MSP Available Mentors
Shlomit Aizik, PhD
Executive Director, Pediatric Exercise and Genomics Research Center
The UC Irvine Health Pediatric Exercise and Genomics Research Center (PERC) is dedicated to unleashing the healing power of exercise. We know that improving health outcomes for children starts with research. Our nationally renowned clinicians, exercise physiologists and researchers are driven to learn what type of exercise, how much and for how long, produces the most predictable, effective outcomes to improve childhood health. They also seek the biological mechanisms that trigger specific physiological responses to exercise. PERC is one of the few centers in the nation exploring the connection between exercise and the epigenome (the intermediary between genes and the environment causing changes in how genes express themselves). Simply put, we’re gaining new knowledge about the human body’s response to exercise at the cellular level.
Our belief is that exercise is good medicine for all children, and especially for those with health challenges. Our results are proving it. Large-scale and innovative investigations underway at our center are already helping kids move forward with their lives, despite the effects of their disabilities, illnesses or injuries. Based within UC Irvine Health School of Medicine . PERC is engaged in an array of pioneering exercise-science studies that can lead to breakthrough results for the next generation.
• To advance pediatric exercise medicine through clinical and laboratory research
• To provide an exercise plan for infants, children and young adults
• To provide preventive and rehabilitative exercise programs
• To promote and foster community partnerships to encourage physical activity in children
Heike Thiel de Bocanegra, MD, PhD
Director, Family Planning Research Program, Obstetrics and Gynecology
The Family Planning Division at the Department of Obstetrics and Gynecology, University of California, Irvine conducts several research and quality improvement studies to assess quality of care and effectiveness of interventions. Medical students could participate or develop complementary programs around the following activities:
1. Developing a pilot project on linking domestic violence programs with family planning services and evaluating its impact
This initiative is a follow up to the June 2, 2017 symposium on "Intimate Partner Violence, Reproductive Coercion, and Family Planning", sponsored by the UCI Initiative to End Family Violence.
2. Assessment of childbearing intention and contraceptive preferences in refugee women in Southern California
This initiative involves several UC campuses (UC San Diego, UC San Francisco and UC Irvine) and involves currently the implementation of pregnancy intention questions and need for contraception at refugee resettlement agencies
3. Adapting the IMPLICIT model to UCI: Training family medicine physicians to screen women for contraceptive needs and depression during well-baby visits
See the Implicit model (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940465/)
Karina Cramer, PhD
Professor, Neurobiology & Behavior
Our research addresses the formation of neural circuits during normal development and in neurodevelopmental disorders. We are also investigating plasticity in neural circuits after injury. Our focus in on central auditory pathways, where highly precise connectivity contributes to sound localization pathways. We are currently studying the roles of glial cells in auditory circuit assembly. We found that astrocytes contribute to synaptogenesis in an important inhibitory pathway, and that they help shape dendritic morphology, which is important for the function of auditory neurons. We found that astrocytes and microglia surround specialized axon terminations, both during normal development and during lesion-induced plasticity. We are currently expanding our study of the roles of microglia in the development of auditory brainstem circuits. A recent discovery in our laboratory has led to a new area of study. We found that caspase-3, normally thought to be associated with cell death, displays an intriguing expression pattern during development. It is seen in axons and its expression ascends the auditory brainstem pathways coincident with synaptogenesis in this system. Inhibition of caspase-3 led to errors in nucleogenesis and axon targeting. We are exploring the mechanisms of caspase-3 function in this system.
Angela Fleischman, MD, PhD
Assistant Professor, Division of Hematology/Oncology
The Fleischman lab studies the pathogenesis of myeloproliferative neoplasm (MPN), a chronic hematologic malignancy characterized by excessive production of myeloid cells, high inflammatory cytokines, bone marrow fibrosis, and in some cases progression to acute leukemia. Specifically, we focus on chronic inflammation as a driver of MPN disease initiation and progression. We use mouse MPN models and primary MPN patient samples as our primary research tools. We are currently utilizing patient samples to identify the mechanism that drives excessive inflammatory cytokine production in MPN. We utilize mouse MPN models to identify how MPN mutant hematopoietic stem cells respond differently to inflammatory stimuli as compared to normal hematopoietic stem cells. We are also developing interventional trials in MPN patients utilizing diet to reduce inflammation.
