington, a medical ethicist and author of Medical Apartheid, states, “It is important for those of us in the medical community to gain awareness of the history because it provides a richer cultural context when engaging the African American community and our patients.” Although many of us are not professionals in the medical community, we are part of a community in which healthcare is crucial, and some of us may one day become healthcare professionals.

Unfortunately, the US has a long and complex history of medical experimentation on marginalized groups, and as Washington states, it is important to understand it, as it has led to a lack of trust in healthcare for many. Throughout history, medical schools disproportionately used African Americans in clinical trials and live surgical demonstrations. Additionally, for 40 years, from 1932 to 1972, the US Public Health Service (PHS) conducted an experiment on African American men who suffered from syphilis that led to slow and painful deaths. 

This unfortunate history of prejudice and discrimination in clinical trials has led to a significant lack of trust. This is seen today in vaccine hesitation and a desire to seek medical treatment. Rebuilding this trust may be difficult, but it is important, as it has led to tremendous inequity in healthcare if some feel as though they are unable to trust the medical systems in place. 

Implicit Bias in Medicine:

Implicit attitudes are thoughts and feelings that often exist outside of conscious awareness, and thus are difficult to consciously acknowledge and control.

Subtle biases towards patients of color may be expressed in several ways. This can include approaching patients with a dominant and condescending tone, failing to provide interpreters when needed, doing less thorough diagnostic work, recommending different treatment options, and allowing some families to visit patients after hours while limiting visitation for other families. 

It is very dangerous for healthcare providers to have implicit bias, and due to the fact that it is implicit, it is often difficult to dismantle. Implicit bias is often learned from a young age, and the environments in which kids are brought up can greatly influence their opinions. Calling out bias and prejudice when you hear it, even among your adolescent peers, can make a difference, as many of them will one day be healthcare professionals. Likewise, if you hear those who are already healthcare professionals (your friends, family, or pediatricians) express bias, don’t be afraid to kindly call it out. 

Lack of Representation in Clinical Trials:

First, socioeconomic status plays a significant role in eligibility of participating in clinical trials. In order to participate in a clinical trial, one must know that the trial is occuring in the first place. Those living in rural areas or those who don’t have access to internet are much less likely to know that the trials are occurring.

Second, due to the complex history of medical experimentation, many black Americans are rightfully hesitant to participate in these trials. 

Third, due to underlying medical conditions and/or lack of education, many people are excluded from trials. For example, over 75% of black women have hypertension, compared to 40% of white women, and in most clinical trials, participants must have no underlying health conditions, such as hypertension. Furthermore, prior to participating in the trials, cognitive screening is performed. A lack of education or lack of English proficiency would cause potential participants to not reach the benchmark to participate. All of these factors result in a significant lack of representation in clinical trials.

It is important to note that clinical trials test potential treatments for the general public, and they often lead to incredible scientific discoveries. Every approved treatment and cure in medicine today once started with a clinical trial. However, when only a select demographic is included in the trials, it is unknown how the treatment would affect the actual population, a significant issue in healthcare today.

The Results of Inequity in Neurology & Psychiatry:

As mentioned in our Alzheimer’s Instagram/Blog posts, Alzheimer’s is a progressive disease. The later AD is diagnosed, the worse it is, and least likely it is to be reversed. Furthermore, AD isn’t the only progressive neurological disease, and most neurological diseases get worse with time, especially those left untreated. 

Because people of color are unfortunately, less likely to seek care early on due to medical bias and the history of medical experimentation, it means that diagnoses are made further on in disease progression.


Acknowledging that healthcare disparities are a problem is the first, but not only step needed to move forward. The NIH has stated that “Virtually absent in literature is evidence-based information on how to reduce an individual health care provider’s bias.” Therefore, it is critical that we point it out when we see it. We highly recommend listening to Joan Quinlan’s episode on MGH Charged to learn more!


Hall, William J, et al. “Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review.”

American Journal of Public Health, American Public Health Association, Dec. 2015, “National Healthcare Quality & Disparities Reports.” AHRQ, “Scholar Speaks About History of Medical Experimentation on African Americans.” Scholar Speaks About History of Medical Experimentation on African Americans | UC San Francisco,

Siegel, Sari, et al. “Assessing the Nation’s Progress toward Elimination of Disparities in Health Care.” Journal of General Internal Medicine, Blackwell Science Inc, Feb. 2004,

Covid-19 Vaccines: How Can We Stop The Hesitation?

By: Adrianna Fusco; Rachel Kimball

*Please check out and talk with your healthcare provider for any questions regarding the COVID-19 Vaccine

*Note that this information is as of April 2021


Officially a year into the pandemic, COVID-19 has had a detrimental impact on our lives. We have all had a “Covid Birthday,” and what was once a “2-week closing” has turned into a very unprecedented time in our lives. 

