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Overnight Camp & The Brain: The Hidden Benefits of a Summer Spent in Cabins

By Rachel Kimball

Picture of a Sunfish Sailboat on Sunset Lake at Camp Tel Noar, a co-ed overnight camp in Hampstead, NH.

Introduction:

Some parents choose to send their kids off to sleep-away camp year after year. As days are filled with sailing, waterskiing, dancing, and bunk time, it makes us wonder: other than the fun that comes out of the several weeks spent away from home, how does it benefit these kids? This question can be answered in many ways ways, but one key component in how overnight camp benefits campers has to do with what the MAPP Scholars focus on most: the brain!

Staying Active & The Brain:

I spent eight summers at a camp in NH, and it is no joke that my watch tracked 20,000+ steps a day. From running to activities, to swimming laps in the pool, to dancing and kickball, kids are more active at camps than anywhere else. As mentioned in our Instagram posts, there is a very clear correlation between physical health and brain health.

Physical activity is any voluntary movement that requires energy. Aerobic exercise raises the rate of respiration and the heart rate. This boosts the immune system, reduces the risk of heart disease, type 2 diabetes, high blood pressure, and falls in older people. Most relevant to MAPP, it boosts cognitive function. Studies show that regular consistent exercise keeps the mind sharp and helps protect cognitive functions such as memory, thinking, and reasoning. Physical activity, especially strength-training, improves balance, increases neural functioning, and improves reaction time.

Many people often say that being in nature “clears our minds.” This is true, and there are also neurological reasons behind this. Recently, researchers studied more than 2,500 kids (ages 5-7). The researchers found that the children who spent more time outdoors had their memory improved by an average of 28 percent! They also found that children who spent time in nature were better at reading other people’s emotions and being socially aware due to increased an increase in brain activity.

Exercise also boosts happy hormone and neurotransmitter levels! It boosts dopamine, noradrenaline, serotonin levels, and and serotonin levels, as well as GABA which is responsible for chemical messaging in the brain. The physical activity at camps also causes release of proteins that promote the growth of new neurons. In addition, the increase in blood flow during exercise causes the brain to receive more oxygen-rich blood, which increases the level of nutrients in the brain.

Exercise also increases molecular targets such as the brain-derived neurotrophic factor (BDNF). This increases synaptogenesis (synapse forming) making which makes it easier to absorb information and form long-term memories. Hence, the physical activity during summer camp summer that comes with a summer at camp significantly benefits the brain.

Decreased Screen Time:

In addition to increasing physical activity, most overnight camps are technology-free and thus decrease campers’ screen time. There’s nothing like seeing your phone on visiting day and finding hundreds of unread texts and notifications. In fact, reduced screen time changes the brain over time.

Early data from a landmark National Institutes of Health (NIH) study that began in 2018 indicates that children who spent more than two hours a day on screen-time activities scored lower on language and thinking tests. Additionally, some , and some children with more than seven hours a day of screen time experienced thinning of the brain’s cortex, which is related the area of the brain related to critical thinking and reasoning. Decreasing this screen time, however, prevents these adverse effects.

Decreased screen time is also correlated with better quality sleep. Screen time close to bedtime prevents bedtime bed time, prevents the increase in melatonin levels necessary to fall asleep. When sleep is decreased to less than seven hours, the brain has less time to clear beta-amyloid away, raising the risk of developing Alzheimer’s Disease. RBy reducing decreasing screen time can increase hours spent sleeping each night, which reduces this additional risk factor of developing Alzheimer’s Disease.

Camp & The Middle Prefrontal Cortex:

The middle prefrontal cortex is the front-most part of the frontal lobe and is found right behind the forehead. It serves various a variety of functions, and enables us to regulate our emotions, feel empathy, communicate, adapt to new situations, make good decisions, and overcome fear. It plays a prominent large role in maintaining and building relationships, and having good emotional and mental health.

When camps influence kids’ minds and make them more confident, build relationships with others, and become more independent, the campers’ mindsets/attitudes aren’t the only things that are changing; their they’re brain structure is actually changing as well, as the middle prefrontal cortex is forming new synapses.