Don Forthal, MD
Division Chief, Infectious Disease
Research in the Forthal laboratory focuses on interactions between antibodies and receptors for antibodies, known as Fc receptors, that are found on a variety of cells. In particular we study antibodies directed against HIV and dengue virus and determine the consequences of those antibodies on virus infection after engagement of the Fc receptors. The overall objective of our research is to develop safe and effective vaccines.
Anand Ganesan MD, PhD
Associate Professor, Dermatology
My laboratory and clinical practice focus on understanding how melanocytes in the skin respond to UV to produce melanin, how UV stimulates melanocytes to migrate from the hair to the skin during vitiligo repigmentation, and how UV stimulates melanocytes migrate out of the skin or the hair to form nevi or melanoma. In the laboratory, we have developed in vivo animal models to study the process of pigmentation, melanocyte migration, and melanoma formation, which have been instrumental in increasing our understanding of melanocyte migration. In addition, we have recently developed novel imaging approaches and single cell genomics approaches to understand what melanocytes migrate out of the hair into the epidermis during vitiligo pigmentation in humans, and also are using animal models to identify genes that control the growth of melanocytic nevi and prevent them from transforming to melanoma. Medical students involved in our research will have the opportunity to participate in translational studies to better understand how vitiligo skin repigments in response to UV or in histopathologic correlation/ genomic studies to determine what differentiates a normal nevus from an evolving melanoma.
Jean Gehricke, PhD
Associate Adjunct Professor, Pediatrics
Dr. Gehricke is a neuroscientist and clinical psychologist at The Center for Autism & Neurodevelopmental Disorders, which is a state of the art diagnostic and treatment facility serving over 2500 children. His neurodevelopmental lab is central to the Center’s research infrastructure by connecting to the Autism Treatment Network, the Autism Intervention Research Network on Physical Health, and the UC Irvine Pediatric Exercise and Genomics Research Center. The lab has 3 project coordinators and over 15 graduate and undergraduate students primarily focusing on studying behavioral treatments for neurodevelopmental disorders including Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder, and associated comordities. Currently funded projects examine the effects of physical exercise on children with ASD as well as career development programs for young adults with ASD. Medical student scholars will learn how to conduct patient-oriented research as well as develop and implement their own study protocols.
Neal Hermanowicz, MD
I am a neurologist with subspecialty expertise in an area known as Movement Disorders. My interests are in clinical investigations in people with Parkinson’s disease and Huntington’s disease. My projects include:
1. Assessment of occult Parkinsonism in people with gastrointestinal dysfunction.
2. Quality of life issues in people with Parkinson’s disease
3. Psychosis symptoms and their treatment in people with Parkinson’s disease
4. Clinical trials of novel therapeutics in people with Parkinson’s disease and Huntington’s disease
Virgina Kimonis, MD
Professor, Genetic and Genomic Medicine
1) Inclusion Body Myopathy associated with Paget's disease of bone and Frontotemporal Dementia (IBMPFD)
IBMPFD is a rare adult onset genetic disease caused by any one of several possible mutations in a gene called Valosin Containing Protein (VCP or p97). The clinical features include one or a combination of the following: myopathy, early–onset Paget’s disease of bone, and premature frontotemporal dementia. IBMPFD is progressive and death typically occurs in the 50s and 60s from respiratory and cardiac failure. IBMPFD is an autosomal dominant disorder. It is estimated that 80% of affected people also have an affected parent and 20% of IBMPFD occurs de novo or without recognized family history. The purpose of the IBMPFD study is to further characterize the molecular mechanisms in individuals and families and to facilitate earlier diagnosis and to monitor the disease progression. As more research is done, we may be able to investigate if different disease causing mutations in the VCP gene cause different symptoms in the individual. This will mean better management and treatment in the future. Subjects travel from across the country to participate in two days of testing which includes a physical exam, questionnaires, blood and urine collection, muscle biopsy, MRI, EMG, EKG, Echocardiogram, bone scan, Neuropysch testing, pulmonary function, dynamometry, and Biodex. We have made a knock-in mouse model of the disease. The following studies are active in the lab:
– Animal studies- treatment trials
• Exon Skipping
– Differentiate iPSCS into myoblasts for Px studies
2) HSPB8 As a result of our interest in inclusion body myopathy we have identified a new disorder. We are making the animal model and stem cells from patient fibroblasts which will then be differentiated to exon skipping oligonucletoides
3) Prader-Willi Syndrome (PWS) and Early-onset Morbid Obesity (EMO) Natural History Study
Prader-Willi Syndrome (PWS) is a genetic disorder characterized by low tone, poor feeding and growth, childhood onset obesity, short stature, distinctive facial features, developmental delay, and behaviour problems. PWS is associated with either paternal deletion of the chromosome 15 or uniparental disomy (UPD), where there are two maternal chromosomes and no paternal contribution. In up to 5% of patients there is a deletion of the imprinting center. Currently no cure available for PWS but growth hormone is largely used as treatment to reduce symptoms. Early Onset Morbid Obesity is characterized by individuals who develop obesity before the age of 4 years. The purpose of the study is to collect natural history information on Prader-Willi syndrome and early onset morbid (severe) obesity to learn more about how these conditions can affect a person throughout his or her life from birth to an adult. This will mean better management and treatment in the future. The data from these studies are being analyzed for publications.As a result of our interest in PWS we have determined that early diagnosis is important to prevent the early obesity and co-morbidities. We are undertaking a lab project to diagnose PWS from newborn filter paper cards. A phase 3 drug trial hopefully will begin in the next few months. UC Irvine will be the lead site for this study.
4) Lysosomal Storage Disorders Registry Natural History studyThe purpose of the LSD Registry is to collect uniform and meaningful data on patients with Lysosomal storage disorders. These are genetic disorders that result from a deficiency of lysosomal enzymes. At UCI we currently treat Pompe, Fabry, Gaucher. The LSD Registry Program uses a database to track outcomes of routine clinical practice for patients with these LSD diseases. We host educational physician and family meetings to increase awareness of LSDs. Also, we are launching a new study investigating the effects of exercise on Pompe disease.The purpose of this program is to better characterize the natural history and progression of these LSD diseases, as well as the clinical responses of patients whose have been prescribed enzyme replacement therapy. Data from our cohort of patients and the Sanofi registry is being utilized for data analysis and publications.Pompe disease resistance training exercise:We are also performing a resistance training exercise study in a cohort of 10 patients with Pompe disease. The study is going well and will be completed after 2 more patients are recruited.Fabry diseaseWe are starting a new trial of a new enzyme treatment for another lysosomal storage disorder: Fabry disease
Jonathan Lakey PhD, MSM
Professor, Surgery and Biomedical Engineering
Our research laboratory has a focus on cell therapies, with specific interest in islet transplantation for diabetes. By focusing on the insulin producing cells within the pancreas we have been able to develop and translate cellular therapies of islet transplantation in patients with longstanding Type 1 diabetes. Our efforts to reduce the requirement of livelong immunosuppressant therapies have driven us to develop biomaterials that can house and protect the transplanted cells from the immune system when transplanted.
As a goal of developing an unlimited source of insulin producing islets, we have several research projects into stem differentiation of insulin producing cells from both embryonic, mesenchymal and iPs derived stem cells.
Having a stable functional source of islets coupled with a safe protective biomaterial will allow us to move forward in curative islet transplant trials for those that suffer from devastating effects of diabetes.
Frank Meyskens, MD, FACP
Professor, Medicine, Biological Chemistry, Public Health, and Epidemiology
My basic and translational work is focused on understanding the biological and molecular underpinnings that lead to cutaneous melanoma from etiology to metastatic disease and to develop preventive and therapeutic interventions.Our major current interests are directed toward defining the redox regulation of key transcriptional events.New projects involve studies of nNOS and melanoma pathogenesis and inhibitors of this process.