As the vaccine distribution begins to accelerate, the light at the end of the tunnel is becoming (slightly) more clear. However, one thing stands in the way: vaccine hesitation. Why are some hesitant to get vaccinated, and what can we do about it? It is important for us to inform ourselves about the science behind the vaccines, so we can encourage others to roll up their sleeves once they are eligible.

The Immune System: 

In order to understand how vaccines work and why they are important, we must first understand the physiology of the immune system. The function of the immune system is to serve as a defense mechanism for our bodies against pathogens such as viruses, bateria, and parasites. 

This process is sustained through two separate systems: the innate immune system and the adaptive immune system. 

The innate immune system provides an immediate response to a pathogen invading the body, and when we are born, the innate immune system is almost completely developed. Physical barriers such as our skin, mucous, and hair are critical parts of the innate immune system, as they enable our body to fight off some pathogens immediately, before they even have a chance to enter our body. If pathogens are able to travel past these physical barriers, they can still be stopped in the bloodstream due to the complement system which sends fighter cells to pathogens to flag them as threats, causing pathogens to be wiped out before wreaking havoc.

While the innate immune system is incredibly important, the adaptive immune system is where vaccines play a role. The adaptive immune system is slower to respond than the innate system, but what sets it apart is its ability to “remember” pathogens. Once the adaptive immune system is introduced to a pathogen, the next time it encounters it, it will be able to better recognize and kill it. The adaptive immune system is made of T lymphocytes (T-Cells,) B lymphocytes (B-Cells,) and antibodies. Let’s talk about how the virus (Sars-CoV-2) turns into COVID-19. 

Sars-CoV-2 →  COVID-19: 

Sars-CoV-2 stands for Severe Acute Respiratory Syndrome Coronavirus 2. This virus contains an RNA genome wrapped in a nucleocapsid and spike proteins. The lipid envelope is the outermost layer which protects the genetic information when traveling between host cells. It is important to note that this layer can be disrupted by soap and water. The spike proteins take on different shapes in different types of coronavirus, and this shape aids in Sars-CoV-2 cells latching onto Ace-2 Receptors in the human body, causing infection. Prior to immunity, there are no B-cells, T-cells, or antigens that can specifically target this virus, which allows the virus to “survive” its entire journey to those Ace-2 receptors, therefore, easily infecting humans who are not immune. 

Let’s dive into the types of vaccines, so we can better understand the COVID-19 vaccines. 

Types of Vaccines:

Vaccines are an important tool for preventing infection by acquiring immunity. There are 5 types of vaccines: 

  • Live Attenuated vaccines – use a weakened form of bacteria/virus for lifetime immunity. 
    • MMR, Rotavirus, Smallpox, Chickenpox, Yellow Fever
  • Vector vaccines –  use killed virus/bacteria
    • Examples: Hepatitis A, Flu, Polio, Rabies 
  • Protein subunit vaccines: uses harmless pieces (proteins) of the virus/bacteria
    • Hepatitis B, HPV, Shingles, Hib, Pneumococcal Disease 
  • Toxoids vaccines: based on toxin produced by virus or bacteria 
    • diphtheria, tetanus
  • mRNA Vaccines: provide instructions 
    • Moderna and Pfizer COVID-19 vaccines

COVID-19 Vaccine Overview:

We previously learned that the adaptive immune system can prevent infection very effectively once you are vaccinated, as your body has a supply of T-Cells and B-Cells specifically designed for that virus ready to go, if needed, and this is exactly what the COVID-19 vaccine does. Once you are vaccinated, your body produces antibodies, T-Cells, and B-Cells, so when you are exposed to Sars-CoV-2, your immune system already knows how to deal with it. 

The COVID-19 vaccines approved are Pfizer, Moderna, and Johnson & Johnson. Pfizer and Moderna are mRNA vaccines. Most vaccines (including the J&J Covid vaccine) contain pathogens so your body is immune to that virus. However, mRNA vaccines provide the instructions for your body to produce that virus or bacteria which then causes your immune system to develop a defense against it. mRNA is a single stranded molecule that exists in all of our cells, and enzymes in the cytoplasm translate that information to make the proteins. 

COVID-19 Vaccine Efficacy

This chart highlights the differences between the 3 approved vaccines in the United States. Although there is a difference in effectiveness statistically speaking, the best vaccine to get is the one that is available to you first. The sooner you are vaccinated, the sooner you are immune. 

COVID-19 Vaccine Concerns:

Q: How was the vaccine created so fast?

