Oncogenes are activated through well-known chromosomal alterations, including gene fusion, translocation and focal amplification. Recent evidence that the control of key genes depends on chromosome structures called insulated neighborhoods led us to investigate whether proto-oncogenes occur within these structures and if oncogene activation can occur via disruption of insulated neighborhood boundaries in cancer cells. We mapped insulated neighborhoods in T-cell acute lymphoblastic leukemia (T-ALL), and found that tumor cell genomes contain recurrent microdeletions that eliminate the boundary sites of insulated neighborhoods containing prominent T-ALL proto-oncogenes. Perturbation of such boundaries in non-malignant cells was sufficient to activate proto-oncogenes. Mutations affecting chromosome neighborhood boundaries were found in many types of cancer. Thus, oncogene activation can occur via genetic alterations that disrupt insulated neighborhoods in malignant cells.
The main tenet of physical biology is that biological phenomena can be subject to the same quantitative and predictive understanding that physics has afforded in the context of inanimate matter. However, the inherent complexity of many of these biological processes often leads to the derivation of complex theoretical descriptions containing a plethora of unknown parameters. Such complex descriptions pose a conceptual challenge to the establishment of a solid basis for predictive biology. In this article, we present various exciting examples of how synthetic biology can be used to simplify biological systems and distill these phenomena down to their essential features as a means to enable their theoretical description. Here, synthetic biology goes beyond previous efforts to engineer nature and becomes a tool to bend nature to understand it. We discuss various recent and classic experiments featuring applications of this synthetic approach to the elucidation of problems ranging from bacteriophage infection, to transcriptional regulation in bacteria and in developing embryos, to evolution. In all of these examples, synthetic biology provides the opportunity to turn cells into the equivalent of a test tube, where biological phenomena can be reconstituted and our theoretical understanding put to test with the same ease that these same phenomena can be studied in the in vitro setting.
Proper expression of genes requires communication with their regulatory elements that can be located elsewhere along the chromosome. The physics of chromatin fibers imposes a range of constraints on such communication. The molecular and biophysical mechanisms by which chromosomal communication is established, or prevented, have become a topic of intense study, and important roles for the spatial organization of chromosomes are being discovered. Here we present a view of the interphase 3D genome characterized by extensive physical compartmentalization and insulation on the one hand and facilitated long-range interactions on the other. We propose the existence of topological machines dedicated to set up and to exploit a 3D genome organization to both promote and censor communication along and between chromosomes.
Moderators and Presenters: Lorraine S. Cordeiro, U Massachusetts Amherst, Christopher Denning, U Massachusetts Boston, Herpreet Thind, U Massachusetts Lowell, Rachel Kulick, U Massachusetts Dartmouth
Session Description: The inaugural Community Research Innovative Scholars will present their perspectives regarding key issues, opportunities and/or challenges regarding community-engaged research. The scholarship of engagement provides opportunities to promote the development of human capital, in the classroom, within communities, in academia, and within the profession. Scholars will discuss the knowledge generation, economic, social and educational impact of their work on their universities and communities. Innovative engagement practices, strategies to address health and educational disparities, and scholarship impacts will be discussed in this panel.
Improving Community Health through an Innovative Collaboration between Academics and Practitioners through the Worcester Academic Health Department
The newly established Academic Health Collaborative at the Worcester Division of Public Health links local universities with the Division of Public Health in a collaborative partnership that bridges health/public health academia and practice to improve community health. It allows the DPH to leverage academic and community resources and expertise to help it achieve its goal to become the “Healthiest City in New England by 2020”.
This innovative collaboration allows the DPH and local partners to train a future generation of students that can work and communicate across disciplines and settings. In addition, it provides structured practicum and internship experience for area college and university students that serves not only the needs of public health but enhances the learning experience for the student. So far, these experiences have been tailored to address priorities identified by the WDPH to support the Division’s Strategic Plan and CHIP are addressed and implemented.