We are also intersted in extending these studies to exploring this activity in glioblastomes. Potential new directions range from profound studies of dormancy to public health interventions
Hamid Moradi MD
Assistant Professor, Nephrology
End stage renal disease is associated with a significant increase in risk of all-cause and cardiovascular mortality. In spite of many recent improvements in dialysis treatment and the adherence of patients and physicians to the quality measures set forth by guidelines, ESRD patients on maintenance hemodialysis (MHD) continue to experience an annual mortality rate of approximately 20%, a rate worse than many cancers. The risk factors responsible for this disproportionately elevated risk of death in MHD patients have not been fully identified. In fact, traditional risk factors such as obesity and hypertriglyceridemia cannot explain the magnitude of the risk observed in these patients given that they are paradoxically associated with better survival in observational studies of hemodialysis patients. In addition, there is accumulating evidence that nontraditional risk factors, such as cachexia and impaired energy metabolism, may play a more prominent role in the higher risk of mortality in patients with ESRD. We recently discovered that serum concentrations of a major activator of the endocannabinoid system, 2-arachidonoylglycerol (2-AG), is significantly increased patients with ESRD on hemodialysis. In addition, highest serum concentrations of this lipid were associated with significantly improved outcomes (reduced risk of death). This important discovery has raised the possibility of using 2-AG (which can be synthesized and infused) as not only a marker of risk but also target for therapy. We hypothesize that the salutary impact of 2-AG in ESRD is most likely due to its impact on protein energy wasting and prevention of cachexia given the role of this molecule and the endocannabinoid (EC) system on metabolism. We have already filed a patent to begin work on assessing this hypothesis and we have prioritized several aims to fully develop this significant discovery. First, we plan to study the regulation of the EC system in an animal model of chronic kidney disease (CKD) to determine the mechanisms by which the EC system can be affected in renal disease. Second, we will be working on different formulations of 2-AG to treat animals with CKD to determine its safety and efficacy in treatment of cachexia/wasting associated this condition. Finally, we hope to analyze further serums samples from patients with ESRD in order to determine the potential utility of 2-AG as a biomarker of risk in patients on hemodialysis.
Adey Nyamathi, ANP, PhD, FAAN
Founding Dean and Distinguished Professor, School of Nursing
Dr. Nyamathi was recruited in 2017 to be the Founding Dean and Distinguished Professor of the Sue & Bill Gross School of Nursing at the University of California, Irvine. She has an outstanding record in nursing as an educator, researcher and administrator. Dr. Nyamathi is an extremely successful researcher with a strong commitment to advancing clinical care and international health. Before becoming the Founding Dean at UCI, she was a Distinguished Professor and Associate Dean for Research and International Scholarship Affairs in the UCLA School of Nursing. She has led multidisciplinary teams of investigators in more than a dozen NIH-funded research grants and other research mechanisms related to HIV/AIDS, tuberculosis and hepatitis for over 30 years. Her domestic research has centered in the Skid Row area of Los Angeles among homeless and incarcerated populations and her international research has focused on working with women living with AIDS in rural India.
Ritesh Parajuli, MD
Assistan Clinical Professor, Division of Hematology/Oncology
1. The first component of my research is the initiation of either Investigator Initiated or Pharmaceutical Company sponsored Clinical trials (Phase I to Phase III) in Breast Cancer.
2. The second component of my research is to involve medical students/ residents and fellows in various projects including case reports, review articles, retrospective chart reviews and Meta Analyses in various topics in Breast Cancer. This approach allows them to complete a defined project in a set period of time, which can result into an abstract and finally a manuscript.