A: The vaccine was created using technology that was created and tested over many years. Moderna (which stands for Modified RNA) was established in 2010, 11 years ago! Vaccines usually take a while to test due to the lack of subjects for testing, but this was not a problem due to the urgency in finding a vaccine for COVID-19 and the willingness of participants to take part. Furthermore, many vaccines are mass produced after they are approved by the FDA to save money and resources in case the vaccine is not approved; however, the COVID-19 vaccines were produced prior to being approved, so when the vaccines were approved, there would already be a supply. The technology along with multitude of subjects and rapid production process lead to the quick creation. It is important to note that the “science” was not rushed in any way.

Q: Is the vaccine safe?

A: Yes, it is. For vaccines to become FDA certified, they must go through intensive and rigorous testing that involves thousands of people, which all 3 approved COVID-19 vaccines have. Long term effects appear 30 to 45 days after the 2nd dosage, and the FDA waited 60 days to pass the vaccines for emergency use, past the period in which severe long-term effects would have appeared.

Q: Can the vaccine alter my DNA?

A: No, the vaccine cannot alter your DNA. The vaccine uses RNA and creates protein based on the virus’s genes, not yours. 

Q: When can children get the vaccine?

A: Right now the Pfizer vaccine is approved for age 16+, and the Moderna Vaccine is 18+. There have yet to be trials run on children, but according to Dr. Fauci, the trials are set to start in late January. The FDA is very careful when giving vaccines to children and pregnant women, and want to confirm the vaccines effectiveness

Q: Why shouldn’t I become immune naturally?

A: Attaining immunity naturally is risky and can lead to multiple health complications, and sometimes death. With COVID-19 people have reported having long term effects after contracting the disease and the death toll is large.Vaccines are more predictable and controllable than disease. The vaccines will give almost the same protection as natural immunity without the risks. 

MAPP Teens’ Role in Combating Vaccine Hesitancy:

As MAPP Ambassadors, our goal is to promote brain health. But what do COVID-19 Vaccines and brain health even have in common? 

First, COVID-19 can have long-term, devastating impacts on neurological function and the brain. For information about this, check out our “COVID-19 & The Brain” Instagram post from 1/18/21. Preventing these neurological complications requires preventing COVID-19, and the best way to do that is to get vaccinated. 

Second, vaccine hesitation is a psychological issue, specifically, psychological constructs and ideologies. The most common forms of psychological constructs are conspiratorial and paranoid beliefs. Although “anti-vaxers” may seem like people who don’t believe in science, much of the time, vaccine hesitancy is the result of misinformation and paranoia.


So now you know more about vaccines than the average person, but what do you do with this knowledge? The best way to combat vaccine hesitation is to educate others about the facts. In order for this pandemic to be over, a majority of the population must be vaccinated so we can reach herd immunity. Start by forwarding this article to others, and sending along information from the CDC. 

The light at the end of the tunnel is there, but in order to reach it, we must reach herd immunity. So step in line, and roll up your sleeves as soon as you are eligible, then encourage others to do the same. 

Works Cited

Adaptive immunity | Immune response (article). (n.d.). Retrieved January 12, 2021, from

Clem, A. (2011, January). Fundamentals of vaccine immunology. Retrieved January 12, 2021, from

Coronavirus disease (COVID-19): Herd immunity, lockdowns and COVID-19. (2020, December 31). Retrieved January 12, 2021, from

Corum, J., & Zimmer, C. (2020, December 05). How Moderna’s Vaccine Works. Retrieved January 12, 2021, from

Herd immunity and COVID-19 (coronavirus): What you need to know. (2020, December 15). Retrieved January 12, 2021, from

Kayla Hui, M. (2020, December 22). What’s in the COVID-19 Vaccines? Retrieved January 12, 2021, from

Price, S. (2020, March). Talk to Patients About: Vaccine Immunity vs. Natural Immunity By Sean Price Texas Medicine March 2020. Retrieved January 12, 2021, from

RNA vaccine. (2021, January 08). Retrieved January 12, 2021, from

Rodriguez, A. (2020, December 14). ‘Nothing too surprising there’: Pfizer’s COVID-19 vaccine ingredients are pretty standard, experts say. Retrieved January 12, 2021, from

Saplakoglu, Y. (2020, February 19). Coronavirus ‘spike’ protein just mapped, leading way to vaccine. Retrieved January 12, 2021, from 

2Simmons-Duffin, S. (2020, November 17). Why Does Pfizer’s COVID-19 Vaccine Need To Be Kept Colder Than Antarctica? Retrieved January 12, 2021, from

Symptoms of Coronavirus. (2020, December 22). Retrieved January 12, 2021, from

The Children’s Hospital of Philadelphia. (2014, November 05). Immune System and Health. Retrieved January 12, 2021, from

“Try Guys Debunk COVID Vaccine Conspiracies With Dr. Fauci.” YouTube, YouTube, 9 Jan. 2021,

Viral envelope. (2021, January 09). Retrieved January 12, 2021, from

*includes class resources like MiniPCR labs for COVID-19 genetics and COVID-19 vaccines


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