Addressing Gaps to Promote Co-learning and Bidirectional Capacity Building in Community Engaged Research: Challenges and Untapped Opportunities
Moderator: Stephenie Lemon, Ph.D., UMass Worcester Prevention Research Center
Session Titles and Presenters
-Learning From Each Other: Other Partnerships, Other Experiences - Linda Silka, Senator George J. Mitchell Center for Sustainability Solutions, University of Maine
-What is Research Literacy? - Lauren R. Powell, PhD Candidate Clinical and Population Health Research, UMass Medical School
-Learning by Doing to Enhance a Community-University Partnership - TBN, The Puerto Rican Cultural Center - Phil Granberry, PhD, The Gaston Institute, UMass Boston
-Enhancing Cultural Competency in Research Teams: The Promise of Simulation-based Training - Marie Boone, Executive Vice President of Planning, Mosaic Cultural Complex
Session Description: Community engagement is increasingly recognized as an essential approach for the development of a body of health-related research that will ultimately improve population health status and promote health equity. However, this approach poses many challenges as well as untapped opportunities. Specific to this session, co-learning and bidirectional capacity building are widely promulgated core principles of community engaged research. The intent of the principles are for community and academic members to learn from each other in both formal and informal ways, leveraging respective strengths, in order to develop sustainable knowledge, skills and resources. In a community–university, partnerships, researchers and community residents must commit not only to sharing their skills and experiences, but also to learning from and valuing each other’s skills. This requires that both groups engage in a bidirectional learning process. Through this co-learning and capacity building, research partnerships and participation can be improved and ultimately the research itself can potentially have greater impact. The purpose of this session is to provide a series of brief presentations from academia and community organizations that will outline specific issues experienced in promoting co-learning and bidirectional capacity for academic teams, community partners and community members and to describe local efforts to enhance co-learning, bidirectional capacity and community engaged research overall.
Diagnostic Evaluation and Home Monitor Use in Late Preterm to Term Infants With Apnea, Bradycardia, and Desaturations
Apnea, bradycardia, and oxygen desaturation events are a common in neonatal intensive care units, with relevant literature to date largely focusing on very low birth weight and extremely low birth weight infants. We conducted a retrospective review of infants born at ≥34 weeks gestational age at 2 tertiary neonatal intensive care units in Boston, MA, between January 2009 and December 2013. Our objectives included (1) describing the diagnostic evaluations performed in late preterm to term infants with discharge-delaying apnea, bradycardia, or oxygen desaturation events and (2) identifying variables associated with home monitor use. Of the 741 eligible infants identified, diagnostic evaluations were variable and infrequent with blood culture, blood glucose, and head ultrasound performed most commonly. The likelihood of home monitor use was greater in infants with either a prolonged inpatient stay or greater gestational age at birth.
This is the Symposium's Keynote presentation by Carolyn M. Jenkins, DrPH, MSN, RD, LD, FAAN, who is the Ann Darlington Edwards Endowed Chair in Nursing and a Professor at the Medical University of South Carolina in Charleston. Dr. Jenkins reviews principles of CEnR (Community-engaged Research) with focus on CBPR (Community-based participatory research); describes community engagement in the context of research frameworks; explores methods for training academic and community members for CEnR; and reviews the Community Engaged Scholars Program and examples of CEnR and action.
OBJECTIVE: To develop a predictive model of cochlear implant (CI) performance in postlingually deafened adults that includes contemporary speech perception testing and the hearing history of both ears.
STUDY DESIGN: Retrospective clinical study. Multivariate predictors of speech perception after CI surgery included duration of any degree of hearing loss (HL), duration of severe-to-profound HL, age at implantation, and preoperative Hearing in Noise Test (HINT) sentences in quiet and HINT sentences in noise scores. Consonant-nucleus-consonant (CNC) scores served as the dependent variable. To develop the model, we performed a stepwise multiple regression analysis.
SETTING: Tertiary referral center.
PATIENTS: Adult patients with postlingual severe-to-profound HL who received a multichannel CI. Mean follow-up was 28 months. Fifty-five patients were included in the initial bivariate analysis.
INTERVENTION(S): Multichannel cochlear implantation.