3. The third component of my translational research is on Tumor Microenvironment and biomarkers in Breast Cancer. Early stage breast cancer has high survival rates but we still cannot predict which patients will respond to neoadjuvant therapy and which patients will progress despite appropriate treatment. Furthermore, we do not have a good way to monitor patient’s response to neoadjuvant treatment. Cell-free circulating tumor DNA (ctDNA) consists of small fragments of nucleic acids not associated with cells that can be found in circulation. CtDNA can be used to find specific tumor mutations (liquid biopsy) that can guide treatment and has also been used to monitor tumor growth. We plan to evaluate if monitoring ctDNA during neoadjuvant treatment can help us predict response to therapy and risk for recurrence. We have collaborated with a Company called Cynvenio that will perform next generation sequencing and genomic analysis of ctDNA. Several studies have demonstrated the presence of circulating tumor cells (CTCs) in patients with early stage breast cancer. Cancer associated fibroblasts (CAFs) are activated fibroblasts that are part of the tumor microenvironment. In contrast to normal fibroblasts, CAFs are perpetually activated and are not able to revert into a normal phenotype or undergo apoptosis. CAFs secrete factors that promote tumor growth and metastasis. We have demonstrated that circulating cancer-associated fibroblasts (cCAFs) can be enumerated simultaneously with CTCs from the peripheral blood of patients with metastatic breast cancer (MBC) and in patients with early breast cancer. The role of cCAFs as markers for tumor response to therapy and their prognostic implications have not been studied. We plan to study if absolute values and changes in cell free tumor DNA (ctDNA) can predict response to neoadjuvant therapy in patients with locally advanced breast cancer. Our study will also investigate if Circulating Cancer Associated Fibroblasts can be found in locally advanced breast cancer and their number [either alone or in combination with ctDNA and enumeration of circulating tumor cells] can predict response to neoadjuvant therapy and survival. We are collaborating with Hitachi Lab at the main campus in Irvine for the CTC-cCAF project and have recently been awarded the American Cancer Society Institutional Research Grant. Mechanisms of understanding factors that increase survival of CTCs in the blood is my area of research too. One mechanism we tend to explore is the expression of tissue factor by CTCs and cCAF clusters and if these tissue factor laden CTC-cCAF clusters have a protective fibrin ring leading on to the formation of Circulating Tumor Micro emboli (CTM).
Uma Rao, MD
Professor and Vice Chair, Psychiatry & Human Behavior
Overarching aims of the research program are (1) to elucidate influential biological, behavioral and psychosocial factors related to child and adolescent behavioral/mental health conditions, and (2) to identify the underlying mechanisms of interventions/treatments for these conditions. Currently, three projects are funded by the National Institutes of Health through Year 2022.
Project 1: The aim is to determine whether adolescents with depressive disorder and a history of childhood abuse have distinct differences in structural and functional neural circuits compared to depressed youth without childhood abuse. Four adolescent groups will be recruited: those with depression and abuse, those with depression but no abuse, those with no psychiatric disorder but have a history of abuse, and those with no disorder or abuse. They will undergo magnetic resonance imaging (MRI) studies to measure structural and functional connectivity profiles in key neural networks associated with the core symptoms of depression (fronto-limbic circuit for depressed mood; fronto-striatal circuit for anhedonia/inability to experience pleasure).
Project 2: Using a randomized controlled design, we will assess the neural substrates (via MRI scans) of risk-taking and risk-avoidant behavior before and after a 6-week computer-interactive, family-based intervention to reduce HIV-risk behaviors in 11-13-year-old African-American (Black) youth. Psychological processes shown to underlie the intervention effects (i.e. reward-drive and cognitive-emotional self-regulation) on behaviors that dissuade alcohol and drug use and sexual activity will be assessed at baseline and 3 months post-intervention.
Project 3: The aim is to examine the mechanisms linking race, stress and biobehavioral factors related to obesity in both natural and controlled environments in Black and White adolescent females. In the natural environment, we will measure cumulative stress in individual, family and social domains. We will assess the effects of stress on the hypothalamic-pituitary-adrenal axis through sustained baseline cortisol (hair) and diurnal (24-hr) rhythm (saliva). In addition, we will measure food intake and physical activity for 7 days. We will manipulate acute stress in the lab and measure salivary cortisol/leptin responses to the stressor and compare food intake between non-stress and stress conditions. Also, we will measure obesity-related parameters including anthropometry, body composition (body fat and lean mass) and cardio-metabolic biomarkers.
David Reinkensmeyer, PhD
Professor, Anatomy & Neurobiology
My laboratory develops robotic devices and wearable sensors for movement rehabilitation after neurologic injuries such as stroke, based on an understanding of neuromuscular plasticity mechanisms. Our ultimate goal is to help people improve their movement recovery, but we also seek to enhance scientific understanding of use-dependent plasticity. We are investigating how such technology, along with computational models, can also play an essential role in assessing and enhancing forthcoming neuro-repair therapies, including stem cell therapies.
Kelli Sharp, PhD
Clair Trevor School of Arts, Department of Dance
Dr. Sharp’s research embodies two pillars. The first pillar focuses on injury prevention and wellness for dancers using motion capture system and applying methods of analysis to determine the relationship of motion in space we can further reduce injuries. The second pillar focuses on the development of novel technologies to advance rehabilitation strategies for individuals with neurological disorders by incorporating tools, such as motion capture systems and functional magnetic resonance (fMRI) with dance/movement therapy.