Different experiences change the brain’s wiring writing of the brain through neuroplasticity when the brain creates new synapses (connections between neurons.) When kids have camp experiences that require them to be independent, form new relationships, and be flexible, these new synapses strengthen. Change in structure causes change in function, so the more these skills and habits are repeated, the more the synapses are strengthened, and the more these skills develop.

Conclusion:

Anyone who has spent a summer or two at sleepaway camp will likely tell you how it changed them. And while the summer did change them as a person, it also changed their brain structure and function. From increased physical activity to decreased screen time, and anatomical changes in the brain, such as in the prefrontal cortex, camp can have a significant great impact on our cognitive health.

Sources:

Cross, Jennifer, Dr. “What Does Too Much Screen Time Do to Children’s Brains?”

New York Presbyterian, healthmatters.nyp.org/

what-does-too-much-screen-time-do-to-childrens-brains/. Accessed 24 Apr.

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summer camp could help.” Spectrum News 1, Charter Communications, July

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Sleepaway Camp.” American Camp Association, American Camp Association,

Inc., Jan. 2014, www.acacamps.org/resource-library/camping-magazine/

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anses-itself. Accessed 24 Apr. 2022.

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https://spectrumnews1.com/ca/la-west/health/2021/07/28/youth-anxiety-and-depression-increased-during-pandemic–summer-camp-could-help#:~:text=In%20addition%20to%20that%2C%20they,the%20mental%20health%20of%20kids.

https://www.nbc15.com/content/misc/Summer-Camp-Boosts-Brain-Development-503576601.html

https://www.acacamps.org/resource-library/camping-magazine/bunks-are-good-brains-neuroscience-sleepaway-camp

Give the Gift of the Outdoors: How Summer Camp Exercises Your Brain

https://www.healthline.com/health-news/a-lack-of-sleep-in-middle-age-can-increase-the-risk-of-dementia#How-the-brain-cleanses-itself

https://hms.harvard.edu/news/screen-time-brain

https://www.nbc15.com/content/misc/Summer-Camp-Boosts-Brain-Development-503576601.html#:~:text=Researchers%20studied%20more%20than%2025,as%20much%20as%2028%20percent.

Careers in Neurology/Psychology

By Rachel Kimball

Introduction:

Neurology and Psychiatry are fascinating fields. Many of us have heard the term “neurologist:” a doctor who focuses on the nervous system’s anatomy, function, and disorders. Likewise, psychiatry is a well-known career. However, there are hundreds of career paths within neurology and psychiatry.

In this blog post, we’ll be discussing many different types of careers within the broader field. This will include an overview of what a day-in-the-life may look like and the path required to get there.

Neurologists:

Neurology is a branch of medicine that deals with nervous system disorders including the brain, spinal cord, nerves, and ganglia. Some of the disorders and diseases they may study and treat include spinal cord disorders, sleep disorders, movement disorders, neurodegenerative diseases, speech and language disorders, and seizure disorders. The key difference between a neurologist and a neurosurgeon is that while both careers require an M.D., a neurologist does not perform surgery.

To become a neurologist, one must receive a 4-year undergraduate degree, obtain their M.D. or D.O., a one-year internship in either internal medicine or medicine/surgery, and complete a 3+ year residency training in an accredited neurology program. After residency, many neurologists choose to pursue further specialization through an additional fellowship program .

Psychiatrists

Psychiatry is the specialty of medicine that focuses on preventing, diagnosing, and treating behavioral, emotional, and mental disorders. A psychiatrist is a medical doctor (M.D. or D.O.) that completed medical school, a four-year residency training in psychiatry, and board exams. Psychiatrists may choose to further specialize their training in child and adolescent psychiatry, g eriatric psychiatry, forensic/legal psychiatry, addiction psychiatry, pain medicine, psychosomatic (mind and body) medicine, or sleep medicine.

Because psychiatrists are medical doctors, they can diagnose and treat various disorders. In addition, they can order medical tests and prescribe medications due to their medical degree. Treatment often includes psychotherapy (“talk therapy”) and prescription medications such as antidepressants, sedatives, hypnotics, mood stabilizers, stimulants, and antipsychotic medications.