MAIN OUTCOME MEASURES(S): Predicted and measured postoperative CNC scores.
RESULTS: The regression analysis resulted in a model that accounted for 60% of the variance in postoperative CNC scores. The formula is (pred)CNC score = 76.05 + (-0.08 x DurHL(CI ear)) + (0.38 x pre-HINT sentences in quiet) + (0.04 x long sev-prof HL(either ear)). Duration of HL was in months. The mean difference between predicted and measured postoperative CNC scores was 1.7 percentage points (SD, 16.3).
CONCLUSION: The University of Massachusetts CI formula uses HINT sentence scores and the hearing history of both ears to predict the variance in postoperative monosyllabic word scores. This model compares favorably with previous studies that relied on Central Institute for the Deaf sentence scores and uses patient data collected by most centers in the United States.
Gallstone disease exacts a considerable financial and social burden worldwide leading to frequent physician visits and hospitalizations. Based on their composition, gallstones are categorized as cholesterol, black pigment, and brown pigment, with each category having a unique structural, epidemiologic, and risk factor profile. Cholesterol crystal formation requires the presence of one or more of the following: (a) cholesterol supersaturation, (b) accelerated nucleation, or (c) gallbladder hypomotility/bile stasis. Some risk factors for cholesterol stones include age, gender, genetics, obesity, rapid weight loss, and ileal disease. Generally, pigment stones are formed by the precipitation of bilirubin in bile, with black stones associated with chronic hemolytic states, cirrhosis, Gilbert syndrome, or cystic fibrosis, and brown stones associated with chronic bacterial or parasitic infections.
Status and Potential of Community-Engaged Research to Investigate Physical Activity Interventions for Children with Autism Spectrum Disorder in Chinese-American Communities
Children with Autism Spectrum Disorder (ASD) engage in less physical activity (PA), and in one estimate (Curtin et al., 2010) were 1.3 times more likely to be obese than their typically developing (TD) peers. Barriers to PA in children with ASD exist at the individual, family/peer and community levels of the socio-ecological model. Research on multilevel adaptations to PA programs has been promising. With adapted coaching, adolescents with ASD have achieved fitness gains equal to those seen in TD children, and have performed high levels of moderate-intensity PA in community settings. Social skills development has also been noted. Community-engaged research is well suited to identifying barriers to PA and designing programs and lifestyle approaches to health. It may be particularly useful for research with children with ASD and their families from culturally diverse communities. Scant research has been conducted on PA in ASD, but it is almost non-existent among Chinese-American children/families, for whom familial and cultural perspectives on ASD, modes of exercise and health, and other factors may diverge from the typical American norm. This poster will: (1) review research on multi-level determinants of PA and exercise, and on programs for children with ASD in general; (2) review research on community-engaged approaches for addressing PA and related health challenges in ASD; (3) describe Chinese-American cultural variables that may influence participation in PA in families with children with ASD; and (4) propose ideas for new community-engaged research and sustainable partnerships that would address these challenges among Chinese-American children and families.
A Pilot Study: Understanding Health Literacy and Linguistic Factors Related to African Immigrants Engagement in Primary Health Care in Massachusetts
Culture impacts how individuals understand, communicate, and respond to health information. Immigrants to the U.S. come from diverse cultural groups and have varying understandings of health care and the U.S. health care system. The primary aim of this study is to explore cultural interpretations and beliefs of select health concepts and to assess the health literacy of African immigrants in Massachusetts. We are a partnership between UMass Graduate School of Nursing, Africans for Improved Access program at the Multicultural AIDS Coalition and Clark University. Using a CBPR approach has been valuable in the design of the study and in our ability to access and engage African immigrants. We are recruiting 100 African immigrants during cultural events, targeted outreach and gatherings in religious communities to complete a Freelist exercise, 2 health literacy assessment tools, and a general health survey. Results of the Freelist exercise will inform development of an interview guide that will be used with 3 Focus Groups of African immigrants to help us understand the cultural interpretation of frequently used health related words and phrases. We are assessing the feasibility and acceptability of 2 health literacy instruments to determine the appropriateness of using these assessments with an immigrant population. The association of health literacy to accessing primary care will be examined. The focus group and general health survey data will help us gain a better understanding of the primary care health experiences of African immigrants and potential factors that facilitate or hinder their engagement in primary health care.