Dara Sorkin, PhD
Associate Professor, Medicine
UNIDAS POR LA VIDA
Unidas por la Vida is an innovative, community-based dyadic lifestyle intervention with Latina mothers who have diabetes and their overweight/obese daughters (age 18 and older) who are at risk for diabetes. Latina mothers and daughters are likely to be mutually influential and, therefore, provide an ideal focus for behavior change. Interventions that leverage these existing mother-daughter dyads have the potential to yield substantial and lasting lifestyle changes that may lead to the reduction of obesity and diabetes. As such, this study will examine whether mothers and daughters who participate together in a dyadic intervention demonstrate greater weight loss and physical activity over time than women who participate in an individual intervention or who receive usual care. Students will have the exciting opportunity to obtain hands on experience in patient recruitment, retention, and intervention implementation in a clinical trial funded by the National Institutes of Health that is evaluating an evidence-based, weight loss and exercise program modeled after the Diabetes Prevention Program and designed for high-need, vulnerable, and low-socioeconomic population. Students will learn how to interact with Latina women from the local OC community, collect basic clinical data (e.g. physical activity, A1c, LDL cholesterol, blood pressure), administer in-person interviews, and view a community-delivered lifestyle intervention program.
UNIDAS SUB-STUDY: Examining the role of Fathers and developing family health behavior profiles
A large body of research recognizes that parents highly influence a child’s dietary habits via the provision of foods, practices such as breastfeeding, monitoring of portions, maintenance of family meals and modeling of their own dietary behaviors and attitudes. However, to date, most research has either solely focused on maternal characteristics and practices or on the mother-child dyad. Scholars from a wide-range of disciplines and policymakers are calling for more research on the role of fathers in obesity prevention efforts as the conventional “maternal centric” approach fails to take a family systems approach. A family systems approach is one that moves beyond the parent-child or parent-parent dyad to examine and conceptualizes families as organizations with multiple subsystems that influence overall processes, dynamics and behaviors that help shape a child’s health and development. A family systems approach may be particularly effective within the Latino context given that it is considered the most important social unit and Latino fathers report more time in childcare activities than fathers in other ethnic groups. Recently, the American Academy of Pediatrics issued a report on the unique role that fathers play in child development including several recommendations for pediatricians to engage them in a clinical setting. As such, this study will examine the father’s unique role in their children’s eating practices and chronic disease risk, while establishing a comprehensive profile of the family’s baseline health status and health behaviors. Students will have the exciting opportunity to perform vitals and basic health assessments.
MI VIDA, MI SALUD – My Life, My Health
Breast cancer and its treatment are associated with a range of symptoms (e.g., fatigue, distress), which can persist years into survivorship and have a lasting negative impact on quality of life. Women with breast cancer are also at high risk for weight gain and developing comorbid chronic conditions such as obesity. Chronic inflammation may be a common mechanism associated with many breast cancer-related symptoms (e.g., fatigue and pain) and obesity. Lifestyle changes to reduce obesity and obesity-related inflammation have been shown to reduce symptom burden in this population. Lifestyle interventions delivered via mobile applications are on the rise in order to provide low cost, personalized options that capitalize on efforts to promote self-management and health behavior change. Self-management strategies (e.g., healthy diet and exercise), as part of a lifestyle intervention, have been associated with improved outcomes in cancer populations; however, these programs rarely included personalization to patients’ preferences, and have had limited success in demonstrating long-term adoption of health behaviors. Although a vast array of health and cancer-related smartphone applications exist, very few have undergone rigorous empirical investigation. We have developed Mi Vida, Mi Salud, a highly innovative M-health weight loss intervention that provides personalized feedback about the relationship between symptoms, mood states, and health behaviors, prompting the patient to self-discover 1) individual stressors and triggers of poor health behaviors and symptom onset and severity and 2) preferential healthy behaviors and adaptive coping strategies to prevent or alleviate symptoms. Students will have the exciting opportunity to obtain hands on experience in patient recruitment, retention, and intervention implementation in a randomized controlled trial that is examining whether the provision of the Mi Vida M-health intervention is associated with greater weight loss and a reduction in pro-inflammatory cytokines relative to health behavior tracking alone. Specifically, under the supervision of the ICTS research nursing program, students will have a training opportunity to perform phlebotomy and conduct vitals and basic health assessments in women who have completed primary treatment for breast cancer.