Neurosurgeon:

Neurosurgeons must also obtain a medical degree and residency program to practice. Neurosurgeons differ from neurologists in the sense that they perform surgery. They diagnose and treat a variety of disorders, including congenital anomalies, trauma, tumors, vascular conditions , brain/spinal infections, and degenerative diseases. Neurosurgeons may perform minor procedures or more complex extensive ones, and they also typically spend time in a clinical setting seeing patients before or after their procedures.

Clinical Psychologist:

Clinical Psychologists do not need to obtain an M.D. or D.O. The path requires completion of an undergraduate degree, and a doctoral degree that sometimes requires a Master’s degree as a prerequisite. clinical psychologists make up one of the largest branches of psychology. Clinical psychologists work in a variety of environments: schools, hospitals, research settings, and training. Some work with patients with physical health concerns such as obesity or diabetes. Others work with patients with mental health disorders such as anxiety and depression, and other clinical psychologists work with students with learning disabilities.

Social Worker:

Social workers are clinicians who serve to enhance their clients well-being and promote social change and the development of communities. Social workers often strive to help their clients reach their essential socio-emotional needs. Social workers may focus on a specific specialty within social work, such as civil rights, unemployment insurance, disability pay, worker’s compensation, reduced mental health stigma, Medicaid and Medicare, or child abuse and neglect prevention. Like clinical psychologists, they often work in medical settings, research environments, or schools, thus, providing a great amount of variety within the sub-field. Some poisons require only completing an undergraduate degree in social work, but most programs require a master’s degree in social work after completion of the undergraduate years.

Genetic Counselor:

Genetic counselors work with patients to assess the risk of various genetic disorders and congenital disabilities in their children. They often work in medical settings, such as clinics or hospitals, and cross genetics with counseling to prevent genetic disorders and comfort families. Outside of their clinical hours, many genetic counselors also engage in research to deepen the field’s understanding of genetics and inheritable disorders. A genetic counselor must first complete a bachelor’s degree followed by a master’s degree in genetic counseling that includes clinical hours.

Neuropathologist:

Neuropathologists focus on neural tissue and diagnose neurological diseases and disorders by examining the brain , spinal cord, and nerves. Neuropathologists contribute greatly to neurological research as they examine different structures and learn more about various diseases while individually diagnosing patients. Neuropathologists play a significant role in biopsies, diagnosis during procedures, and autopsies. Neuropathologists focus a lot of their research on causes of death, degenerative brain disorders such as Alzheimer’s disease and other forms of dementia, and brain tumors. To become a neuropathologist, one must complete their undergraduate degree, obtain an M.D. or D.O, complete residency training in pathology, and then further specialize in neuropathology through a fellowship program and training.

Neuropsychologist:

A neuropsychologist is a clinician that focuses on the relationship between behavior/emotion and the biology/neuroanatomy of the brain. Neuropsychologists must obtain a doctorate in psychology and further post-doctoral training in neuropsychology. Neuropsychologists often diagnose and treat memory disorders, mood disturbances, learning disabilities, nervous system dysfunction, and developmental disorders. Their biological and psychological background enables them to use both qualitative psychological testing and medical imaging/tests to diagnose a set of symptoms. This multidisciplinary sub-field of psychology is excellent for those interested in the biological factors of neurological disorders.

Neuroradiologist:

A neuroradiologist is a radiologist that specializes in diagnosing neurological disorders through the use of medical imaging. Neuroradiologists must obtain a bachelor’s degree, attend medical school, complete residency training in radiology, and further training such as a fellowship in neuroradiology. Similar to neurosurgeons and neurologists, neuroradiologists are a type of physician. Neuroradiologists often analyze X-rays, MRIs, and CT scans of the brain and spinal cord. They also diagnose neurodegenerative diseases, tumors, and brain injuries.

Neuropharmacologist:

Neuropharmacology is the study of the effects of various drugs on the nervous system. Neuropharmacologists work to understand how different chemicals, such as medications and illicit drugs, affect the nervous system while synthesizing drugs that treat neurological disorders. Neuropharmacologists need to obtain a master’s or doctorate in neuropharmacology after completing a bachelor’s degree.

Psychophysicist:

As the name alludes, psychophysics studies the relationship between psychology and physics,specifically between physical stimuli and the psychological response/sensations it produces. Psychophysicists often work in research settings and may play a role in a clinical setting. Their research accounts for much of what we know about neurology and how our brain responds to stimuli. To become a psychophysicist, you must complete a master’s or doctorate in psychology and obtain further training in psychophysics. Most psychophysicists also have an undergraduate background that includes Physics to some extent.