One quarter of the population of Cape Cod is over age 65, and in the eight outermost towns on the peninsula of Cape Cod, known as the Lower and Outer Cape, the challenges of caring for an older population are compounded by the effects of rural isolation. As many residents have chosen to “age in place” with little family or social support, medical and behavioral health needs often go unaddressed due to the lack of access to needed healthcare and supporting services that plagues underserved rural areas. Outer Cape Health Services (OCHS), a federally-qualified community health center and the primary medical and behavioral health provider in the area, has established a home visit program to reach isolated patients who may otherwise be denied access to these services. This program is lead by the Care Coordination team, which collaborates with local Councils on Aging, the Visiting Nurses Association, EMS, and other community resources to identify and engage these complex, high-acuity patients and provide wrap-around services. However, gaps remain in communication among agencies regarding existing and potential cases. Additionally, little data exist on the health challenges faced by this underserved population, and how care coordination can better address medical and psychosocial needs. To address these gaps, a cross-departmental team at OCHS has begun a community-based research project with the goal of developing a network of consumers, providers and agencies to develop research questions and collaborate on interventions. The team is in the process of identifying key stakeholders and developing community-building strategies.
The American Foundation for Suicide Prevention (AFSP) strives to reduce suicide attempts and deaths through research, education, and advocacy. AFSP has been at the forefront of changing minds about suicide prevention and creating effective means of intervention.
Stigma and myths surrounding mental illness and suicide still prevail and contribute to its incidence. People often hesitate to admit suicidal ideation and to seek help. Healthcare professionals are in a key position to identify people who are suicidal and connect them with appropriate services. In order to do this, they need to not only know about suicide but be willing to intervene.
Advocacy is the act of creating political, economic, and social change. It is the professional responsibility of those working in healthcare to be active advocates for underserved populations where care is not optimal. This ability must be learned and practiced.
Educational opportunities are needed to address the cognitive components of suicide as a health issue and advocacy as a professional responsibility. However, the affective and procedural domains must also be addressed in order to make the transition of this knowledge to practical use. There is substantial evidence that service learning is effective in addressing attitudes towards marginalized issues. It is also a powerful mechanism to improve self-efficacy in a skill. Establishing a partnership between UMass and AFSP to develop service learning coursework to meet the goals of educating students in health-related majors in aspects of suicide prevention and advocacy would benefit both parties. Goals would include program development and evaluation.
Socio-cultural and Linguistic Adaptation of CDC CHANGE Action Guide to Conduct a Community Health Assessment in the Dominican Republic: A Multi-disciplinary and Mixed Methods Approach
Background. Third world communities like Las Malvinas, located in the Dominican Republic (DR), often face public health challenges. Instituting healthy communities requires collaborative public health services. The US has used evidence-based initiatives including the CDC’s CHANGE tool to address community health. There is a need to adapt these initiatives to other contexts. Clemson University (CU) students have partnered with Dominican University (UNIBE) and the Las Malvinas community to improve the community’s health and well-being.
Methods. The team’s ACTION steps include: assembling a community team and strategy, reviewing the CHANGE sectors, and gathering the data to use in the CHANGE tool. The Community Health Improvement Plan (CHIP) will be developed from that data. After reviewing reports on Las Malvinas and site visits alongside public health theory, students modified CHANGE data tools both culturally and linguistically.
Results. Five public health priorities for Las Malvinas were identified: sanitation, education, unwanted pregnancies, vaccine-preventable diseases, and chronic diseases. CU students will travel to Las Malvinas and collect data via focus groups, interviews, and GIS household survey, created by CU students.