USING HEALTH INFORMATION TECHNOLOGY TO SCREEN FOR DEPRESSION AND PTSD
The prevalence rate of depression in primary care is high. Primary care providers serve as the initial point of contact for the majority of patients with depression, yet, approximately 50% of cases remain unrecognized. The under-diagnosis of depression may be further exacerbated in limited English-language proficient (LEP) populations. Language barriers may result in less discussion of patients' mental health needs and fewer referrals to mental health services, particularly given competing priorities of other medical conditions and providers' time pressures. Recent advances in Health Information Technology (HIT) may facilitate novel ways to screen for depression and other mental health disorders in LEP populations. The purpose of this paper is to describe the rationale and protocol of a clustered randomized controlled trial that will test the effectiveness of an HIT intervention that provides a multi-component approach to delivering culturally competent, mental health care in the primary care setting. The HIT intervention has four components: 1) web-based provider training, 2) multimedia electronic screening of depression and PTSD in the patients' primary language, 3) Computer generated risk assessment scores delivered directly to the provider, and 4) clinical decision support. The outcomes of the study include assessing the potential of the HIT intervention to improve screening rates, clinical detection, provider initiation of treatment, and patient outcomes for depression and post-traumatic stress disorder (PTSD) among LEP Cambodian refugees who experienced war atrocities and trauma during the Khmer Rouge. This technology has the potential to be adapted to any LEP population in order to facilitate mental health screening and treatment in the primary care setting.
Kyoko Yokomori, PhD
Professor, Department of Biological Chemistry
Our research focus is to understand how chromatin structure and dynamics influence gene transcription and DNA repair, and how their dysregulation leads to human diseases. We identified previously the FSHD muscular dystrophy is a “heterochromatin abnormality disorder”. We are currently developing FSHD modeling cells by introducing the FSHD mutations into immortalized normal human myoblasts. We are also carrying out high-throughput single cell analysis of patient muscle cell samples to understand disease heterogeneity and to identify a small population of disease-driving cells. We are also taking proteomic approaches to identify components of heterochromatin whose misregulation may contribute to the disease phenotype.
The outcome of these projects should have direct impact on our understanding of FSHD biology and the potential development of novel diagnostic/therapeutic strategies.
Kai Zheng, PhD
Associate Professor, Informatics
The Health and Information (HAI) Lab at the University of California, Irvine focuses on the impact of clinician-technology interaction on patient safety, as well as how people use personal technology for their own wellbeing. The following as sample projects that the Lab is currently conducting: Understanding Individuals’ Navigational Competence in Healthcare: Xinning Gui and Dr. Yunan Chen are investigating how patients and their caregivers utilize information sources and choose, engage, and coordinate the health services using qualitative interviews of patients, caregivers, and patient navigators. Understanding Patient Questions about their Medical Data: Tera Reynolds and Dr. Kai Zheng are analyzing threads in an online health forum and generating insights into common questions and how these get resolved through the collective wisdom of patients, using qualitative methods and computational analysis. Guiding Attention and Action: Mustafa Hussain and Dr. Kai Zheng are aiming to reduce alert fatigue, a phenomenon in which too many false alerts results in a loss of trust in the alerting system. This is a particular problem in hospitals and clinical settings, where computerized Electronic Health Records (EHRs) attempt to guide physician decision-making using Clinical Decision Support (CDS), primarily in the form of pop-up alerts. Information Retrieval for Electronic Health Records (EHRs): Mohammad Eletriby and Dr. Kai Zheng are developing a software tool to facilitate information retrieval from EHRs based on text mining technology. Self-Tracking for Disease Management: Dr. Yu Chen is developing a mobile application to promote mental health for patients with chronic illnesses, using interviews to understand patient needs. Self-Tracking for Older Adults: Clara Caldeira and Dr. Yunan Chen are investigating how seniors use self-tracking for health, and how to design technology that can better meet their needs.