Electroneurodiagnostic Technician:

Electroneurodiagnostic Technicians are radio-techs that specialize in the nervous system. They use various imaging techniques and tests including electroencephalographs (EEGs), nerve condition studies, electromyography (EMG), evoked potential (EP) Machinery, and inoperative monitoring (IOM). The tests they perform allow neurologists and neuroradiologists to diagnose disorders and diseases. Electroneurodiagnostic Technicians work in hospitals, research institutions, epilepsy monitoring units, and sleep disorder centers. To become an electroneurodiagnostic technician, one must complete a two-year associate’s degree and complete further training to pass the exam administered by the American Board of Electroencephalographic and Evoked Potential Technologists.

Neuroscience Nurse:

A neuroscience nurse is an RN that treats and monitors patients with neurological disorders such as brain trauma, neurodegenerative diseases, and strokes. They may work in an in-patient or out-patient setting and tend to be in clinics or hospitals.

Psychobiologist:

Psychobiologists work to study the physiological and evolutionary mechanisms responsible for human behavior. They often work in research settings to understand the relationship between biological factors and psychology, similar to that of a neuropsychologist (just without the clinical background oftentimes.) Psychobiologists believe that biology plays a significant role in human behavior and perform research to show why and how. Their findings play a major role in the field of neuropsychology and psychobiology. To become a psychobiologist, you must first complete an undergraduate degree and obtain a master’s or doctorate in psychology or a Ph.D. in biology. The key difference between neuroscience/neuropsychology and psychobiology is that psychobiologists focus on biological factors outside of just neurology.

Neuroanatomist:

Neuroanatomists focus on the anatomy and structure of the nervous system, often working on research and providing much of the information necessary for clinicians to diagnose. They make discoveries every day as they examine tissue. Their role is similar to that of a neuropathologist, but the career path does not require an M.D. or D.O. To become a neuroanatomist, you must obtain a master’s degree or doctorate.

Conclusion:

The wide variety of careers within neurology makes it an excellent choice for anyone interested in the field. An interest in neurology can take you in so many directions from neurophysicists to neuropathologists, and everything in between! This post included many of the different types of careers within neurology/psychiatry, but not all of them: there are many more to choose from, and a quick google search will show you countless opportunities in the field. Passion and an open mind will lead to a career in neurology that you love! Best of luck 🙂

Sources:

“Genetic Counselors : Occupational Outlook Handbook.” U.S. Bureau of Labor Statistics, U.S. Bureau of Labor Statistics, 18 Apr. 2022, https://www.bls.gov/ooh/healthcare/genetic-counselors.htm.

Learn.org, https://learn.org/articles/Neuropharmacologist_Frequently_Asked_Career_and_Salary_Questions.html#:~:text=Schools%20offer%20neuropharmacology%20degrees%20at,graduates%20are%20eligible%20as%20well.

“Neurology at Highland Hospital.” What Is a Neurologist? – Neurology – Highland Hospital – University of Rochester Medical Center, https://www.urmc.rochester.edu/highland/departments-centers/neurology/what-is-a-neurologist.aspx.

“Neuroscience Nurse.” Discover Nursing, https://nursing.jnj.com/specialty/neuroscience-nurse#:~:text=A%20Neuroscience%20Nurse%20helps%20patients,learn%20to%20manage%20their%20condition.

Pathologists, The Royal College of. “Become a Neuropathologist.” Homepage, https://www.rcpath.org/discover-pathology/careers-in-pathology/careers-in-medicine/become-a-neuropathologist.html.

Pietro, MaryAnn De. “Neuropsychologist: Definition and Patient Education.” Healthline, Healthline Media, 9 July 2017, https://www.healthline.com/health/neuropsychologist#typical-procedures.

“Pursuing a Career in Clinical or Counseling Psychology.” American Psychological Association, American Psychological Association, https://www.apa.org/education-career/guide/subfields/clinical/education-training.

“What Is a Neuroradiologist?” Invision Sally Jobe, https://www.invisionsallyjobe.com/what-is-a-neuroradiologist/.