Discussion. Adapting and translating evidence-based practices across cultures poses opportunities and challenges. CU research team designed this project by relying on expertise and collaboration with a local university and neighborhood organization. Challenges included: (a) working from abroad, (b) language barriers, (c) binational IRB approval, (d) adapting CHANGE tool, and (e) limited community organizations. Despite these challenges, this project showed the value of cross-cultural collaboration and use of public health assessment tools to reach communities worldwide.
Biographies of all the speakers at the 5th annual Community Engagement and Research Symposium, held Friday, March 25, 2016 at the University of Massachusetts Medical School, Worcester, MA.
View abstracts and full text of selected posters presented at the 2016 Community Engagement and Research Sympsoium
The Deaf community - a minority group of 500,000 Americans who use American Sign Language (ASL) - experiences trauma and addiction at rates double to the general population. Yet, there are no evidence-based treatments that have been evaluated to treat trauma, addiction, or other behavioral health conditions among Deaf people.
Current evidence-based treatments fail to meet the needs of Deaf clients. One example is Seeking Safety, a well-validated therapy for people recovering from trauma and addiction. Seeking Safety includes a therapist guide and client handouts for 25 therapy sessions, each teaching clients a safe coping skill. When Seeking Safety was used with Deaf clients, unique barriers were revealed with regard to the client materials: they were presented in complex English instead of ASL, nor sensitive to Deaf people’s culture, social norms, and history of oppression.
To address these barriers, Dr. Anderson assembled a team of Deaf and hearing researchers, clinicians, filmmakers, actors, artists, and Deaf people in recovery to develop Signs of Safety, a Deaf-accessible toolkit to be used with Seeking Safety. Signs of Safety is comprised of a therapist companion guide and population-specific client materials, including visual handouts and ASL teaching stories on digital video, which present key learning points via an “educational soap opera.”
Dr. Anderson is currently leading a pilot study of Signs of Safety. Preliminary results show that participants are reporting symptom reduction from baseline to follow-up and high levels of satisfaction with the model, giving us the confidence to further pursue this line of research.
WE ACT's Environmental Health and Justice Leadership Training (EHJLT) Program: A Tool to Help Disseminate Research to Community Members Who Live/Work in Northern Manhattan (NYC)
Background: WE ACT for Environmental Justice is a nonprofit organization whose work centers around three pillars: research, community organizing, and advocacy. Through long standing partnerships with academic institutions such as Columbia Center for Children’s Environmental Health and the NIEHS Center in Northern Manhattan, WE ACT has fostered opportunities for the translation of research conducted by both academic institutions and community members living in Northern Manhattan.
Methods: One tool that WE ACT uses to disseminate research is the Environmental Health and Justice Leadership Training (EHJLT) Program: a 10 week course where a cohort of 25 community members are introduced to environmental concerns affecting Northern Manhattan such as Clean Air Quality, Food Justice, Toxic Products, Affordable Transportation, Healthy Indoor Environments, among others. Guest presenters who are lead investigators or have expertise in the field are also invited to share their findings.
Results/Conclusion: Surveys collected at the beginning and end of the program demonstrated an increase in environmental health literacy. Graduates of the EHJLT program build upon the knowledge they gain by participating in campaign specific working groups, lobbying to pass statewide initiatives such as the Child Safe Products Act, and giving testimony at public hearings. Translating scientific evidence into sound policy is necessary for the creation and sustainability of healthy and equitable communities. Training programs similar to the EHJLT can be a helpful and replicable model in disseminating research and fostering capacity to decrease health disparities from the ground up.
The Engaged Department Initiative (EDI) is a place-based cross-institutional collaboration located in the Grand Rapids region. Participating organizations include Michigan Campus Compact (MiCC), Grand Valley State University (GVSU), Grand Rapids Community College (GRCC), and Aquinas College (AQ). This innovative ethnographic case study is focused on evaluating how well the initiative completes their goals of increasing faculty knowledge and skills, expanding students’ community engagement, fostering intra- and inter- collaborations between the three institutions of higher education, and enhancing community partnerships. The hopes of this initiative is to make a real difference in the community and to create engaged citizens. By disseminating this research, we aspire to offer recommendations for people interested in spanning boundaries and working on place-based change in their own region.