“What Is a Neurosurgeon?” What Is a Neurosurgeon – Neurosurgery – Highland Hospital – University of Rochester Medical Center, https://www.urmc.rochester.edu/highland/departments-centers/neurosurgery/what-is-a-neurosurgeon.aspx#:~:text=A%20neurosurgeon%20is%20a%20physician,degenerative%20diseases%20of%20the%20spine.

“What Is Psychiatry?” Psychiatry.org – What Is Psychiatry?, https://www.psychiatry.org/patients-families/what-is-psychiatry-menu.

“What Is Social Work?” Social Work License Map, 28 Mar. 2022, https://socialworklicensemap.com/become-a-social-worker/what-is-social-work/.

Psychophysics: How We Smell, Hear, and See

By: Rachel Kimball

Introduction:

The five senses are something that we often learn about at a young age. We can navigate the world through our five senses, and even though they are prevalent in our daily lives, most people don’t know how they work. Perception is something that we couldn’t live without, and though our brain knows how it works, we ourselves, aren’t aware of its exact mechanics!

How could we interact with the things around us without our sense of perception? How could we communicate without our ability to see, hear, or feel? How could we enjoy the foods we eat for dinner or smell delicious baked goods as they come out of the oven?

We’ll dive into three of the five senses (sight, hearing, and smell) and how they work in this post.

Overview of Sensory Processes:

To understand how the five senses work, we must first understand how the brain detects stimuli. The process of sensation goes from physical stimulation to a physiological response and then finally to a sensory experience. Each sensory system has distinct receptors and neural pathways. Sensory receptors are specialized structures that respond to physical stimuli by producing electrical changes that initiate neural impulses. For example, smell is detected through the olfactory nerve, while taste buds detect stimuli sent to the brain through facial and favus nerves. Touch and pain are detected through skin neurons and then sent to the spinal nerves.earing is detected by pressure-sensitive hair cells in the cochlea of the inner ear and then enter the brain through the auditory brain. Lastly, sight is processed through rods and cones in the retina and optic nerve in the eye..

More potent stimuli produce more significant receptor potentials, leading to faster action potentials in nerves that send information to the brain. When a stimulus is strong, the brain reacts faster to that stimulus. When there are changes in the stimuli around us, our brain’s job is to detect the change and alert us. When the stimuli first change around you, you detect it. For example, If you put a wristwatch on, you will feel it when you put it on, then later not feel the pressure. When you smell a strong scent, the smell seems to fade as you stay there. This is due to sensory adaptation: when we are exposed to the same stimuli for a length of time, we become used to it, and the sensory system adapts by becoming less sensitive than it was before, eventually leading to you not noticing it.

Absolute and Difference Threshold:

Absolute threshold and difference threshold are two commonly used terms in Psychophysics. Absolute threshold describes the weakest intensity of a stimulus that can be detected at least 50 percent of the time. Although there are “average” absolute thresholds for each of the 5 senses, the exact levels vary for each person. The difference threshold describes the minimum change in a stimulus that can be detected between two different stimuli. Weber’s Law states that the just noticeable difference for a stimulus is proportional to the magnitude of the original stimulus. Therefore, it is harder to detect a change in strong stimuli than in weak stimuli.

Smell:

The stimuli for smell are chemical molecules that enter the nose, so smell is considered a chemical sense. It is also referred to as the olfactory system, and the olfactory epithelium is where stimuli are detected. The stimuli for smell are chemical molecules that evaporate into the air and then bond to a receptor site, which changes shape. This causes an electrical change that leads to an action potential of the nerve, sending the message to the brain. The axons of the olfactory system eventually reach the olfactory bulb in the brain, where they form synapses (connections between neurons) in the glomeruli structure. The glomeruli then send the message to other brain parts, such as the hypothalamus, where we respond emotionally to the smell. Our ability to taste different flavors is dependent on our smell, so if you ever have to eat something yucky, pinch your nostrils! There are differences between people when it comes to olfactory sensitivity. Women, for example, are more sensitive to odors than men. In addition, genetic differences cause there to be differences in what odors we can identify. Some people can sense at least 75 odors while others cannot. Sensitivity to different odors is also dependent on our experiences and what smells we have been exposed to before.

Hearing:

Unlike smell, sound is a physical stimulus rather than a chemical one. Sound travels in waves and reaches our ears through the vibration of air (or another medium.) Waves vary in frequency, and sound waves of greater frequency are higher energy and sound higher-pitched. Waves in lower frequency are lower-pitched and sound lower-pitched. The amplitude (height) of waves can also vary. Higher amplitude waves are louder than waves with lower amplitudes. Humans can hear amplitudes from 20 to 20,000 Hz. The anatomy of the ear enables us to make sense of auditory stimuli. It consists of the pinna (the visible portion of the ear) and the auditory canal, which begins at the ear’s opening and ends at the eardrum. Vibrations of sound waves cause the eardrum to vibrate. The eardrum is also called the tympanic membrane. The middle ear is an air-filled cavity that has three bones called ossicles that are tiny! The three bones are called the hammer, anvil, and stirrup. When the eardrum vibrates, it causes the ossicles to vibrate as well. The middle ear’s primary purpose is to amplify the sound waves’ intensity to enable transduction. Transduction is the response of action-potentials in neurons that eventually leads to a response, such as the brain making sense of the stimuli, in which you become aware of it. Transduction occurs in the inner ear in the cochlea. In the inner duct, a tube in the inner ear, are hair cells on the basilar membrane. At the end of each hair cell is a synapse that forms with auditory neurons, leading to the auditory nerve which runs to the brain. The hair cells then release a neurotransmitter, causing action potentials that send messages to the brain.

Sight:

When I was in preschool, we were learning about the five senses, and one of the activities was to draw a house blindfolded. When I heard that the activity was going to make us “blind,” I refused to participate because I thought the activity would make me go permanently blind, which three-year-old me didn’t want! But how do we see? Of the five senses, vision is actually the one that we know the most about.

When we see, light waves are transmitted across the cornea (the front part of the eye that acts as a barrier,) and then the waves pass through the pupil. The pupil’s job is to adjust how much light we are exposed to.

For example, in a dark room, our pupils dilate and increase in size, and when we are staring at something bright, the pupils decrease in diameter.

The light waves then pass through the lens. The lens serves similarly as the lens of a camera, as it focuses the image so we can eventually decode what we’re looking at. Once the light waves have passed through the front-most part of the eye, including the cornea, pupil, and lens, it hits the retina at the back-most side of the eye. The retina has two main types of cells: rods and cones. Cones are responsible for color vision and mainly concentrate in the fovea, which is in the center of the retina. Rods are found away from the retina’s center and are used primarily in dark light and for the less-fine details of sight.

The information gathered through these steps is then transmitted to the brain through the optic nerve. The information then passes through the optic chiasm to enable both hemispheres in the brain to receive the information (even when the information is only from one side of the visual field or only uses one eye, such as if one eye is closed). The information then passes to the lateral geniculate nucleus, eventually ending in the primary visual cortex of the occipital lobe.

Conclusion:

The science of how we see, smell and hear beautifully illustrates the interdisciplinary nature of neuroscience and how psychology, physics, and biology can all come together to describe a key component of Neuroscience: Psychophysics.

With this information, we can better understand how the senses work and what is happening in our bodies as we see, smell, and hear.

For more blog posts, check out our website!

Sources:

Gray, Peter. Psychology. Worth Publishers, 2014.

“How Do We Hear?” National Institute of Deafness and Other Communication Disorders, U.S. Department of Health and Human Services, https://www.nidcd.nih.gov/health/how-do-we-hear.

Let’s Talk Science, and February 03. “How We See.” Let’s Talk Science, 3 Feb. 2020, https://letstalkscience.ca/educational-resources/backgrounders/how-we-see.

“Smell Disorders.” National Institute of Deafness and Other Communication Disorders, U.S. Department of Health and Human Services, https://www.nidcd.nih.gov/health/smell-disorders#:~:text=Your%20sense%20of%20smell%E2%80%94like,connect%20directly%20to%20the%20brain.

Accepting MAPP Scholar Applications 2022

This year we will be accepting 2 scholars, applications are due February 11, 2022. If you are currently enrolled in an undergraduate or a graduate program related to Psychology, Neuroscience, or related fields – we strongly encourage you to apply!

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

Introduction:

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.

Conclusion:

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!

References:

“Caregiver Health.” Caregiver Health – Family Caregiver Alliance,

www.caregiver.org/resource/caregiver-health/.

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

www.caregiverstress.com/stress-management/signs-of-stress/emotional-signs-caregiver-stress/.

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

www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/mental-health-caregivers .

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

www.helpguide.org/articles/stress/caregiver-stress-and-burnout.htm.

Image: https://associationsnow.com/wp-content/uploads/2017/06/alzheimer-600×360.jpg

Cheat Sheet to Brain Health

By Rachel Kimball

Introduction:

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!

Nutrition:

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

Conclusion:

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.

Sources:

Bates, Mary. “A Dose of Music for Pain Relief.” BrainFacts.org,www.brainfacts.org/archives/2013/a-dose-of-music-for-pain-relief.

Collingwood, Jane. “The Power of Music To Reduce Stress.” Psych Central, Psych Central, 17 May 2016, psychcentral.com/lib/the-power-of-music-to-reduce-stress/.

Corliss, Julie. “Music and Heart Health.” Harvard Health Blog, 29 May 2018, www.health.harvard.edu/blog/music-and-heart-health-2018060713962.

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, www.ncbi.nlm.nih.gov/pmc/articles/PMC4519690/.

“Sleep Deprivation.” Department of Neurology, 18 Aug. 2020, www.columbianeurology.org/neurology/staywell/sleep-deprivation.

“Sleep Deprivation: Causes, Symptoms, & Treatment.” Sleep Foundation, 11 Dec. 2020, www.sleepfoundation.org/sleep-deprivation. Tarokh, Leila, et al.

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

Medicine,Nov.2016,www.ncbi.nlm.nih.gov/pmc/articles/PMC5074885/. Urrila, Anna S, et al.

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

Scientific Reports, Nature Publishing Group, 9 Feb. 017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5299428/.

Advanced Neurotherapy, PC. “6 Essential Nutrients to Promote Brain Function.” Advanced Neurotherapy, www.advancedneurotherapy.com/blog/2015/02/06/brain-function-nutrients.

Gómez-Pinilla, Fernando. “Brain Foods: the Effects of Nutrients on Brain Function.” Nature Reviews. Neuroscience, U.S. National Library of Medicine, July 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2805706/.

“Nutrition and Brain Health.” HealthEngine Blog, 21 Mar. 2019, healthengine.com.au/info/nutrition-and-brain-health.

Drugs and the Brain, https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brainneurotransmitters

Reynolds, Susan. “Have You Fed Your Brain Today?” Psychology Today, Sussex Publishers, 7 Sept. 2011, www.psychologytoday.com/us/blog/prime-your-gray-cells/201109/have-you-fed-your-brain-today.

Test Post

Your Brain: An Introduction to Its Anatomy

By: Rachel Kimball

Introduction:

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.

Cerebellum:

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).

Brainstem:

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.

Conclusion:

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.

Sources:

“Brainstem.” Encyclopædia Britannica, Encyclopædia Britannica, Inc., www.britannica.com/science/brainstem.

Johnson, Jon. “Hypothalamus: Function, Hormones, and Disorders.” Edited by Daniel Murrell , Medical News Today, MediLexicon International, 22 Aug. 2018, www.medicalnewstoday.com/articles/312628.

“Medical and Health Information.” Medical News Today, MediLexicon International, www.medicalnewstoday.com/.

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

Healthcare Disparities: An Improvement in Equity Starts With Us

By: Rachel Kimball

Introduction:

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.

Conclusion:

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!

Sources:

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, www.ncbi.nlm.nih.gov/pmc/articles/PMC4638275/. “National Healthcare Quality & Disparities Reports.” AHRQ,

www.ahrq.gov/research/findings/nhqrdr/index.html. “Scholar Speaks About History of Medical Experimentation on African Americans.” Scholar Speaks About History of Medical Experimentation on African Americans | UC San Francisco, www.ucsf.edu/news/2007/12/7682/scholar-speaks-about-history-medical-experimentation-african-american.

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, www.ncbi.nlm.nih.gov/pmc/articles/PMC1492147/.

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